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Sample records for staging n0 oral

  1. Staging N0 oral cancer

    DEFF Research Database (Denmark)

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

    2005-01-01

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

  2. Staging N0 Oral Cancer: Lymphoscintigraphy and Conventional Imaging

    International Nuclear Information System (INIS)

    Thomsen, J.B.; Soerensen, J.A.; Grupe, P.; Karstoft, J.; Krogdahl, A.

    2005-01-01

    PURPOSE: To compare sentinel lymph node biopsy, magnetic resonance imaging (MRI), Doppler ultrasonography, and palpation as staging tools in patients with T1/T2 N0 cancer of the oral cavity. MATERIAL AND METHODS: Forty consecutive patients were enrolled (17 F and 23 M, aged 32-90 years), 24 T1 and 16 T2 cN0 squamous cell carcinoma of the oral cavity. Palpation was carried out by two observers prior to inclusion. MRI, gray-scale and Doppler ultrasonography were performed. Lymphoscintigraphies were done after peritumoral injections of 99mTc labelled rheniumsulphide nanocolloid, followed by sentinel lymph node biopsy guided by a gamma probe and Patent Blue. Palpation, Doppler ultrasonography, MRI, and sentinel lymph node biopsy were compared to a combination of histopathology and follow-up. Diagnostic testing was performed using the x2 test. RESULTS: Histopathological examination revealed metastatic spread to the neck in 14 of 40 patients. One patient had bilateral neck disease. Sentinel lymph node biopsy and ultrasonography were performed in 80 neck sides of 40 patients and MRI in 70 neck sides (5 patients were claustrophobic). SN revealed suspicious lymph nodes in 12 necks, ultrasonography in 23 necks, and MRI in 9 necks. The positive predictive value of sentinel lymph node biopsy was 100%, ultrasonography 57%, and MRI 56%. The respective negative predictive values were 96%, 96%, and 85%. The sensitivity of sentinel lymph node biopsy 80% was comparable to ultrasonography 87%, but the sensitivity of MRI 36% was low. The specificities were 100%, 85%, and 93%, respectively. By combined sentinel lymph node biopsy and ultrasonography the overall sensitivity could have been 100%. CONCLUSION: Sentinel lymph node biopsy improved staging of patients with small N0 oral cancers. Combined sentinel lymph node biopsy and Doppler ultrasonography may further improve staging. MRI and simple palpation results were poor

  3. 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)

  4. Clinically-staged T3N0 rectal cancer: is preoperative chemoradiotherapy the optimal treatment?

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    Lombardi, Raffaele; Cuicchi, Dajana; Pinto, Carmine; Di Fabio, Francesca; Iacopino, Bruno; Neri, Stefano; Tardio, Maria Lucia; Ceccarelli, Claudio; Lecce, Ferdinando; Ugolini, Giampaolo; Pini, Sara; Di Tullio, Piergiorgio; Taffurelli, Mario; Minni, Francesco; Martoni, Andrea; Cola, Bruno

    2010-03-01

    Preoperative chemoradiotherapy has been widely adopted as the standard of care for stage II-III rectal cancers. However, patients with T3N0 lesions had been shown to have a better prognosis than other categories of locally advanced tumor. Thus, neoadjuvant chemoradiation is likely to be overtreatment in this subgroup of patients. Nevertheless, the low accuracy rate of preoperative staging techniques for detection of node-negative tumors does not allow to check this hypothesis. We analyzed a group of patients with cT3N0 low rectal cancer who underwent neoadjuvant chemoradiotherapy with the purpose of evaluating the incidence of metastatic nodes in the resected specimens. Between January 2002 and February 2008, 100 patients with low rectal cancer underwent clinical staging by means of endorectal ultrasound, computed tomography, positron emission tomography, and magnetic resonance imaging. All patients received preoperative 5-fluorouracil-based chemoradiotherapy and surgical resection with curative aim. Of 100 patients with locally advanced rectal cancer, 32 were clinically staged as T3N0M0. Pathological analysis showed the presence of lymph node metastases in nine patients (28%) (node-positive group). In the remaining 23 cases, clinical N stage was confirmed at pathology (node-negative group). Node-positive and node-negative groups differ only in the number of ypT3 tumors (P cancer represents an undertreatment risk in at least 28% of cases, making necessary the use of postoperative chemoradiotherapy. Preoperative chemoradiotherapy should be the therapy of choice on the grounds of the principle that overtreatment is less hazardous than undertreatment for cT3N0 rectal cancers.

  5. A Prospective Study of Level IIB Nodal Metastasis (Supraretrospinal) in Clinically N0 Oral Squamous Cell Carcinoma in Indian Population.

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    Chheda, Yogen P; Pillai, Sundaram K; Parikh, Devendra G; Dipayan, Nandy; Shah, Shakuntala V; Alaknanda, Gupta

    2017-06-01

    Oral cavity carcinoma is the most common cancer in Indian population. Metastatic nodal disease is the most important prognostic factor for oral cancers. In head and neck cancers with clinically N0 neck, standard selective neck dissection is performed by protecting the spinal accessory nerve to remove level IIA & IIB lymph nodes. The purpose of this study was to analyze the significance of level IIB dissection in patients of oral cavity cancer who underwent primary surgery with functional neck dissection. Two hundred ten patients with clinically N0 neck underwent neck dissection, where level IIB lymph nodes were dissected, labelled and processed separately. Among 210 patients of clinically N0 neck, 168 patients were pathologically N0 (80 %). Out of remaining 42 (20 %), 36 (17.14 %) were pN1 and 6 (2.86 %) were pN2. Among those with pN1 (36), level IB was involved in 24 patients (66.67 %) and level IIA was involved in 12 patients (33.33 %). Only 2 patients had involvement of level IIB lymph nodes. Among 6 patients of pN2 disease, 4 patients had simultaneous involvement of level IB and level IIA lymph nodes. Remaining 2 patients had isolated involvement of level III lymph nodes. Thus only 2 patients (level IIB lymph node involvement. Thus we conclude that a frozen section of level 2a is advisable to decide the need for level 2b node dissection in clinically N0 neck as the sensitivity of clinical evaluation is extremely low.

  6. Evaluation of treatment results in patients with early glottic cancer (stage T 1a N 0, T 1b N 0) treated with Manchester irradiation modality

    International Nuclear Information System (INIS)

    Przeorek, W.; Skladowski, K.; Przeorek, C.

    2007-01-01

    Data charts of 64 patients with stage I glottic cancer treated with Manchester irradiation modality in the 1 st Radiotherapy Clinic of Msc Memorial Institute in Gliwice has been retrospectively analyzed. There were 55 males and 9 females at median age 63 years (range from 37 to 83 years). In 40 (62%) patients pathological subtype of squamous cell cancer has not been established. In 19 (30%) patients microscopic examination revealed keratinizing and in 5 (8%) nonkeratinizing type of neoplasm. In 49 (77%) patients the tumour involved only one vocal cord, in 11 (17%) both, in 3 (5%) vocal cord and commissure and 1 (1%) patient both cords and commissure. All patients were treated with 60C o machines (36 patients - 56%) or high energy photons (28 patients - 44%). Radiotherapy was conducted with so called Manchester modality with one daily fraction of 3 Gy to a total dose of 51-54 Gy. Overall treatment time varied between 21 and 23 days. Acute mucosal reaction was evaluated with the morphological-functional Dische scale as well as with the EORTC/RTOG scoring system. The criteria of treatment efficacy were: 5-year local control, 5-year survival without serious complications (3 and 4 EORTC) and 5-year survival after salvage surgery in relapsed patients. In 63 patients complete regression of the tumour was observed up to 6 months of follow-up. One patient failed at the time of radiotherapy ending. In one case distant metastases to lungs were noticed. In 6 patients local relapses were discovered of which 3 were successfully salvaged with the surgery. In one patient, 18 months after radiotherapy massive oedema of laryngeal mucosa occurred. In this case tracheostomy was needed. 5-year local control, local control after salvage surgery and survival without serious complication rates are 89%, 97% and 95% respectively. 1. Radiotherapy with Manchester modality is a safe and effective treatment of stage I glottic cancer. 2. Despite hypofractionation the risk of severe complication

  7. The pattern of relapse and survival of elective irradiation of the upper neck for stage N0 nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    He, Xiayun; Pan, Ziqiang; Guo, Xiaomao; Ye, Ming; Zhang, Zhen; He, Shaoqin; Liu, Taifu

    2012-01-01

    To investigate patterns of failure and survival rates of elective irradiation of upper neck in N0 nasopharyngeal carcinoma patients. From February 1996 to November 2002, 97 patients without cervical lymph node involvement were admitted for radiotherapy alone. Before treatment, each patient underwent enhanced CT of nasopharynx and neck. All patients received radiotherapy to the nasopharynx, skull base, and upper neck drainage areas (including levels II, III, and VA). The upper neck was irradiated to a total dose of 50-56 Gy/25-28 fractions/5-5.6 weeks. For the primary tumor, 22 patients used conventional fractionation for a total dose of 70 Gy/35 fractions/7 weeks, and 75 patients used an accelerated hyperfractionationated schedule for a total dose of 78 Gy/60 fractions/6 weeks. The median follow-up of these 97 patients was 7.75 years. 10 patients had recurrences in the nasopharynx, 8 had distant metastasis, and 5 had recurrences in the cervical lymph nodes. Among the cervical lymph node failures, the areas of recurrence were in the II drainage areas in 4 patients who had neck dissections afterwards, and in IA drainage areas in 1 patient who also had recurrence in the nasopharynx. The causes of death were recurrence in the nasopharynx for 8 patients, 1 of these also had recurrence in the neck, distant metastases in 8 patients, and non-neoplastic diseases in 3 patients. The causes of failure of N0 patients with nasopharyngeal carcinoma after radiotherapy alone to the nasopharynx and upper neck were nasopharyngeal recurrence, distant metastasis, and cervical recurrence in order of frequency. Elective irradiation of upper neck (II, III, VA) is advised for stage N0 patients diagnosed by enhanced CT of neck. Cervical recurrence alone is rare, which did not greatly affect the long-term survival after salvage neck dissection

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

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    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

  9. Elective Inguinal Node Irradiation in Early-Stage T2N0 Anal Cancer: Prognostic Impact on Locoregional Control

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    Zilli, Thomas, E-mail: Thomas.Zilli@hcuge.ch [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Betz, Michael [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Radiation Oncology Institute, Hirslanden Lausanne, Lausanne (Switzerland); Bieri, Sabine [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Ris, Frederic; Roche, Bruno [Department of Surgery, Geneva University Hospital, Geneva (Switzerland); Roth, Arnaud D. [Oncosurgery Unit, Geneva University Hospital, Geneva (Switzerland); Allal, Abdelkarim S. [Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland); Department of Radiation Oncology,Hôpital Fribourgeois, Fribourg (Switzerland)

    2013-09-01

    Purpose: To evaluate the influence of elective inguinal node radiation therapy (INRT) on locoregional control (LRC) in patients with early-stage T2N0 anal cancer treated conservatively with primary RT. Methods and Materials: Between 1976 and 2008, 116 patients with T2 node-negative anal cancer were treated curatively with RT alone (n=48) or by combined chemoradiation therapy (CRT) (n=68) incorporating mitomycin C and 5-fluorouracil. Sixty-four percent of the patients (n=74) received elective INRT. Results: Over a median follow-up of 69 months (range, 4-243 months), 97 (84%) and 95 patients (82%) were locally and locoregionally controlled, respectively. Rates for 5-year actuarial local control, LRC, cancer-specific, and overall survival for the entire population were 81.7% ± 3.8%, 79.2% ± 4.1%, 91.1% ± 3.0%, and 72.1% ± 4.5%, respectively. The overall 5-year inguinal relapse-free survival was 92.3% ± 2.9%. Isolated inguinal recurrence occurred in 2 patients (4.7%) treated without INRT, whereas no groin relapse was observed in those treated with INRT. The 5-year LRC rates for patients treated with and without INRT and with RT alone versus combined CRT were 80.1% ± 5.0% versus 77.8% ± 7.0% (P=.967) and 71.0% ± 7.2% versus 85.4% ± 4.5% (P=.147), respectively. A trend toward a higher rate of grade ≥3 acute toxicity was observed in patients treated with INRT (53% vs 31%, P=.076). Conclusions: In cases of node-negative T2 anal cancer, the inguinal relapse rate remains relatively low with or without INRT. The role of INRT in the treatment of early-stage anal carcinoma needs to be investigated in future prospective trials.

  10. Evaluation of the Reliability of Clinical Staging of T2N0 Esophageal Cancer: A Review of the Society of Thoracic Surgeons Database

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    Crabtree, Traves D.; Kosinski, Andrzej S.; Puri, Varun; Burfeind, William; Bharat, Ankit; Patterson, G Alexander; Hofstetter, Wayne; Meyers, Bryan F.

    2014-01-01

    Background Clinical staging of esophageal cancer has improved with PET/CT and endoscopic ultrasound. Despite such progress, small single center studies have questioned the reliability of clinical staging of T2N0 esophageal cancer. This study broadly examines the adequacy of clinical staging of T2N0 disease using the Society of Thoracic Surgeons database. Methods We retrospectively studied 810 clinical stage T2N0 patients from 2002-2011. There were 58 excluded because of incomplete pathologic staging data. Clinical stage, pathologic stage, and preoperative characteristics were recorded. Logistic regression analysis was utilized to identify factors associated with upstaging at the time of surgery. Results Among 752 clinical stage T2N0 patients, 35.9 %(270) received induction therapy prior to surgery. Of 482 patients that went directly to surgery, 27.4%(132) were confirmed as pathologic T2N0, 25.9%(125) were downstaged(i.e. T0-1N0), while 46.7%(225) were upstaged at surgery (T3-4N0 or TanyN1-3). Exclusive tumor upstaging(i.e. pathological T3-4N0) accounted for 18.2%(41), while exclusive nodal upstaging(i.e. pathological T1-2N1-3) accounted for 44.5%(100). Combined tumor and nodal upstaging(i.e. pathological T3-4N1-3) accounted for 37.3%(84). Among patients who received induction therapy, 38.1%(103) were upstaged vs. 46.7%(225) without induction therapy(p=0.026). Comparing the induction therapy group and the primary surgical group, postoperative 30-day mortality(3.7% vs. 3.7%, p=1.0) and morbidity(46.3% vs. 45%, p=0.76) were similar. Conclusion Despite advances in staging techniques clinical staging of T2N0 esophageal cancer remains unreliable. Recognizing T2N0 as a threshold for induction therapy in esophageal cancer, many surgeons have opted to treat T2N0 disease with induction therapy, despite the fact that one quarter of these patients will be pathological T1N0. While this study demonstrated similar perioperative morbidity and mortality with and without induction

  11. Satellite pulmonary nodule in the same lobe (T4N0) should not be staged as IIIB non-small cell lung cancer.

    Science.gov (United States)

    Bryant, Ayesha S; Pereira, Sara J; Miller, Daniel L; Cerfolio, Robert James

    2006-11-01

    Treatment of non-small cell lung cancer depends on stage. Patients with T4 lesions represent a heterogeneous group. A case-control study of patients with pathologically proven, node-negative T4 lesions (T4 N0 M0) was conducted. Patients with T4 disease were stratified as T4 from a satellite nodule (T4-satellite) or T4 from local invasion (T4-invasion). T4-satellite patients were matched 1:4 for sex and histology with resected control patients with stage IA, IB, and IIA non-small cell lung cancer and matched 1:3 with stage II non-small cell lung cancer. Survival and the maximal standardized uptake value on F-18 fluorodeoxyglucose-positron emission tomography scans were compared. There were 337 patients, 26 patients with T4-satellite lesions, 25 with T4-invasion lesions, and 286 controls (104 patients with T1 N0 M0, 104 with T2 N0 M0, and 78 with T1 N1 M0 or T2 N1 M0 lesions). The two T4 groups were similar for age, race, sex, and neoadjuvant therapy rates. The 5-year survival was 80% for the T1 N0 M0 patients, 68% for T2 N0 M0, 57% for T4-satellite N0 M0, 45% for T1 N1 M0 or T2 N1 M0, and 30% for the T4-invasion N0 M0 patients (p = 0.016). Multivariate analysis showed that only the type of T4 impacted survival (p = 0.011). The median maximal standardized uptake values of the cancers were 4.2 for T1 N0 M0, 4.8 for T4-satellite, 5.4 for T2 N0 M0, 7.8 for T1 N1 M0 or T2 N1 M0, and 8.8 for the T4-invasion patients. Larger studies are needed; however, patients with T4-satellite non-small cell lung cancer who undergo complete resection have survival and maximal standardized uptake values similar to patients with stage IB and stage IIA lesions. Their survival is significantly better than those with T4-invasion. Patients with T4-satellite N0 M0 lesions should not be classified as stage IIIB and should not be grouped with patients with T4-invasion, and resection should be considered.

  12. FDG PET in oral and oropharyngeal cancer. Value for confirmation of N0 neck and detection of occult metastases

    NARCIS (Netherlands)

    Krabbe, Christiaan A.; Dijkstra, Pieter U.; Pruim, Jan; van der Laan, Bernard F. M.; van der Wal, Jacqueline E.; Gravendeel, Joost P.; Roodenburg, Jan L. N.

    Treatment of the clinical NO neck in squamous cell carcinoma (SCC) of oral cavity and oropharynx remains a dilemma. None of the current imaging modalities are able to detect the presence of micrometastases in the lymph nodes of clinical NO necks reliably. The aim of this study was to determine the

  13. Respective prognostic value of genomic grade and histological proliferation markers in early stage (pN0 breast carcinoma.

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    Fabien Reyal

    Full Text Available Genomic grade (GG is a 97-gene signature which improves the accuracy and prognostic value of histological grade (HG in invasive breast carcinoma. Since most of the genes included in the GG are involved in cell proliferation, we performed a retrospective study to compare the prognostic value of GG, Mitotic Index and Ki67 score.A series of 163 consecutive breast cancers was retained (pT1-2, pN0, pM0, 10-yr follow-up. GG was computed using MapQuant Dx(R.GG was low (GG-1 in 48%, high (GG-3 in 31% and equivocal in 21% of cases. For HG-2 tumors, 50% were classified as GG-1, 18% as GG-3 whereas 31% remained equivocal. In a subgroup of 132 ER+/HER2- tumors GG was the most significant prognostic factor in multivariate Cox regression analysis adjusted for age and tumor size (HR = 5.23, p = 0.02.In a reference comprehensive cancer center setting, compared to histological grade, GG added significant information on cell proliferation in breast cancers. In patients with HG-2 carcinoma, applying the GG to guide the treatment scheme could lead to a reduction in adjuvant therapy prescription. However, based on the results observed and considering (i the relatively close prognostic values of GG and Ki67, (ii the reclassification of about 30% of HG-2 tumors as Equivocal GG and (iii the economical and technical requirements of the MapQuant micro-array GG test, the availability in the near future of a PCR-based Genomic Grade test with improved performances may lead to an introduction in clinical routine of this test for histological grade 2, ER positive, HER2 negative breast carcinoma.

  14. Clinical outcomes for T1-2N0-1 oral tongue cancer patients underwent surgery with and without postoperative radiotherapy

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    Shim, Su Jung; Cha, Jihye; Koom, Woong Sub; Kim, Gwi Eon; Lee, Chang Geol; Choi, Eun Chang; Keum, Ki Chang

    2010-01-01

    The aim of this study was to assess the results of curative surgery with and without radiotherapy in patients with T 1-2 N 0-1 oral tongue squamous cell carcinoma (OSCC) and to evaluate survival and prognostic factors. Retrospective analysis of 86 patients with T 1-2 N 0-1 OSCC who received surgery between January 2000 and December 2006. Fourteen patients (16.3%) received postoperative radiotherapy (PORT). Patient characteristics, tumor characteristics, treatment modality, failure patterns, and survival rates were analyzed. The median follow-up was 45 months. The five-year overall survival (OS) and disease-free survival (DFS) rates were 80.8% and 80.2%, respectively. Higher tumor grade and invasion depth ≥ 0.5 cm were the significant prognostic factors affecting five-year OS and DFS (OS rate; 65% vs. 91%, p = 0.001 for grade; 66% vs. 92%, p = 0.01 for invasion depth: DFS rate; 69% vs. 88%, p = 0.005 for grade; 66% vs. 92%, p = 0.013 for invasion depth). In the risk group, there was no local failure in patients with postoperative radiotherapy. In T 1-2 N 0-1 OSCC, factors that affected prognosis after primary surgery were higher tumor grade and deep invasion depth over 0.5 cm. Postoperative radiotherapy should be considered in early oral tongue cancer patients with these high-risk pathologic features

  15. Clinical outcomes for T1-2N0-1 oral tongue cancer patients underwent surgery with and without postoperative radiotherapy

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    Choi Eun

    2010-05-01

    Full Text Available Abstract Background The aim of this study was to assess the results of curative surgery with and without radiotherapy in patients with T1-2N0-1 oral tongue squamous cell carcinoma (OSCC and to evaluate survival and prognostic factors. Methods Retrospective analysis of 86 patients with T1-2N0-1 OSCC who received surgery between January 2000 and December 2006. Fourteen patients (16.3% received postoperative radiotherapy (PORT. Patient characteristics, tumor characteristics, treatment modality, failure patterns, and survival rates were analyzed. Results The median follow-up was 45 months. The five-year overall survival (OS and disease-free survival (DFS rates were 80.8% and 80.2%, respectively. Higher tumor grade and invasion depth ≥ 0.5 cm were the significant prognostic factors affecting five-year OS and DFS (OS rate; 65% vs. 91%, p = 0.001 for grade; 66% vs. 92%, p = 0.01 for invasion depth: DFS rate; 69% vs. 88%, p = 0.005 for grade; 66% vs. 92%, p = 0.013 for invasion depth. In the risk group, there was no local failure in patients with postoperative radiotherapy. Conclusions In T1-2N0-1 OSCC, factors that affected prognosis after primary surgery were higher tumor grade and deep invasion depth over 0.5 cm. Postoperative radiotherapy should be considered in early oral tongue cancer patients with these high-risk pathologic features.

  16. Does Adjuvant Radiation Therapy Improve Outcomes In pT1-3N0 Oral Cavity Cancer With Tumor-Free Margins and Perineural Invasion?

    International Nuclear Information System (INIS)

    Liao, C.-T.; Chang, J.T.-C.; Wang, H.-M.; Ng, S.-H.; Hsueh Chuen; Lee, L.-Y.; Lin, C.-H.

    2008-01-01

    Purpose: The criteria for administration of adjuvant radiation therapy (RT) in oral cavity squamous cell carcinoma (OSCC) remain controversial, and it is unclear whether patients with pT1-3N0 disease benefit from adjuvant radiation in the presence of free margins and perineural invasion. The goal of this report was to determine whether this group would benefit from adjuvant radiation therapy in terms of 5-year local control rate and overall survival rate. Methods and Materials: We retrospectively reviewed our case records from January 1996 to May 2005. In all, 460 pT1-3N0 OSCC patients had tumor-free margins, of whom 68 had perineural invasion. Postoperative adjuvant RT was performed in patients with pT4 tumors, positive lymph nodes, or close margins (≤4 mm). In addition, selected OSCC patients with large pT3 tumors or perineural invasion received postoperative adjuvant RT. Local control and overall survival rates were plotted by Kaplan-Meier analysis. Results: There were no significant differences in 5-year local control (p 0.1936) and overall survival (p = 0.5580) rates between patients with perineural invasion compared with those without. Among patients with perineural invasion, the addition of adjuvant radiotherapy did not significantly alter the 5-year local control rate (p = 0.3170) or the overall survival rate (p = 0.0935). Conclusion: Altogether, these data seem to indicate that radical surgical resection alone should be considered a sufficient treatment for OSCC patients with pT1-3N0 disease, even in the presence of perineural invasion

  17. CT characteristics and pathological implications of early stage (T1N0M0) lung adenocarcinoma with pure ground-glass opacity

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    Jin, Xin; Zhao, Shao-hong; Wu, Jian; Wu, Chong-chong; Chang, Rui-ping; Ju, Hai-yue [Chinese PLA General Hospital, Department of Radiology, Beijing (China); Gao, Jie; Wang, Dian-jun [Chinese PLA General Hospital, Department of Pathology, Beijing (China)

    2015-09-15

    To analyze the CT characteristics and pathological classification of early lung adenocarcinoma (T1N0M0) with pure ground-glass opacity (pGGO). Ninety-four lesions with pGGO on CT in 88 patients with T1N0M0 lung adenocarcinoma were selected from January 2010 to December 2012. All lesions were confirmed by pathology. CT appearances were analyzed including lesion location, size, density, uniformity, shape, margin, tumour-lung interface, internal and surrounding malignant signs. Lesion size and density were compared using analysis of variance, lesion size also assessed using ROC curves. Gender of patients, lesion location and CT appearances were compared using χ2-test. There were no significant differences in gender, lesion location and density with histological invasiveness (P > 0.05). The ROC curve showed that the possibility of invasive lesion was 88.73 % when diameter of lesion was more than 10.5 mm. There was a significant difference between lesion uniformity and histological invasiveness (P = 0.01). There were significant differences in margin, tumour-lung interface, air bronchogram with histological invasiveness (P = 0.02,P = 0.00,P = 0.048). The correlation index of lesion size and uniformity was r = 0.45 (P = 0.00). The lesion size and uniformity, tumour-lung interface and the air bronchogram can help predict invasive extent of early stage lung adenocarcinoma with pGGO. (orig.)

  18. Is Thymomectomy Alone Appropriate for Stage I (T1N0M0) Thymoma? Results of a Propensity-Score Analysis.

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    Nakagawa, Kazuo; Yokoi, Kohei; Nakajima, Jun; Tanaka, Fumihiro; Maniwa, Yoshimasa; Suzuki, Makoto; Nagayasu, Takeshi; Asamura, Hisao

    2016-02-01

    The optimal mode of resection for thymoma in nonmyasthenic patients remains unclear. The aim of this study was to explore whether or not thymomectomy alone is a relevant option for patients with stage I (T1N0M0) thymoma in the proposed TNM classification. We investigated 2,835 patients with thymic epithelial tumors treated at 32 institutions participating in the Japanese Association for Research on the Thymus (JART). A total of 1286 patients with thymomectomy: resection of thymoma with partial thymectomy (n = 289) or thymothymomectomy: resection of thymoma with total thymectomy (n = 997) for stage I thymoma were included. Surgical and oncologic outcomes were compared between the 2 groups. Patients who underwent thymomectomy were older (61.1 versus 57.0 years; p = 0.000) and had smaller tumors (4.77 versus 5.99 cm; p = 0.000) than those who underwent thymothymomectomy. There was a significant difference in the distribution of histologic subtype (p = 0.007). After propensity-score matching, the matched cohort consisted of 276 patients in each group. Postoperative complications were seen more frequently in the thymothymomectomy group than in the thymomectomy group (8.3% versus 4.3%; p = 0.0397). The 5-year overall survival rate was 97.3% in the thymomectomy group and 96.9% in the thymothymomectomy group (p = 0.487). Patients who underwent thymomectomy tended to have local recurrence more frequently than did those who underwent thymothymomectomy (2.2% versus 0.4%; p = 0.0613). Thymomectomy alone is acceptable for stage I thymoma in regard to postoperative complications and prognosis. Further studies are needed to evaluate long-term outcomes. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Long-term prognostic performance of Ki67 rate in early stage, pT1-pT2, pN0, invasive breast carcinoma.

    Directory of Open Access Journals (Sweden)

    Fabien Reyal

    Full Text Available BACKGROUND: Molecular signatures may become of use in clinical practice to assess the prognosis of breast cancers. However, although international consensus conferences sustain the use of these new markers in the near future, concerns remain about their degree of discordance and cost-effectiveness in different international settings. The present study aims to validate Ki67 as prognostic factor in a large cohort of early-stage (pT1-pT2, pN0 breast cancer patients. METHODS: 456 patients treated in 1995-1996 were identified in the Institut Curie database. Ki67 (MIB1 was retrospectively assessed by immunohistochemistry for all cases. The prognostic value of this index was compared to that of histological grade (HG, Estrogen receptor (ER and HER2 status. Distant disease free interval, loco-regional recurrence, time-lapse from first metastatic diagnosis to death were analyzed. RESULTS: All 456 patients were treated by lumpectomy plus axillary dissection and radiotherapy. 27 patients (5.9% received systemic treatment. Tumors were classified as HG1 in 35%, HG2 in 42% and HG3 in 23% of cases. ER was expressed in 86% of the tumors, HER2 in 5% and 14% were triple negative. The median follow-up was 151 [5-191] months. Distant and loco-regional disease recurrences were observed in 16% and 18%, respectively. High (>20% Ki67 rate [HR = 3 (1.8-4.8, p<10e-06] and HG3 [HR = 4.4 (2.2-8.6, p = 0.00002] were associated with an increased rate of distant relapse. In multivariate analysis, the Ki67 remained the only significant prognostic factor in the subgroups of ER positive HER2 negative [HR = 2.6 (1.5-4.6, p = 0.0006] and ER positive HER2 negative HG2 tumors [HR = 2.2 (1.01-4.8, p = 0.04]. CONCLUSIONS: We validate the prognosis value of the Ki67 rate in small size node negative breast cancer. We conclude that Ki67 is a potential cost-effective decision marker for adjuvant therapy in early-stage HG2, pT1-pT2, pN0, breast cancers.

  20. Oral cancer staging established by magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Rogério Ribeiro de Paiva

    2011-12-01

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

  1. Local-Regional Recurrence With and Without Radiation Therapy After Neoadjuvant Chemotherapy and Mastectomy for Clinically Staged T3N0 Breast Cancer

    International Nuclear Information System (INIS)

    Nagar, Himanshu; Mittendorf, Elizabeth A.; Strom, Eric A.; Perkins, George H.; Oh, Julia L.; Tereffe, Welela; Woodward, Wendy A.; Gonzalez-Angulo, Ana M.; Hunt, Kelly K.; Buchholz, Thomas A.; Yu, Tse-Kuan

    2011-01-01

    Purpose: The purpose of this study was to determine local-regional recurrence (LRR) risk according to whether postmastectomy radiation therapy (PMRT) was used to treat breast cancer patients with clinical T3N0 disease who received neoadjuvant chemotherapy (NAC) and mastectomy. Methodsand Materials: Clinicopathology data from 162 patients with clinical T3N0 breast cancer who received NAC and underwent mastectomy were retrospectively reviewed. A total of 119 patients received PMRT, and 43 patients did not. The median number of axillary lymph nodes (LNs) dissected was 15. Actuarial rates were calculated using the Kaplan-Meier method and compared using the log-rank test. Results: At a median follow-up of 75 months, 15 of 162 patients developed LRR. For all patients, the 5-year LRR rate was 9% (95% confidence interval [CI], 4%-14%). The 5-year LRR rate for those who received PMRT was 4% (95% CI, 1%-9%) vs. 24% (95% CI, 10%-39%) for those who did not receive PMRT (p <0.001). A significantly higher proportion of irradiated patients had pathology involved LNs and were ≤40 years old. Among patients who had pathology involved LNs, the LRR rate was lower in those who received PMRT (p <0.001). A similar trend was observed for those who did not have pathology involved LN disease. Among nonirradiated patients, the appearance of pathologic LN disease after NAC was the only clinicopathologic factor examined that significantly correlated with the risk of LRR. Conclusions: Breast cancer patients with clinical T3N0 disease treated with NAC and mastectomy but without PMRT had a significant risk of LRR, even when there was no pathologic evidence of LN involvement present after NAC. PMRT was effective in reducing the LRR rate. We suggest PMRT should be considered for patients with clinical T3N0 disease.

  2. Definitive radiotherapy with or without chemotherapy for clinical stage T4N0-1 non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yeon Joo; Song, Si Yeol; Jeong, Seong Yun; Kim, Sang We; Lee, Jung Shin; Kim, Su Ssan; Choi, Eun Kyung [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Choi, Won Sik [Dept. of Radiation Oncology, Gangneung Asan Hospital, Gangneung (Korea, Republic of)

    2015-12-15

    To determine failure patterns and survival outcomes of T4N0-1 non-small cell lung cancer (NSCLC) treated with definitive radiotherapy. Ninety-five patients with T4N0-1 NSCLC who received definitive radiotherapy with or without chemotherapy from May 2003 to October 2014 were retrospectively reviewed. The standard radiotherapy scheme was 66 Gy in 30 fractions. The main concurrent chemotherapy regimen was 50 mg/m2 weekly paclitaxel combined with 20 mg/m2 cisplatin or AUC 2 carboplatin. The primary outcome was overall survival (OS). Secondary outcomes were failure patterns and toxicities. The median age was 64 years (range, 34 to 90 years). Eighty-eight percent of patients (n = 84) had an Eastern Cooperative Oncology Group performance status of 0-1, and 42% (n = 40) experienced pretreatment weight loss. Sixty percent of patients (n = 57) had no metastatic regional lymph nodes. The median radiation dose was EQD2 67.1 Gy (range, 56.9 to 83.3 Gy). Seventy-one patients (75%) were treated with concurrent chemotherapy; of these, 13 were also administered neoadjuvant chemotherapy. At a median follow-up of 21 months (range, 1 to 102 months), 3-year OS was 44%. The 3-year cumulative incidences of local recurrence and distant recurrence were 48.8% and 36.3%, respectively. Pretreatment weight loss and combined chemotherapy were significant factors for OS. Acute esophagitis over grade 3 occurred in three patients and grade 3 chronic esophagitis occurred in one patient. There was no grade 3-4 radiation pneumonitis. Definitive radiotherapy for T4N0-1 NSCLC results in favorable survival with acceptable toxicity rates. Local recurrence is the major recurrence pattern. Intensity modulated radiotherapy and radio-sensitizing agents would be needed to improve local tumor control.

  3. Meta-analysis of adjuvant chemotherapy versus surgery alone in T2aN0 stage IB non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Tianxiang Zhang

    2018-01-01

    Conclusion: Adjuvant chemotherapy after surgery was beneficial to the patients with Stage IB disease in terms of OS and progression-free survival. Therefore, we recommend clinicians to take this treatment strategy into account for the patients with Stage IB NSCLC.

  4. Stereotactic hypofractionated radiotherapy in stage I (T1-2 N0 M0) non-small-cell lung cancer (NSCLC)

    International Nuclear Information System (INIS)

    Zimmermann, Frank B.; Geinitz, Hans; Schill, Sabine; Thamm, Reinhard; Nieder, Carsten; Schratzenstaller, Ulrich; Molls, Michael

    2006-01-01

    Stereotactic Radiotherapy has the potential to produce high local control rates with low risk of severe lung toxicity. From December 2000 to January 2006, 68 inoperable patients (median age 76 years) with stage I NSCLC received definitive hSRT. A mean total dose of 37.5 Gy (24-40 Gy; 60%-isodose) in 3-5 fractions was applied. Immobilisation was carried out by means of a vacuum couch and low pressure foil (Medical Intelligence, Schwab Muenchen, Germany). Staging procedures were thoracic and abdominal CT-scan, FDG-PET and CT or MRI of the brain in all patients. Clinical target volume was the tumor as seen in lung windowing of CT and in FDG-PET. Organ movements (6-22 mm) and patient positioning in the couch (3-12 mm) were added as safety margin for the definition of the planning target volume (PTV), that was enclosed by the 60%-isodose. We observed four (6%) local tumor recurrences, resulting in an actuarial local tumor control rate of 96%, 88% and 88% after 1, 2 and 3 year follow-up. Nineteen patients died, with eight patients due to cancer (12%), two to local tumor progression alone. Cancer-specific survival is 96%, 82% and 73% at 1, 2 and 3 years. Eleven patients died from comorbidities, making a 53% overall 3-year survival. Fifty five percent of the patients were affected by mild acute and subacute side effects, with only 3% experiencing pneumonitis III. Late effects were pneumonitis III in 1%, rib fractures in 3%, and benign pleural effusion in 2 patients. Hypofractionated SRT is safe even in elderly patients with stage I NSCLC and significantly reduced lung capacity. It leads to high local control rates and should be offered to patients not amenable for curative resection

  5. Stereotactic hypofractionated radiotherapy in stage I (T1-2 N0 M0) non-small-cell lung cancer (NSCLC)

    Energy Technology Data Exchange (ETDEWEB)

    Zimmermann, Frank B.; Geinitz, Hans; Schill, Sabine; Thamm, Reinhard; Nieder, Carsten; Schratzenstaller, Ulrich; Molls, Michael [Technical Univ., Klinikum rechts der Isar, Munich (Germany). Dept. of Radiation Oncology

    2006-09-15

    Stereotactic Radiotherapy has the potential to produce high local control rates with low risk of severe lung toxicity. From December 2000 to January 2006, 68 inoperable patients (median age 76 years) with stage I NSCLC received definitive hSRT. A mean total dose of 37.5 Gy (24-40 Gy; 60%-isodose) in 3-5 fractions was applied. Immobilisation was carried out by means of a vacuum couch and low pressure foil (Medical Intelligence, Schwab Muenchen, Germany). Staging procedures were thoracic and abdominal CT-scan, FDG-PET and CT or MRI of the brain in all patients. Clinical target volume was the tumor as seen in lung windowing of CT and in FDG-PET. Organ movements (6-22 mm) and patient positioning in the couch (3-12 mm) were added as safety margin for the definition of the planning target volume (PTV), that was enclosed by the 60%-isodose. We observed four (6%) local tumor recurrences, resulting in an actuarial local tumor control rate of 96%, 88% and 88% after 1, 2 and 3 year follow-up. Nineteen patients died, with eight patients due to cancer (12%), two to local tumor progression alone. Cancer-specific survival is 96%, 82% and 73% at 1, 2 and 3 years. Eleven patients died from comorbidities, making a 53% overall 3-year survival. Fifty five percent of the patients were affected by mild acute and subacute side effects, with only 3% experiencing pneumonitis III. Late effects were pneumonitis III in 1%, rib fractures in 3%, and benign pleural effusion in 2 patients. Hypofractionated SRT is safe even in elderly patients with stage I NSCLC and significantly reduced lung capacity. It leads to high local control rates and should be offered to patients not amenable for curative resection.

  6. Staging of Cervical Lymph Nodes in Oral Squamous Cell Carcinoma

    DEFF Research Database (Denmark)

    Norling, Rikke; Buron, Birgitte Marie Due; Therkildsen, Marianne Hamilton

    2014-01-01

    INTRODUCTION: Clinical staging of patients with oral squamous cell carcinoma (OSCC) is crucial for the choice of treatment. Computed tomography (CT) and/or magnetic resonance imaging (MRI) are typically recommended and used for staging of the cervical lymph nodes (LNs). Although ultrasonography (US...

  7. Endobronchial ultrasound-guided transbronchial needle aspiration for systematic nodal staging of lung cancer in patients with N0 disease by computed tomography and integrated positron emission tomography-computed tomography.

    Science.gov (United States)

    Ong, Philip; Grosu, Horiana; Eapen, George A; Rodriguez, Macarena; Lazarus, Donald; Ost, David; Jimenez, Carlos A; Morice, Rodolfo; Bandi, Venkata; Tamara, Luis; Cornwell, Lorraine; Green, Linda; Zhu, Angela; Casal, Roberto F

    2015-03-01

    Data regarding the sensitivity of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for staging of lung cancer in patients with radiographic N0 disease is scant and inconsistent. With increasing use of nonoperative ablative therapies, studies focusing on the performance characteristics of EBUS-TBNA in this population are important. To evaluate the sensitivity and negative predictive value (NPV) of EBUS-TBNA in patients with non-small cell lung cancer and radiographic N0 disease both by computed tomography (CT) and positron emission tomography (PET)-CT. This was a retrospective review of EBUS-TBNA performed for lung cancer staging at two major academic centers from 2009 to 2014. Patients with radiographic N0 disease (lymph nodes [LN]≤1 cm in the short axis and maximum standardized uptake value≤2.5 by PET-CT) were included. Primary outcome was sensitivity and NPV of EBUS-TBNA. Two hundred twenty patients with radiographic N0 disease underwent EBUS-TBNA, and 734 LN were sampled (median 3, range 1-6). Median LN diameter was 0.72 cm. One hundred patients (45.5%) underwent surgery, and 120 patients (54.5%) had nonsurgical therapy. N status was up-staged in 49 patients (22.3%): 18 by EBUS-TBNA (N1=11, N2=6, N3=1), 27 by surgery (N1 intralobar=16, N1 extralobar=3, N2=8 [5 LN in stations 4 and 7, and 3 LN in stations 5-6), and 4 by imaging follow-up (N1=2, N2=2). Overall false-negative rate of EBUS was 14.1% (sensitivity, 36.7%; specificity, 100%; and NPV, 84.7%). False-negative rate was 27 and 3.3% in surgical and nonsurgical populations, respectively. Excluding patients with occult disease "outside" the reach of EBUS, the overall false-negative rate of EBUS-TBNA was 5.5% (sensitivity, 60%; specificity, 100%; and NPV, 93.4%). This is the largest report of EBUS-TBNA in patients with N0 disease by "integrated" PET-CT. The majority of false-negative EBUS results were in LN stations outside its reach. In our study, both sensitivity and NPV of

  8. Oral misoprostol versus oxytocin in the management of third stage of labour

    International Nuclear Information System (INIS)

    Aziz, S.; Kazi, S.; Haq, G.; Soomro, N.

    2014-01-01

    Objectives: To compare oral misoprostol versus intramuscular oxytocin in the management of third stage of labour. Methods: The quasi-experimental study was conducted at the Obstetrics and Gynaecology Unit II, Civil Hospital, Karachi, from June 20 to December 19, 2006. A total of 70 patients diagnosed in active phase of labour who fulfilled the inclusion criteria were selected by non-probability convenience sampling. These patients were divided into 2 groups of 35 patients each, for Oxytocin (Group 1) and misoprostol (Group 2). Main and secondary outcome measures were analysed. SPSS 10 was used for statistical analysis. Results: Average amount of blood loss(ml) was 267.14+-140.35 with Oxytocin versus 302.86+-160.4, with Misoprostol, this difference was statistically insignificant (p=0.236). Average drop in haemoglobin concentration (g/dl) with Oxytocin was 1.55+-0.38 vs 1.66+-0.61 with Misoprostol (p=0.684). Drop in haematocrit (%) was 4.18+-0.64 with Oxytocin vs. 4.50+-0.92 with Misoprostol (p=0.133). There was also insignificant difference in duration of third stage of labour, between oxytocin and Misoprostol groups (5.37+-2.20 vs. 5.23+-2.46, p=0.451) Shivering, in Misoprostol group occured in n=11 (31.4%) vs n=3 (8.6%) with Oxytocin (p=0.017) and pyrexia in n=6 (17.1%) with misoprostol vs n=0, with oxytocin (p=0.025) thus significantly higher in misoprostol group. Conclusion: There were no major differences in oral misoprostol and intramuscular oxytocin in the management of third stage of labour. (author)

  9. Comparison between computed tomography with oral oil-based contrast and laparotomy for gastric cancer staging; Tomografia computerizada con contraste oral graso frente a lapartomia en la estadificacion del cancer gastrico

    Energy Technology Data Exchange (ETDEWEB)

    Marco, S. F.; Garcia-Vila, J. H.; Cervera, J.; Gomez, R.; Piqueras, R. M.; Perona, I.; Escrig, J.; Salvador, J. L. [Hospital General de Castello. Castellon (Spain)

    2000-07-01

    To compare the utility of conventional computed tomography (CT) with oral oil-based contrast with that of laparotomy in the preoperative staging of gastric cancer. We prospectively studied 41 patients diagnosed as having gastric adenocarcinoma according to the results of endoscopy and biopsy. Applying the TNM classification for gastric cancer staging, we compared the findings in CT associated with oral oil-based contrast and intraoperative staging with definitive postoperative pathological staging. Definitive pathological studies demonstrated that there were 7 stage T1-T2 lesions, 26 stage T3 and 8 stage T4. The assessment of lymph node involvement showed that 10 patients presented stage N0 and 31 stage N1-N3. Ten patients had metastases. The diagnostic reliability for tumor staging according to CT was 56% versus 80% for laparotomy. In the determination of nodal involvement CT had a diagnostic yield of 71% versus 6% for laparotomy. Metastatic disease was correctly diagnosed by CT in 83% of cases versus 88% by laparotomy. There were no statistically significant differences between CT with oral oil-based contrast and laparotomy for the staging of nodal involvement and metastases. However, the CT diagnosis was significantly more reliable than laparotomy for the determination of tumor infiltration. (Author) 21 refs.

  10. Are Stage of Change constructs relevant for subjective oral health in a vulnerable population?

    Science.gov (United States)

    Jamieson, L M; Parker, E J; Broughton, J; Lawrence, H P; Armfield, J M

    2015-06-01

    Stage of Change constructs may be proxy markers of psychosocial health which, in turn, are related to oral health. To determine if Stage of Change constructs were associated with subjective oral health in a population at heightened risk of dental disease. Stage of Change constructs were developed from a validated 18-item scale and categorised into 'Pre-contemplative', 'Contemplative' and 'Active'. A convenience sample of 446 Australian non-Aboriginal women pregnant by an Aboriginal male (age range 14-43 years) provided data to evaluate the outcome variables (self-rated oral health and oral health impairment), the Stage of Change constructs and socio-demographic, behavioural and access-related factors. Factors significant at the p health and 34% had oral health impairment. Around 12% were 'Pre-contemplative', 46% 'Contemplative' and 42% 'Active'. Being either 'pre-contemplative' or 'contemplative' was associated with poor self-rated oral health after adjusting for socio-demographic factors. 'Pre-contemplative' ceased being significant after adjusting for dentate status and dental behaviour. 'Pre-contemplative' remained significant when adjusting for dental cost, but not 'Contemplative'. The Stages of Change constructs ceased being associated with self-rated oral health after adjusting for all confounders. Only 'Contemplative' (reference: 'Active') was a risk indicator in the null model for oral health impairment which persisted after adding dentate status, dental behaviour and dental cost variables, but not socio-demographics. When adjusting for all confounders, 'Contemplative' was not a risk indicator for oral health impairment. Both the 'Pre-contemplative' and 'Contemplative' Stage of Change constructs were associated with poor self-rated oral health and oral health impairment after adjusting for some, but not all, covariates. When considered as a proxy marker of psychosocial health, Stage of Change constructs may have some relevance for subjective oral health.

  11. Estudo da drenagem linfática e eficácia da tomografia computadorizada na detecção de metástases linfonodais em pacientes clinicamente N0 com carcinoma espinocelular de boca e orofaringe Lymphatic drainage and efficiency of computed tomography in the detection of lymph node metastasis in N0 staged patients with squamous cell carcinoma of the mouth and oropharynx

    Directory of Open Access Journals (Sweden)

    Addah Regina da Silva Freire

    2002-03-01

    Full Text Available O exame clínico não é suficiente para avaliar, com precisão, o envolvimento linfonodal em carcinomas de boca e orofaringe. Avaliamos 21 pacientes portadores de carcinoma espinocelular de boca e orofaringe, estadiados clinicamente como N0. Em todos os pacientes foi feita tomografia computadorizada de face e pescoço, e linfocintilografia. A sensibilidade e a especificidade da tomografia computadorizada foram de 16% e 73% para o lado homolateral, e 0% e 90% para o contralateral, respectivamente. Drenagem linfática foi vista em 76,2% dos casos. A não-migração ocorreu em casos de difícil injeção do radiofármaco, como fossa amigdaliana e região retromolar. A migração bilateral ocorreu apenas em casos de soalho bucal, em que havia envolvimento da linha mediana. A partir desses resultados conclui-se que a tomografia computadorizada foi menos eficiente que o exame clínico. Porém, o tomógrafo utilizado foi o não-helicoidal e, portanto, a eficácia do tomógrafo helicoidal não foi avaliada. A linfocintilografia foi útil na avaliação de pacientes clinicamente N0 e estamos utilizando o método para avaliar linfonodo sentinela nos carcinomas de boca.Clinical examination alone is not sufficient to precisely evaluate lymph node involvement in head and neck cancer. The results of computed tomography of the neck and lymphoscintigraphy were evaluated in 21 patients with carcinoma of the mouth and oropharynx staged N0. Nine patients were treated by homolateral and 12 by bilateral neck dissection. Sensitivity and specificity of computed tomography were 16% and 73% for homolateral side and 0% and 90% for contralateral side, respectively. Lymphatic drainage was observed in 76.2% of the cases. No-migration was associated with cases involving the retromolar region and tonsillar fossa, where injection of the 99mTc-Dextran 500 is more difficult. Bilateral migration occurred only in carcinomas of the floor of the mouth, with involvement of the

  12. Harvesting oral mucosa for one-stage anterior urethroplasty

    Directory of Open Access Journals (Sweden)

    Sanjay Balwant Kulkarni

    2014-01-01

    Full Text Available Oral mucosa has been the most popular substitute material for urethral reconstructive surgery because it is easy to harvest, is easy to access, has a concealed donor site scar, and obviates most of the problems associated with other grafts. However, the success of using oral mucosa for urethral surgery is mainly attributed to the biological properties of this tissue. Herein, the surgical steps of harvesting oral mucosa from the inner cheek are presented with an emphasis on tips and tricks to render the process easier and more reproducible and to prevent intra and post-operative complications. The following steps are emphasized: Nasal intubation, ovoid shape graft, delicate harvesting leaving the muscle intact, donor site closure and removal of submucosal tissue.

  13. Treatment of the glottic squamous cell carcinoma in stages T1-T2, N0: surgery versus radiotherapy: retrospective study of 50 patients attended at the Hospital Mexico in the period 2005 to 2011

    International Nuclear Information System (INIS)

    Diaz Munoz, Angie

    2014-01-01

    Recurrence rates are compared in patients with glottic cancer in early stages, treated with surgery and/or radiotherapy. The study was composed by all patients diagnosed with glottic cancer in the Servicio de Otorrinolaringologia from Hospital Mexico, in early stages during the period 2005 to 2011. The local and locoregional recurrence rates are determined. Differences in recurrence rates are analyzed. Factors associated to higher recurrence rates are identified. Treatment with radiotherapy has had statistically a higher proportion of local recurrence than treatment with surgery [es

  14. Differentiation of oral precancerous stages with optical coherence tomography based on the evaluation of optical scattering properties of oral mucosae

    Science.gov (United States)

    Tsai, M. T.; Lee, J. D.; Lee, Y. J.; Lee, C. K.; Jin, H. L.; Chang, F. Y.; Hu, K. Y.; Wu, C. P.; Chiang, C. P.; Yang, C. C.

    2013-04-01

    Optical coherence tomography (OCT) has been demonstrated to be a powerful tool for noninvasive, real-time oral cancer diagnosis. However, in previous reports, OCT has still been found to be difficult to use in the diagnosis of oral precancerous stages, including mild dysplasia and moderate dysplasia. In clinical applications, early diagnosis and treatment of oral cancer can greatly improve the survival rate. Therefore, in this study, we propose a new approach to differentiate the oral precancerous stages based on the evaluation of the optical scattering properties of the epithelial layer, which is where the dysplastic cells start to develop in the precancerous stages. Instead of using exponential decay fitting to evaluate the scattering properties of mucosal tissues based on the Beer-Lambert law, linear fitting of the OCT depth intensity is used to evaluate the scattering properties of normal and dysplastic cells. From the statistical results of the linear fitting, the slope, a, can be an effective indicator to discriminate healthy mucosa and moderate dysplasia when an a value equal to zero is the threshold value, and the intercept, b, can be used to differentiate healthy and dysplastic mucosae, as well as mild and moderate dysplasia, when b values of 0.15 and 0.18 are used as the threshold values, respectively. Furthermore, this approach is also applied to the determination of the safe margin between normal and abnormal mucosae, making it possible to provide real-time, in vivo inspection during oral maxillofacial surgery.

  15. The added value of SPECT-CT for the identification of sentinel lymph nodes in early stage oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Toom, Inne J. den; Bree, Remco de [VU University Medical Center, Department of Otolaryngology-Head and Neck Surgery, Amsterdam (Netherlands); UMC Utrecht Cancer Center, University Medical Center, Department of Head and Neck Surgical Oncology, PO Box 85500, Utrecht (Netherlands); Schie, Annelies van; Hoekstra, Otto S. [VU University Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam (Netherlands); Weert, Stijn van [VU University Medical Center, Department of Otolaryngology-Head and Neck Surgery, Amsterdam (Netherlands); Karagozoglu, K.H. [VU University Medical Center/Academic Centre for Dentistry (ACTA) Amsterdam, Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam (Netherlands); Bloemena, Elisabeth [VU University Medical Center/Academic Centre for Dentistry (ACTA) Amsterdam, Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam (Netherlands); VU University Medical Center, Department of Pathology, Amsterdam (Netherlands)

    2017-06-15

    To assess the role of single-photon emission computed tomography with computed tomography (SPECT-CT) for the identification of sentinel lymph nodes (SLNs) in patients with early stage (T1-T2) oral cancer and a clinically negative neck (cN0). In addition to planar lymphoscintigraphy, SPECT-CT was performed in 66 consecutive patients with early stage oral cancer and a clinically negative neck. The addition of SPECT-CT to planar images was retrospectively analyzed for the number of additional SLNs, more precise localization of SLNs, and importance of anatomical information by a team consisting of a nuclear physician, surgeon, and investigator. Identification rate for both imaging modalities combined was 98% (65/66). SPECT-CT identified 15 additional SLNs in 14 patients (22%). In 2/15 (13%) of these additional SLNs, the only metastasis was found, resulting in an upstaging rate of 3% (2/65). In 20% of the patients with at least one positive SLN, the only positive SLN was detected due to the addition of SPECT-CT. SPECT-CT was considered to add important anatomical information in two patients (3%). In 5/65 (8%) of the patients initially scored SLNs on planar lymphoscintigrams were scored as non-SLNs when SPECT-CT was added. There were four false-negative SLN biopsy procedures in this cohort. The addition of SPECT-CT to planar lymphoscintigraphy is recommended for the identification of more (positive) SLNs and better topographical orientation for surgery in sentinel lymph node biopsy for early stage oral cancer. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Tetiana Vivcharenko

    2016-12-01

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

  17. Delivering a powerful oral presentation: all the world's a stage.

    Science.gov (United States)

    Papanas, N; Maltezos, E; Lazarides, M K

    2011-04-01

    Oral presentations are, to a great extent, a matter of talent, but they can be practised and improved. There are three kinds of presentations: the short talk (5-10 minutes), the intermediate talk (15 minutes) and the long talk (approximately 45 minutes). Whatever the kind of the presentation, careful preparation is mandatory. The speaker needs to know how long the presentation is expected to be, who the audience is and what main messages should be conveyed. Power point and other visual aids may be appropriately used to facilitate communication. The information presented by these aids should be simple, concrete and intelligible, and the presenter should refrain from reading out the slides word for word. During the presentation, several pitfalls should be avoided: wrong type of presentation, exceeding the allocated time, poor structure, inadequate use of power point and/or other visual aids, poor control of language, poor control of voice, poor appearance on the podium, and poor control of nerves. Ideally, the successful oral presentation is a performance. Thus, the speaker may make the most of appearance, voice, eye contact and movement, in order to increase eloquence.

  18. 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

  19. Acute oral toxicity of chemicals in terrestrial life stages of amphibians: Comparisons to birds and mammals.

    Science.gov (United States)

    Crane, Mark; Finnegan, Meaghean; Weltje, Lennart; Kosmala-Grzechnik, Sylwia; Gross, Melanie; Wheeler, James R

    2016-10-01

    Amphibians are currently the most threatened and rapidly declining group of vertebrates and this has raised concerns about their potential sensitivity and exposure to plant protection products and other chemicals. Current environmental risk assessment procedures rely on surrogate species (e.g. fish and birds) to cover the risk to aquatic and terrestrial life stages of amphibians, respectively. Whilst a recent meta-analysis has shown that in most cases amphibian aquatic life stages are less sensitive to chemicals than fish, little research has been conducted on the comparative sensitivity of terrestrial amphibian life stages. Therefore, in this paper we address the questions "What is the relative sensitivity of terrestrial amphibian life stages to acute chemical oral exposure when compared with mammals and birds?" and "Are there correlations between oral toxicity data for amphibians and data for mammals or birds?" Identifying a relationship between these data may help to avoid additional vertebrate testing. Acute oral amphibian toxicity data collected from the scientific literature and ecotoxicological databases were compared with toxicity data for mammals and birds. Toxicity data for terrestrial amphibian life stages are generally sparse, as noted in previous reviews. Single-dose oral toxicity data for terrestrial amphibian life stages were available for 26 chemicals and these were positively correlated with LD50 values for mammals, while no correlation was found for birds. Further, the data suggest that oral toxicity to terrestrial amphibian life stages is similar to or lower than that for mammals and birds, with a few exceptions. Thus, mammals or birds are considered adequate toxicity surrogates for use in the assessment of the oral exposure route in amphibians. However, there is a need for further data on a wider range of chemicals to explore the wider applicability of the current analyses and recommendations. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Prognostic significance of gene amplification of ACTN4 in stage I and II oral tongue cancer.

    Science.gov (United States)

    Kakuya, T; Mori, T; Yoshimoto, S; Watabe, Y; Miura, N; Shoji, H; Onidani, K; Shibahara, T; Honda, K

    2017-08-01

    Despite complete resection of the early stage of oral tongue cancer by partial glossectomy, late cervical lymph node metastasis is frequently observed. Gene amplification of ACTN4 (protein name: actinin-4) is closely associated with the metastatic potential of various cancers. This retrospective study was performed to demonstrate the potential usefulness of ACTN4 gene amplification as a prognostic biomarker in patients with stage I/II oral tongue cancer. Fifty-four patients with stage I/II oral tongue cancer were enrolled retrospectively, in accordance with the reporting recommendations for tumour marker prognostic studies (REMARK) guidelines. The copy number of ACTN4 and the protein expression of actinin-4 were evaluated by fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC), respectively. The overall survival time of patients with gene amplification of ACTN4 was significantly shorter than that of patients without gene amplification (P=0.0010, log-rank test). Gene amplification of ACTN4 was a significant independent risk factor for death in patients with stage I/II oral tongue cancer (hazard ratio 6.08, 95% confidence interval 1.66-22.27). Gene amplification of ACTN4 is a potential prognostic biomarker for overall survival in oral tongue cancer. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  1. 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)

  2. Oral and pharyngeal cancer : Analysis of patient delay at different tumor stages

    NARCIS (Netherlands)

    Brouha, XDR; Tromp, DM; Hordijk, GJ; Winnubst, JAM; de Leeuw, JRJ

    2005-01-01

    Background. The aim of this study was to examine which factors are related to patient delay in a cohort of consecutive patients with pharyngeal cancer and oral cancer and to determine whether the different stages of patient delay (ie, appraisal, illness, behavioral, and scheduling) were related to

  3. One-stage Penile Urethroplasty Using Oral Mucosal Graft and Glue.

    Science.gov (United States)

    Barbagli, Guido; Pellegrini, Graziella; Corradini, Francesca; Montorsi, Francesco; Sansalone, Salvatore; Butnaru, Denis; Lazzeri, Massimo

    2016-12-01

    Repair of penile urethral strictures is a challenging problem for which different techniques have been suggested. To describe a new surgical technique for one-stage penile urethroplasty using an oral graft and glue, and to assess its safety and efficacy. A retrospective review of medical records for patients who underwent one-stage penile urethroplasty using oral mucosa and glue from February 2013 to October 2014 was performed. The penile urethra was opened and the urethral plate was incised to create a wide window within which the oral graft was pasted with glue. The urethra was sutured over the catheter. Clinical data were collected in a database. Intraoperative and postoperative complications and outcomes were assessed. A descriptive statistical analysis was performed. Fourteen patients were included in the study. Median operative time was 60min. The median postoperative stay was 3 d. Three intraoperative and one postoperative complication occurred. In all patients, voiding cystourethrography 2 wk after surgery failed to show urethral fistula or sacculation. No patients complained of penile chordee or sexual dysfunction after surgery. Median follow-up was 16 mo. Among the 14 patients, 12 (85.7%) procedures were successful and two (14.3%) were failures. Study limitations include the small sample size and short follow-up. An in vitro study and a one-stage reconstruction of penile urethral strictures with an oral mucosa graft and glue showed that the procedure is safe and efficient, but further studies including larger series of patients and longer follow-up are required. We report on the repair of penile urethral stricture using one-stage urethroplasty with oral mucosa and glue. This new technique was safe and effective, with limited complications and satisfactory outcomes. We plan to increase the use of this technique in the future. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  4. Development and evaluation of the Stages of Change in Oral Health instrument.

    Science.gov (United States)

    Jamieson, Lisa M; Armfield, Jason M; Parker, Eleanor J; Roberts-Thomson, Kaye F; Broughton, John; Lawrence, Herenia P

    2014-10-01

    Oral health personnel are limited in their ability to assess the readiness of patients to make changes to improve oral health. We aimed to develop and test the Stages of Change in Oral Health (SOCOH) model, a scaled index of the stages of change - pre-contemplative, contemplative or active - with particular emphasis on pregnancy. Items were collected in a self-report questionnaire conducted among a convenience sample of 446 mothers (age range: 14-43 years) pregnant with Aboriginal children in South Australia, Australia. Scales representing openness (four items; Cronbach's alpha = 0.73), value (four items; Cronbach's alpha = 0.71), inconvenience (six items; Cronbach's alpha = 0.79) and permissiveness (four items; Cronbach's alpha = 0.66) were developed. Participants were categorised according to the Stages of Change model and were evaluated against key self-reported oral health outcomes. Some 11.9% of participants were classified as pre-contemplators, 46.4% as contemplators and 41.7% as active. A higher proportion of active participants had a higher education, last visited a dentist less than a year previously, had no dental fear, owned a toothbrush, brushed the previous day, used toothpaste, had no difficulties paying a $100 dental bill, self-reported their dental health as 'excellent' and in the previous 12 months did not experience dental pain, embarrassment related to their dental appearance or difficulties eating food. The SOCOH model offers an internally consistent and valid instrument for detailed assessment of the readiness for change in regarding oral health behaviours in pregnancy and has potential benefits for clinical decision making and research. © 2014 FDI World Dental Federation.

  5. The development and validation of oral cancer staging using administrative health data

    International Nuclear Information System (INIS)

    Li-Ting, Chang; Chung-Ho, Chen; Yi-Hsin, Yang; Pei-Shan, Ho

    2014-01-01

    Oral cancer is a major global health problem. The complexity of histological prognosticators in oral cancer makes it difficult to compare the benefits of different treatment regimens. The Taiwanese National Health database provides an opportunity to assess correlations between outcome and treatment protocols and to compare the effects of different treatment regimens. However, the absence of indices of disease severity is a critical problem. The aim of this study was to ascertain how accurately we could assess the severity of oral cancer at the time of initial diagnosis on the basis of variables in a national database. In the cancer registry database of a medical center in Taiwan, we identified 1067 histologically confirmed cases of oral cancer (ICD9 codes 140, 141 and 143–145) that had been first diagnosed and subjected to initial treatment in this hospital. The clinical staging status was considered as the gold standard and we used concordance (C)-statistics to assess the model’s predictive performance. We added the predictors of treatment modality, cancer subsite, and age group to our models. Our final overall model included treatment regimen, site, age, and two interaction terms; namely, interactions between treatment regimen and age and those between treatment regimen, site, and age. In this model, the C-statistics were 0.82–0.84 in male subjects and 0.96–0.99 in female subjects. Of the models stratified by age, the model that considered treatment regimen and site had the highest C-statistics for the interaction term, this value being greater than 0.80 in male subjects and 0.9 in female subjects. In this study, we found that adjusting for sex, age at first diagnosis, oral cancer subsite, and therapy regimen provided the best indicator of severity of oral cancer. Our findings provide a method for assessing cancer severity when information about staging is not available from a national health-related database

  6. Submandibular Gland Involvement in Early Stage Oral Cavity Carcinomas: Can the Gland be left behind

    International Nuclear Information System (INIS)

    Ashfaq, K.; Ashfaq, M.; Ahmed, A.; Khan, M.; Azhar, M.

    2014-01-01

    Objective: To determine the frequency of submandibular gland involvement in early oral cavity tumors. Study Design: Observational study. Place and Duration of Study: ENT Department, CMH, Rawalpindi, from January 2008 to December 2011. Methodology: Data of 110 oral cavity tumors operated over 2008 - 2011 was retrieved from ENT OPD, tumor registry in AFIP and from Head and Neck Oncology Forum Registry. Cases of oral cavity tumors that had undergone elective neck dissections were retrospectively studied for invasion of the submandibular gland, TNM Staging, perineural, perivascular, lymphovascular invasion, site specific frequency of oral cavity tumors and frequency of lymph node metastasis. Results: Tumors of tongue were the most common constituting 42%, squamous cell carcinoma was the histological diagnosis in 90% cases. Sixty eight (61.8%) cases were node negative. Selective neck dissection was done in 55.5% of the cases. Submandibular gland was involved in 2 cases (1.8%). Conclusion: Submandibular gland metastasis from early oral cavity tumors is rare; any neoplastic involvement of the gland usually occurs via direct spread. (author)

  7. Oral tegafur-uracil as metronomic therapy following intravenous FOLFOX for stage III colon cancer.

    Directory of Open Access Journals (Sweden)

    Wen-Yen Huang

    Full Text Available The purpose of this study was to estimate the impact of metronomic therapy with oral tegafur-uracil (UFUR following an intravenous FOLFOX regimen as surgical adjuvant chemotherapy on the overall survival (OS and disease-free survival (DFS of stage III colon cancer patients. From the retrospective database of patients who underwent a surgical resection for colorectal cancer at the Tri-Service General Hospital from October 2008 through December 2014, stage III colon carcinomas treated with radical R0 resection were reviewed. One hundred thirty two patients were treated with a FOLFOX regimen (comparison group, and 113 patients were treated with the same regimen followed by additional oral UFUR (UFUR group. The clinical characteristics and mean age of the comparison and UFUR groups were similar. Furthermore, for all study patients, DFS was not significantly different between the two groups. However, 5-year OS rates were 86.8% and 68.5% in the UFUR and comparison groups, respectively (p = 0.0107. Adding UFUR to a FOLFOX regimen was found to significantly improve the OS in patients with stage III colon cancer. UFUR as a maintenance therapy following FOLFOX regimen as an alternative therapeutic option for the treatment of stage III colon cancer patients.

  8. Oral tegafur-uracil as metronomic therapy following intravenous FOLFOX for stage III colon cancer.

    Science.gov (United States)

    Huang, Wen-Yen; Ho, Ching-Liang; Lee, Chia-Cheng; Hsiao, Cheng-Wen; Wu, Chang-Chieh; Jao, Shu-Wen; Yang, Jen-Fu; Lo, Cheng-Hsiang; Chen, Jia-Hong

    2017-01-01

    The purpose of this study was to estimate the impact of metronomic therapy with oral tegafur-uracil (UFUR) following an intravenous FOLFOX regimen as surgical adjuvant chemotherapy on the overall survival (OS) and disease-free survival (DFS) of stage III colon cancer patients. From the retrospective database of patients who underwent a surgical resection for colorectal cancer at the Tri-Service General Hospital from October 2008 through December 2014, stage III colon carcinomas treated with radical R0 resection were reviewed. One hundred thirty two patients were treated with a FOLFOX regimen (comparison group), and 113 patients were treated with the same regimen followed by additional oral UFUR (UFUR group). The clinical characteristics and mean age of the comparison and UFUR groups were similar. Furthermore, for all study patients, DFS was not significantly different between the two groups. However, 5-year OS rates were 86.8% and 68.5% in the UFUR and comparison groups, respectively (p = 0.0107). Adding UFUR to a FOLFOX regimen was found to significantly improve the OS in patients with stage III colon cancer. UFUR as a maintenance therapy following FOLFOX regimen as an alternative therapeutic option for the treatment of stage III colon cancer patients.

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  10. Treatment outcome of advance staged oral cavity cancer: concurrent chemoradiotherapy compared with primary surgery.

    Science.gov (United States)

    Tangthongkum, Manupol; Kirtsreesakul, Virat; Supanimitjaroenporn, Pasawat; Leelasawatsuk, Peesit

    2017-06-01

    Concurrent chemoradiotherapy (CCRT) has been reported as effective and has become an acceptable treatment in advanced oral cancer. However, to date there is insufficient data to conclude that CCRT provides a good survival outcome. The purpose of this study was to compare survival rates and complications in patients with resectable advanced oral cavity squamous cell carcinoma treated with either CCRT or surgery with adjuvant radiotherapy (RT)/chemoradiotherapy (CRT). Stage III or IVa oral cavity carcinoma patients treated with curative intent by either CCRT or surgery with adjuvant RT were identified over a 7-year period (2009-2015). Survival rates and treatment complications were analyzed and compared between the two groups. 61 patients underwent CCRT and 128 patients underwent surgical excision and received postoperative RT. There was no statistically significant difference in survival outcome between the two treatment groups. 5-year overall survival rates (OS) were 33 versus 24% (P = 0.191) and the disease-specific survival rates (DSS) were 27 versus 25% (P = 0.857) when comparing the CCRT group and surgery with adjuvant RT/CRT group, respectively. Long-term complications were comparable between the two groups. CCRT has comparable survival outcome and complications for the treatment of advanced oral cavity squamous cell carcinoma, compared to surgery with adjuvant RT/CRT.

  11. Efficacy of Multimodal Therapy in the Survival Outcomes of Advanced-Stage (Stage III-Stage IV) Oral Carcinoma Patients: An Institutional Experience in Asian Indian Population.

    Science.gov (United States)

    Dhawan, Amit; Duggal, Prahlad; Bhullar, Ramandeep Singh; Kaur, Tejinder; Sandhu, Amneet; Kaur, Kirandeep

    2018-03-01

    Primary ablative surgery followed by post-op radiotherapy (S-RT) remains the mainstay of treatment for stage III-stage IV oral carcinoma. A retrospective analysis of survival rates of advanced-stage OSCC patients treated with multimodal therapies (S-RT or combined chemoradiation) was performed to analyse the outcome for patient survival and whether addition of adjuvant chemotherapy (S-CRT) improves survival. Demographic, pathological, treatment and follow-up data of 128 patients were included in the study. Sixty-nine patients received S-RT, while 55 patients were opted for S-CRT. Overall survival, disease-specific survival and disease-free survival were estimated with Kaplan-Meier analysis and compared between groups with Cox regression analysis. Survival was significantly influenced by the type of modality and regional spread of disease. S-CRT group had improved overall, disease-specific, disease-free and metastasis-free survival compared to S-RT group. A survival advantage of 10% was achieved in S-CRT group compared to S-RT group even in patients with extracapsular spread and perineural invasion. Addition of adjuvant chemotherapy to S-RT improves survival outcomes in advanced OSCC, especially in patients with regional spread of disease.

  12. Oral cancer trends in a single head-and-neck cancer center in the Netherlands; decline in T-stage at the time of admission.

    Science.gov (United States)

    Weijers, Manon; Leemans, C René; Aartman, Irene H; Karagozoglu, K Hakki; van der Waal, Isaäc

    2011-11-01

    In this study we evaluated the possible epidemiologic changes of oral cancer patients in the Netherlands between the years 1980-1984 and 2000-2004. We specifically studied the differences in male-female ratio, age, TNM-stage, site distribution, and alcohol and tobacco use. Patients from the VU University Medical Center with an oral squamous cell carcinoma of the oral cavity registered in 1980-1984 (n=200), group 1, were compared to patients registered in 2000-2004 (n=184), group 2. Trends in prevalence, site distribution, TNM-stage, alcohol and tobacco use, age and gender were studied. The male-female ratio has decreased from 1.8 to 1.2. There were no differences in age between the two groups of patients. The site distribution was similar in both groups. The most commonly involved sites were the tongue and the floor of mouth. In group 2 more patients were diagnosed with a T1 tumour. There were no differences in tobacco use between the two different groups. There were much more light drinkers (0-2 drinks per day) in group 2 than in group 1, whereas there were more heavy drinkers (>4 per day) in group 1 than in group 2 (p<0.001). This was observed in both male and female patients. In our study there were no significant differences between the patients registered in the years 1980-1984 and 2000-2004 regarding the mean age of the patients, site distribution and smoking habits. The male-female ratio has decreased. In the recent group more patients were staged T1N0 and there was a strong decrease of the patients who were heavy drinkers.

  13. The relevance of uniform reporting in oral leukoplakia: Definition, certainty factor and staging based on experience with 275 patients

    Science.gov (United States)

    Brouns, Elisabeth R E A.; Baart, Jacques A.; Bloemena, Elisabeth; Karagozoglu, Hakki

    2013-01-01

    The aim of the present study was to evaluate the definition of oral leukoplakia, proposed by the WHO in 2005 and taking into account a previously reported classification and staging system, including the use of a Certainty factor of four levels with which the diagnosis of leukoplakia can be established. In the period 1997-2012 a hospital-based population of 275 consecutive patients with a provisional diagnosis of oral leukoplakia has been examined. In only 176 patients of these 275 patients a firm diagnosis of leukoplakia has been established based on strict clinicopathological criteria. The 176 patients have subsequently been staged using a classification and staging system based on size and histopathologic features. For use in epidemiological studies it seems acceptable to accept a diagnosis of leukoplakia based on a single oral examination (Certainty level 1). For studies on management and malignant transformation rate the recommendation is made to include the requirement of histopathologic examination of an incisional or excisional biopsy, representing Certainty level 3 and 4, respectively. This recommendation results in the following definition of oral leukoplakia: “A predominantly white lesion or plaque of questionable behaviour having excluded, clinically and histopathologically, any other definable white disease or disorder”. Furthermore, we recommend the use of strict diagnostic criteria for predominantly white lesions for which a causative factor has been identified, e.g. smokers’ lesion, frictional lesion and dental restoration associated lesion. Key words:Oral epithelial dysplasia, oral leukoplakia, potentially malignant oral disorders. PMID:23085711

  14. T1N0 to T2N0 Squamous Cell Carcinoma of the Glottic Larynx Treated With Definitive Radiotherapy

    International Nuclear Information System (INIS)

    Chera, Bhishamjit S.; Amdur, Robert J.; Morris, Christopher G.; Kirwan, Jessica M.; Mendenhall, William M.

    2010-01-01

    Purpose: To report the treatment outcomes of definitive radiotherapy (RT) for early-stage squamous cell carcinoma (SCCA) of the glottic larynx. Methods and Materials: We retrospectively reviewed the medical records of 585 patients with T1N0 to T2N0 invasive SCCA of the glottic larynx treated between 1964 and 2006 with RT alone. All patients had at least 2 years of follow-up, had histologic diagnosis of invasive SCCA, and received continuous-course RT. None of these patients received chemotherapy or had elective nodal RT. The probabilities of local control (LC), ultimate LC, ultimate LC with larynx preservation, neck control, cause-specific survival (CSS), and overall survival (OS) were calculated by the Kaplan-Meier product-limit method. Results: The median follow-up for survivors was 12 years. Five-year LC rates were as follows: T1A, 94%; T1B, 93%; T2A, 80%; and T2B, 70%. Multivariate analysis revealed that overall treatment time greater than 41 days (p = 0.001) and poorly differentiated histology (p = 0.016) adversely affected LC. Five-year rates of ultimate LC with laryngeal preservation were: T1A, 95%; T1B, 94%, T2A, 81%; and T2B, 74%. Twenty-four (4%) of 585 patients failed in the neck; only 7 neck failures (1%) were isolated. Five-year CSS and OS rates were as follows: T1A, 97% and 82%; T1B, 99% and 83%; T2A, 94% and 76%; and T2B, 90% and 78%, respectively. Ten (1.7%) patients had severe and/or fatal complications. One patient died of a radiation-induced carotid artery angiosarcoma. Conclusion: Based on our study results, RT cures a high proportion of patients with T1N0 to T2N0 glottic SCCAs and has a low rate of severe complications.

  15. [Dynamic concept of oral lichen planus. The diagnosis easy at early stages may become difficult in ancient lichen planus].

    Science.gov (United States)

    Lombardi, Tommaso; Küffer, Roger

    2016-02-01

    Dynamic concept of oral lichen planus. The diagnosis easy at early stages may become difficult in ancient lichen planus. Lichen planus is a chronic inflammatory dermatosis of the skin, skin appendages and mucous membranes, which frequently affects the oral mucosa. Its aetiology still remains unknown, and currently accepted pathogenesis is that of an autoimmune cell-mediated disease. To the contrary of skin lichen planus, oral lichen planus is a long-term chronic disease with dynamic evolution, in which progressive and profound changes of the clinical and histopathological aspects occur over time and under the influence of various exogenous factors. By convention, in the history of the oral lichen planus four successive stages can be distinguished without well-defined boundaries between them. These stages can be defined as an initial phase; a long intermediate phase with alternating periods of activity and quiescence, which has a gradually increasing risk of malignant transformation; a late stage which activity is traditionally diminished; and a post-lichen cicatricial stage with an absent or negligible and undetectable activity, often undiagnosed because clinically unrecognized; in this stage, the lesion does not respond to usual treatments, but retains the same risk of malignant transformation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. pN0(i+) Breast Cancer: Treatment Patterns, Locoregional Recurrence, and Survival Outcomes

    International Nuclear Information System (INIS)

    Karam, Irene; Lesperance, Maria F.; Berrang, Tanya; Speers, Caroline; Tyldesley, Scott; Truong, Pauline T.

    2013-01-01

    Purpose: To examine treatment patterns, recurrence, and survival outcomes in patients with pN0(i+) breast cancer. Methods and Materials: Subjects were 5999 women with AJCC (6th edition) pT1-3, pN0-N1a, M0 breast cancer diagnosed between 2003 and 2006. Of these, 4342 (72%) had pN0, 96 (2%) had pN0(i+), 349 (6%) had pNmic (micrometastases >0.2 mm to ≤2 mm), and 1212 (20%) had pN1a (1-3 positive macroscopic nodes) disease. Treatment characteristics and 5-year Kaplan-Meier local recurrence, regional recurrence (RR), locoregional recurrence (LRR), and overall survival were compared between nodal subgroups. Multivariable analysis was performed using Cox regression modeling. A 1:3 case-match analysis examined outcomes in pN0(i+) cases compared with pN0 controls matched for similar tumor and treatment characteristics. Results: Median follow-up was 4.8 years. Adjuvant systemic therapy use increased with nodal stage: 81%, 92%, 95%, and 94% in pN0, pN0(i+), pNmic, and pN1a disease, respectively (P<.001). Nodal radiation therapy (RT) use also increased with nodal stage: 1.7% in pN0, 27% in pN0(i+), 33% in pNmic, and 63% in pN1a cohorts (P<.001). Five-year Kaplan-Meier outcomes in pN0 versus pN0(i+) cases were as follows: local recurrence 1.7% versus 3.7% (P=.20), RR 0.5% versus 2.2% (P=.02), and LRR 2.1% versus 5.8% (P=.02). There were no RR events in 26 patients with pN0(i+) disease who received nodal RT and 2 RR events in 70 patients who did not receive nodal RT. On multivariable analysis, pN0(i+) was not associated with worse locoregional control or survival. On case-match analysis, LRR and overall survival were similar between pN0(i+) and matched pN0 counterparts. Conclusions: Nodal involvement with isolated tumor cells is not a significant prognostic factor for LRR or survival in this study's multivariable and case-match analyses. These data do not support the routine use of nodal RT in the setting of pN0(i+) disease. Prospective studies are needed to define optimal

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

    International Nuclear Information System (INIS)

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

    1991-01-01

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

  18. COMPARISON OF SIDE EFFECTS OF MISOPROSTOL BY ORAL AND RECTAL ROUTES IN ACTIVE MANAGEMENT OF THIRD STAGE OF LABOUR

    Directory of Open Access Journals (Sweden)

    Ratna Bulusu

    2017-01-01

    Full Text Available BACKGROUND Every year, there are 14 million cases of PPH. It accounts for about 25% of maternal deaths worldwide. This can be reduced by active management of third stage of labour. Administration of misoprostol after delivery of neonate has been shown to be effective in reducing amount of blood loss during delivery. The aim of the study is to compare the side effects of misoprostol in terms of distribution, frequency and severity by oral and rectal route for active management of third stage of labour. MATERIALS AND METHODS A prospective randomised study conducted on 100 women in labour in Department of OBG in MVJMC and RH. They were divided into 2 groups of 50 parturient mothers each group receiving misoprostol (600 µg by oral route (Group 1 and rectal route (Group 2. Outcome of these women were noted in terms of blood loss, duration of 3 rd stage of labour and side effects like shivering, fever, diarrhoea, nausea and vomiting. RESULTS There was not much difference in amount of blood loss and duration of third stage among the two groups. However, side effects were more in the group receiving misoprostol orally (32% as compared to that receiving by rectal route (14%. CONCLUSION In the present study, both oral and rectal routes are effective in active management of third stage of labour. However, rectal route has lesser side effects.

  19. The relevance of uniform reporting in oral leukoplakia: Definition, certainty factor and staging based on experience with 275 patients

    NARCIS (Netherlands)

    Brouns, E.R.E.A.; Baart, J.A.; Bloemena, E.; Karagozoglu, H.; van der Waal, I.

    2013-01-01

    The aim of the present study was to evaluate the definition of oral leukoplakia, proposed by the WHO in 2005 and taking into account a previously reported classification and staging system, including the use of a Certainty factor of four levels with which the diagnosis of leukoplakia can be

  20. Safety, pharmacokinetic, and efficacy studies of oral DB868 in a first stage vervet monkey model of human African trypanosomiasis.

    Directory of Open Access Journals (Sweden)

    John K Thuita

    Full Text Available There are no oral drugs for human African trypanosomiasis (HAT, sleeping sickness. A successful oral drug would have the potential to reduce or eliminate the need for patient hospitalization, thus reducing healthcare costs of HAT. The development of oral medications is a key objective of the Consortium for Parasitic Drug Development (CPDD. In this study, we investigated the safety, pharmacokinetics, and efficacy of a new orally administered CPDD diamidine prodrug, 2,5-bis[5-(N-methoxyamidino-2-pyridyl]furan (DB868; CPD-007-10, in the vervet monkey model of first stage HAT. DB868 was well tolerated at a dose up to 30 mg/kg/day for 10 days, a cumulative dose of 300 mg/kg. Mean plasma levels of biomarkers indicative of liver injury (alanine aminotransferase, aspartate aminotransferase were not significantly altered by drug administration. In addition, no kidney-mediated alterations in creatinine and urea concentrations were detected. Pharmacokinetic analysis of plasma confirmed that DB868 was orally available and was converted to the active compound DB829 in both uninfected and infected monkeys. Treatment of infected monkeys with DB868 began 7 days post-infection. In the infected monkeys, DB829 attained a median C(max (dosing regimen that was 12-fold (3 mg/kg/day for 7 days, 15-fold (10 mg/kg/day for 7 days, and 31-fold (20 mg/kg/day for 5 days greater than the IC50 (14 nmol/L against T. b. rhodesiense STIB900. DB868 cured all infected monkeys, even at the lowest dose tested. In conclusion, oral DB868 cured monkeys with first stage HAT at a cumulative dose 14-fold lower than the maximum tolerated dose and should be considered a lead preclinical candidate in efforts to develop a safe, short course (5-7 days, oral regimen for first stage HAT.

  1. Safety, Pharmacokinetic, and Efficacy Studies of Oral DB868 in a First Stage Vervet Monkey Model of Human African Trypanosomiasis

    Science.gov (United States)

    Thuita, John K.; Wolf, Kristina K.; Murilla, Grace A.; Liu, Qiang; Mutuku, James N.; Chen, Yao; Bridges, Arlene S.; Mdachi, Raymond E.; Ismail, Mohamed A.; Ching, Shelley; Boykin, David W.; Hall, James Edwin; Tidwell, Richard R.; Paine, Mary F.; Brun, Reto; Wang, Michael Zhuo

    2013-01-01

    There are no oral drugs for human African trypanosomiasis (HAT, sleeping sickness). A successful oral drug would have the potential to reduce or eliminate the need for patient hospitalization, thus reducing healthcare costs of HAT. The development of oral medications is a key objective of the Consortium for Parasitic Drug Development (CPDD). In this study, we investigated the safety, pharmacokinetics, and efficacy of a new orally administered CPDD diamidine prodrug, 2,5-bis[5-(N-methoxyamidino)-2-pyridyl]furan (DB868; CPD-007-10), in the vervet monkey model of first stage HAT. DB868 was well tolerated at a dose up to 30 mg/kg/day for 10 days, a cumulative dose of 300 mg/kg. Mean plasma levels of biomarkers indicative of liver injury (alanine aminotransferase, aspartate aminotransferase) were not significantly altered by drug administration. In addition, no kidney-mediated alterations in creatinine and urea concentrations were detected. Pharmacokinetic analysis of plasma confirmed that DB868 was orally available and was converted to the active compound DB829 in both uninfected and infected monkeys. Treatment of infected monkeys with DB868 began 7 days post-infection. In the infected monkeys, DB829 attained a median Cmax (dosing regimen) that was 12-fold (3 mg/kg/day for 7 days), 15-fold (10 mg/kg/day for 7 days), and 31-fold (20 mg/kg/day for 5 days) greater than the IC50 (14 nmol/L) against T. b. rhodesiense STIB900. DB868 cured all infected monkeys, even at the lowest dose tested. In conclusion, oral DB868 cured monkeys with first stage HAT at a cumulative dose 14-fold lower than the maximum tolerated dose and should be considered a lead preclinical candidate in efforts to develop a safe, short course (5–7 days), oral regimen for first stage HAT. PMID:23755309

  2. PTEN allelic loss is an important mechanism in the late stage of development of oral leucoplakia into oral squamous cell carcinoma.

    Science.gov (United States)

    Miyahara, Ligia A N; Pontes, Flávia S C; Burbano, Rommel M R; Conte Neto, Nicolau; Guimarães, Douglas M; Fonseca, Felipe P; Pontes, Hélder A R

    2018-01-01

    The aim of this study was to analyse allelic loss of the phosphatase and tensin homologue deleted on chromosome 10 (PTEN) gene and its protein immuno-expression in dysplastic oral lesions and oral squamous cell carcinomas (OSCCs). Samples were collected from 153 patients [20 ranulas used as a control (C); 30 leucoplakias with mild dysplasia (MD); 30 leucoplakias with moderate to severe dysplasia (MSD); 73 oral squamous cell carcinoma (OSCC)]. PTEN protein expression was investigated using immunohistochemistry, and PTEN allelic loss was analysed by fluorescence in-situ hybridisation (FISH). Differences among groups were evaluated using the χ 2 test. PTEN expression was higher in MSD (P = 0.002) and OSCC (P = 0.0259) compared with the C group; additionally, a higher expression was observed in MSD (P = 0.0035) and OSCC (P = 0.049) than MD. Regarding FISH analysis, a higher hemizygous (single copy) loss was observed in OSCC than in C (P = 0.0467) and in OSCC than in MD (P = 0.0175), as well as a higher homozygous deletion in OSCC compared with C (P = 0.0159) and OSCC than MD (P = 0.0145). The results of this work suggest that PTEN allelic loss is an important mechanism in the late stage of the development of oral potentially malignant lesions into oral cancer. © 2017 John Wiley & Sons Ltd.

  3. Exploring the oral microbiota of children at various developmental stages of their dentition in the relation to their oral health

    NARCIS (Netherlands)

    Crielaard, W.; Zaura, E.; Schuller, A.A.; Huse, S.M.; Montijn, R.C.; Keijser, B.J.F.

    2011-01-01

    Background An understanding of the relation of commensal microbiota to health is essential in preventing disease. Here we studied the oral microbial composition of children (N = 74, aged 3 - 18 years) in natural transition from their deciduous to a permanent dentition and related the microbial

  4. Exploring the oral microbiota of children at various developmental stages of their dentition in the relation to their oral health

    NARCIS (Netherlands)

    Crielaard, W.; Zaura, E.; Schuller, A.A.; Huse, S.M.; Montijn, R.C.; Keijser, B.J.F.

    2011-01-01

    BACKGROUND: An understanding of the relation of commensal microbiota to health is essential in preventing disease. Here we studied the oral microbial composition of children (N = 74, aged 3 - 18 years) in natural transition from their deciduous to a permanent dentition and related the microbial

  5. The relevance of uniform reporting in oral leukoplakia: definition, certainty factor and staging based on experience with 275 patients

    OpenAIRE

    Brouns, Elisabeth-REA; Baart, Jacques A; Bloemena, Elisabeth; Karagozoglu, Hakki; Van der Waal, Isaäc

    2013-01-01

    The aim of the present study was to evaluate the definition of oral leukoplakia, proposed by the WHO in 2005 and taking into account a previously reported classification and staging system, including the use of a Certainty factor of four levels with which the diagnosis of leukoplakia can be established. In the period 1997-2012 a hospital-based population of 275 consecutive patients with a provisional diagnosis of oral leukoplakia has been examined. In only 176 patients of these 275 patients a...

  6. Side-effects of oral misoprostol in the third stage of labour – a ...

    African Journals Online (AJOL)

    Background. Misoprostol, an irlexpensive, stable, orally active prostaglandirl analogue, has been suggested for use in the prevention of postpartum haemorrhage. Potential side-effects, however, need to be quantified. Objective. To compare the rate of postpartum shivering and pyrexia following oral misoprostol 600 pg and ...

  7. The role of lymphoscintigraphy, sentinel mode biopsy and positron emission tomography in the staging of the neck in early oral squamous cell carcinoma

    Science.gov (United States)

    Hyde, Nicholas Charles

    This thesis explores the limitations of current imaging modalities in the evaluation of the clinically node negative (N0) neck in early oral squamous cell carcinoma and evaluates the utility of two new interventions. It will become evident that the use of clinical parameters and conventional imaging to detect clinically occult cervical lymph node metastases is an imprecise science. The presence of metastases in the neck is the single most important determinant of survival. Hitherto the lack of timely intervention in this regard may have been contributory in amplifying their effect upon survival. There is an obvious requirement for a more accurate technique to stage the neck in this patient group. Therefore the application of lymphoscintigraphy in combination with sentinel node biopsy (SNB), and positron emission tomography (PET) have been investigated. It appears that PET, whilst having a number of useful roles in the generic head and neck oncology patient, has little to contribute in the diagnosis of occult neck disease. In contra-distinction lymphoscintigraphy and SNB are not only feasible in the diagnosis of occult metastases, but also enhance our knowledge of lymphatic drainage from the oral cavity. This has, in some circumstances, led to the modification of initially prescribed treatment plans. Such is the current pace of technological advance that over the course of this research an entirely new imaging modality has emerged - PET/CT. Whilst it has not been possible to apply this retrospectively to the original patient population early experience of this novel technique in head and neck malignancy is explored and reported. The results of these initial applications are encouraging.

  8. Plasmablastic lymphoma of the oral cavity in an HIV-positive patient: staging with 18F-FDG PET/CT

    International Nuclear Information System (INIS)

    Makis, William; Ciarallo, Anthony; Lisbona, Robert

    2011-01-01

    Plasmablastic lymphoma of the oral cavity is a very rare and only recently recognized entity that has been identified almost exclusively in HIV-infected individuals. It has a predilection for the oral cavity, often exhibits very aggressive behavior and has a poor prognosis. The use of 18F-FDG PET/CT in the evaluation of HIV-associated lymphomas is a recent development, and its use in the staging of plasmablastic lymphoma of the oral cavity has not been previously reported. This rare report highlights the usefulness of 18F-FDG PET/CT in the staging of plasmablastic lymphoma of the oral cavity

  9. Plasmablastic lymphoma of the oral cavity in an HIV-positive patient: staging with 18F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Makis, William (Dept. of Nuclear Medicine, Brandon Regional Health Centre, Brandon (Canada)), email: makisw79@yahoo.com; Ciarallo, Anthony; Lisbona, Robert (Dept. of Nuclear Medicine, Royal Victoria Hospital, McGill Univ. Health Centre, Montreal (Canada))

    2011-11-15

    Plasmablastic lymphoma of the oral cavity is a very rare and only recently recognized entity that has been identified almost exclusively in HIV-infected individuals. It has a predilection for the oral cavity, often exhibits very aggressive behavior and has a poor prognosis. The use of 18F-FDG PET/CT in the evaluation of HIV-associated lymphomas is a recent development, and its use in the staging of plasmablastic lymphoma of the oral cavity has not been previously reported. This rare report highlights the usefulness of 18F-FDG PET/CT in the staging of plasmablastic lymphoma of the oral cavity

  10. Comparative study of clinicofunctional staging of oral submucous fibrosis with qualitative analysis of collagen fibers under polarizing microscopy

    Directory of Open Access Journals (Sweden)

    Ceena Denny

    2009-01-01

    Full Text Available Objective : The aim of the study was to assess the severity of the disease in oral submucous fibrosis (OSF, correlate the clinical, functional staging with histopathological staging, and analyze collagen distribution in different stages of OSF using the picrosirius red stain under polarizing microscopy. Materials and Methods : The study included randomly incorporated 50 subjects, of whom 40 were patients with OSF, and 10 were in the control group. Clinical, functional staging in OSF cases was done depending upon definite criteria. A histopathological study was conducted using the hematoxylin and eosin stain and picrosirius red stain. Collagen fibers were analyzed for thickness and polarizing colors. Furthermore, clinical, functional, and histopathological stages were compared. Statistical Analysis : Descriptive data which included mean, SD, and percentages were calculated for each group. Categorical data were analyzed by the chi-square test. Multiple group comparisons were made by one-way ANOVA followed by Student′s t-test for pairwise comparisons. For all tests, a P-value of 0.05 or less was considered for statistical significance. Results : As the severity of the disease increased, clinically, there was definite progression in subjective and objective symptoms. Polarized microscopic, examination revealed, there was a gradual decrease in the green-greenish yellow color of the fibers and a shift to orange red-red color with increase in severity of the disease. Thereby, it appeared that the tight packing of collagen fibers in OSF progressively increased as the disease progressed from early to advanced stages. We observed that the comparison of functional staging with histopathological staging was a more reliable indicator of the severity of the disease. Conclusion : In the present study, we observed that mouth opening was restricted with advancing stages of OSF. The investigation also points to the importance of assessing the cases of OSF

  11. The Mark Coventry, MD, Award: Oral Antibiotics Reduce Reinfection After Two-Stage Exchange: A Multicenter, Randomized Controlled Trial.

    Science.gov (United States)

    Frank, Jonathan M; Kayupov, Erdan; Moric, Mario; Segreti, John; Hansen, Erik; Hartman, Curtis; Okroj, Kamil; Belden, Katherine; Roslund, Brian; Silibovsky, Randi; Parvizi, Javad; Della Valle, Craig J

    2017-01-01

    Many patients develop recurrent periprosthetic joint infection after two-stage exchange arthroplasty of the hip or knee. One potential but insufficiently tested strategy to decrease the risk of persistent or recurrent infection is to administer additional antibiotics after the second-stage reimplantation. (1) Does a 3-month course of oral antibiotics decrease the risk of failure secondary to infection after a two-stage exchange? (2) Are there any complications related to the administration of oral antibiotics after a two-stage exchange? (3) In those patients who develop a reinfection, is the infecting organism different from the initial infection? Patients at seven centers randomized to receive 3 months of oral antibiotics or no further antibiotic treatment after operative cultures after the second-stage reimplantation were negative. Adult patients undergoing two-stage hip or knee revision arthroplasty for a periprosthetic infection who met Musculoskeletal Infection Society (MSIS) criteria for infection at the first stage were included. Oral antibiotic therapy was tailored to the original infecting organism(s) in consultation with an infectious disease specialist. MSIS criteria as used by the treating surgeon defined failure. Surveillance of patients for complications, including reinfection, occurred at 3 weeks, 6 weeks, 3 months, 12 months, and 24 months. If an organism demonstrated the same antibiotic sensitivities as the original organism, it was considered the same organism; no DNA subtyping was performed. Analysis was performed as intent to treat with all randomized patients included in the groups to which they were randomized. A log-rank survival curve was used to analyze the primary outcome of reinfection. At planned interim analysis (enrollment is ongoing), 59 patients were successfully randomized to the antibiotic group and 48 patients to the control group. Fifty-seven patients had an infection after TKA and 50 after a THA. There was no minimum followup

  12. Effect of Habits and Nutritional Status on Clinical Grading and Histopathological Staging in Patients with Oral Sub Mucous Fibrosis

    Science.gov (United States)

    Lanke, Rama Brahmam; Shetty, Rakhith; Akifuddin, Syed; Sahu, Manish; Singh, Navneet; Kaur, Gagandeep; Goyal, Garish

    2015-01-01

    Background Oral submucous fibrosis (OSMF) is a chronic progressive debilitating disease affecting the oral, oropharyngeal and sometimes the oesophageal mucosa resulting in inability to eat due to burning, ulcers and stiffness. Aim The study was undertaken, to evaluate the correlation of clinical staging, histological grading and nutritional status using body mass index (BMI) with gutkha (habit) index in OSMF patients. Materials and Methods The study group comprised of 50 patients clinically diagnosed and histopathologically confirmed cases of OSMF. Habit (gutkha) index was calculated by multiplying duration and frequency. Body mass index was calculated by dividing weight in kilograms and height in centimetres of the patient. Results Male to female ratio was 2.8:1. Clinical grading increased with increase in gutkha index, patients with gutkha index 1-50, maximum were in mild stage; with gutkha index 51-100, maximum in moderate and patients with gutkha index 101-150, all were in severe stage. Histological staging showed direct correlation with gutkha index, it increased with increase in gutkha index with p <0.05. Site analysis showed that buccal mucosa and retromolar area were involved in all the patient and floor of mouth in 46% of patients Body mass index analysis revealed that out of 27 patients with moderate clinical staging 3 was underweight; out of 3 with severe clinical staging, 2 was underweight. Conclusion The duration and frequency of areca nut product use effects on the incidence and severity of OSMF and the patient becomes unable to eat due to burning, ulcers and inability to open mouth which affect the health of the individual. Thus it is important to access the nutritional status to improve the survival rate of patients. PMID:26557616

  13. End Stage Renal Disease: Not a Contraindication for Minor Oral Surgery-Protocol for the Management of Oral Surgery patients with ESRD on Hemodialysis.

    Science.gov (United States)

    Pendem, Sneha; Lakshmi Narayana, G; Ravi, Poornima

    2017-06-01

    To describe a safe and effective protocol for the management of patients with end stage renal disease (ESRD) undergoing minor oral surgery. A prospective cohort study was conducted on all patients with ESRD who were referred for dental consultation. A definite protocol was designed in consultation with the nephrologist to minimize the risk of bleeding and wound healing complications during and after the minor surgical procedures. 36 patients consented for the protocol to be followed while 4 patients did not comply with the protocol and in 2 cases the protocol could be followed. The intra operative, post operative bleeding, and the wound healing were assessed in these patients. 36 patients had uneventful extractions as the blood pressure was brought down to pre hypertensive stage following the protocol. 4 patients who did not comply with the protocol had episodes of bleeding in the post operative period. There were two special scenarios where additional precautions had to be taken have been discussed. The wound healing was satisfactory in all these patients. The protocol discussed in this article helps us provide safe minor oral surgical treatment in patients with ESRD.

  14. 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 oropharynx cancer. |

  15. oral

    African Journals Online (AJOL)

    Chlorhexidine 0,2% gluconate is used as a mouth rinse and is an effective antibacterial agent. Its primary side- effects are staining of the teeth and the oral mucosa, particularly the dorsal surface of the tongue. However, this is transient. It has been shown to be effective as a prophylactic agent in preventing oral candidosis in ...

  16. Oral Therapy, Microbiological Findings, and Comorbidity Influence the Outcome of Prosthetic Joint Infections Undergoing 2-Stage Exchange.

    Science.gov (United States)

    Ascione, Tiziana; Pagliano, Pasquale; Balato, Giovanni; Mariconda, Massimo; Rotondo, Renato; Esposito, Silvano

    2017-07-01

    The aim of the present study was to investigate potential predictive factors of an unfavorable outcome in patients with prosthetic joint infection (PJI) undergoing 2-stage exchange. Patients with PJI undergoing 2-stage exchange and observed over a 5-year period (2009-2013) were included. Cure was defined by the disappearance of infection after a 96-week follow-up period. Statistical analysis was performed using the Mann-Whitney U test, the Fisher exact test, and the multivariate analysis. One-hundred twenty-two patients with PJI were included (median age, 69 years [range, 36-80 years]; 48% males, 47 hip PJI, and 75 knee PJI). Known comorbidities related to an increased risk of infection were reported in 43 patients (35%). Microbiological definition was obtained in 101 (83%) patients, and Staphylococcus aureus was isolated in 44 (36%) patients. Coagulase-negative staphylococci were isolated in 41 (34%) patients. A favorable outcome was obtained in 102 of 122 patients (84%). After univariate analysis, bacterial growth from operative specimens (P = .007), growth of Gram-positive bacteria (P < .001), use of oral therapy (P = .01), and absence of known comorbidities (P = .02) were associated with favorable outcome. Administration of rifampin (P = .99) and results of blood analysis were not predictive of outcome. After multivariate analysis was applied, infection sustained by Gram-positive bacteria, administration of oral antibiotics, and absence of known comorbidities frequently resulted in favorable outcome. A favorable outcome in patients with PJI undergoing 2-stage procedure was associated with an infection sustained by Gram-positive bacteria, absence of known comorbidities, and administration of oral therapy. Therefore, failure rate can be reduced with appropriate treatment choices. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Is it time to incorporate 'depth of infiltration' in the T staging of oral tongue and floor of mouth cancer?

    Science.gov (United States)

    Piazza, Cesare; Montalto, Nausica; Paderno, Alberto; Taglietti, Valentina; Nicolai, Piero

    2014-04-01

    To summarize recent acquisitions in three-dimensional tongue and floor of mouth anatomy that can help in better evaluation of the pathways of cancer progression within these oral subsites, thus giving some hints for refining of the current TNM staging system. The Visual Human Project is an initiative aimed at establishing a three-dimensional dataset of anatomy of two cadavers made available free to the scientific community. Visual human data have been analyzed by specific software thus improving our three-dimensional understanding of the tongue myostructure. It is already known that there is limited prognostic utility in using the two-dimensional surface diameter alone as criterion for T1-T3 definition. Recently, also the T4a categorization for the infiltration of 'deep' or extrinsic tongue muscles has been criticized. This is largely because the descriptor 'deep' does not take into account the fact that considerable portions of these muscles lie in a very superficial plane. Different prognosticators have been proposed for inclusion into the TNM staging system of oral cancer but 'depth of tumor infiltration' seems to be the most robust, universally recognized, and reproducible in the preoperative, intraoperative, and postoperative settings. Oral tongue and floor of mouth cancer needs to be classified according to a revised TNM staging system in which 'depth of infiltration' should be taken into account. An 'ideal cut off' for distinguishing 'low' (T1-T2) from 'high-risk' (T3-T4) categories has been proposed based on the literature review, but needs retrospective as well as large prospective trials before its validation.

  18. Expression of CA-IX is associated with advanced stage tumors and poor survival in oral squamous cell carcinoma patients.

    Science.gov (United States)

    Pérez-Sayáns, Mario; Suárez-Peñaranda, José Manuel; Pilar, Gayoso-Diz; Supuran, Claudiu T; Pastorekova, Silvia; Barros-Angueira, Francisco; Gándara-Rey, José Manuel; García-García, Abel

    2012-10-01

    Carbonic anhydrases (CAs), a group of ubiquitously expressed metalloenzymes, are involved in numerous physiological and pathological processes, including tumorigenicity. Specifically, CA-IX has been primarily found in hypoxic tumor tissues. This is a retrospective study of tumors from the Tissue Bank of the Pathology Department of the University Hospital of Santiago de Compostela. We selected 50 oral squamous cell carcinomas (OSCCs) using Tissue Microarray (TMA) technology. The immunohistochemical study was performed to determine CA-IX expression. The resulting data were subject to statistical analysis and survival curves. Of the 50 cases, 23 were detected in early stages (I and II) and 27 in advanced stages (III and IV). In the first year, almost 50% of patients in stages III-IV died, which contrasted with those patients in initial stages who registered a survival rate of 80% (P = 0.019). Regarding the expression of CA-IX, nine cases (18%) were negative, 18 cases (36%) were moderate, while 23 cases (46%) were intense. Tumors in stages I-II showed a positivity of 52.6%; however, in advanced stages, the percentage reached 95.5% (P = 0.002). Regarding CA-IX expression and survival, patients with tumors with strong staining had a lower average survival time (13.8 months) than patients with negative or weak-moderate staining (33.4 and 32.8 months, respectively), log-rank=6.1, P value=0.0484. Early diagnosis of these tumors is essential to improve patient survival. CA-IX expression augments with increasing tumor stage, probably related with the degree of hypoxia; thus, its measurement can be used as a prognostic factor. © 2012 John Wiley & Sons A/S.

  19. Curative Radiation Therapy for T2N0M0

    International Nuclear Information System (INIS)

    Park, In Kyu; Kim, Jae Choel

    1995-01-01

    Purpose : Surgery is the treatment of choice for resectable non-small cell lung cancer. For patients who are medically unable to tolerate a surgical resection or who refuse surgery, radiation therapy is an acceptable alternative. A retrospective analysis of patients with stage I non-small cell lung cancer treated with curative radiation therapy was performed to determine the results of curative radiation therapy and patterns of failure, and to identify factors that may influence survival. Materials and Methods : From 1986 through 1993, 39 patients with T2N0M0 non-small cell lung cancer were treated with curative radiation therapy at department of radiation oncology, Kyungpook national university hospital All patients were not candidates for surgical resection because of either patient refusal (16 patients), poor pulmonary function (12 patients), old age (7 patients), poor performance (2 patients) or coexisting medical disease (2 patients). Median age of patients was 67 years. Histologic cell type was squamous cell carcinoma in 1. All patients were treated with megavoltage irradiation and radiation dose raged from 5000cGy to 6150 cGy with a median dose of 600cGy. The median follow-up was 17 months with a range of 4 to 82 months. Survival was measured from the date therapy initiated. Results : The overall survival rate for entire patients was 40.6% at 2 years and 27.7% at 3 years, with a median survival time of 21 months he disease-free survival at 2 and 3 years was 51.7% and 25.8%, respectively. Of evaluable 20 Patients with complete response, 15 Patients were considered to have failed. Of these, 13 patients showed local failure and 2 patients failed distantly. Response to treatment (p=0.0001), tumor size (p=0.0019) and age p=0.0247) were favorably associated with overall survival. Only age was predictive for disease-free survival (p=0.0452). Conclusion : Radiation therapy is an effective treatment for small (less than 3 cm) tumors, and should be offered as an

  20. HIF1-alpha overexpression indicates a good prognosis in early stage squamous cell carcinomas of the oral floor

    Directory of Open Access Journals (Sweden)

    Joos Ulrich

    2005-07-01

    Full Text Available Abstract Background Hypoxia-inducible factor 1 (HIF-1 is a transcription factor, which plays a central role in biologic processes under hypoxic conditions, especially concerning tumour angiogenesis. HIF-1α is the relevant, oxygen-dependent subunit and its overexpression has been associated with a poor prognosis in a variety of malignant tumours. Therefore, HIF-1α expression in early stage oral carcinomas was evaluated in relation to established clinico-pathological features in order to determine its value as a prognostic marker. Methods 85 patients with histologically proven surgically treated T1/2 squamous cell carcinoma (SCC of the oral floor were eligible for the study. Tumor specimens were investigated by means of tissue micro arrays (TMAs and immunohistochemistry for the expression of HIF-1. Correlations between clinical features and the expression of HIF-1 were evaluated by Kaplan-Meier curves, log-rank tests and multivariate Cox regression analysis. Results HIF-1α was frequently overexpressed in a probably non-hypoxia related fashion. The expression of HIF-1α was related with a significantly improved 5-year survival rate (p Conclusion HIF-1α overexpression is an indicator of favourable prognosis in T1 and T2 SCC of the oral floor. Node negative patients lacking HIF-1α expression may therefore be considered for adjuvant radiotherapy.

  1. HIF1-alpha overexpression indicates a good prognosis in early stage squamous cell carcinomas of the oral floor

    International Nuclear Information System (INIS)

    Fillies, Thomas; Werkmeister, Richard; Diest, Paul J van; Brandt, Burkhard; Joos, Ulrich; Buerger, Horst

    2005-01-01

    Hypoxia-inducible factor 1 (HIF-1) is a transcription factor, which plays a central role in biologic processes under hypoxic conditions, especially concerning tumour angiogenesis. HIF-1α is the relevant, oxygen-dependent subunit and its overexpression has been associated with a poor prognosis in a variety of malignant tumours. Therefore, HIF-1α expression in early stage oral carcinomas was evaluated in relation to established clinico-pathological features in order to determine its value as a prognostic marker. 85 patients with histologically proven surgically treated T1/2 squamous cell carcinoma (SCC) of the oral floor were eligible for the study. Tumor specimens were investigated by means of tissue micro arrays (TMAs) and immunohistochemistry for the expression of HIF-1. Correlations between clinical features and the expression of HIF-1 were evaluated by Kaplan-Meier curves, log-rank tests and multivariate Cox regression analysis. HIF-1α was frequently overexpressed in a probably non-hypoxia related fashion. The expression of HIF-1α was related with a significantly improved 5-year survival rate (p < 0.01) and a significantly increased disease free period (p = 0.01) independent from nodal status and tumour size. In primary node negative T1/T2 SCC of the oral floor, absence of HIF-1α expression specified a subgroup of high-risk patients (p < 0.05). HIF-1α overexpression is an indicator of favourable prognosis in T1 and T2 SCC of the oral floor. Node negative patients lacking HIF-1α expression may therefore be considered for adjuvant radiotherapy

  2. Stimuli-disassembling gold nanoclusters for diagnosis of early stage oral cancer by optical coherence tomography

    Science.gov (United States)

    Kim, Chang Soo; Ingato, Dominique; Wilder-Smith, Petra; Chen, Zhongping; Kwon, Young Jik

    2018-01-01

    A key design consideration in developing contrast agents is obtaining distinct, multiple signal changes in diseased tissue. Plasmonic gold nanoparticles (Au NPs) have been developed as contrast agents due to their strong surface plasmon resonance (SPR). This study aims to demonstrate that stimuli-responsive plasmonic Au nanoclusters (Au NCs) can be used as a contrast agent for optical coherence tomography (OCT) in detecting early-stage cancer. Au NPs were clustered via acid-cleavable linkers to synthesize Au NCs that disassemble under mildly acidic conditions into individual Au NPs, simultaneously diminishing SPR effect (quantified by scattering intensity) and increasing Brownian motion (quantified by Doppler variance). The acid-triggered morphological and accompanying optico-physical property changes of the acid-disassembling Au NCs were confirmed by TEM, DLS, UV/Vis, and OCT. Stimuli-responsive Au NCs were applied in a hamster check pouch model carrying early-stage squamous carcinoma tissue. The tissue was visualized by OCT imaging, which showed reduced scattering intensity and increased Doppler variance in the dysplastic tissue. This study demonstrates the promise of diagnosing early-stage cancer using molecularly programmable, inorganic nanomaterial-based contrast agents that are capable of generating multiple, stimuli-triggered diagnostic signals in early-stage cancer.[Figure not available: see fulltext.

  3. Oral fexinidazole for late-stage African Trypanosoma brucei gambiense trypanosomiasis: a pivotal multicentre, randomised, non-inferiority trial.

    Science.gov (United States)

    Mesu, Victor Kande Betu Ku; Kalonji, Wilfried Mutombo; Bardonneau, Clélia; Mordt, Olaf Valverde; Blesson, Séverine; Simon, François; Delhomme, Sophie; Bernhard, Sonja; Kuziena, Willy; Lubaki, Jean-Pierre Fina; Vuvu, Steven Lumeya; Ngima, Pathou Nganzobo; Mbembo, Hélène Mahenzi; Ilunga, Médard; Bonama, Augustin Kasongo; Heradi, Josué Amici; Solomo, Jean Louis Lumaliza; Mandula, Guylain; Badibabi, Lewis Kaninda; Dama, Francis Regongbenga; Lukula, Papy Kavunga; Tete, Digas Ngolo; Lumbala, Crispin; Scherrer, Bruno; Strub-Wourgaft, Nathalie; Tarral, Antoine

    2018-01-13

    Few therapeutic options are available to treat the late-stage of human African trypanosomiasis, a neglected tropical disease, caused by Trypanosoma brucei gambiense (g-HAT). The firstline treatment is a combination therapy of oral nifurtimox and intravenous eflornithine that needs to be administered in a hospital setting by trained personnel, which is not optimal given that patients often live in remote areas with few health resources. Therefore, we aimed to assess the safety and efficacy of an oral regimen of fexinidazole (a 2-substituted 5-nitroimidazole with proven trypanocidal activity) versus nifurtimox eflornithine combination therapy in patients with late-stage g-HAT. In this randomised, phase 2/3, open-label, non-inferiority trial, we recruited patients aged 15 years and older with late-stage g-HAT from g-HAT treatment centres in the Democratic Republic of the Congo (n=9) and the Central African Republic (n=1). Patients were randomly assigned (2:1) to receive either fexinidazole or nifurtimox eflornithine combination therapy according to a predefined randomisation list (block size six). The funder, data management personnel, and study statisticians were masked to treatment. Oral fexinidazole was given once a day (days 1-4: 1800 mg, days 5-10: 1200 mg). Oral nifurtimox was given three times a day (days 1-10: 15 mg/kg per day) with eflornithine twice a day as 2 h infusions (days 1-7: 400 mg/kg per day). The primary endpoint was success at 18 months (ie, deemed as patients being alive, having no evidence of trypanosomes in any body fluid, not requiring rescue medication, and having a cerebrospinal fluid white blood cell count ≤20 cells per μL). Safety was assessed through routine monitoring. Primary efficacy analysis was done in the modified intention-to-treat population and safety analyses in the intention-to-treat population. The acceptable margin for the difference in success rates was defined as 13%. This study has been completed and is registered with

  4. The hypospadias classification affected the surgical outcomes of staged oral mucosa graft urethroplasty in hypospadias reoperation: An observational study.

    Science.gov (United States)

    Zheng, Dachao; Fu, Shi; Li, Wenji; Xie, Minkai; Guo, Jianhua; Yao, Haijun; Wang, Zhong

    2017-11-01

    The staged graft urethroplasty is a recommended technique for repairing complex hypospadias. This retrospective study aimed to investigate the outcomes of this technique in hypospadias patients undergoing reoperation and to analyze the underlying contributing factors including age, meatus location, and graft and suture type.We retrospectively analyzed 40 hypospadias patients undergoing reoperation who received a staged oral graft urethroplasty, including 15 buccal mucosal grafts and 25 lingual mucosal grafts. Median age at presentation was 18.5 years, and median follow-up was 17.5 months (range 8-30 months). The patients were classified according to their original meatus location.Twenty-five complications developed in 12 of 40 (30%) cases, including 6 fistulas (15%), 7 infections (17.5%), 9 cases of glans dehiscence (22.5%), and 3 cases of stenosis (7.5%). There was no significant difference in the overall complication rates between prepuberty and postpuberty groups. In addition, no significant difference in complications was found between the 2 graft techniques. The complications were significantly higher in the original perineal type compared with the original penoscrotal type (7/10 vs 5/30, P = .0031). Seven patients who originally had perineal hypospadias developed multiple complications.Based on this study, the staged graft urethroplasty is an effective technique in reoperative hypospadias repairs with reasonable complication risk. The hypospadias classification affects the surgical outcomes. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  5. The administration of multipotent stromal cells at precancerous stage precludes tumor growth and epithelial dedifferentiation of oral squamous cell carcinoma.

    Science.gov (United States)

    Bruna, Flavia; Arango-Rodríguez, Martha; Plaza, Anita; Espinoza, Iris; Conget, Paulette

    2017-01-01

    Multipotent stromal cells (MSCs) are envisioned as a powerful therapeutic tool. As they home into tumors, secrete trophic and vasculogenic factors, and suppress immune response their role in carcinogenesis is a matter of controversy. Worldwide oral squamous cell carcinoma (OSCC) is the fifth most common epithelial cancer. Our aim was to determine whether MSC administration at precancerous stage modifies the natural progression of OSCC. OSCC was induced in Syrian hamsters by topical application of DMBA in the buccal pouch. At papilloma stage, the vehicle or 3×10 6 allogenic bone marrow-derived MSCs were locally administered. Four weeks later, the lesions were studied according to: volume, stratification (histology), proliferation (Ki-67), apoptosis (Caspase 3 cleaved), vasculature (ASMA), inflammation (Leukocyte infiltrate), differentiation (CK1 and CK4) and gene expression profile (mRNA). Tumors found in individuals that received MSCs were smaller than those presented in the vehicle group (87±80 versus 54±62mm 3 , p<0.05). The rate of proliferation was two times lower and the apoptosis was 2.5 times higher in lesions treated with MSCs than in untreated ones. While the laters presented dedifferentiated cells, the former maintained differentiated cells (cytokeratin and gene expression profile similar to normal tissue). Thus, MSC administration at papilloma stage precludes tumor growth and epithelial dedifferentiation of OSCC. Copyright © 2016. Published by Elsevier B.V.

  6. A novel tumor: specimen index for assessing adequacy of resection in early stage oral tongue cancer.

    Science.gov (United States)

    Montero, Pablo H; Palmer, Frank L; Shuman, Andrew G; Patel, Purvi D; Boyle, Jay O; Kraus, Dennis H; Morris, Luc G; Shah, Jatin P; Shaha, Ashok R; Singh, Bhuvanesh; Wong, Richard J; Ganly, Ian; Patel, Snehal G

    2014-03-01

    Surgical margin status frequently affects decisions regarding adjuvant treatment; however, reporting and interpretation of surgical margins is subject to considerable subjectivity because of many factors including the adequacy of resection. We developed a novel measure of the adequacy of surgical resection, the tumor: specimen index (TSI), and tested its utility at predicting clinical outcomes in a retrospective cohort study. An institutional database was queried to identify previously untreated patients with T1 and T2 oral tongue cancer who underwent surgery during 1985-2009 (n=433). The TSI, a geometric mean representing the percentage of the surgical specimen that is occupied by the tumor in average single dimension, was calculated from the largest measured lengths, widths, and heights of the tumor in relation to the entire surgical specimen. Multivariate analyses of locoregional recurrence-free probability (LRRFP) and disease-specific survival (DSS) were performed with commonly accepted prognosticators in addition to TSI and surgical margins status. The mean TSI was 41 (range 11-90; SD 14). Surgical margin status was associated with TSI; margins were negative in 84% of patients with TSITSI⩾45 (pTSI⩾45 was associated with worse LRRFP (57% vs. 76%, pTSI, surgical margin status independently predicted LRRFP (p=0.014) but not DSS. When TSI was included, only TSI, and not surgical margin status, was an independent predictor of both LRRFP (p=0.002) and DSS (p=0.011). The tumor: specimen index is an easily-calculated metric for estimating the adequacy of 3-dimensional resection in T1 and T2 oral tongue cancer that independently predicts oncologic outcomes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Need for intensive histopathologic analysis to determine lymph node metastases when using sentinel node biopsy in oral cancer

    DEFF Research Database (Denmark)

    Bilde, Anders; von Buchwald, Christian; Therkildsen, Marianne Hamilton

    2008-01-01

    OBJECTIVE: To determine the predictive value of sentinel node biopsy (SNB)-assisted neck dissection in patients with oral squamous cell carcinoma (SCC) stage T1 to 2N0M0 and to determine the incidence of subclinical metastases. STUDY DESIGN: Prospective cohort study. METHODS: Fifty-one patients...... feasible in identifying subclinical metastasis, thus accurately staging the neck with a high degree of sensitivity in patients with oral SCC T1 to 2N0M0 when additional histopathology was performed. The vast majority of patients in this study would have been spared selective neck dissection had reliance...... dissection in patients with oral SCC....

  8. Oral calcium carbonate affects calcium but not phosphorus balance in stage 3-4 chronic kidney disease.

    Science.gov (United States)

    Hill, Kathleen M; Martin, Berdine R; Wastney, Meryl E; McCabe, George P; Moe, Sharon M; Weaver, Connie M; Peacock, Munro

    2013-05-01

    Patients with chronic kidney disease (CKD) are given calcium carbonate to bind dietary phosphorus, reduce phosphorus retention, and prevent negative calcium balance; however, data are limited on calcium and phosphorus balance during CKD to support this. Here, we studied eight patients with stage 3 or 4 CKD (mean estimated glomerular filtration rate 36 ml/min) who received a controlled diet with or without a calcium carbonate supplement (1500 mg/day calcium) during two 3-week balance periods in a randomized placebo-controlled cross-over design. All feces and urine were collected during weeks 2 and 3 of each balance period and fasting blood, and urine was collected at baseline and at the end of each week. Calcium kinetics were determined using oral and intravenous (45)calcium. Patients were found to be in neutral calcium and phosphorus balance while on the placebo. Calcium carbonate supplementation produced positive calcium balance, did not affect phosphorus balance, and produced only a modest reduction in urine phosphorus excretion compared with placebo. Calcium kinetics demonstrated positive net bone balance but less than overall calcium balance, suggesting soft-tissue deposition. Fasting blood and urine biochemistries of calcium and phosphate homeostasis were unaffected by calcium carbonate. Thus, the positive calcium balance produced by calcium carbonate treatment within 3 weeks cautions against its use as a phosphate binder in patients with stage 3 or 4 CKD, if these findings can be extrapolated to long-term therapy.

  9. Characterization of the properties of a selective, orally bioavailable autotaxin inhibitor in preclinical models of advanced stages of liver fibrosis.

    Science.gov (United States)

    Baader, Manuel; Bretschneider, Tom; Broermann, Andre; Rippmann, Joerg F; Stierstorfer, Birgit; Kuttruff, Christian A; Mark, Michael

    2018-02-01

    Autotaxin (ATX) is a secreted phospholipase which hydrolyses lysophosphatidylcholine to generate lysophosphatidic acid (LPA). The extracellular signalling molecule LPA exerts its biological actions through activation of six GPCRs expressed in various cell types including fibroblasts. Multiple preclinical studies using knockout animals, LPA receptor antagonists or ATX inhibitors have provided evidence for a potential role of the ATX/LPA axis in tissue fibrosis. Despite growing evidence for a correlation between ATX levels and the degree of fibrosis in chronic liver diseases, including viral hepatitis and hepatocellular carcinoma, the role of ATX in non-alcoholic steatohepatitis (NASH) remains unclear. The relevance of ATX in the pathogenesis of liver fibrosis was investigated by oral administration of Ex_31, a selective ATX inhibitor, in a 10 week model of carbon tetrachloride-induced liver injury and in a 14 week model of choline-deficient amino acid-defined diet-induced liver injury in rats. Oral administration of Ex_31, a selective ATX inhibitor, at 15 mg·kg -1 twice daily in therapeutic intervention mode resulted in efficient ATX inhibition and more than 95% reduction in plasma LPA levels in both studies. Treatment with Ex_31 had no effect on biomarkers of liver function, inflammation, or fibrosis and did not result in histological improvements in diseased animals. Our findings question the role of ATX in the pathogenesis of hepatic fibrosis and the potential of small molecule ATX inhibitors for the treatment of patients with NASH and advanced stages of liver fibrosis. © 2017 The British Pharmacological Society.

  10. Leucoplasia pilosa oral: aspectos histopatológicos da fase subclínica Oral hairy leukoplakia: histopathologic features of the subclinical stage

    Directory of Open Access Journals (Sweden)

    Eliane Pedra DIAS

    2001-06-01

    Full Text Available A leucoplasia pilosa oral (LPO é uma das manifestações orais mais comuns na AIDS, com valor diagnóstico e prognóstico. A LPO está relacionada ao Epstein-Barr vírus (EBV, com características clínicas e histopatológicas definidas. Já existem relatos de uma fase subclínica da LPO, porém sem caracterização histopatológica. O presente trabalho teve por objetivo descrever os aspectos histopatológicos desta fase, bem como realizar uma análise comparativa entre a LPO subclínica e clínica, com a finalidade de verificar a suficiência diagnóstica dos critérios histopatológicos. Trata-se de um estudo retrospectivo de 11 casos, obtidos a partir de cinco biópsias realizadas em pacientes com lesão e da borda de seis línguas sem lesão macroscopicamente detectável, provenientes de necropsias. Foram utilizados os seguintes métodos: histopatologia, imuno-histoquímica e hibridização in situ. Os aspectos histopatológicos que caracterizaram a fase subclínica da LPO foram: ausência de paraceratose e papilomatose, acantose leve, presença de células claras e alterações nucleares (inclusão tipo Cowdry A, núcleo em "vidro fosco" e núcleo "em colar". Houve identificação do EBV através da hibridização in situ e da imuno-histoquímica nas alterações nucleares observadas na histopatologia. Concluiu-se, com fundamentos na identificação do EBV nas alterações nucleares, que a LPO em sua fase subclínica, da mesma forma que na lesão clínica, apresenta características histopatológicas específicas e suficientes para um diagnóstico definitivo, independentemente da identificação do EBV.Oral hairy leukoplakia (OHL is one of the most common oral manifestations of AIDS, with diagnostic and prognostic value. OHL is associated to the Epstein-Barr virus and presents clinical and histological defined characteristics. There have already been reports about a subclinical stage of OHL, although they lacked histopathologic

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

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  12. Oral cancer trends in a single head-and-neck cancer center in the Netherlands; decline in T-stage at the time of admission

    NARCIS (Netherlands)

    Weijers, M.; Leemans, C.R.; Aartman, I.H.; Karagozoglu, K.H.; van der Waal, I.

    2011-01-01

    OBJECTIVES: In this study we evaluated the possible epidemiologic changes of oral cancer patients in the Netherlands between the years 1980-1984 and 2000-2004. We specifically studied the differences in male-female ratio, age, TNM-stage, site distribution, and alcohol and tobacco use. MATERIALS AND

  13. Explanation of the JET n=0 chirping mode

    International Nuclear Information System (INIS)

    Berk, H.L.; Boswell, C.J.; Borba, D.; Figueiredo, A.C.A.; Nave, M.F.F.; Johnson, T.; Pinches, S.D.; Sharapov, S.E.

    2006-01-01

    Persistent rapid up and down frequency chirping modes with a toroidal mode number of zero (n=0) are observed in the JET tokomak when energetic ions, in the range of several hundred keV, are created by high field side ion cyclotron resonance frequency heating. Fokker-Planck calculations demonstrate that the heating method enables the formation of an energetically inverted ion distribution which supplies the free energy for the ions to excite a mode related to the geodesic acoustic mode (GAM). The large frequency shifts of this mode are attributed to the formation of phase space structures whose frequencies, which are locked to an ion orbit bounce resonance frequency, are forced to continually shift so that energetic particle energy can be released to counterbalance the energy dissipation present in the background plasma. (author)

  14. Definitive radiation therapy for clinical stage N0-N1 epidermoid carcinoma of the lung

    International Nuclear Information System (INIS)

    Hayakawa, Kazushige; Mitsuhashi, Norio; Saito, Yoshihiro; Yamakawa, Michitaka; Nakayama, Yuko; Katano, Susumu; Furuta, Masaya; Niibe, Hideo

    1993-01-01

    From 1976 through 1989, 94 patients with epidermoid carcinoma of the lung without mediastinal nodal involvement were treated with definitive radiation therapy (RT) at Gunma University Hospital. All patients were treated with 10 MV X-rays and the mediastinum was treated in 86% of the patients. The total dose ranged from 60 Gy to 80 Gy with once-daily conventional fractionation. The actuarial two and five-year survival rates of the entire group were 44% and 22%, respectively, with a median survival time (MST) of 17 months. Patients with a performance status of 0-1 lived longer than those with a status of 2 or more (MST 22.5 vs. 12 months). The survival of 60 patients with T2 tumors was better than that of 24 patients with T3 tumors (MST 19 vs. 13.5 months). Forty-seven patients with tumors less than 5 cm in diameter had a two-year progression rate of 25%, in comparison with 39% for 47 patients with tumors greater than 5 cm. The survival difference between these two groups was statistically significant (p<0.01). Patients given a total dose of 80 Gy or over had only 20% local progression at the time of the last follow-up, but they had a lower long-term survival rate than those given a total dose of 60-74 Gy because of the development of pulmonary insufficiency after high-dose irradiation. There was no relapse in the field given 40 Gy or more to the mediastinum for prophylaxis in the patients with no evidence of primary progression. The actuarial five-year survival rates for the patients given 40 Gy or more to the mediastinum, and for the patients given less than 40 Gy were 32% and 9%, respectively. These was a statistically significant difference between these two survival curves, (p<0.05). Differences in survival did not depend on age, sex, or location of the primary tumor. These results should provide support for definitive RT to manage patients with medically inoperable or unresectable epidermoid carcinoma of the lung without mediastinal nodal involvement. (author)

  15. Oral calcium carbonate affects calcium but not phosphorus balance in stage 3–4 chronic kidney disease

    Science.gov (United States)

    Hill, Kathleen M.; Martin, Berdine R.; Wastney, Meryl; McCabe, George P.; Moe, Sharon M.; Weaver, Connie M.; Peacock, Munro

    2014-01-01

    Chronic kidney disease (CKD) patients are given calcium carbonate to bind dietary phosphorus and reduce phosphorus retention, and to prevent negative calcium balance. Data are limited on calcium and phosphorus balance in CKD to support this. The aim of this study was to determine calcium and phosphorus balance and calcium kinetics with and without calcium carbonate in CKD patients. Eight stage 3/4 CKD patients, eGFR 36 mL/min, participated in two 3-week balances in a randomized placebo-controlled cross-over study of calcium carbonate (1500 mg/d calcium). Calcium and phosphorus balance were determined on a controlled diet. Oral and intravenous 45calcium with blood sampling and urine and fecal collections were used for calcium kinetics. Fasting blood and urine were collected at baseline and end of each week of each balance period for biochemical analyses. Results showed that patients were in neutral calcium and phosphorus balance while on placebo. Calcium carbonate produced positive calcium balance, did not affect phosphorus balance, and produced only a modest reduction in urine phosphorus excretion compared with placebo. Calcium kinetics demonstrated positive net bone balance but less than overall calcium balance suggesting tissue deposition. Fasting biochemistries of calcium and phosphate homeostasis were unaffected by calcium carbonate. If they can be extrapolated to effects of chronic therapy, these data caution against the use of calcium carbonate as a phosphate binder. PMID:23254903

  16. Lanthanum carbonate oral powder: satisfaction, preference and adherence in French and Spanish patients with end-stage renal disease

    Directory of Open Access Journals (Sweden)

    Michael Keith

    2016-10-01

    Full Text Available Background: Phosphate binders, such as lanthanum carbonate, control elevated serum-phosphate levels in patients with end-stage renal disease (ESRD. Lanthanum carbonate is available in oral powder and tablet form. The aim of this survey was to investigate satisfaction with, preference for, and adherence to lanthanum carbonate oral powder in patients with ESRD. Scope: Patients from France and Spain who had been taking lanthanum carbonate powder for at least 4 weeks, and who had experience of other phosphate binders of any formulation, were asked to complete an online or telephone survey. Treatment satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication-9; preference was measured using 5-point Likert scale agreement ratings; and adherence was measured using the Morisky Medication Adherence Scale-4. Data were evaluated using bivariate analyses. Findings: Overall, 160 patients participated (80 per country. Lanthanum carbonate powder was reported to have a higher effectiveness rating (p<0.05, be more convenient (p<0.05, and provide a higher level of satisfaction (p<0.01 than previous binders. There was an overall preference for lanthanum carbonate powder over previous binders of any formulation (p<0.001. Adherence to medication was similar for all binders analysed: 66.3% of French patients adhered to lanthanum carbonate powder, and 65.0% adhered to previous binder treatment (p=not significant; 52.5% of Spanish patients adhered to lanthanum carbonate powder, and 56.3% adhered to previous binder treatment (p=not significant. Limitations: The survey enrolled patients who had already experienced phosphate binders before the study began. Information on patient preferences for and adherence to previous phosphate binders was therefore based on the patients’ memories of these experiences, which may have been subject to change over time. Although most participants completed the online survey in this study, a telephone survey

  17. A phase I study of postoperative concurrent radiotherapy and oral doxifluridine and leucovorin for II/III stage rectal cancer

    International Nuclear Information System (INIS)

    Jin Jing; Li Yexiong; Tang Yuan; Wang Weihu; Wang Shulian; Song Yongwen; Liu Yueping; Yu Zihao; Liu Xinfan

    2008-01-01

    Objective: A phase I study was conducted to determine the maximal tolerated dose (MTD) and the dose-limiting toxicity (DLT) of chemotherapy of oral doxifluridine (5-dFUR) and leucovorin with concurrent standard radiotherapy(RT) as adjuvant treatment in patients with rectal cancer. Methods: Patients aged 18-75 years old, Kamofsky scored ≥70%, stage II/III rectal cancer after curative surgery were eligible. Total RT dose was delivered as DT 50 Gy in the fraction of 2.0 Gy per day for 5 weeks to the pelvic area. 5-dFUR was administered concurrently with radiotherapy in escalating doses, and oral leucovorin was administered in a fixed dose of 30 mg/(m 2 ·d), both 3 times daily, from the 1 st day of RT to the last day. The DLTs included grade 3 or grade 4 hematologic and nonhematologie toxicity. Results: From Aug. 2005 to Mar. 2007, 16 patients were enrolled at the following dose levels: 450 mg/(m 2 ·d) (3 patients), 550 mg/(m 2 ·d) (6 patients) and 650 mg/(m 2 ·d) (7 patients). Diarrhea, neutropenia and nausea/vomit were the most common side effects although all neutropenia was less grade 3. The DLT was observed in 1 patient at 550 mg/(m 2 ·d) (grade 4 diarrhea), but none in the following 3 patients at the same dose level. At 650 mg/(m 2 ·d) level, the first patient quitted the study due to a severe abdominal cramp pain in the 3rd week of RT. In the following 3 enrolled patients, one suffered grade 3 abdominal cramp pain, diarrhea, fatigue, nausea/vomit and grade 2 neutropenia and fever. Grade 3 diarrhea was also observed in all the additional 3 patients at 650 mg/(m 2 ·d) dose level. So the dose escalation was ended up to 650 mg/(m 2 ·d). Four of 16 patients didn't complete the scheduled concurrent chemoradiotherapy due to severe side effects, including 1 at 550 mg/(m 2 ·d) dose level, and 3 at 650 mg/(m 2 ·d). The DLTs were observed as grade 3/4 diarrhea, grade 3 abdominal cramp pain, fatigue and nausea/vomit. Conclusions: Diarrhea is the most common and

  18. Chemotherapy of second stage human African trypanosomiasis: comparison between the parenteral diamidine DB829 and its oral prodrug DB868 in vervet monkeys.

    Directory of Open Access Journals (Sweden)

    John K Thuita

    2015-02-01

    Full Text Available Human African trypanosomiasis (HAT, sleeping sickness ranks among the most neglected tropical diseases based on limited availability of drugs that are safe and efficacious, particularly against the second stage (central nervous system [CNS] of infection. In response to this largely unmet need for new treatments, the Consortium for Parasitic Drug Development developed novel parenteral diamidines and corresponding oral prodrugs that have shown cure of a murine model of second stage HAT. As a rationale for selection of one of these compounds for further development, the pharmacokinetics and efficacy of intramuscular (IM active diamidine 2,5-bis(5-amidino-2-pyridylfuran (DB829; CPD-0802 and oral prodrug2,5-bis[5-(N-methoxyamidino-2-pyridyl]furan (DB868 were compared in the vervet monkey model of second stage HAT. Treatment was initiated 28 days post-infection of monkeys with T. b. rhodesiense KETRI 2537. Results showed that IM DB829 at 5 mg/kg/day for 5 consecutive days, 5 mg/kg/day every other day for 5 doses, or 2.5 mg/kg/day for 5 consecutive days cured all monkeys (5/5. Oral DB868 was less successful, with no cures (0/2 at 3 mg/kg/day for 10 days and cure rates of 1/4 at 10 mg/kg/day for 10 days and 20 mg/kg/day for 10 days; in total, only 2/10 monkeys were cured with DB868 dose regimens. The geometric mean plasma Cmax of IM DB829 at 5 mg/kg following the last of 5 doses was 25-fold greater than that after 10 daily oral doses of DB868 at 20 mg/kg. These data suggest that the active diamidine DB829, administered IM, should be considered for further development as a potential new treatment for second stage HAT.

  19. Chemotherapy of Second Stage Human African Trypanosomiasis: Comparison between the Parenteral Diamidine DB829 and Its Oral Prodrug DB868 in Vervet Monkeys

    Science.gov (United States)

    Thuita, John K.; Wolf, Kristina K.; Murilla, Grace A.; Bridges, Arlene S.; Boykin, David W.; Mutuku, James N.; Liu, Qiang; Jones, Susan K.; Gem, Charles O.; Ching, Shelley; Tidwell, Richard R.; Wang, Michael Z.; Paine, Mary F.; Brun, Reto

    2015-01-01

    Human African trypanosomiasis (HAT, sleeping sickness) ranks among the most neglected tropical diseases based on limited availability of drugs that are safe and efficacious, particularly against the second stage (central nervous system [CNS]) of infection. In response to this largely unmet need for new treatments, the Consortium for Parasitic Drug Development developed novel parenteral diamidines and corresponding oral prodrugs that have shown cure of a murine model of second stage HAT. As a rationale for selection of one of these compounds for further development, the pharmacokinetics and efficacy of intramuscular (IM) active diamidine 2,5-bis(5-amidino-2-pyridyl)furan (DB829; CPD-0802) and oral prodrug2,5-bis[5-(N-methoxyamidino)-2-pyridyl]furan (DB868) were compared in the vervet monkey model of second stage HAT. Treatment was initiated 28 days post-infection of monkeys with T. b. rhodesiense KETRI 2537. Results showed that IM DB829 at 5 mg/kg/day for 5 consecutive days, 5 mg/kg/day every other day for 5 doses, or 2.5 mg/kg/day for 5 consecutive days cured all monkeys (5/5). Oral DB868 was less successful, with no cures (0/2) at 3 mg/kg/day for 10 days and cure rates of 1/4 at 10 mg/kg/day for 10 days and 20 mg/kg/day for 10 days; in total, only 2/10 monkeys were cured with DB868 dose regimens. The geometric mean plasma Cmax of IM DB829 at 5 mg/kg following the last of 5 doses was 25-fold greater than that after 10 daily oral doses of DB868 at 20 mg/kg. These data suggest that the active diamidine DB829, administered IM, should be considered for further development as a potential new treatment for second stage HAT. PMID:25654243

  20. Chemotherapy of second stage human African trypanosomiasis: comparison between the parenteral diamidine DB829 and its oral prodrug DB868 in vervet monkeys.

    Science.gov (United States)

    Thuita, John K; Wolf, Kristina K; Murilla, Grace A; Bridges, Arlene S; Boykin, David W; Mutuku, James N; Liu, Qiang; Jones, Susan K; Gem, Charles O; Ching, Shelley; Tidwell, Richard R; Wang, Michael Z; Paine, Mary F; Brun, Reto

    2015-02-01

    Human African trypanosomiasis (HAT, sleeping sickness) ranks among the most neglected tropical diseases based on limited availability of drugs that are safe and efficacious, particularly against the second stage (central nervous system [CNS]) of infection. In response to this largely unmet need for new treatments, the Consortium for Parasitic Drug Development developed novel parenteral diamidines and corresponding oral prodrugs that have shown cure of a murine model of second stage HAT. As a rationale for selection of one of these compounds for further development, the pharmacokinetics and efficacy of intramuscular (IM) active diamidine 2,5-bis(5-amidino-2-pyridyl)furan (DB829; CPD-0802) and oral prodrug2,5-bis[5-(N-methoxyamidino)-2-pyridyl]furan (DB868) were compared in the vervet monkey model of second stage HAT. Treatment was initiated 28 days post-infection of monkeys with T. b. rhodesiense KETRI 2537. Results showed that IM DB829 at 5 mg/kg/day for 5 consecutive days, 5 mg/kg/day every other day for 5 doses, or 2.5 mg/kg/day for 5 consecutive days cured all monkeys (5/5). Oral DB868 was less successful, with no cures (0/2) at 3 mg/kg/day for 10 days and cure rates of 1/4 at 10 mg/kg/day for 10 days and 20 mg/kg/day for 10 days; in total, only 2/10 monkeys were cured with DB868 dose regimens. The geometric mean plasma Cmax of IM DB829 at 5 mg/kg following the last of 5 doses was 25-fold greater than that after 10 daily oral doses of DB868 at 20 mg/kg. These data suggest that the active diamidine DB829, administered IM, should be considered for further development as a potential new treatment for second stage HAT.

  1. 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

  2. Comparative study: Oral mucosal lesions, signs and symptoms in diabetes mellitus patients with end stage renal disease with analogous findings in diabetes mellitus patients with non-end stage renal disease

    Directory of Open Access Journals (Sweden)

    Balasubramani Senthil

    2017-01-01

    Full Text Available Aim: The aim of this study is to compare oral signs, symptoms and oral lesions type and prevalence, in end stage renal disease (ESRD with non-end stage renal disease (NESRD in diabetes mellitus (DM patients. Methodology: Two groups of DM patients were studied, Group 1 includes 100 patients with ESRD, who were under hemodialysis therapy, and Group 2 includes100 patients with NESRD whose serum creatinine level is <2.0 mg/dl. The DM status and other laboratory investigations were recorded, with the patients consent and thorough oral examination was performed and the findings were recorded. All the data were entered into Microsoft Excel sheets. Statistical analysis including Pearson's correlation analysis, Chi-square test, and t-test were done using SPSS software SYSTAT version 7.0. Results: On thorough clinical examination, the prevalence of oral lesions was found to be higher in ESRD patients. The most common lesions such as saburral tongue (P ≤ 0.002, petechiae/ecchymoses (P ≤ 0.000, pale mucosa (P ≤ 0.000, stomatitis medicamentosa (P ≤ 0.043 fissured tongue, smooth tongue, candidiasis, dry and fissured lips, angular cheilitis, uremic stomatitis, signs such as uremic fetor (P ≤ 0.000, xerostomia and symptoms like burning tongue, unpleasant taste are noted. Conclusion: The high prevalence of uremic fetor, saburral tongue, pale mucosa, and petechiae/ecchymoses in ESRD patient group can be considered as a possible sign of undiagnosed advanced stage of renal disease in other diabetic patients.

  3. Prevalence and early detection of oral fungal infection: a cross-sectional controlled study in a group of Swedish end-stage renal disease patients.

    Science.gov (United States)

    Thorman, Royne; Neovius, Martin; Hylander, Britta

    2009-01-01

    Early detection and treatment of local oral fungal infection (OFI) minimize the risk of overgrowth and more serious complications such as invasive infections. Generalized fungal infection increases both morbidity and mortality in end-stage renal disease (ESRD) patients. This study reports the prevalence of ongoing OFI in patients with ESRD and presents correlations with dental microbial plaque formation and mouth dryness. It also describes how oral fungal growth correlates with oral lesions associated with fungal infection. From March 2007 to October 2008, 93 ESRD patients and 45 age- and gender-matched controls were consecutively asked to participate in the study. In total, 34 patients were treated with peritoneal dialysis (PD) and 59 with haemodialysis (HD). OFI was diagnosed by taking two smear layers from the buccal mucosa. The samples from each side of the mouth were stained with the periodic acid Schiff (PAS) method. The associations between histological findings, age, gender, type of dialysis treatment, tobacco habits, self-experienced mouth dryness, taste disturbances, dental plaque and gingivitis were investigated. The presence of erythematous oral stomatitis, membranous candidiasis and angular cheilitis was noted to clarify how the presence of fungal hyphae correlate with oral lesions associated with OFI. OFI was found in 32% of the ESRD patients and 11% of the controls (p=0.007). An extensive OFI, defined as frequent fungal hyphae formations in oral mucosal smear layers, was found in 3% of the PD and 17% of the HD patients. Oral lesions, defined as clinical signs associated with OFI such as erythematous oral stomatitis, membranous candidiasis or angular cheilitis, were found in 37% of the patients with OFI, while 5% of the patients without findings of fungal infection presented oral lesions associated with OFI (p=0.0002). Furthermore, patients with self-reported mouth dryness were three times more likely (p=0.02) to be diagnosed with OFI. ESRD patients

  4. Comparison of health-related quality of life of patients with different precancer and oral cancer stages.

    Science.gov (United States)

    Rana, Majeed; Gellrich, Nils-Claudius; Rana, Madiha

    2015-03-01

    Health-related quality of life (HR-QoL) informations are becoming an important tool for the treatment concept for cancer patients. The purpose of this study was to evaluate how the quality of life depends on the disease severity of pre- and oral cancer patients and which factors influence their quality of life. During this study, 106 patients with a premalignant oral lesion, 174 patients with oral squamous cell carcinoma (OSSC) as well as 21 patients with a recurrence of OSSC were asked about their oral health-related quality of life. Additionally, the UW-QOLv4 was used to record the psychological and clinical symptoms from which the patients of the three groups are suffering. Significant differences with respect to oral HR-QoL of life between the groups could be evaluated. Patients with a recurrence have the lowest and patients with precancer the highest HR-QoL. Within the groups, there is a difference regarding the significance of the psychological factors. The lowest values were achieved for mood within all three groups. Anxiety is of key importance for the precancer group whereas appearance and activity are of importance for the patients having a tumor. The patients of the recurrence group are heavily affected by all factors. The quality of life differs depending on the disease. The patients of the recurrence group have the lowest oral health-related quality of life for all aspects analyzed, and they are suffering the most with respect to the psychological dimensions of the UW-QOLv4. The present study examined the quality of life depending on the severity of the disease of pre- and oral cancer patients and which factors significantly influenced their quality of life. The evaluated findings of relevant variables may have therapeutic relevance for the multidisciplinary treatment of oral cancer patients in the future.

  5. Can neck irradiation be an alternative to neck dissection in early stage carcinoma oral tongue operated for primary alone? Experience from a single institute

    Directory of Open Access Journals (Sweden)

    Sushmita Ghoshal

    2016-07-01

    Full Text Available Purpose: To study pattern of failure, locoregional control rates (LCR and disease free survival (DFS in post-operative patients of carcinoma oral tongue, and to study the impact of nodal dissection on DFS in stage I and II patients.Methods: 102 patients of carcinoma oral tongue treated between January 2009 and December 2013 were analyzed. All patients were operated for primary disease, but neck dissection was done in 78 (76.5% patients only. However, radiation to primary site along with neck region was received by all patients. Pattern of failure, LCR and DFS were estimated.Results: At median follow up of 12 months, 10.8% patients failed locally, 10.8% in nodal region, 2.9% both at local and nodal site, and 5.9% patients failed distally. 2 year LCR and DFS was 71.2%, 90.9%, 79.5%, 0% and 55.2%, 64.4%, 57.8%, 0% in stage I, II, III, IV respectively. 2 year DFS in stage I patients, who underwent nodal dissection and post-operative radiation (14 patients was 64.3% and in whom only neck irradiation was done (15 patients, it was 45.8%, however difference was not significant (p = 0.5. But in stage II patients, 33 patients who underwent nodal dissection and post-operative radiation, 2 year DFS was 85.4% and it was 21.4% in 7 patients who underwent neck radiation only, and difference showed trend towards significance (p = 0.05. 2 or more positive lymph nodes post dissection was the only poor prognostic factor that correlated with DFS (p = 0.02Conclusion: While in stage I, neck irradiation alone can be a possible alternative to neck dissection and post-operative radiation; for stage II, neck dissection is mandatory.

  6. A comparative study on efficacy of different treatment modalities of oral submucous fibrosis evaluated by clinical staging in population of Southern Rajasthan

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    Saurabh Goel

    2015-01-01

    Full Text Available Aim: To compare the efficacy of oral lycopene and injection betamethasone with control group in the management of oral submucous fibrosis. Materials and Methods: A hospital based longitudinal study, conducted on 270 patients over a period of 2 years (September 2010-September 2012. Results: Out of 270 cases 223 (82.59% were males and 47 (17.40% were females which showed a male predominance and the ratio was 5:1. In stage I it was found that both the test groups, i.e., injection betamethasone and capsule lycopene had a significant improvement in mouth opening than control group. In stage II, it was found that the test group injection betamethasone showed 24 better results as compared to capsule lycopene this could be because of better accessibility of the fibrotic bands for injecting betamethasone solution at the site of the lesion and showed highly significant difference (P < 0.0001. In stage III, it was found that the capsule lycopene showed better results as compared to injection betamethasone and the difference was highly significant (P < 0.0001. This could be because of restricted mouth opening and inability to reach the site for injecting betamethasone solution. Conclusion: It is evident from the study that capsule lycopene and injection betamethasone hold good promise in the treatment of this multifactorial crippling disease.

  7. Predictive Value of Epidermal Growth Factor (EGF andLaminin-5 for Clinicopathologic Oral squamous Cell Carcinoma (OSCC Staging and Grading in Lranian Population

    Directory of Open Access Journals (Sweden)

    Shima Nafarzadeh

    2010-11-01

    Full Text Available Background:Squamous cell carcinoma (SCC constitutes the main oral malignancy.Parallel to better understanding of molecular and genetic patterns of tumor behavior, more precise correlation of tumor markers such as Epidermal Growth Factor (EGF and Laminin-5 are sought to estimate macroscopic and microscopic tumor status.Methods:We conducted a cross-sectional study collecting oral SCC samples during 2006-2007 from Pathology Department of Shahid Beheshti Dental School. Mmunohistochemical staining with antibodies against EGFR and laminin-5 along with staining degree were reported by two experienced pathologist including degree of staining (low, medium , high, and pathological grading and clinical staging obtained from medical records .   Results: Forty two patients' paraffin blocks of SCC examined with mean age 58( 18.72 yrs ranged between 21-88, female to male ratio of 1.33:1 was observed. The study analyses revealed a significant correlation between the expression of laminin-5 with tumor stage and grade (P< 0.001 r=0.547 and r=0.545 respectively, yet no significant correlation between expression of EGFR and tumor stage or grade (P=0.894 r=-0.018 and P=0.543 r=0.86 respectively. Considering high degree of staining and stage IV; sensitivity, specifity ,positive predictive value (PPV and negative predictive value (NPVof 44%, 54%, 44% and 78% calculated for ERGF and 55%, 78%,58% and 86% for laminin-5 respectively.Considering high degree of staining and grade 3;sensitivity,specifity,positive predictive value (PPV and negative predictive value (NPV of 57%, 57%,17% and 86% calculated for EGFR and 85%, %82, 50% and 96% for Laminin-5 espectively.Conclusion: We concluded that laminin-5 has a better prediction for developing higher tumor stage or grade but further research needed for identifying the precise role of EGFR.

  8. Pharmacology of DB844, an orally active aza analogue of pafuramidine, in a monkey model of second stage human African trypanosomiasis.

    Directory of Open Access Journals (Sweden)

    John K Thuita

    Full Text Available Novel drugs to treat human African trypanosomiasis (HAT are still urgently needed despite the recent addition of nifurtimox-eflornithine combination therapy (NECT to WHO Model Lists of Essential Medicines against second stage HAT, where parasites have invaded the central nervous system (CNS. The pharmacology of a potential orally available lead compound, N-methoxy-6-{5-[4-(N-methoxyamidino phenyl]-furan-2-yl}-nicotinamidine (DB844, was evaluated in a vervet monkey model of second stage HAT, following promising results in mice. DB844 was administered orally to vervet monkeys, beginning 28 days post infection (DPI with Trypanosoma brucei rhodesiense KETRI 2537. DB844 was absorbed and converted to the active metabolite 6-[5-(4-phenylamidinophenyl-furanyl-2-yl]-nicotinamide (DB820, exhibiting plasma C(max values of 430 and 190 nM for DB844 and DB820, respectively, after the 14th dose at 6 mg/kg qd. A 100-fold reduction in blood trypanosome counts was observed within 24 h of the third dose and, at the end of treatment evaluation performed four days post the last drug dose, trypanosomes were not detected in the blood or cerebrospinal fluid of any monkey. However, some animals relapsed during the 300 days of post treatment monitoring, resulting in a cure rate of 3/8 (37.5% and 3/7 (42.9% for the 5 mg/kg×10 days and the 6 mg/kg×14 days dose regimens respectively. These DB844 efficacy data were an improvement compared with pentamidine and pafuramidine both of which were previously shown to be non-curative in this model of CNS stage HAT. These data show that synthesis of novel diamidines with improved activity against CNS-stage HAT was possible.

  9. Pharmacology of DB844, an Orally Active aza Analogue of Pafuramidine, in a Monkey Model of Second Stage Human African Trypanosomiasis

    Science.gov (United States)

    Thuita, John K.; Wang, Michael Z.; Kagira, John M.; Denton, Cathrine L.; Paine, Mary F.; Mdachi, Raymond E.; Murilla, Grace A.; Ching, Shelley; Boykin, David W.; Tidwell, Richard R.; Hall, James E.; Brun, Reto

    2012-01-01

    Novel drugs to treat human African trypanosomiasis (HAT) are still urgently needed despite the recent addition of nifurtimox-eflornithine combination therapy (NECT) to WHO Model Lists of Essential Medicines against second stage HAT, where parasites have invaded the central nervous system (CNS). The pharmacology of a potential orally available lead compound, N-methoxy-6-{5-[4-(N-methoxyamidino) phenyl]-furan-2-yl}-nicotinamidine (DB844), was evaluated in a vervet monkey model of second stage HAT, following promising results in mice. DB844 was administered orally to vervet monkeys, beginning 28 days post infection (DPI) with Trypanosoma brucei rhodesiense KETRI 2537. DB844 was absorbed and converted to the active metabolite 6-[5-(4-phenylamidinophenyl)-furanyl-2-yl]-nicotinamide (DB820), exhibiting plasma Cmax values of 430 and 190 nM for DB844 and DB820, respectively, after the 14th dose at 6 mg/kg qd. A 100-fold reduction in blood trypanosome counts was observed within 24 h of the third dose and, at the end of treatment evaluation performed four days post the last drug dose, trypanosomes were not detected in the blood or cerebrospinal fluid of any monkey. However, some animals relapsed during the 300 days of post treatment monitoring, resulting in a cure rate of 3/8 (37.5%) and 3/7 (42.9%) for the 5 mg/kg×10 days and the 6 mg/kg×14 days dose regimens respectively. These DB844 efficacy data were an improvement compared with pentamidine and pafuramidine both of which were previously shown to be non-curative in this model of CNS stage HAT. These data show that synthesis of novel diamidines with improved activity against CNS-stage HAT was possible. PMID:22848769

  10. Role of prophylactic central neck dissection in cN0 papillary thyroid cancer

    Science.gov (United States)

    Costa, S; Giugliano, G; Santoro, L; Ywata De Carvalho, A; Massaro, MA; Gibelli, B; De Fiori, E; Grosso, E; Ansarin, M; Calabrese, L

    2009-01-01

    Summary Prophylactic central neck dissection in papillary thyroid cancer is controversial. In this retrospective cohort study, the aim was to assess possible advantages of prophylactic central neck dissection with total thyroidectomy in cN0 papillary thyroid cancer. A total of 244 consecutive patients with papillary thyroid cancer, without clinical and ultrasound nodal metastases (cN0), were evaluated out of 1373 patients operated for a thyroid disease at the Istituto Europeo di Oncologia, Milan, Italy from 1994 to 2006. Of these 244 patients, 126 (Group A) underwent thyroidectomy with central neck dissection, while 118 (Group B) underwent thyroidectomy alone. Demographic, clinical and pathological features were analysed. Overall recurrence rate was 6.3% (8/126) in Group A and 7.7% (9/118) in Group B, with a mean follow-up of 47 (Group A) and 64 (Group B) months. In Group A patients, 47% were pN1a and all patients with recurrence had nodal involvement (p = 0.002). Survival rate did not differ in the two groups. Nine patients were lost to follow-up. Group A patients were older and their tumours were larger in size; according to the pT distribution, a higher extra-capsular invasion rate was observed. The two groups were equivalent as far as concerns histological high risk variants and multifocality. Nodal metastases correlated with stage: pT1-2 vs. pT3-T4a, p = 0.0036. A lower risk of nodal metastases was related to thyroiditis (p = 0.0034). In conclusion, central neck metastases were predictive of recurrence without influencing prognosis. From data obtained, possible greatest efficacy of central neck dissection in pT3-4 papillary thyroid cancer without thyroiditis is suggested. PMID:20111614

  11. Tumor budding is a strong and reproducible prognostic marker in T3N0 colorectal cancer.

    LENUS (Irish Health Repository)

    Wang, Lai Mun

    2012-02-01

    BACKGROUND: Tumor budding along the advancing front of colorectal adenocarcinoma is an early event in the metastatic process. A reproducible, prognostic budding scoring system based on outcomes in early stage colorectal cancer has not been established. DESIGN: One hundred twenty-eight T3N0M0 colorectal carcinoma patients with known outcome were identified. Tumor budding was defined as isolated tumor cells or clusters of <5 cells at the invasive tumor front. Tumor bud counts were generated in 5 regions at 200x by 2 pathologists (conventional bud count method). The median bud count per case was used to divide cases into low (median=0) and high budding (median > or =1) groups. Forty cases were reevaluated to assess reproducibility using the conventional and a novel rapid bud count method. RESULTS: Fifty-seven (45%) carcinomas had high and 71 (55%) had low budding scores. High budding was associated with an infiltrative growth pattern (P<0.0001) and lymphovascular invasion (P=0.005). Five-year cancer-specific survival was significantly poorer in high compared with low budding groups: 63% versus 91%, respectively, P<0.0001. Multivariate analysis demonstrated tumor budding to be independently prognostic (hazard ratio=4.76, P<0.001). Interobserver agreement was at least equivalent comparing the conventional to the rapid bud count methods: 87.5% agreement (kappa=0.75) versus 92.5% agreement (kappa=0.85), respectively. CONCLUSIONS: Tumor budding is a strong, reproducible, and independent prognostic marker of outcome that is easily assessed on hematoxylin and eosin slides. This may be useful for identifying the subset of T3N0M0 patients at high risk of recurrence who may benefit from adjuvant therapy.

  12. Oral Anticoagulants to Prevent Stroke in Nonvalvular Atrial Fibrillation in Patients With CKD Stage 5D: An NKF-KDOQI Controversies Report.

    Science.gov (United States)

    Bansal, Vinod K; Herzog, Charles A; Sarnak, Mark J; Choi, Michael J; Mehta, Ravindra; Jaar, Bernard G; Rocco, Michael V; Kramer, Holly

    2017-12-01

    Stroke risk may be more than 3-fold higher among patients with chronic kidney disease stage 5D (CKD-5D) compared to the general population, with the highest stroke rates noted among those 85 years and older. Atrial fibrillation (AF), a strong risk factor for stroke, is the most common arrhythmia and affects >7% of the population with CKD-5D. Warfarin use is widely acknowledged as an important intervention for stroke prevention with nonvalvular AF in the general population. However, use of oral anticoagulants for stroke prevention in patients with CKD-5D and nonvalvular AF continues to be debated by the nephrology community. In this National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) controversies report, we discuss the existing observational studies that examine warfarin use and associated stroke and bleeding risks in adults with CKD-5D and AF. Non-vitamin K-dependent oral anticoagulants and their potential use for stroke prevention in patients with CKD-5D and nonvalvular AF are also discussed. Data from randomized clinical trials are urgently needed to determine the benefits and risks of oral anticoagulant use for stroke prevention in the setting of AF among patients with CKD-5D. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  13. Oral nutritional supplements containing (n-3) polyunsaturated fatty acids affect the nutritional status of patients with stage III non-small cell lung cancer during multimodality treatment.

    Science.gov (United States)

    van der Meij, Barbara S; Langius, Jacqueline A E; Smit, Egbert F; Spreeuwenberg, Marieke D; von Blomberg, B Mary E; Heijboer, Annemieke C; Paul, Marinus A; van Leeuwen, Paul A M

    2010-10-01

    Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), (n-3) fatty acids from fish oil, have immune-modulating effects and may improve nutritional status in cancer. The objective of this study was to investigate the effects of an oral nutritional supplement containing (n-3) fatty acids on nutritional status and inflammatory markers in patients with non-small cell lung cancer (NSCLC) undergoing multimodality treatment. In a double-blind experiment, 40 patients with stage III NSCLC were randomly assigned to receive 2 cans/d of a protein- and energy-dense oral nutritional supplement containing (n-3) fatty acids (2.0 g EPA + 0.9 g DHA/d) or an isocaloric control supplement. EPA in plasma phospholipids, energy intake, resting energy expenditure (REE), body weight, fat free mass (FFM), mid-upper arm circumference (MUAC), and inflammatory markers were assessed. Effects of intervention were analyzed by generalized estimating equations and expressed as regression coefficients (B). The intervention group (I) had a better weight maintenance than the control (C) group after 2 and 4 wk (B = 1.3 and 1.7 kg, respectively; P oral nutritional supplement containing (n-3) fatty acids beneficially affects nutritional status during multimodality treatment in patients with NSCLC.

  14. [A case of stage IV rectal cancer with whom EPA oral nutritional supplements could resolve cachectic condition and promote patient compliance with cancer chemotherapy].

    Science.gov (United States)

    Hamamura, Kenji; Nakaya, Maki; Nakagawa, Mio; Miyazaki, Mitsukazu; Miki, Chikao

    2011-05-01

    We report a case of a Stage IV rectal cancer patient for whom EPA oral nutritional supplements promoted treatment compliance with cancer chemotherapy by resolving a refractory cachectic condition. A 76-year-old male who developed a local re-growth of residual disease and multiple lung metastases after abdomino-perineal resection for lower rectal cancer was referred to our clinic for chemotherapy. On admission, he suffered from a loss of appetite as well as a 30% loss of usual body weight, caused by a cachectic condition with systemic inflammatory response. On starting chemotherapy, his daily diet was supplemented with EPA containing oral nutritional supplements (EPA ONS). Within 2 weeks after initiating EPA ONS treatment, the systemic inflammatory response resolved, and at the same time, body weight and the serum level of albumin increased, which allowed treatment compliance with aggressive multidrug chemotherapy. The patient gained 10 kg in body weight even after 12 months of aggressive chemotherapy, and has attained a longstanding partial remission from the disease. Although cancer cachexia is generally regarded as an end-stage irreversible pathological condition, EPA ONS may promote patient compliance with cancer chemotherapy by resolving cachectic condition, and thus may improve survival.

  15. Oral Magnesium Supplementation in Chronic Kidney Disease Stages 3 and 4: Efficacy, Safety, and Effect on Serum Calcification Propensity—A Prospective Randomized Double-Blinded Placebo-Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Iain Bressendorff

    2017-05-01

    Discussion: Oral Mg supplementation was safe and well tolerated in CKD stages 3 and 4 and improved T50, but did not increase intracellular Mg. Further studies are needed to investigate the long-term effects of Mg supplementation in CKD stage 3 and 4 and whether improvement in calcification propensity is related to clinical endpoints.

  16. A phase II study of cisplatin, oral administration of etoposide, OK-432 and radiation therapy for inoperable stage III non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Abe, Yoshinao [Hirosaki Univ., Aomori (Japan). School of Medicine; Takahashi, Jutaro; Fukuda, Hiroshi [and others

    1998-12-01

    This study was designed to evaluate the feasibility and efficiency of giving cisplatin, etoposide, and OK-432 concurrently with conventional radiotherapy (RTx) for patient`s with inoperable stage III, based on the TNM classification according to the International Union against Cancer staging system for lung cancer (1987) non-small cell lung cancer (NSCLC). From January 1992 to December 1994, 31 patients with cytologically or histologically confirmed stage III NSCLC were treated with RTx, to a total dose of 56-64 Gy, with concurrent daily oral administration of etoposide (25 mg) and cisplatin (20 mg) for 5 days during the third or fourth week from the start of RTx. The subcutaneous injection of 1 or 2 KE of OK-432, three times a week, for the duration of radiotherapy also started from the beginning of RTx. The number of eligible patients was 29 (26 men and 3 women). Their mean age was 66 years (range, 55-77 years). Six patients had an Eastern Cooperative Oncology Group performance status (PS) of 0; 15, 1; 8; 2. Three were stage IIIA, and 26, stage IIIB. Histologically, 2 had adenocarcinoma, 23, squamous cell carcinoma, and 4, large cell carcinoma. In 27 of the 29 patients, the RTx schedule was completed. There were no treatment-related deaths. Grade 4 toxicity (according to World Health Organisation criteria) leukopenia (700/{mu}l) was observed in 1 patient. The response rate was 79% and the median survival was 17 months. Survival rates at 1, 2 and 3 years were 62%, 31%, and 21%, respectively. The local failure rate was 51%. The combination of cisplatin, etoposide, and OK-432, given concurrently with conventional RTx is feasible and effective for inoperable stage III NSCLC. (author)

  17. Early-stage squamous cell carcinoma of the oropharynx: Radiotherapy vs. Trans-Oral Robotic Surgery (ORATOR) – study protocol for a randomized phase II trial

    International Nuclear Information System (INIS)

    Nichols, Anthony C; Kuruvilla, Sara; Chen, Jeff; Corsten, Martin; Odell, Michael; Eapen, Libni; Theurer, Julie; Doyle, Philip C; Wehrli, Bret; Kwan, Keith; Palma, David A; Yoo, John; Hammond, J Alex; Fung, Kevin; Winquist, Eric; Read, Nancy; Venkatesan, Varagur; MacNeil, S Danielle; Ernst, D Scott

    2013-01-01

    The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has markedly increased over the last three decades due to newly found associations with human papillomavirus (HPV) infection. Primary radiotherapy (RT) is the treatment of choice for OPSCC at most centers, and over the last decade, the addition of concurrent chemotherapy has led to a significant improvement in survival, but at the cost of increased acute and late toxicity. Transoral robotic surgery (TORS) has emerged as a promising alternative treatment, with preliminary case series demonstrating encouraging oncologic, functional, and quality of life (QOL) outcomes. However, comparisons of TORS and RT in a non-randomized fashion are susceptible to bias. The goal of this randomized phase II study is to compare QOL, functional outcomes, toxicity profiles, and survival following primary RT (± chemotherapy) vs. TORS (± adjuvant [chemo] RT) in patients with OPSCC. The target patient population comprises OPSCC patients who would be unlikely to require chemotherapy post-resection: Tumor stage T1-T2 with likely negative margins at surgery; Nodal stage N0-2, ≤3 cm in size, with no evidence of extranodal extension on imaging. Participants will be randomized in a 1:1 ratio between Arm 1 (RT ± chemotherapy) and Arm 2 (TORS ± adjuvant [chemo] RT). In Arm 1, patients with N0 disease will receive RT alone, whereas N1-2 patients will receive concurrent chemoradiation. In Arm 2, patients will undergo TORS along with selective neck dissections, which may be staged. Pathologic high-risk features will be used to determine the requirement for adjuvant radiotherapy +/- chemotherapy. The primary endpoint is QOL score using the M.D. Anderson Dysphagia Inventory (MDADI), with secondary endpoints including survival, toxicity, other QOL outcomes, and swallowing function. A sample of 68 patients is required. This study, if successful, will provide a much-needed randomized comparison of the conventional strategy of primary RT

  18. Managing oral phosphate binder medication expenditures within the Medicare bundled end-stage renal disease prospective payment system: economic implications for large U.S. dialysis organizations.

    Science.gov (United States)

    Park, Haesuk; Rascati, Karen L; Keith, Michael S

    2015-06-01

    From January 2016, payment for oral-only renal medications (including phosphate binders and cinacalcet) was expected to be included in the new Medicare bundled end-stage renal disease (ESRD) prospective payment system (PPS). The implementation of the ESRD PPS has generated concern within the nephrology community because of the potential for inadequate funding and the impact on patient quality of care. To estimate the potential economic impact of the new Medicare bundled ESRD PPS reimbursement from the perspective of a large dialysis organization in the United States. We developed an interactive budget impact model to evaluate the potential economic implications of Medicare payment changes to large dialysis organizations treating patients with ESRD who are receiving phosphate binders. In this analysis, we focused on the budget impact of the intended 2016 integration of oral renal drugs, specifically oral phosphate binders, into the PPS. We also utilized the model to explore the budgetary impact of a variety of potential shifts in phosphate binder market shares under the bundled PPS from 2013 to 2016. The base model predicts that phosphate binder costs will increase to $34.48 per dialysis session in 2016, with estimated U.S. total costs for phosphate binders of over $682 million. Based on these estimates, a projected Medicare PPS $33.44 reimbursement rate for coverage of all oral-only renal medications (i.e., phosphate binders and cinacalcet) would be insufficient to cover these costs. A potential renal drugs and services budget shortfall for large dialysis organizations of almost $346 million was projected. Our findings suggest that large dialysis organizations will be challenged to manage phosphate binder expenditures within the planned Medicare bundled rate structure. As a result, large dialysis organizations may have to make treatment choices in light of potential inadequate funding, which could have important implications for the quality of care for patients

  19. Ten-year clinico-statistical study of oral squamous cell carcinoma

    International Nuclear Information System (INIS)

    Aoki, Shinjiro; Kawabe, Ryoichi; Chikumaru, Hiroshi; Saito, Tomokatsu; Hirota, Makoto; Miyake, Tetsumi; Omura, Susumu; Fujita, Kiyohide

    2003-01-01

    This clinico-statistical study includes 232 cases of oral squamous cell carcinoma that underwent radical treatment in the Department of Oral and Maxillofacial Surgery, Yokohama City University Hospital, during the decade from 1991 to 2000. Surgery was principally adopted as the first line for treatment in 199 cases, and radiotherapy in 33 cases. The 5-year overall survival rate was 73.4%. The results according to stage were as follows: stage I, 87.5%; Stage II, 77.9%; Stage III, 63.5%; and Stage IV A, 44.7%. The primary sites were classified as follows: upper gingiva, 85.2%; tongue, 73.7%; floor of mouth, 68.9%; lower gingiva, 66.3%; buccal mucosa, 63.9%; and hard palate, 50%. For tongue cancer, the 5-year overall survival rates by stage were: Stage I, 90.8%; Stage II, 82.1%; Stage III, 40.3%; and Stage IV A, 45.7%. Statistical significance was seen between cases of Stages I and II and those of Stages III and IV A stage. For lower gingival cancer, the 5-year overall survival rates by stage were: Stage I, 90.8%; Stage II, 82.1%; Stage III, 40.3%; and Stage IV A, 45.7%. Even in Stage I lower gingival cancers had unfavorable clinical outcomes. Preventive neck dissections were performed on 52 N 0 neck patients, but clinically negative nodes however showed metastasis in 14 patients (26.9%). (author)

  20. Survival of T4aN0 and T3N+ laryngeal cancer patients: a retrospective institutional study and systematic review.

    Science.gov (United States)

    Khoueir, Nadim; Matar, Nayla; Farah, Chadi; Francis, Evana; Tabchy, Bassam; Haddad, Amine

    2015-01-01

    We aim to assess the correlation of tumor and nodal staging to survival in pT3N+ and T4aN0 laryngeal cancer with subgroup analysis within stage IVa (pT4N0 and pT3N2). Retrospective cohort study with systematic review of the literature. Hotel Dieu de France University Hospital (tertiary referral center). Laryngeal cancer patients' registries were reviewed from 1998 to 2012 selecting pT3N+ and pT4aN0 patients treated by primary total layngectomy. Overall survivals were compared using Log rank and Kaplan-Meier analysis. A systematic review was performed by 2 reviewers including all the articles reporting the outcome of these categories of patients. Online databases, including PubMed and EMBASE, were used. Reference sections of identified studies were examined for additional articles. Thirteen T3N+ patients and 19 T4aN0 patients treated by primary total laryngectomy were included. Five-year overall survival for T3N+, T3N2 and T4aN0 was respectively 33%, 32.1% and 73.7%. Due to the small sample, the difference was not significant. The systematic review revealed three articles reporting overall survival outcome for the T4N0 group and 6 articles for the T3N+. At 5years, the survival ranged from 62.5% to 73% in T4N0 and from 32.2% to 77% in T3N+. In advanced stage laryngeal cancer, T4aN0 tends toward a better survival than T3N+ especially when compared to T3N2 although they are grouped in the same TNM stage IVa. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Synaptic interactions between perifornical lateral hypothalamic area, locus coeruleus nucleus and the oral pontine reticular nucleus are implicated in the stage succession during sleep-wakefulness cycle

    Directory of Open Access Journals (Sweden)

    Angel eNunez

    2013-11-01

    Full Text Available The perifornical area in the posterior lateral hypothalamus (PeFLH has been implicated in several physiological functions including the sleep-wakefulness regulation. The PeFLH area contains several cell types including those expressing orexins (Orx; also known as hypocretins, mainly located in the PeF nucleus. The aim of the present study was to elucidate the synaptic interactions between Orx neurons located in the PeFLH area and different brainstem neurons involved in the generation of wakefulness and sleep stages such as the locus coeruleus (LC nucleus (contributing to wakefulness and the oral pontine reticular nucleus (PnO nucleus (contributing to REM sleepAnatomical data demonstrated the existence of a neuronal network involving the PeFLH area, LC and the PnO nuclei that would control the sleep-wake cycle. Electrophysiological experiments indicated that PeFLH area had an excitatory effect on LC neurons. PeFLH stimulation increased the firing rate of LC neurons and induced an activation of the EEG. The excitatory effect evoked by PeFLH stimulation in LC neurons was blocked by the injection of the Orx-1 receptor antagonist SB-334867 into the LC. Similar electrical stimulation of the PeFLH area evoked an inhibition of PnO neurons by activation of GABAergic receptors because the effect was blocked by bicuculline application into the PnO. Our data also revealed that the LC and PnO nuclei exerted a feedback control on neuronal activity of PeFLH area. Electrical stimulation of LC facilitated firing activity of PeFLH neurons by activation of catecholaminergic receptors whereas PnO stimulation inhibited PeFLH neurons by activation of GABAergic receptors. In conclusion, Orx neurons of the PeFLH area seem to be an important organizer of the wakefulness and sleep stages in order to maintain a normal succession of stages during the sleep-wakefulness cycle.

  2. Salivary mRNA markers having the potential to detect oral squamous cell carcinoma segregated from oral leukoplakia with dysplasia.

    Science.gov (United States)

    Michailidou, Evangelia; Tzimagiorgis, Georgios; Chatzopoulou, Fani; Vahtsevanos, Konstantinos; Antoniadis, Konstantinos; Kouidou, Sofia; Markopoulos, Anastasios; Antoniades, Dimitrios

    2016-08-01

    In the current study the presence of extracellular IL-1B, IL-8, OAZ and SAT mRNAs in the saliva was evaluated as a tool in the early detection of oral squamous cell carcinoma. 34 patients with primary oral squamous cell carcinoma stage T1N0M0/T2N0M0, 20 patients with oral leukoplakia and dysplasia (15 patients with mild dysplasia and 5 with severe dysplasia/in situ carcinoma) and 31 matched healthy-control subjects were included in the study. The presence of IL-1B, IL-8, OAZ and SAT mRNA was evaluated in extracellular RNA isolated from saliva samples using sequence-specific primers and real-time RT-PCR. ROC curve analysis was used to estimate the ability of the biomarkers to detect oral squamous cell carcinoma patients. The data reveal that the combination of these four biomarkers provides a good predictive probability of up to 80% (AUC=0.799, p=0.002) for patients with oral squamous cell carcinoma but not patients suffering from oral leukoplakia with dysplasia. Moreover, the combination of only the two biomarkers (SAT and IL-8) also raises a high predictive ability of 75.5% (AUC=0.755, p=0.007) approximately equal to the four biomarkers suggesting the use of the two biomarkers only in the prediction model for oral squamous cell carcinoma patients limiting the economic and health cost in half. SAT and IL-8 mRNAs are present in the saliva in high quality and quantity, with a good discriminatory ability for oral squamous cell carcinoma patients only but not for patients with oral leukoplakia and dysplasia an oral potentially malignant disorder. Copyright © 2016. Published by Elsevier Ltd.

  3. Civil liability - aspects of the law n0 6.453 of 1977

    International Nuclear Information System (INIS)

    Rocha, L.M.G. da

    1980-01-01

    The nuclear damage liability in the Brazilian legal scope is discussed. The law n 0 6.453 of september 1977, which characterizes the nuclear activities criminal illicits and prescribes the correspondent penalties, is analysed. (A.L.) [pt

  4. P-channel NAS-sensor for separate measurement of γ-n0-irradiation

    International Nuclear Information System (INIS)

    Litovchenko, P.G.; Marusan, Yi.O.; Barabash, L.Yi.; Kuts, V.Yi.; Pyinkovs'ka, M.B.; Rozenfel'd, A.B.; Khyivrich, V.Yi.

    1995-01-01

    It is shown the principal possibility of creation of accident mono single crystal dosimeter which is based on P-channel of MOS-transistor for separate measurement of γ-n 0 -irradiation in mixed γ-n-fields

  5. Cuprizone decreases intermediate and late-stage progenitor cells in hippocampal neurogenesis of rats in a framework of 28-day oral dose toxicity study

    Energy Technology Data Exchange (ETDEWEB)

    Abe, Hajime; Tanaka, Takeshi; Kimura, Masayuki; Mizukami, Sayaka [Laboratory of Veterinary Pathology, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-8509 (Japan); Pathogenetic Veterinary Science, United Graduate School of Veterinary Sciences, Gifu University, 1-1 Yanagido, Gifu-shi, Gifu 501-1193 (Japan); Saito, Fumiyo; Imatanaka, Nobuya; Akahori, Yumi [Chemicals Evaluation and Research Institute, Japan, 1-4-25 Koraku, Bunkyo-ku, Tokyo 112-0004 (Japan); Yoshida, Toshinori [Laboratory of Veterinary Pathology, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-8509 (Japan); Shibutani, Makoto, E-mail: mshibuta@cc.tuat.ac.jp [Laboratory of Veterinary Pathology, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-8509 (Japan)

    2015-09-15

    Developmental exposure to cuprizone (CPZ), a demyelinating agent, impairs intermediate-stage neurogenesis in the hippocampal dentate gyrus of rat offspring. To investigate the possibility of alterations in adult neurogenesis following postpubertal exposure to CPZ in a framework of general toxicity studies, CPZ was orally administered to 5-week-old male rats at 0, 120, or 600 mg/kg body weight/day for 28 days. In the subgranular zone (SGZ), 600 mg/kg CPZ increased the number of cleaved caspase-3{sup +} apoptotic cells. At ≥ 120 mg/kg, the number of SGZ cells immunoreactive for TBR2, doublecortin, or PCNA was decreased, while that for SOX2 was increased. In the granule cell layer, CPZ at ≥ 120 mg/kg decreased the number of postmitotic granule cells immunoreactive for NEUN, CHRNA7, ARC or FOS. In the dentate hilus, CPZ at ≥ 120 mg/kg decreased phosphorylated TRKB{sup +} interneurons, although the number of reelin{sup +} interneurons was unchanged. At 600 mg/kg, mRNA levels of Bdnf and Chrna7 were decreased, while those of Casp4, Casp12 and Trib3 were increased in the dentate gyrus. These data suggest that CPZ in a scheme of 28-day toxicity study causes endoplasmic reticulum stress-mediated apoptosis of granule cell lineages, resulting in aberrations of intermediate neurogenesis and late-stage neurogenesis and following suppression of immediate early gene-mediated neuronal plasticity. Suppression of BDNF signals to interneurons caused by decreased cholinergic signaling may play a role in these effects of CPZ. The effects of postpubertal CPZ on neurogenesis were similar to those observed with developmental exposure, except for the lack of reelin response, which may contribute to a greater decrease in SGZ cells. - Highlights: • Effect of 28-day CPZ exposure on hippocampal neurogenesis was examined in rats. • CPZ suppressed intermediate neurogenesis and late-stage neurogenesis in the dentate gyrus. • CPZ suppressed BDNF signals to interneurons by decrease of

  6. Cuprizone decreases intermediate and late-stage progenitor cells in hippocampal neurogenesis of rats in a framework of 28-day oral dose toxicity study

    International Nuclear Information System (INIS)

    Abe, Hajime; Tanaka, Takeshi; Kimura, Masayuki; Mizukami, Sayaka; Saito, Fumiyo; Imatanaka, Nobuya; Akahori, Yumi; Yoshida, Toshinori; Shibutani, Makoto

    2015-01-01

    Developmental exposure to cuprizone (CPZ), a demyelinating agent, impairs intermediate-stage neurogenesis in the hippocampal dentate gyrus of rat offspring. To investigate the possibility of alterations in adult neurogenesis following postpubertal exposure to CPZ in a framework of general toxicity studies, CPZ was orally administered to 5-week-old male rats at 0, 120, or 600 mg/kg body weight/day for 28 days. In the subgranular zone (SGZ), 600 mg/kg CPZ increased the number of cleaved caspase-3 + apoptotic cells. At ≥ 120 mg/kg, the number of SGZ cells immunoreactive for TBR2, doublecortin, or PCNA was decreased, while that for SOX2 was increased. In the granule cell layer, CPZ at ≥ 120 mg/kg decreased the number of postmitotic granule cells immunoreactive for NEUN, CHRNA7, ARC or FOS. In the dentate hilus, CPZ at ≥ 120 mg/kg decreased phosphorylated TRKB + interneurons, although the number of reelin + interneurons was unchanged. At 600 mg/kg, mRNA levels of Bdnf and Chrna7 were decreased, while those of Casp4, Casp12 and Trib3 were increased in the dentate gyrus. These data suggest that CPZ in a scheme of 28-day toxicity study causes endoplasmic reticulum stress-mediated apoptosis of granule cell lineages, resulting in aberrations of intermediate neurogenesis and late-stage neurogenesis and following suppression of immediate early gene-mediated neuronal plasticity. Suppression of BDNF signals to interneurons caused by decreased cholinergic signaling may play a role in these effects of CPZ. The effects of postpubertal CPZ on neurogenesis were similar to those observed with developmental exposure, except for the lack of reelin response, which may contribute to a greater decrease in SGZ cells. - Highlights: • Effect of 28-day CPZ exposure on hippocampal neurogenesis was examined in rats. • CPZ suppressed intermediate neurogenesis and late-stage neurogenesis in the dentate gyrus. • CPZ suppressed BDNF signals to interneurons by decrease of cholinergic

  7. Combined cryosurgical, chemotherapeutic, and radiotherapeutic management of T1-4N0M0 oral cavity cancers

    International Nuclear Information System (INIS)

    Airoldi, M.; Fazio, M.; Gandolfo, S.; Vercellino, V.; Ozzello, F.; Pedani, F.; Camoletto, D.; Negri, L.

    1985-01-01

    Eighty-four previously untreated patients (69 males, 15 females) with squamous carcinoma of the tongue (30 patients), floor of the mouth (30), cheek (16), and retromolar region (8) were treated using a protocol comprising cryosurgery + chemotherapy, followed by external 60 Co radiotherapy. The follow-up period was at least 6 months (median, 50 months). Cryosurgery (1-2 sessions in 49 T1-2 cases; 2-4 in 35 T3-4 cases) was accompanied by a CMF (cyclophosphamide, methotrexate, 5-fluorouracil) schedule (T1-2, two courses; T3-4, three courses). Radiotherapy was given 15 to 20 days after combined cryochemotherapy (T1, 50 Gy on tumor and lymph nodes; T2-3-4, same with an extra dose of 10 to 15 Gy on the primary lesion). Complete remission was reached 4 months after treatment in 76 of 84 patients (90.5%). Survival with no evidence of disease (NED) in the 57 patients (27 T1-2, 30 T3-4) with a follow-up of more than 3 years was 59.6% for the series as a whole, 70.3% for T1-2, and 50.0% for T3-4; 78.2% for the tongue, 52.6% for the floor, 66.6% for the cheek, and 0% for the retromolar region. The picture was much the same after 5 years. Actuarial survival at 6 years was 66% in the series as a whole, 75.5% in T1-2, and 57.5% in T3-4 (tongue 86.9%, floor 56.1%, cheek 68.4%, and retromolar region 0%). It is believed that the results obtained in tumors of the tongue, floor and cheek, coupled with the conservative aspects of the protocol, make it a suitable subject for a controlled trial

  8. GILT - A randomised phase III study of oral vinorelbine and cisplatin with concomitant radiotherapy followed by either consolidation therapy with oral vinorelbine and cisplatin or best supportive care alone in stage III non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Flentje, Michael [University Hospital Wuerzburg, Dept. of Radiotherapy, Wuerzburg (Germany); Huber, Rudolf M. [University Hospital Munich, Member of the German Center for Lung Research (DZL CPC-M), Munich (Germany); Engel-Riedel, Walburga [University Hospital Merheim, Dept. of Pneumonology, Cologne (Germany); Andreas, Stefan [Dept. of Pneumonology, Immenhausen (Germany); Kollmeier, Jens [Helios Emil-von-Behring Hospital, Berlin (Germany); Staar, Susanne [Municipal Hospital Bremen-Mitte, Bremen (Germany); Dickgreber, Nicolas [University Hospital Hannover, Hannover (Germany); Vaissiere, Nathalie; Almeida, Cecilia de [Institut de Recherche Pierre Fabre, Boulogne (France); Edlich, Birgit [Pierre Fabre Pharma GmbH, Freiburg (Germany); Fietkau, Rainer [University Hospital Erlangen, Erlangen (Germany)

    2016-04-15

    Concurrent chemoradiotherapy (CRT) is considered standard for inoperable stage III non-small cell lung cancer (NSCLC). Consolidation chemotherapy (CC) following CRT is intended to further improve outcomes, yet studies have shown discordant results. This phase III study assessed CRT followed by best supportive care (BSC) or consolidation with oral vinorelbine and cisplatin. Patients received two cycles of oral vinorelbine (50 mg/m{sup 2} days 1, 8 and 15) + cisplatin (20 mg/m{sup 2} days 1-4) q4w + radiotherapy (RT; 66 Gy). Patients with at least stable disease (SD) were randomised to either two cycles oral vinorelbine (60-80 mg/m{sup 2} days 1 and 8) + cisplatin (80 mg/m{sup 2} day 1) q3w + BSC or BSC alone. Primary endpoint was progression-free survival (PFS). A total of 279 patients were enrolled for CRT and 201 patients were randomised to CC or BSC. Both CRT and CC were well tolerated, with limited radiation-mediated grade 3/4 toxicities (CRT/CC/BSC: oesophagitis-related events 12.9 %/3.1 %/0 %; grade 3 pneumonitis 0 %/0 %/2 %) and chemotherapy-mediated grade 3/4 toxicities (CRT/CC: neutropenia 11.2 %/22.1 %; leukopenia 18.3 %/26.7 %; grade 3 nausea 5.0 %/2.3 %, grade 3 vomiting 3.2 %/3.5 %). Median PFS from randomisation was 6.4 (5.0-8.7) and 5.5 (3.8-7.4) months in the CC and BSC arms (hazard ratio, HR = 0.93 [0.69-1.26]; p = 0.63), respectively; median overall survival (OS) 20.8 (13.5-25.3) and 18.5 (13.6-24.7) months, respectively. Consolidation chemotherapy after concurrent CRT did not prolong PFS or OS. Concurrent RT with oral vinorelbine and cisplatin demonstrated a favourable safety profile and represents a suitable treatment regimen for inoperable stage III NSCLC. (orig.) [German] Simultane Radiochemotherapie (CRT) wird als Standardtherapie beim inoperablen Stadium III des nicht-kleinzelligen Lungenkarzinoms (NSCLC) angesehen. Konsolidierende Chemotherapie (CC) nach der CRT zielt darauf ab, das Therapieergebnis zu verbessern, allerdings zeigen Studien

  9. Hypofractionated Radiation Therapy Followed by Surgery in Treating Patients With Advanced Squamous Cell Carcinoma of the Oral Cavity

    Science.gov (United States)

    2017-11-15

    Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Verrucous Carcinoma of the Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Verrucous Carcinoma of the Oral Cavity; Tongue Cancer

  10. Functionalization of ( n, 0) CNTs ( n = 3-16) by uracil: DFT studies

    Science.gov (United States)

    Mirzaei, Mahmoud; Harismah, Kun; Jafari, Elham; Gülseren, Oğuz; Rad, Ali Shokuhi

    2018-01-01

    Density functional theory (DFT) calculations were performed to investigate stabilities and properties for uracil (U)-functionalized carbon nanotubes (CNTs). To this aim, the optimized molecular properties were evaluated for ( n, 0) models of CNTs ( n = 3-16) in the original and U-functionalized forms. The results indicated that the dipole moments and energy gaps were independent of tubular diameters whereas the binding energies showed that the U-functionalization could be better achieved for n = 8-11 curvatures of ( n, 0) CNTs. Further studies based on the evaluated atomic-scale properties, including quadrupole coupling constants ( C Q ), indicated that the electronic properties of atoms could detect the effects of diameters variations of ( n, 0) CNTs, in which the effects were very much significant for the atoms around the U-functionalization regions. Finally, the achieved results of singular U, original CNTs, and CNT-U hybrids were compared to each other to demonstrate the stabilities and properties for the U-functionalized ( n, 0) CNTs.

  11. Delayed risk stratification system in pT1aN0/Nx DTC patients treated without radioactive iodine

    Directory of Open Access Journals (Sweden)

    Danuta Ga˛sior-Perczak

    2017-09-01

    Full Text Available Purpose: Delayed risk stratification (DRS system by Momesso and coworkers was accepted by the American Thyroid Association as a diagnostic tool for the risk stratification of unfavorable clinical outcomes and to monitor the clinical outcomes of differentiated thyroid cancer (DTC patients treated without radioactive iodine (RAI. The aim of this study was to evaluate the DRS system in patients with pT1aN0/Nx stage. Methods: The study included 304 low-risk patients after thyroidectomy (n = 202 or lobectomy (n = 102 without RAI and were treated at a single center. The median age was 50.5 years, 91.1% were women and the median follow-up was 4 years. DRS of the treatment response was performed based on medical records and according to the criteria of Momesso and coworkers. Disease course (recurrence, death and status (remission, persistent disease on December 31, 2016 were evaluated. The relationship between unfavorable outcomes and the DRS system was evaluated. Results: Response to initial therapy was excellent in 272 patients (89.5%, indeterminate in 31 (10.2% and biochemical incomplete (increased TgAb levels in one (0.3%. Two patients in the excellent response group experienced recurrence at 6 and 7 years of follow-up (after lobectomy. None of the patients with indeterminate and biochemical incomplete response developed structural disease, and none of the patients died during the follow-up. Conclusions: The DRS system was not useful for predicting the risk of unfavorable clinical outcomes and cannot be used to personalize the monitoring method of the disease in patients at pT1aN0/Nx stage who are not treated with RAI.

  12. Dose-individualized stereotactic body radiotherapy for T1-3N0 non-small cell lung cancer: Long-term results and efficacy of adjuvant chemotherapy

    International Nuclear Information System (INIS)

    Chen Yongshun; Guo Wenhao; Lu You; Zou Bingwen

    2008-01-01

    Purpose: To evaluate the efficacy of dose-individualized stereotactic body radiotherapy (SBRT) and adjuvant chemotherapy in stage T1-3N0M0 non-small cell lung cancer (NSCLC). Materials and methods: Sixty-five patients with T1-3N0M0 NSCLC treated by SBRT between April 2001 and August 2005 were included. Twenty patients were CT-staged at stage T1, 34 at stage T2, and 11 at stage T3. All patients underwent no elective nodal irradiation. SBRT total doses ranged from 71.8 to 115.2 Gy of biological equivalent dose (BED) in 3.6 to 8.0 Gy daily fractions. Seventeen patients were offered cisplatin-containing adjuvant chemotherapy. Results: The overall response rate was 90.6% at six months. The 3- and 5-year overall survival rates for all patients were 57.3% and 35.1%, respectively, and for stage T1-2 patients these were 60.2, 36.5%, respectively. Of all patients, the 3- and 5-year overall survival rates of adjuvant chemotherapy group were 80.5% and 46.0%, respectively, and those of patients with SBRT alone were 49.6% and 31.5%, respectively. Patients who accepted adjuvant chemotherapy had a lower relapse rate and better overall survival. Acute toxicities were mild, and no long-term toxicity was observed. Conclusions: Patients treated with the dose-individualization strategy of SBRT showed excellent local control and improved survival. Adjuvant chemotherapy may reduce the frequency of relapse and increase overall survival in stage at T1-3N0M0 NSCLC patients

  13. The critical release rates for the dissociating gas N204/N02/N0

    International Nuclear Information System (INIS)

    Porter, W.H.L.

    1979-03-01

    Dissociating vapour systems have certain characteristics which make them attractive as coolants, notably a large effective specific heat which is significantly greater than that for the individual components of the gas mixture, and also an enhanced boundary layer heat transfer coefficient resulting from the physical characteristics of thermal dissociation. In part these effects ensure that a dissociating gas has a greatly improved thermal capacity and heat transfer capability when compared with most inert gases. In this report the critical release rates for the dissociating vapour system N 2 0 4 -N0 2 -N0 are established, principally in the two phase region, and the thermodynamics of nitrogen tetroxide are examined. (U.K.)

  14. Size-dependent concentration of N0 paramagnetic centres in HPHT nanodiamonds

    OpenAIRE

    Yavkin, Boris V; Mamin, Georgy V; Gafurov, Marat R.; Orlinskii, Sergei B.

    2015-01-01

    Size-calibrated commercial nanodiamonds synthesized by high-pressure high-temperature (HPHT) technique were studied by high-frequency W and conventional X band electron paramagnetic resonance (EPR) spectroscopy. The numbers of spins in the studied samples were estimated. The core-shell model of the HPHT nanodiamonds was proposed to explain the observed dependence of the concentration of the N0 paramagnetic centers. Two other observed paramagnetic centers are attributed to the two types of str...

  15. N0/N1, PNL, or LNR? The effect of lymph node number on accurate survival prediction in pancreatic ductal adenocarcinoma.

    Science.gov (United States)

    Valsangkar, Nakul P; Bush, Devon M; Michaelson, James S; Ferrone, Cristina R; Wargo, Jennifer A; Lillemoe, Keith D; Fernández-del Castillo, Carlos; Warshaw, Andrew L; Thayer, Sarah P

    2013-02-01

    We evaluated the prognostic accuracy of LN variables (N0/N1), numbers of positive lymph nodes (PLN), and lymph node ratio (LNR) in the context of the total number of examined lymph nodes (ELN). Patients from SEER and a single institution (MGH) were reviewed and survival analyses performed in subgroups based on numbers of ELN to calculate excess risk of death (hazard ratio, HR). In SEER and MGH, higher numbers of ELN improved the overall survival for N0 patients. The prognostic significance (N0/N1) and PLN were too variable as the importance of a single PLN depended on the total number of LN dissected. LNR consistently correlated with survival once a certain number of lymph nodes were dissected (≥13 in SEER and ≥17 in the MGH dataset). Better survival for N0 patients with increasing ELN likely represents improved staging. PLN have some predictive value but the ELN strongly influence their impact on survival, suggesting the need for a ratio-based classification. LNR strongly correlates with outcome provided that a certain number of lymph nodes is evaluated, suggesting that the prognostic accuracy of any LN variable depends on the total number of ELN.

  16. Size-dependent concentration of N0 paramagnetic centres in HPHT nanodiamonds

    Directory of Open Access Journals (Sweden)

    B.V. Yavkin, G.V. Mamin, M.R. Gafurov, S.B. Orlinskii

    2015-12-01

    Full Text Available Size-calibrated commercial nanodiamonds synthesized by high-pressure high-temperature (HPHT technique were studied by high-frequency W- and conventional X-band electron paramagnetic resonance (EPR spectroscopy. The numbers of spins in the studied samples were estimated. The core-shell model of the HPHT nanodiamonds was proposed to explain the observed dependence of the concentration of the N0 paramagnetic centers. Two other observed paramagnetic centers are attributed to the two types of structures in the nanodiamond shell.

  17. Magnetic Properties of Co6On (n=0–9,12

    Directory of Open Access Journals (Sweden)

    Jelena Tamulienė

    2009-01-01

    Full Text Available We present quantum chemical investigations on magnetic properties of several Co6On (n=0–9,12 nanoparticles. The results of calculations show, that only Co6, and Co6O8 particles display paramagnetic properties while other nanoparticles investigated reveal diamagnetic ones. The reason of the derivative paramagnetizability is discussed here. Calculations reveal that the stability of these compounds increases with the increase of the number of O atoms. The limit when the future increase of oxygen atoms does not change binding energy per atoms remarkably is found. The reason why the O atoms could stabilize the Co nanoparticles and change magnetic properties of them is discussed.

  18. Preoperative chemoradiotherapy followed by local excision in clinical T2N0 rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Young Seob; Park, Jin Hong; Ahn, Seung Do [Dept. of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); and others

    2016-09-15

    To investigate whether preoperative chemoradiotherapy (PCRT) followed by local excision (LE) is feasible approach in clinical T2N0 rectal cancer patients. Patients who received PCRT and LE because of clinical T2 rectal cancer within 7 cm from anal verge between January 2006 and June 2014 were retrospectively analyzed. LE was performed in case of a good clinical response after PCRT. Patients' characteristics, treatment record, tumor recurrence, and treatment-related complications were reviewed at a median follow-up of 49 months. All patients received transanal excision or transanal minimally invasive surgery. Of 34 patients, 19 patients (55.9%) presented pathologic complete response (pCR). The 3-year local recurrence-free survival and disease free-survival were 100.0% and 97.1%, respectively. There was no recurrence among the patients with pCR. Except for 1 case of grade 4 enterovesical fistula, all other late complications were mild and self-limiting. PCRT followed by an LE might be feasible as an alternative to total mesorectal excision in good responders with clinical T2N0 distal rectal cancer.

  19. Symmetry Breaking of B2N((-, 0, +)): An Aspect of the Electric Potential and Atomic Charges.

    Science.gov (United States)

    Monajjemi, Majid; Bagheri, Samira; Moosavi, Matin S; Moradiyeh, Nahid; Zakeri, Mina; Attarikhasraghi, Naime; Saghayimarouf, Nastaran; Niyatzadeh, Ghorban; Shekarkhand, Marzie; Khalilimofrad, Mohammad S; Ahmadin, Hashem; Ahadi, Maryam

    2015-12-03

    In this study, the three forms of B2N((-, 0, +))-radical, anion and cation-have been compared in terms of electric potential and atomic charges, ESP, rather than the well-known cut of the potential energy surface (PES). We have realized that the double minimum of the BNB radical is related to the lack of the correct permutational symmetry of the wave function and charge distribution. The symmetry breaking (SB) for B2N((0, +)) exhibits energy barrier in the region of (5-150) cm(-1). The SB barrier goes through a dynamic change with no centrosymmetric form which depends on the wave function or charge distribution. In spite of A ˜ 2 Σ g + exited state, the B ˜ 2 ∏ g excited configuration contributes to the ground state ( B ˜ 2 ∏ g - X ˜ 2 Σ u + ) for forming radicals. The SB did not occur for the anion form (B2N((-))) in any electrostatic potential and charges distribution. Finally, we have modified the Columbic term of the Schrödinger equation to define the parameters "αα' and ββ'" in order to investigate the SBs subject.

  20. Preoperative chemoradiotherapy followed by local excision in clinical T2N0 rectal cancer

    International Nuclear Information System (INIS)

    Shin, Young Seob; Park, Jin Hong; Ahn, Seung Do

    2016-01-01

    To investigate whether preoperative chemoradiotherapy (PCRT) followed by local excision (LE) is feasible approach in clinical T2N0 rectal cancer patients. Patients who received PCRT and LE because of clinical T2 rectal cancer within 7 cm from anal verge between January 2006 and June 2014 were retrospectively analyzed. LE was performed in case of a good clinical response after PCRT. Patients' characteristics, treatment record, tumor recurrence, and treatment-related complications were reviewed at a median follow-up of 49 months. All patients received transanal excision or transanal minimally invasive surgery. Of 34 patients, 19 patients (55.9%) presented pathologic complete response (pCR). The 3-year local recurrence-free survival and disease free-survival were 100.0% and 97.1%, respectively. There was no recurrence among the patients with pCR. Except for 1 case of grade 4 enterovesical fistula, all other late complications were mild and self-limiting. PCRT followed by an LE might be feasible as an alternative to total mesorectal excision in good responders with clinical T2N0 distal rectal cancer

  1. Radiotherapy or surgery for T2N0M0 glottic carcinoma?

    International Nuclear Information System (INIS)

    Stalpers, L.J.A.; Daal, W.A.J. van; Verbeek, A.L.M.

    1989-01-01

    Decision analysis was used to evaluate the results of treatment of T 2 N 0 M 0 glottic carcinoma as presented in the literature. Based on mean values for recurrence, salvage eligibility after recurrence and salvage success, the 5-year survival after radiotherapy and surgery proved to be almost identical, 85 and 86%. If the recurrence rates and the salvage rates were varied, a marginal advantage for surgery in small tumours and a major advantage in more extended tumours was seen if only survival is considered. To take the quality of speech into account, a utility analysis was performed. A utility scale was defined ranging from 0.0 as the value for death, to 1.0 for a successfully irradiated patient with preservation of normal speech. A utility of 0.99 or less for the laryngectomized patient would favour radiotherapy over surgery for all T 2 tumours. In patients with T 2b tumours and in extreme circumstances, e.g. if failure rates of radiotherapy are extremely low, an exact assessment of patient utilities may be pivotal. Under normal circumstances radiotherapy is preferred for T 2 N 0 M 0 glottic carcinoma if both survival and the quality of speech are taken into account. (author). 39 refs.; 5 figs.; 1 tab

  2. Localization of twisted N=(0,2) gauged linear sigma models in two dimensions

    Energy Technology Data Exchange (ETDEWEB)

    Closset, Cyril [Simons Center for Geometry and Physics, State University of New York, Stony Brook, NY 11794 (United States); Gu, Wei [Department of Physics MC 0435, Virginia Tech, 850 West Campus Drive, Blacksburg, VA 24061 (United States); Jia, Bei [Theory Group, Physics Department, University of Texas, Austin, TX 78612 (United States); Sharpe, Eric [Department of Physics MC 0435, Virginia Tech, 850 West Campus Drive, Blacksburg, VA 24061 (United States)

    2016-03-14

    We study two-dimensional N=(0,2) supersymmetric gauged linear sigma models (GLSMs) using supersymmetric localization. We consider N=(0,2) theories with an R-symmetry, which can always be defined on curved space by a pseudo-topological twist while preserving one of the two supercharges of flat space. For GLSMs which are deformations of N=(2,2) GLSMs and retain a Coulomb branch, we consider the A/2-twist and compute the genus-zero correlation functions of certain pseudo-chiral operators, which generalize the simplest twisted chiral ring operators away from the N=(2,2) locus. These correlation functions can be written in terms of a certain residue operation on the Coulomb branch, generalizing the Jeffrey-Kirwan residue prescription relevant for the N=(2,2) locus. For abelian GLSMs, we reproduce existing results with new formulas that render the quantum sheaf cohomology relations and other properties manifest. For non-abelian GLSMs, our methods lead to new results. As an example, we briefly discuss the quantum sheaf cohomology of the Grassmannian manifold.

  3. Preliminary preformulation studies of a 2-(3,4-dimethoxyphenyl)ethylamine derivative for oral administration at an exploratory stage of new drug development.

    Science.gov (United States)

    Morita, M; Hosokami, T; Konno, T; Kinuno, K; Mafune, E; Takasugi, N

    1995-03-01

    Preliminary preformulation studies of a 2-(3,4-dimethoxyphenyl)ethylamine derivative were investigated. The hydrochloride form showed incompatibility with the excipients used for oral dosage forms. There were several crystal forms of the free base, namely, alpha-anhydrate, beta-anhydrate, monohydrate, and trihydrate. The trihydrate form was unstable. The degree of crystallinity of the beta-anhydrate form was difficult to control. The monohydrate form was difficult to manufacture with constant quality. The serum levels of the compounds in rats were almost related to the dissolution rates in the JP 1st disintegration medium from the discs. The serum level of alpha-anhydrate was the lowest. However, the dissolution rates from the formulations of alpha-anhydrate were improved. After oral administration of the improved formulation, the serum level of alpha-anhydrate in beagle dogs was almost triple that after the oral administration of the capsule of the hydrochloride form.

  4. Dental implications in oral cancer patients.

    Science.gov (United States)

    Escoda-Francolí, Jaume; Rodríguez-Rodríguez, Araceli; Pérez-García, Silvia; Gargallo-Albiol, Jordi; Gay-Escoda, Cosme

    2011-07-01

    A study is made of the dental implications of oral cancer, with a view to avoiding the complications that appear once oncological treatment is started. The study comprised a total of 22 patients diagnosed with oral cancer according to clinical and histological criteria in the Service of Maxillofacial Surgery (Dental Clinic of the University of Barcelona, Spain) during the period 1996-2005, and posteriorly treated in different hospital centers in Barcelona. Of the 22 patients diagnosed with oral cancer in our Service, the present study finally analyzed the 12 subjects who reported for the dental controls. As regards the remaining 10 patients, 5 had died and 5 could not be located; these subjects were thus excluded from the analysis. All of the smokers had abandoned the habit. The most common tumor location was the lateral margin of the tongue. None of the patients visited the dentist regularly before the diagnosis of oral cancer. T1N0M0 was the most common tumor stage. Surgery was carried out in 50% of the cases, while 8.4% of the patients received radiotherapy and 41.6% underwent surgery with postoperative radiotherapy. In turn, 66.6% of the patients reported treatment sequelae such as dysgeusia, xerostomia or speech difficulties, and one patient suffered osteoradionecrosis. Forty-one percent of the patients did not undergo regular dental controls after cancer treatment. As regards oral and dental health, 16.6% presented caries, and 50% had active periodontal disease. Protocols are available for preventing the complications of oral cancer treatment, and thus for improving patient quality of life. However, important shortcomings in the application of such protocols on the part of the public health authorities make it difficult to reach these objectives.

  5. Laser-radiation therapy for T2N0M0 laryngeal-glottic cancer

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Gen; Hayabuchi, Naofumi; Toda, Yukihiro; Suefuji, Hiroaki; Ogo, Etuyo; Nakajima, Tadashi [Kurume Univ., Fukuoka (Japan). School of Medicine

    2002-03-01

    The purpose of this study was to evaluate the laser-radiation combined therapy for T2N0M0 laryngeal-glottic cancer in order to preserve the larynx. The subjects consisted of 52 patients with T2N0M0 laryngeal-glottic cancer treated with laser-radiation combined therapy between 1980 and 1999. Patients ranged in age from 40-88 years, with a median of 70 years, and included 51 men and one woman. During this period, treatment was administered with different radiation devices ({sup 60}Co or 4 MV-X ray), and 40-72 Gy (median, 60Gy) of radiation therapy were administered. Tumor and treatment characteristics were correlated with local control at a median follow-up of 61 months (range 12-210 months). Concurrent chemotherapy was administered to 32 patients; 29 were treated with 5-FU and vitamin A (FAR), and 3 were treated with low-dose CDDP. Post treatment vocal function was examined in 37 patients. The voice was evaluated in terms of four parameters: maximum phonation time (MPT), mean air flow rate during phonation over a comfortable duration (MFR), fundamental frequency range of phonation (F0 range), and sound pressure level range of phonation (SPL range). The five-year cause-specific-survival rate was 98.0%, and the local control rate was 91.8%. Three of 4 patients who had locally relapsed were administered total laryngectomy as salvage therapy. One patient was administered the tracheostomy for late complication. The actuarial laryngeal preservation rate was 92.3%. We did not find any significant relationship between local relapse and extent of disease, subglottic extension, or anterior commissure involvement. Concurrent chemotherapy was not a significant prognostic factor. Laser debulking followed by radiation therapy did not change the voice significantly except the F0 range. We conclude that the laser-radiation combined therapy for T2N0M0 laryngeal-glottic cancer was effective therapy for not only preservation of the voice but also for vocal function. (author)

  6. Laser-radiation therapy for T2N0M0 laryngeal-glottic cancer

    International Nuclear Information System (INIS)

    Suzuki, Gen; Hayabuchi, Naofumi; Toda, Yukihiro; Suefuji, Hiroaki; Ogo, Etuyo; Nakajima, Tadashi

    2002-01-01

    The purpose of this study was to evaluate the laser-radiation combined therapy for T2N0M0 laryngeal-glottic cancer in order to preserve the larynx. The subjects consisted of 52 patients with T2N0M0 laryngeal-glottic cancer treated with laser-radiation combined therapy between 1980 and 1999. Patients ranged in age from 40-88 years, with a median of 70 years, and included 51 men and one woman. During this period, treatment was administered with different radiation devices ( 60 Co or 4 MV-X ray), and 40-72 Gy (median, 60Gy) of radiation therapy were administered. Tumor and treatment characteristics were correlated with local control at a median follow-up of 61 months (range 12-210 months). Concurrent chemotherapy was administered to 32 patients; 29 were treated with 5-FU and vitamin A (FAR), and 3 were treated with low-dose CDDP. Post treatment vocal function was examined in 37 patients. The voice was evaluated in terms of four parameters: maximum phonation time (MPT), mean air flow rate during phonation over a comfortable duration (MFR), fundamental frequency range of phonation (F0 range), and sound pressure level range of phonation (SPL range). The five-year cause-specific-survival rate was 98.0%, and the local control rate was 91.8%. Three of 4 patients who had locally relapsed were administered total laryngectomy as salvage therapy. One patient was administered the tracheostomy for late complication. The actuarial laryngeal preservation rate was 92.3%. We did not find any significant relationship between local relapse and extent of disease, subglottic extension, or anterior commissure involvement. Concurrent chemotherapy was not a significant prognostic factor. Laser debulking followed by radiation therapy did not change the voice significantly except the F0 range. We conclude that the laser-radiation combined therapy for T2N0M0 laryngeal-glottic cancer was effective therapy for not only preservation of the voice but also for vocal function. (author)

  7. Staging of early lymph node metastases with the sentinel lymph node technique and predictive factors in T1/T2 oral cavity cancer

    DEFF Research Database (Denmark)

    Pedersen, Nicklas Juel; Jensen, David Hebbelstrup; Hedbäck, Nora

    2015-01-01

    BACKGROUND: The purpose of this study was to examine the diagnostic accuracy of detecting lymph node metastases and to identify predictive and prognostic clinicopathological factors in patients with oral squamous cell carcinoma (OSCC) undergoing sentinel lymph node biopsy (SLNB). METHODS: All...

  8. Oral manifestations of syphilis: a review

    Directory of Open Access Journals (Sweden)

    A.B. Soares

    2004-01-01

    Full Text Available Syphilis is an infectious disease presenting stages associated with specific oral lesions. Therefore, health professionals should be familiar with the different syphilis oral manifestations at each stage and be prepared to refer any suspected patient for further evaluation. This report describes the most important clinical factors of each stage, emphasizing the oral manifestations.

  9. [Laparoscopic resection of the transplanted kidney for renal cell carcinoma T1N0M0].

    Science.gov (United States)

    Vtorenko, V I; Trushkin, R N; Lubennikov, A E; Kolesnikov, N O

    2017-04-01

    Laparoscopic resection of the transplanted kidney has been very rarely reported in the literature. On the one hand, this is due to the extremely low incidence of tumors of renal transplants. On the other hand, these patients are usually managed by open surgery due to difficulties in laparoscopic resection because of the scar tissue in the kidney area. Other options, though rarely performed, are cryosurgery and radiofrequency ablation of the tumor. In this article we report our own experience with a patient who underwent laparoscopic resection of renal transplant for renal cell carcinoma T1aN0M0 19 years after kidney transplantation. The tumor sized 27 cm was found incidentally by routine ultrasound. The operative time was 115 minutes, the renal ischemia time - 28 min. No intra- and postoperative complications were observed. Histological examination revealed renal cell carcinoma, surgical margins were negative. The patient was discharged on the 7th day after the surgery, no graft dysfunction was observed.

  10. Pathological analysis of the Candida albicans-infected tongue tissues of a murine oral candidiasis model in the early infection stage.

    Science.gov (United States)

    Okada, Masashi; Hisajima, Tatsuya; Ishibashi, Hiroko; Miyasaka, Takahiro; Abe, Shigeru; Satoh, Tazuko

    2013-04-01

    The early pathological process of Candida infection and immunological responses in tongues of the mice with experimental oral candidiasis was analysed. CD-1 mice, pretreated by prednisolone were orally inoculated with Candida albicans. Symptoms were monitored by measuring the area of white tongue coating and number of viable Candida cells in oral cavity. The histopathological analysis was carried by PAS-stain and immunofluorescent staining. IL-4, IL-12p70, IFN-γ, TNF-α in recovered from the homogenates of the tongues were measured by ELISA. The fungus invaded the tongue surface of the mice and white patches developed within 24h after inoculation. Histopathological examination indicated the presence of local acute inflammation in superficial tissues of tongues covered by mycelium of C. albicans. Pathological exacerbation was observed from 24 to 48 h after the inoculation and from then the symptoms of oral candidiasis appeared to move into the recovery phase. Inflammatory cells mainly consisting of neutrophils was accumulated and located under the lesions covered by Candida-hyphae. An increase in IL-12p70 and IFN-γ in tongue homogenates was observed at 48 h after inoculation. The worst condition in the pathological process in experimental oral candidiasis was found 48 h after C. albicans inoculation. When the surface of the Candida-inoculated tongues was covered with Candida-hyphae, a dense accumulation of neutrophils was observed under the lesions and homogenates of the tongues contained increased levels of IL-12p70 and IFN-γ. These suggested that local pathological condition of Candida-infected tongues may be affected by neutrophils accumulation and increased levels of some cytokines. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Oral Health

    Science.gov (United States)

    ... section Home A-Z Health Topics Oral health Oral health > A-Z Health Topics Oral health (PDF, 154 ... To receive Publications email updates Enter email Submit Oral health Women have unique oral health concerns. Changing hormone ...

  12. Combination of oral activated charcoal plus low protein diet as a new alternative for handling in the old end-stage renal disease patients.

    Science.gov (United States)

    Musso, C G; Michelangelo, H; Reynaldi, J; Martinez, B; Vidal, F; Quevedo, M; Parot, M; Waisman, G; Algranati, L

    2010-01-01

    Chronic dialysis is a valid therapeutic option in very elderly ESRD patients, even though the decision to dialyze or not has little impact on survival. Additionally, very old patients usually do not agree with starting chronic dialysis. Even though, activated charcoal is a cheap treatment for working as adsorbent for nitrogenous products its utility is very limited. We studied the combination of a low protein diet and oral activated charcoal to reduce serum urea and creatinine levels in very old ESRD patients who had refused to start chronic dialysis. Nine lucid, very old > 80 years, ESRD patients who had refused to start dialysis were prescribed a treatment based on a combination of a very low protein diet and oral activated charcoal (30 gram/day). None of the patients had anuria, oliguria, edema, significant metabolic acidosis or hyperkalemia. None of them had significant gastrointestinal symptoms. After one week and ten months of charcoal use significant decrease in blood urea and creatinine levels was observed and none of them required emergency dialysis during this time. In conclusion, in patients more than 80 years of age low protein diet and oral activated charcoal may control the uremic symptoms effectively.

  13. Photodynamic Therapy Using Temoporfin Before Surgery in Treating Patients With Recurrent Oral Cavity or Oropharyngeal Cancer

    Science.gov (United States)

    2014-09-02

    Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage II Squamous Cell Carcinoma of the Oropharynx; Stage II Verrucous Carcinoma of the Oral Cavity; Tongue Cancer

  14. Olefin metathesis reaction on GaN (0 0 0 1) surfaces

    International Nuclear Information System (INIS)

    Makowski, Matthew S.; Zemlyanov, Dmitry Y.; Ivanisevic, Albena

    2011-01-01

    Proof-of-concept reactions were performed on GaN (0 0 0 1) surfaces to demonstrate surface termination with desired chemical groups using an olefin cross-metathesis reaction. To prepare the GaN surfaces for olefin metathesis, the surfaces were hydrogen terminated with hydrogen plasma, chlorine terminated with phosphorous pentachloride, and then terminated with an alkene group via a Grignard reaction. The olefin metathesis reaction then bound 7-bromo-1-heptene. The modified surfaces were characterized by X-ray photoelectron spectroscopy (XPS), atomic force microscopy, and water contact angle measurements following each step in the reaction scheme. The XPS data was used to qualitatively identify surface chemical species and to quantitatively determine molecular surface coverage. The bromine atom in 7-bromo-1-heptene served as a heteroatom for identification with XPS. The reaction scheme resulted in GaN substrates with a surface coverage of 0.10 monolayers and excellent stability towards oxidation when exposed to oxygen plasma.

  15. Olefin metathesis reaction on GaN (0 0 0 1) surfaces

    Energy Technology Data Exchange (ETDEWEB)

    Makowski, Matthew S. [Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907 (United States); Zemlyanov, Dmitry Y. [Birck Nanotechnology Center, Purdue University, West Lafayette, IN 47907 (United States); Ivanisevic, Albena, E-mail: albena@purdue.edu [Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907 (United States); Department of Chemistry, Purdue University, West Lafayette, IN 47907 (United States)

    2011-03-01

    Proof-of-concept reactions were performed on GaN (0 0 0 1) surfaces to demonstrate surface termination with desired chemical groups using an olefin cross-metathesis reaction. To prepare the GaN surfaces for olefin metathesis, the surfaces were hydrogen terminated with hydrogen plasma, chlorine terminated with phosphorous pentachloride, and then terminated with an alkene group via a Grignard reaction. The olefin metathesis reaction then bound 7-bromo-1-heptene. The modified surfaces were characterized by X-ray photoelectron spectroscopy (XPS), atomic force microscopy, and water contact angle measurements following each step in the reaction scheme. The XPS data was used to qualitatively identify surface chemical species and to quantitatively determine molecular surface coverage. The bromine atom in 7-bromo-1-heptene served as a heteroatom for identification with XPS. The reaction scheme resulted in GaN substrates with a surface coverage of 0.10 monolayers and excellent stability towards oxidation when exposed to oxygen plasma.

  16. Number of negative lymph nodes as a prognostic factor for ypN0-N1 breast cancer patients undergoing neoadjuvant chemotherapy.

    Science.gov (United States)

    Xin, Fei; Yu, Yue; Yang, Zheng-Jun; Hou, Li-Kun; Mao, Jie-Fei; Xia, Li; Wang, Xin; Cao, Xu-Chen

    2016-06-01

    Some of node-positive patients could have a pathologically complete response in terms of lymph nodes. For these patients, the number of negative lymph nodes (NLNs) may be higher than that in the same-stage patients who initially received mastectomy. After neoadjuvant chemotherapy (NAC), the following treatment especially the postmastectomy radiotherapy (PMRT) is controversial for ypN1 (with one to three positive lymph nodes after NAC) patients. A total of 289 patients who received NAC from 2006 to 2009 were included in the investigation. The prognostic value of the number of NLNs on these patients was analyzed. Besides, we analyzed if the number of NLNs would give some indications on PMRT in ypN1 patients. The follow-up of all the patients began the first chemotherapy on 15 March 2015. The 5-year disease-free survival (DFS) and overall survival (OS) rates were determined as 67.2 and 81.1 %, respectively. The number of NLNs was associated with primary stage (p number of NLNs is an independent prognostic factor in both DFS and OS. In ypN0-N1 stage, patients with >13 NLNs had better DFS (p patients with ≤13 NLNs. Although the fact patients in ypN2-N3 stage with >13 NLNs had better DFS and OS than the others, there were no significant statistical difference. In the subgroup analysis, PMRT improved the OS (p patients with ≤13 NLNs. The number of NLNs is a prognostic indicator in ypN0-N1 patients. Patients in ypN1 stage with less number of NLNs will benefit from PMRT.

  17. Clinical T2N0 Esophageal Cancer: Identifying Pretreatment Characteristics Associated with Pathologic Upstaging and the Potential Role for Induction Therapy

    Science.gov (United States)

    Samson, Pamela; Puri, Varun; Robinson, Clifford; Lockhart, Craig; Carpenter, Danielle; Broderick, Stephen; Kreisel, Daniel; Krupnick, A. Sasha; Patterson, G. Alexander; Meyers, Bryan; Crabtree, Traves

    2016-01-01

    Background While studies have suggested standard therapy for clinical T2N0 esophageal cancer should be primary surgery, we hypothesize there is a subgroup for whom induction therapy may result in improved overall survival (OS). Methods cT2N0 esophageal cancer patients receiving induction therapy or upfront esophagectomy (UE) were identified in the National Cancer Data Base (NCDB). UE patients were dichotomized as 1) pathologically upstaged or 2) same-or down-staged. Logistic regression models identified variables associated with upstaging and Kaplan-Meier analysis compared median OS. Results From 2006–2012, 932 (52.2%) cT2N0 patients received UE, while 853 (47.8%) received induction therapy first. 326/713 (45.7%) UE patients were upstaged. 87/326 (26.7%) patients had T upstaging, 98/326 (30.1%) had N upstaging, and 141/326 (43.3%) had both. Patients upstaged after UE had a higher tumor grade (35.1% versus 57.1% Grade 3), and a higher rate of lymphovascular invasion (LVI, 57.1% versus 17.7%), both p<0.001. Variables associated with upstaging included LVI (OR 6.0, 95% CI 2.9 – 12.5, p<0.001) and tumor grade 3 (OR 9.4, 1.8 – 48.4, p=0.007). Of upstaged UE patients, only 144 (44.2%) received adjuvant therapy. The median OS for cT2N0 patients upstaged after UE was 27.5 ± 2.5 months versus 43.9 ± 2.9 months for induction therapy patients (any resultant pathologic stage, p<0.001). Conclusions Half of all cT2N0 patients were pathologically upstaged after UE with worse survival compared to patients receiving induction therapy. Refining an upstaging model would help select patients for induction therapy and increase the rate of chemotherapy in patients at risk for systemic disease. PMID:27083246

  18. Canine oral melanoma.

    Science.gov (United States)

    Bergman, Philip J

    2007-05-01

    Melanoma is the most common oral malignancy in the dog. Oral and/or mucosal melanoma has been routinely considered an extremely malignant tumor with a high degree of local invasiveness and high metastatic propensity. Primary tumor size has been found to be extremely prognostic. The World Health Organization staging scheme for dogs with oral melanoma is based on size, with stage I = or = 4cm tumor and/or lymph node metastasis, and stage IV = distant metastasis. Median survival times for dogs with oral melanoma treated with surgery are approximately 17 to 18, 5 to 6, and 3 months with stage I, II, and III disease, respectively. Significant negative prognostic factors include stage, size, evidence of metastasis, and a variety of histologic criteria. Standardized treatments such as surgery, coarse-fractionation radiation therapy, and chemotherapy have afforded minimal to modest stage-dependent clinical benefits and death is usually due to systemic metastasis. Numerous immunotherapeutic strategies have been employed to date with limited clinical efficacy; however, the use of xenogeneic DNA vaccines may represent a leap forward in clinical efficacy. Oral melanoma is a spontaneous syngeneic cancer occurring in outbred, immunocompetent dogs and appears to be a more clinically faithful therapeutic model for human melanoma; further use of canine melanoma as a therapeutic model for human melanoma is strongly encouraged. In addition, the development of an expanded but clinically relevant staging system incorporating the aforementioned prognostic factors is also strongly encouraged.

  19. Efficacy of Intensity Modulated Radiation Therapy After Surgery in Early Stage of Esophageal Carcinoma;

    Science.gov (United States)

    2018-02-22

    Esophageal Neoplasm; Esophageal Cancer TNM Staging Primary Tumor (T) T2; Esophageal Cancer TNM Staging Primary Tumor (T) T3; Esophageal Cancer TNM Staging Regional Lymph Nodes (N) N0; Esophageal Cancer TNM Staging Distal Metastasis (M) M0

  20. The histologic risk model is a useful and inexpensive tool to assess risk of recurrence and death in stage I or II squamous cell carcinoma of tongue and floor of mouth.

    Science.gov (United States)

    Sinha, Namita; Rigby, Matthew H; McNeil, Michael L; Taylor, S Mark; Trites, Jonathan Rb; Hart, Robert D; Bullock, Martin J

    2018-02-02

    Surgery is the mainstay of treatment for low-stage (stage I/II, ie, T1N0/T2N0) squamous cell carcinoma of oral cavity. However, a significant percentage of low-stage squamous cell carcinoma of oral cavity will develop local recurrence and disease-related mortality. In this study, we stratified 64 patients with low-stage of oral tongue and floor of mouth patients into high-, intermediate- and low-risk categories based on existing histologic risk model. The classification of these risk categories was based on presence or absence of perineural invasion and evaluation of tumor-host junction for worst pattern of invasion and lymphocytic host response. We correlated risk category and other variables with recurrence and death. In a univariate model, high-risk category tumors had a significantly higher rate of recurrence and death due to recurrence compared with low/intermediate-risk categories (P=0.000 and P=0.047, respectively). Controlling for margin status and T-stage, high-risk category had a 12.4 odds ratio of later recurrence when compared with low/intermediate-risk categories, with a P-value of 0.001. In conclusion, we found low-stage oral cavity squamous cell carcinoma patients with high-risk category have a significantly higher risk for recurrence when compared with patients in the low- or intermediate-risk category, even when controlling for margin status and T-stage. These patients may be suitable candidates for adjuvant treatment to decrease morbidity and mortality associated with a recurrence. Our results indicate that the histologic risk model is a useful and simple tool to assess risk of recurrence in stage I or II squamous cell carcinoma of oral cavity.Modern Pathology advance online publication, 2 February 2018; doi:10.1038/modpathol.2017.183.

  1. Double-blind, placebo-controlled first in human study to investigate an oral vaccine aimed to elicit an immune reaction against the VEGF-Receptor 2 in patients with stage IV and locally advanced pancreatic cancer

    International Nuclear Information System (INIS)

    Niethammer, Andreas G; Springer, Marco; Grenacher, Lars; Buchler, Markus W; Koch, Moritz; Weitz, Jürgen; Haefeli, Walter E; Schmitz-Winnenthal, Friedrich H; Lubenau, Heinz; Mikus, Gerd; Knebel, Philipp; Hohmann, Nicolas; Leowardi, Christine; Beckhove, Philipp; Akhisaroglu, Mustafa; Ge, Yingzi

    2012-01-01

    The investigational oral DNA vaccine VXM01 targets the vascular endothelial growth factor receptor 2 (VEGFR-2) and uses Salmonella typhi Ty21a as a vector. The immune reaction elicited by VXM01 is expected to disrupt the tumor neovasculature and, consequently, inhibit tumor growth. VXM01 potentially combines the advantages of anti-angiogenic therapy and active immunotherapy. This phase I trial examines the safety, tolerability, and immunological and clinical responses to VXM01. The randomized, placebo-controlled, double blind dose-escalation study includes up to 45 patients with locally advanced and stage IV pancreatic cancer. The patients will receive four doses of VXM01 or placebo in addition to gemcitabine as standard of care. Doses from 10 6 cfu up to 10 10 cfu of VXM01 will be evaluated in the study. An independent data safety monitoring board (DSMB) will be involved in the dose-escalation decisions. In addition to safety as primary endpoint, the VXM01-specific immune reaction, as well as clinical response parameters will be evaluated. The results of this study shall provide the first data regarding the safety and immunogenicity of the oral anti-VEGFR-2 vaccine VXM01 in cancer patients. They will also define the recommended dose for phase II and provide the basis for further clinical evaluation, which may also include additional cancer indications. EudraCT No.: 2011-000222-29, NCT01486329, ISRCTN68809279

  2. Intraoperative radiotherapy (IORT) with low-energy photons as a boost in patients with early-stage oral cancer with the indications for postoperative radiotherapy. Treatment feasibility and preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Rutkowski, Tomasz; Wygoda, Andrzej; Hutnik, Marcin; Skladowski, Krzysztof; Wydmanski, Jerzy; Maciejewski, Boguslaw [Dept. of Radiation Oncology, Maria Sklodowska-Curie Memorial Cancer and Inst. of Oncology, Gliwice Branch (Poland); Maciejewski, Adam; Szymczyk, Cezary; Wierzgon, Janusz [Dept. of Surgery, Maria Sklodowska-Curie Memorial Cancer Center and Inst. of Oncology, Gliwice Branch (Poland); Orlef, Andrzej [Dept. of Physics, Maria Sklodowska-Curie Memorial Cancer Center and Inst. of Oncology, Gliwice Branch (Poland)

    2010-09-15

    Purpose: To evaluate the feasibility and preliminary results of intraoperative radiotherapy (IORT) with low-energy photons as a boost in patients with early-stage oral cancer with the indications for postoperative radiotherapy. Patients and Methods: Between 2003 and 2006, 16 patients with early-stage cancer of mobile tongue (n = 10 [63%]) or floor of the mouth (n = 6 [37%]) treated at Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Poland, were evaluated for IORT boost with the INTRABEAM {sup registered} System (Carl Zeiss Surgical GmbH; IORT-PRS) because of the high risk of local recurrence due to positive margins on frozen pathologic section. After tumor resection, the applicator was positioned in the tumor bed. The applicator's diameter (range: 1.5-5 cm) was selected to encompass high-risk area of tumor recurrence. The dose (5 Gy, 7 Gy, or 7.5 Gy) was applied according to tumor volume and bone proximity. External-beam radiotherapy (EBRT) was provided to the tumor bed in all patients (50 Gy) and to the nodal area, when needed. Toxicity and local tumor control were assessed. Results: Median follow-up was 36 months. IORT did not increase acute mucosal reaction. Local tumor control was found in all cases. Early mucosal reaction did not exceed 3 according to the RTOG scale and healed in median time of 35 days after completion of EBRT. No late adverse effects were observed. Conclusion: This preliminary report has demonstrated the feasibility of IORT-PRS for patients with early oral cancer with the indications for postoperative radiotherapy. This method may be considered an alternative boost technique, although additional studies are needed to establish long-term results in a larger group of patients. (orig.)

  3. Efficacy, Safety, and Dose of Pafuramidine, a New Oral Drug for Treatment of First Stage Sleeping Sickness, in a Phase 2a Clinical Study and Phase 2b Randomized Clinical Studies.

    Directory of Open Access Journals (Sweden)

    Christian Burri

    2016-02-01

    Full Text Available Sleeping sickness (human African trypanosomiasis [HAT] is caused by protozoan parasites and characterized by a chronic progressive course, which may last up to several years before death. We conducted two Phase 2 studies to determine the efficacy and safety of oral pafuramidine in African patients with first stage HAT.The Phase 2a study was an open-label, non-controlled, proof-of-concept study where 32 patients were treated with 100 mg of pafuramidine orally twice a day (BID for 5 days at two trypanosomiasis reference centers (Angola and the Democratic Republic of the Congo [DRC] between August 2001 and November 2004. The Phase 2b study compared pafuramidine in 41 patients versus standard pentamidine therapy in 40 patients. The Phase 2b study was open-label, parallel-group, controlled, randomized, and conducted at two sites in the DRC between April 2003 and February 2007. The Phase 2b study was then amended to add an open-label sequence (Phase 2b-2, where 30 patients received pafuramidine for 10 days. The primary efficacy endpoint was parasitologic cure at 24 hours (Phase 2a or 3 months (Phase 2b after treatment completion. The primary safety outcome was the rate of occurrence of World Health Organization Toxicity Scale Grade 3 or higher adverse events. All subjects provided written informed consent.Pafuramidine for the treatment of first stage HAT was comparable in efficacy to pentamidine after 10 days of dosing. The cure rates 3 months post-treatment were 79% in the 5-day pafuramidine, 100% in the 7-day pentamidine, and 93% in the 10-day pafuramidine groups. In Phase 2b, the percentage of patients with at least 1 treatment-emergent adverse event was notably higher after pentamidine treatment (93% than pafuramidine treatment for 5 days (25% and 10 days (57%. These results support continuation of the development program for pafuramidine into Phase 3.

  4. Disease Assessment of Elderly Patients with Early and Middle Stage Knee Osteoarthritis took the Kidney-tonifying and tendons-relaxing formula orally, combined with fumigations and odium hyaluronate injection

    Directory of Open Access Journals (Sweden)

    Hong-Guang Huang

    2016-05-01

    Full Text Available Objective: To analyze the diseases condition of the elderly patients with early and middle stage osteoarthritis of the knee took the Kidney-tonifying and tendons-relaxing formula orally, combined with fumigations and odium hyaluronate injection. Methods: A total of 78 cases of elderly knee osteoarthritis patients were selected in our hospital from August 2011 to February 2014 as observation group. 88 cases of joint function normal healthy people were chosen as the control group. After treatment, differences of serum protein expressions and CTX II, COMP, HA levels as well as related factors of Hippo-Yap signaling pathway in the synovial fluid, such as HMGB2, CCL1 and PD-1of the two groups were compared. Results: after treatment, serum PON-1, paraoxonase-3, AMBP, ApoM, KAP and TN expression levels in the observation group were higher than those of the control group patients. APOL1 level was lower than that of the control group. After 1 month, 3 months and 6 months’ treatment, serum COMP level in the observation group was lower than that in the control group patients. CTX II, HA levels were higher than those in the control group. After 1 month, 3 months and 6 months’ treatment YAP, BCL-2 levels in synovial fluid in the observation group were higher than those in the control group. Synovial fluid HMGB2 CCL1, NO and PD-1 levels of the observation group patients after treatment were lower than those of the control group. Conclusions: the elderly patients with early and middle stage knee osteoarthritis can be treated by oral administration, fumigation combined with sodium hyaluronate injection in the treatment of knee osteoarthritis, which can optimize the whole body and local non-infective inflammatory state, and promote the rehabilitation of the patients.

  5. Intraoperative 3-D imaging improves sentinel lymph node biopsy in oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bluemel, Christina; Herrmann, Ken; Buck, Andreas K.; Lapa, Constantin [University Hospital Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Kuebler, Alexander; Hartmann, Stefan; Linz, Christian; Mueller-Richter, Urs [University Hospital Wuerzburg, Department of Oral and Maxillofacial Plastic Surgery, Wuerzburg (Germany); Geissinger, Eva; Wild, Vanessa [University Wuerzburg, Institute of Pathology, Wuerzburg (Germany)

    2014-12-15

    The aim of this study was to prospectively evaluate the feasibility and potential advantages of freehand single-photon emission computed tomography (fhSPECT) compared with conventional intraoperative localization techniques for sentinel lymph node biopsy (SLNB) in oral cancer. Between November 2012 and February 2014, 23 consecutive patients with clinical T1/T2 oral squamous cell carcinoma and a cN0 neck were recruited. All patients underwent SLNB followed by elective neck dissection (END). All patients received preoperative lymphoscintigraphy. To detect the SLNs intraoperatively, fhSPECT with a combination of conventional acoustic SLN localization and 3-D visual navigation was used. All but one of the SLNs detected by preoperative imaging were successfully mapped intraoperatively by fhSPECT (detection rate 98 %), including those in six patients with a tumour in the floor of the mouth. A histopathology analysis revealed positive SLNs in 22 % of patients. No further metastases were found in LNs resected during END. SLNB correctly predicted the final LN stage in all patients (accuracy 100 %). Additional radioactive LNs, which were not present on preoperative lymphoscintigraphy, were observed in three patients. FhSPECT is a feasible technology that allows the accurate identification of SLNs in oral cancer. FhSPECT overcomes the shine-through phenomenon, one of the most important limitations of SLNB, thereby confirming the importance of SLNB in patients with cN0 oral cancer. (orig.)

  6. No effect of human serum and erythrocytes enriched in n-3 fatty acids by oral intake on Plasmodium falciparum blood stage parasites in vitro

    DEFF Research Database (Denmark)

    Abu-Zeid, Y A; Hansen, H S; Jakobsen, P H

    1993-01-01

    To examine the effect of n-3 polyunsaturated fatty acids (n-3 PUFA) on the erythrocytic growth of Plasmodium falciparum, serum and erythrocytes were separated from blood of a healthy donor before and after he had taken fish oil capsules for 8 days. Such intake supplied an amount of eicosapentaenoic...... acid (EPA, 20:5n-3) of 3.5 g/d and docosahexaenoic acid (DHA, 22:6n-3) of 2.5 g/d and 24 mg/d of total tocopherol. Post-intake fish oil serum (post-s) and erythrocytes (post-e) were tested in vitro for inhibitory activity against blood stages of P. falciparum compared with pre-intake serum (pre...

  7. Impact on long-term survival of the number of lymph nodes resected in patients with pT1N0 gastric cancer after R0 resection: A multicenter study in China.

    Science.gov (United States)

    Zhao, Jiuda; Du, Feng; Zhang, Yu; Kan, Jie; Dong, Li; Shen, Guoshuang; Zheng, Fangchao; Chen, Hui; Zhao, Junhui; Ji, Faxiang; Luo, Yang; Ma, Fei; Wang, Ziyi; Xu, Binghe

    2016-08-01

    Although studies on the association between the number of lymph nodes resected and prognosis in patients with pT2-4N0 stages of gastric cancer have reported consistent results, there is no consensus on the optimal number of lymph nodes to be examined for pT1N0 stage gastric cancer. The aim of this study was to evaluate the long-term effect of the number of lymph nodes removed on the outcomes of patients with pT1N0 stage gastric cancer after R0 resection.From December 2009 to December 2011, 227 patients undergoing R0 resection of pT1N0 stage gastric cancer at 4 Chinese centers were enrolled in this study. Patients were assigned to 2 groups according to the number of lymph nodes dissected (≤15 or > 15). Standard survival methods and restricted multivariable Cox regression models were applied.More women (P = 0.031) were in the ≤15 group than in the >15 group. The mean number of lymph nodes removed from women was greater than that from men (P = 0.007). The 5-year survival rate was significantly higher in the >15 lymph nodes resected group than the ≤15 group. The number of lymph nodes resected was identified as an independent prognostic factor and was significantly correlated with overall survival (OS).A lymphadenectomy with dissection of more than 15 lymph nodes improved the long-term survival of patients with pT1N0 gastric cancer after R0 resection. Therefore, it is necessary to consider removing more than 15 lymph nodes among such patients.

  8. Is Elective Irradiation to the Lower Neck Necessary for N0 Nasopharyngeal Carcinoma?

    International Nuclear Information System (INIS)

    Gao Yunsheng; Zhu Guopei; Lu Jiade; Ying Hongmei; Kong Ling; Wu Yongru; Hu Chaosu

    2010-01-01

    Purpose: To summarize our experience and treatment results in lymph node-negative nasopharyngeal carcinoma treated in a single institution. Methods and Materials: From January 2000 to December 2003, 410 patients with lymph node-negative nasopharyngeal carcinoma were retrospectively analyzed. The T-stage distribution was 18.8% in T1, 54.6% in T2 (T2a, 41 patients; T2b, 183 patients), 13.2% in T3, and 13.4% in T4. All patients received radiotherapy to the nasopharynx, skull base, and upper neck drainage areas, including levels II, III, and VA. The dose was 64-74 Gy, 1. 8-2.0 Gy per fraction over 6.5-7.5 weeks to the primary tumor with 60 Co or 6-MV X-rays, and 50-56 Gy to levels II, III, and VA. Residual disease was boosted with either 192 Ir afterloading brachytherapy or small external beam fields. Results: The median follow-up time was 54 months (range, 3-90 months). Four patients developed neck recurrence, and only 1 patient (0.2%) experienced relapse outside the irradiation fields. The 5-year overall survival rate was 84.2%. The 5-year relapse-free survival rate, distant metastasis-free survival rate, and disease-free survival rate were 88.6%, 90.6% and 80.1%, respectively. Both univariate and multivariate analyses demonstrated that T classification was the only significant prognostic factor for predicting overall survival. The observed serious late toxicities were radiation-induced brain damage (7 cases), cranial nerve palsy (16 cases), and severe trismus (13 cases; the distance between the incisors was ≤1 cm). Conclusion: Elective levels II, III, and VA irradiation is suitable for nasopharyngeal carcinoma without neck lymph node metastasis.

  9. Identification of candidates for postmastectomy radiotherapy in patients with pT3N0M0 breast cancer

    International Nuclear Information System (INIS)

    Hamamoto, Yasushi; Ohsumi, Shozo; Aogi, Kenjiro; Takashima, Shigemitsu; Shinohara, Shuichi; Nakajima, Naomi; Kataoka, Masaaki

    2013-01-01

    There is still controversy concerning the indication of postmastectomy radiotherapy (PMRT) for pT3N0M0 breast cancer. To identify the candidates for PMRT in this subset, we investigated failure patterns, and searched for risk factors for isolated locoregional failure in pT3N0M0 breast cancer after mastectomy without PMRT. Among 1,176 patients who received mastectomy without PMRT for untreated unilateral breast cancer between 1990 and 2002, 64 patients (5%) had pT3N0M0 breast cancer (age 30-81 years; median 52.5 years). Isolated locoregional failure as the initial failure occurred in three patients. For all 64 patients, the 8-year failure-free survival rate, the isolated locoregional failure-free rate, and the distant failure-free rate were 76, 93, and 82%, respectively. Incidence of isolated locoregional failure as the initial failure was 18% (2/11) for patients 40 years or younger and 2% (1/53) for patients older than 40 years. The 8-year isolated locoregional failure-free rates were 73% for patients 40 years or younger and 98% for patients older than 40 years (p=0.0135). Concerning pT3N0M0 breast cancer, incidence of isolated locoregional failure was comparatively low after mastectomy without PMRT. Routine use of PMRT for all pT3N0M0 patients seemed to be unacceptable. PMRT may be useful for younger patients because of the comparatively high incidence of isolated locoregional failure. Because of the small number of cases in our series, further studies are necessary to determine the usefulness of PMRT for younger patients with pT3N0M0 breast cancer. (author)

  10. Evaluation of Gas Reburning and Low N0x Burners on a Wall Fired Boiler

    Energy Technology Data Exchange (ETDEWEB)

    None

    1998-07-01

    Under the U.S. Department of Energy's Clean Coal Technology Program (Round 3), a project was completed to demonstrate control of boiler NOX emissions and to a lesser degree, due to coal replacement, SO2 emissions. The project involved combining Gas Reburning with Low NOX Burners (GR-LNB) on a coal-fired electric utility boiler to determine if high levels of NO, reduction (70VO) could be achieved. Sponsors of the project included the U.S. Depatiment of Energy, the Gas Research Institute, Public Service Company of Colorado, Colorado Interstate Gas, Electric Power Research Institute, and the Energy and Environmental Research Corporation. The GR-LNB demonstration was petformed on Public Service Company of Colorado's (PSCO) Cherokee Unit #3, located in Denver, Colorado. This unit is a 172 MW~ wall-fired boiler that uses Colorado bituminous, low-sulfur coal. It had a baseline NO, emission level of 0.73 lb/1 OG Btu using conventional burners. Low NOX burners are designed to yield lower NOX emissions than conventional burners. However, the NOX control achieved with this technique is limited to 30-50Y0. Also, with LNBs, CO emissions can increase to above acceptable standards. Gas Reburning (GR) is designed to reduce NO, in the flue gas by staged fuel combustion. This technology involves the introduction of' natural gas into the hot furnace flue gas stream. When combined, GR and LNBs minimize NOX emissions and maintain acceptable levels of CO emissions. A comprehensive test program was completed, operating over a wide range of boiler conditions. Over 4,000 hours of operation were achieved, providing substantial data. Measurements were taken to quantify reductions in NOX emissions, the impact on boiler equipment and operability and factors influencing costs. The GR-LNB technology achieved good NO, emission reductions and the goals of the project were achieved. Although the performance of the low NOX burners (supplied by others) was less than expected, a NOX

  11. A phase I study of concurrent chemotherapy and thoracic radiotherapy with oral epigallocatechin-3-gallate protection in patients with locally advanced stage III non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Zhao, Hanxi; Zhu, Wanqi; Xie, Peng; Li, Huiqin; Zhang, Xiqin; Sun, Xiaorong; Yu, Jinming; Xing, Ligang

    2014-01-01

    Background and purpose: Patients with unresectable stage III non-small-cell lung cancer receiving concurrent chemoradiotherapy often develop esophagitis that may lead to unplanned treatment interruptions, which may severely reduce rates of locoregional tumor control and survival. No effective treatment that would reduce the incidence and severity of this complication has been identified up to now. Although acceleration of normal tissue protection using epigallocatechin-3-gallate (EGCG) has been reported, its actual clinical practicability remains obscure. Methods and materials: This is a phase I study of EGCG in combination with standard chemoradiation in surgically unresectable stage III non-small-cell lung cancer. Chemotherapy (cisplatin and etoposide) was given concurrently with radiation. EGCG solution was swallowed three times a day after the occurrence of grade 2 esophagitis at six concentration levels and dose escalation followed a standard phase I design. Esophageal toxicity and patient-reported pain was recorded weekly. Results: Twenty-four patients with AJCC stage IIIA (six) and IIIB (eighteen) completed the course of therapy. Twelve had squamous histology, ten adenocarcinoma, and two not specified. Patients were treated in six cohorts at six dose levels of EGCG. RT was not interrupted with a median dose of 64 Gy. There were no dose-limiting toxicities reported in all EGCG dosing tiers. Dramatic regression of esophagitis to grade 0/1 was observed in 22 of 24 patients, whereas grade 2 esophagitis persisted in 2 of 24 patients at the end of radiotherapy. The pain score was also reduced from a mean of 4.58 (N = 24), 1.29 (N = 24), 1.42 (N = 24), 0.96 (N = 23) to 1.13 (N = 16) every week in turn. Conclusion: We conclude that the oral administration of EGCG is feasible, safe and effective. The phase II recommended concentration is 440 μmol/L

  12. Evaluation of Gas Reburning and Low N0x Burners on a Wall Fired Boiler

    Energy Technology Data Exchange (ETDEWEB)

    None

    1998-09-01

    Under the U.S. Department of Energy's Clean Coal Technology Program (Round 3), a project was completed to demonstrate control of boiler emissions that comprise acid rain precursors, especially NOX. The project involved operating gas reburning technology combined with low NO, burner technology (GR-LNB) on a coal-fired utility boiler. Low NOX burners are designed to create less NOX than conventional burners. However, the NO, control achieved is in the range of 30-60-40, and typically 50%. At the higher NO, reduction levels, CO emissions tend to be higher than acceptable standards. Gas Reburning (GR) is designed to reduce the level of NO. in the flue gas by staged fuel combustion. When combined, GR and LNBs work in harmony to both minimize NOX emissions and maintain an acceptable level of CO emissions. The demonstration was performed at Public Service Company of Colorado's (PSCO) Cherokee Unit 3, located in Denver, Colorado. This unit is a 172 MW. wall-fired boiler that uses Colorado bituminous, low-sulfur coal and had a pre GR-LNB baseline NOX emission of 0.73 lb/1 Oe Btu. The target for the project was a reduction of 70 percent in NOX emissions. Project sponsors included the U.S. Department of Energy, the Gas Research Institute, Public Service Company of Colorado, Colorado Interstate Gas, Electric Power Research Institute, and the Energy and Environmental Research Corporation (EER). EER conducted a comprehensive test demonstration program over a wide range of boiler conditions. Over 4,000 hours of operation were achieved. Intensive measurements were taken to quantify the reductions in NOX emissions, the impact on boiler equipment and operability, and all factors influencing costs. The results showed that GR-LNB technology achieved excellent emission reductions. Although the performance of the low NOX burners (supplied by others) was somewhat less than expected, a NOX reduction of 65% was achieved at an average gas heat input of 180A. The performance goal

  13. Oral Cancer

    Science.gov (United States)

    Oral cancer can form in any part of the mouth. Most oral cancers begin in the flat cells that cover the ... your mouth, tongue, and lips. Anyone can get oral cancer, but the risk is higher if you are ...

  14. Treatment of metabolic acidosis in patients with stage 3 chronic kidney disease with fruits and vegetables or oral bicarbonate reduces urine angiotensinogen and preserves glomerular filtration rate.

    Science.gov (United States)

    Goraya, Nimrit; Simoni, Jan; Jo, Chan-Hee; Wesson, Donald E

    2014-11-01

    Alkali therapy of metabolic acidosis in patients with chronic kidney disease (CKD) with plasma total CO2 (TCO2) below 22 mmol/l per KDOQI guidelines appears to preserve estimated glomerular filtration rate (eGFR). Since angiotensin II mediates GFR decline in partial nephrectomy models of CKD and even mild metabolic acidosis increases kidney angiotensin II in animals, alkali treatment of CKD-related metabolic acidosis in patients with plasma TCO2 over 22 mmol/l might preserve GFR through reduced kidney angiotensin II. To test this, we randomized 108 patients with stage 3 CKD and plasma TCO2 22-24 mmol/l to Usual Care or interventions designed to reduce dietary acid by 50% using sodium bicarbonate or base-producing fruits and vegetables. All were treated to achieve a systolic blood pressure below 130 mm Hg with regimens including angiotensin converting enzyme inhibition and followed for 3 years. Plasma TCO2 decreased in Usual Care but increased with bicarbonate or fruits and vegetables. By contrast, urine excretion of angiotensinogen, an index of kidney angiotensin II, increased in Usual Care but decreased with bicarbonate or fruits and vegetables. Creatinine-calculated and cystatin C-calculated eGFR decreased in all groups, but loss was less at 3 years with bicarbonate or fruits and vegetables than Usual Care. Thus, dietary alkali treatment of metabolic acidosis in CKD that is less severe than that for which KDOQI recommends therapy reduces kidney angiotensin II activity and preserves eGFR.

  15. Remarkable response to photodynamic therapy in residual T4N0M0 nasopharyngeal carcinoma: a case report

    NARCIS (Netherlands)

    Indrasari, S. R.; Timmermans, A. J.; Wildeman, M. A.; Karakullukcu, M. B.; Herdini, C.; Hariwiyanto, B.; Tan, I. B.

    2012-01-01

    Local treatment of residual or recurrent nasopharyngeal carcinoma (NPC) is a challenge. Photodynamic therapy (PDT) is an established treatment modality for incurable head and neck carcinoma. Several studies reported induction of an immune response after PDT. We present a patient with residual T4N0M0

  16. High-dose-rate iridium-192 afterloading therapy combined with external beam radiotherapy for T1c-T3bN0M0 prostate cancer.

    Science.gov (United States)

    Jo, Yoshimasa; Hiratsuka, Junichi; Fujii, Tomohiro; Takenaka, Atsushi; Fujisawa, Masato

    2004-09-01

    To determine the efficacy of radiotherapy (RT) for T1c-T3bN0M0 prostate cancer in a prospective clinical trial of concurrent external beam RT and fractionated iridium-192 high-dose-rate brachytherapy. Included in the study were 98 patients with T1c-T3bN0M0 prostate cancer who were diagnosed between October 1997 and September 2002 and underwent high-dose-rate brachytherapy with external beam RT. Treatment consisted of external beam RT (four ports) to the prostate of 16 fractions of 2.3 Gy to a total dose of 36.8 Gy and high-dose-rate brachytherapy of 4 fractions of 6.0 Gy within 30 hours to a total dose of 24.0 Gy. No patient received adjuvant hormonal therapy after RT. The most recent prostate-specific antigen level was 0.0 to 3.9 ng/mL (median 0.4). Seven patients (7.1%) developed recurrence and treatment was considered a failure (bone metastasis in two and biochemical failure in five). The overall biochemical disease-free survival (bDFS) rate was 95.9% at 2 years and 92.9% at 5 years. The bDFS rate by T stage was 98.6% at 2 years and 95.9% at 5 years for Stage T1c-T2b and 88.0% and 84.0% for Stage T3a-b, respectively (P = 0.047). The 2-year and 5-year bDFS rate was better in patients with an initial prostate-specific antigen level of less than 20 ng/mL compared with 20 ng/mL or greater (98.6% and 97.1% versus 93.1% and 82.8%, respectively, P = 0.0261). Acute toxicity was mild to moderate (Radiation Therapy Oncology Group grade 1-2) and consisted of cystourethritis or proctitis in 29 (29.6%) of 98 patients. With a low complication rate and satisfactory bDFS rates, this combination therapy can be considered an alternative method for clinical Stage T1c-T3b prostate cancer and is expected to improve patient quality of life. Additional long-term follow-up is needed to confirm this treatment.

  17. SU-E-T-63: Carotid Sparing Tomohelical Three Dimensional Conformal Radiotherapy for T1N0 Glottic Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hong, C; Ju, S; Ahn, Y; Oh, D; Noh, J; Chung, K; Kim, J; Han, Y; Choi, D [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2014-06-01

    Purpose: We investigated the dosimetric benefit and treatment efficiency of carotid-sparing TomoHelical (TH) three-dimensional conformal radiotherapy (3DCRT) for early glottic cancer. Methods: Computed tomography (CT) simulation was performed for 10 patients with early-stage (T1N0M0) glottic squamous cell carcinoma. The clinical target volume, planning target volume (PTV), carotid artery (CA), and spinal cord (SP) were delineated for each CT data set. Two-field 3DCRT (2F-3DCRT), three-field intensity-modulated radiation therapy (IMRT) (3F-IMRT), TomoHelical-IMRT (TH-IMRT), and TH-3DCRT plans were generated, with a total prescribed dose of 67.5 Gy in 30 fractions to the PTV for each patient. In order to evaluate plan quality, dosimetric characteristics were compared in terms of the conformity index (CI) and homogeneity index (HI) for the PTV, V35, V50, and V63 for the CAs and in terms of the maximum dose for the SP. Additionally, treatment planning and delivery times were compared to evaluate treatment efficiency. Results: The CIs for 3F-IMRT (0.650±0.05), TH-IMRT (0.643±0.03), and TH-3DCRT (0.631±0.03) were much better than that for 2F-3DCRT (0.318±0.03). The HIs for TH-IMRT (1.053±0.01) and TH-3DCRT (1.055±0.01) were slightly better than those for 2F-3DCRT (1.062±0.01) and 3F-IMRT (1.091±0.007). 2F-3DCRT showed poor CA sparing in terms of the V35, V50, and V63 compared to 3F-IMRT, TH-IMRT, and TH-3DCRT (p<0.05), whereas there was no significant dose difference between 3F-IMRT, TH-IMRT, and TH-3DCRT (p>0.05). The maximum dose to the SP with all plans was below 45 Gy. The treatment planning times for 2F-3DCRT (5.9±0.66 min) and TH-3DCRT (7.32±0.94 min) were much lower than those for 3F-IMRT (45.51±2.76 min) and TH-IMRT (35.58±4.41 min), whereas the delivery times with all plans was below 3 minutes. Conclusion: TH-3DCRT showed excellent carotid sparing capability, comparable to that with TH-IMRT, with high treatment efficiency and short planning and

  18. Infrared and Raman spectra of (η 6-C 6H 6- nX n)Cr(CO) 3 complexes where X = Me ( n = 0-6) or OMe ( n = 0-2). A study of metal—ligand interactions

    Science.gov (United States)

    Armstrong, R. S.; Aroney, M. J.; Barnes, C. M.; Nugent, K. W.

    1994-07-01

    A systematic study is reported of the infrared and Raman spectra of methyl and methoxy substituted benzene chromium tricarbonyl complexes (η 6-C 6H 6- nX n)Cr(CO) 3 where X = Me ( n = 0-6) or OMe ( n = 0-2). Bands have been assigned and intensities calculated for a number of vibrational modes. Trends in the wavenumbers and band intensities of the arenemetal, metalcarbonyl and carbonyl bonds are examined to gain an insight into metal—ligand interactions and intramolecular electron rearrangements with progressive substitution on the arene. The results are discussed with regard σ-, π- and δ-contributions to arenemetal bonding and of σ- and π-components in metal-carbonyl and carbonyl bonding. The intensities are related to the polarities and polarizabilities of individual bonds within the molecules, and variations in these bond electronic properties with arene substitution are examined.

  19. Liquid phase interaction in TiC0,5N0,5-TiNi-Mo and TiC0,5N0,5-TiNi-Ti-Mo

    International Nuclear Information System (INIS)

    Askarova, L.Kh; Grigorov, I.G.; Zajnulin, Yu.G.

    1998-01-01

    Using the methods of X ray diffraction analysis, electron microscopy and X ray spectrum microanalysis a study was made into specific features of phase and structure formation in alloys TiC 0,5 N 0,5 -TiNi-Mo and TiC 0,5 N 0,5 -TiNi-Mo in the presence of a liquid phase at temperatures of 1380-1600 deg C. It is revealed that the physical and chemical processes taking place during the liquid-phase sintering result in the formation of a three-phase alloy consisting of nonstoichiometric titanium carbonitride TiC 0.5-x N 0.5-x , a molybdenum base solid solution of titanium, nickel and carbon Mo(Ti, Ni, C) and one of two intermetallic compounds, either TiNi or Ni 3 Ti. Metallic element concentration in individual phase constituents of the alloy is determined by means of X ray spectrum microanalysis

  20. Freeze-Dried Black Raspberries in Preventing Oral Cancer Recurrence in High-Risk Appalachian Patients Previously Treated With Surgery For Oral Cancer

    Science.gov (United States)

    2018-03-04

    Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage II Squamous Cell Carcinoma of the Oropharynx; Stage II Verrucous Carcinoma of the Oral Cavity; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage III Verrucous Carcinoma of the Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer

  1. 0dB Eb/N(0) burst mode SCPC modem with high coding gain FEC

    Science.gov (United States)

    Namiki, Junji; Ohtani, Susumu; Yasuda, Yutaka

    A digital SCPC modem for 0dB Eb/N(0) burst signal is described in this paper. When demodulation process is followed by a powerful error correction function, carrier phase and clock timing control systems should maintain control in a higher bit error rate (BER) environment so as to obtain a sufficient error correction performance. This paper presents new digital demodulator structure satisfying above mentioned requirements by using digital signal processors. A proposed demodulator has a new adaptive PLL called 'Beatless Pull-In PLL', and a highly reliable 'carrier detector' to detect carrier portion of preamble. A proposed demodulator has been manufactured, and a misacquisition probability was experimentally verified to be less than .0025 at C/N = 3 dB (Eb/N(0) = 0db).

  2. The location of locoregional recurrence in pathologic T3N0, non-irradiated lower rectal cancer

    International Nuclear Information System (INIS)

    Kim, Mi Sun; Keum, Ki Chang; Rhee, Woo Joong; Kim, Hyun Ju; Kim, Min Ji; Choi, Seo Hee; Nam, Ki Chang; Koom, Woong Sub

    2013-01-01

    To investigate the patterns of locoregional recurrence of pathologic T3N0 (pT3N0) lower rectal cancer omitting postoperative radiotherapy (RT) and explore the potential of modification of a RT field. From Jan 2003 to Nov 2011, 35 patients omitting preoperative or postoperative RT for pT3N0 lower rectal cancer were included. We defined the lower rectal cancer as the tumor with the inferior margin located below the virtual line-a convergent level between rectal wall and levator ani muscle. All patients had radiologic examinations for recurrence evaluation during the follow-up duration. The median follow-up duration was 66.4 months (range, 1.4 to 126.1 months). Eight (22.9%) of the 35 patients had recurrence. Three (8.6%) was local recurrence (LR) only, 3 (8.6%) was distant metastasis (DM) only, and 2 (5.7%) was LR with DM. All LR were located at primary tumor sites. The overall survival rate, LR-free survival rate, and DM-free survival rate at 5 years was 79.8%, 83%, and 87%, respectively. All LR developed from tumors over 5 cm. However, there was no statistical significance (p = 0.065). There was no other risk factor for LR. Even though the patients included in this study had pathologically favorable pT3N0 rectal cancer, LR developed in 14.3% of patients. Most of the LR was located at primary tumor sites prior to surgery. Based on these findings, it might seem reasonable to consider postoperative RT with a smaller radiation field to the primary tumor site rather than the conventional whole pelvic irradiation.

  3. National Practice Patterns for Clinical T1N0 Nasopharyngeal Cancer in the Elderly: A National Cancer Data Base Analysis.

    Science.gov (United States)

    Post, Carl M; Lin, Chi; Adeberg, Sebastian; Gupta, Mrigank; Zhen, Weining; Verma, Vivek

    2018-03-01

    The standard of care for T1N0 nasopharyngeal cancer (NPC) is definitive radiation therapy (RT). However, practice patterns in the elderly may not necessarily follow national guidelines. Herein, we investigated national practice patterns for T1N0 NPC. The National Cancer Data Base (NCDB) was queried for clinical T1N0 primary NPC cases (2004-2013) in patients ≥70 years old. Patient, tumor, and treatment parameters were extracted. Kaplan-Meier analysis was used to compare overall survival (OS) between patients receiving RT versus those under observation. Logistic regression was used to examine variables associated with receipt of RT. Cox proportional hazards modeling determined variables associated with OS. Landmark analysis of patients surviving 1 year or more was performed to assess survival differences between groups. In total, data of 147 patients were analyzed. RT was delivered to 89 patients (61%), whereas 58 (39%) patients underwent observation. On multivariable analysis, older patients were less likely to receive RT (p=0.003), but there were no differences between groups in terms of Charlson-Deyo comorbidity index. Median and 5-year OS in patients receiving RT versus those under observation were 71 and 33 months, and 59% and 48% (p=0.011), respectively. For patients surviving 1 year or more (n=96), there was a strong trend showing that receipt of RT was associated with better median and 5-year OS. This National Data Base analysis shows that observation is relatively common for T1N0 NPC in the elderly, but is associated with poorer survival. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  4. Decree-Law N0 678 of 26 November 1981 concerning the creation of local health centres

    International Nuclear Information System (INIS)

    1981-01-01

    This Decree-Law provides for direct employment of workers by the Regions in connection with the creation of adequate health centres and radioactive decontamination centres, following nuclear emergencies in areas where nuclear power plants are located. This Decree-Law was converted into Act N 0 12 of 26th January 1982 and published in the Official Gazette of 27th January 1982. (NEA) [fr

  5. Construction of a pathological risk model of occult lymph node metastases for prognostication by semi-automated image analysis of tumor budding in early-stage oral squamous cell carcinoma.

    Science.gov (United States)

    Pedersen, Nicklas Juel; Jensen, David Hebbelstrup; Lelkaitis, Giedrius; Kiss, Katalin; Charabi, Birgitte; Specht, Lena; von Buchwald, Christian

    2017-03-14

    It is challenging to identify at diagnosis those patients with early oral squamous cell carcinoma (OSCC), who have a poor prognosis and those that have a high risk of harboring occult lymph node metastases. The aim of this study was to develop a standardized and objective digital scoring method to evaluate the predictive value of tumor budding. We developed a semi-automated image-analysis algorithm, Digital Tumor Bud Count (DTBC), to evaluate tumor budding. The algorithm was tested in 222 consecutive patients with early-stage OSCC and major endpoints were overall (OS) and progression free survival (PFS). We subsequently constructed and cross-validated a binary logistic regression model and evaluated its clinical utility by decision curve analysis. A high DTBC was an independent predictor of both poor OS and PFS in a multivariate Cox regression model. The logistic regression model was able to identify patients with occult lymph node metastases with an area under the curve (AUC) of 0.83 (95% CI: 0.78-0.89, P <0.001) and a 10-fold cross-validated AUC of 0.79. Compared to other known histopathological risk factors, the DTBC had a higher diagnostic accuracy. The proposed, novel risk model could be used as a guide to identify patients who would benefit from an up-front neck dissection.

  6. Factors influencing the treatment outcome for patients with T2N0 glottic carcinoma treated by definitive radiotherapy

    International Nuclear Information System (INIS)

    Fukuda, Ichiro; Kanehira, Chihiro; Kobayashi, Masao; Aoki, Manabu; Takagi, Sayako; Shirahama, Jun; Honda, Chikara

    2007-01-01

    The purpose of this study was to determine the prognostic factors affecting local outcomes for patients with T2N0 glottic carcinoma treated by definitive radiotherapy. A total of 48 patients with T2N0 squamous cell carcinoma treated by definitive radiotherapy between 1992 and 2005 were studied. Cumulative probability of overall survival, cause-specific survival, local control and larynx-preserving were calculated according the Kaplan-Meier method, and the prognostic significance of patient's age, number of subsites involved, impaired cord mobility, anterior commisure involved, total dose and overall treatment time were analyzed using the log-rank test in univariate analysis and Cox regression in multivariate analysis. Follow-up ranged from 13 to 141 months (median, 62 months). Five-year survivals were: overall, 95.3%; cause-specific, 97.9% and five years rates were local control, 61.4%; larynx-preserving, 76.4%. Multivariate analyses of the six parameters showed that overall treatment time significantly influenced the probability of local control, and impaired mobility and overall treatment time affected the probability of larynx-preserving. Our study showed that longer overall treatment time significantly worsened the percentage of local control and larynx-preserving for patients with T2N0 glottic carcinoma treated with definitive radiotherapy. Therefore, we suggest treating, the patients in a shorter treatment course. (author)

  7. Challenges in Comparative Oral Epic

    Directory of Open Access Journals (Sweden)

    John Miles Foley

    2012-10-01

    Full Text Available Originally written in 2001 and subsequently published in China, this collaborative essay explores five questions central to comparative oral epic with regard to Mongolian, South Slavic, ancient Greek, and Old English traditions: “What is a poem in oral epic tradition?” “What is a typical scene or theme in oral epic tradition?” “What is a poetic line in oral epic tradition?” “What is a formula in an oral epic tradition?” “What is the register in oral epic poetry?” Now available for the first time in English, this essay reflects a foundational stage of what has become a productive and long-term collaboration between the Center for Studies in Oral Tradition and the Institute of Ethnic Literature of the Chinese Academy of Social Sciences.

  8. Incidence and patterns of regional metastasis in early oral squamous cell cancers: feasibility of submandibular gland preservation.

    Science.gov (United States)

    Razfar, Ali; Walvekar, Rohan R; Melkane, Antoine; Johnson, Jonas T; Myers, Eugene N

    2009-12-01

    We aimed to study the incidence of metastasis to the submandibular gland (SMG) and to establish the oncologic basis of SMG preservation in early-stage cancer of the oral cavity (OSCC). This was a retrospective study of 261 patients with OSCC treated primarily with surgery at a tertiary medical center. One hundred thirty-two early-stage (T1-2, N0) OSCCs were further analyzed. The mean age was 59 years with male-to-female sex ratio of 1.4:1. Two hundred sixty-one neck dissections were performed with SMG removal in 253 patients. One patient with an advanced floor of mouth cancer had obvious infiltration of the SMG. Only 2.5% (3 of 116) patients with early-stage OSCC had level I metastasis; none had SMG metastases. SMG preservation in early cancers (T1-2, N0) of the oral cavity should be feasible unless there is evidence of direct invasion of the gland or close proximity of the cancer to it.

  9. Risk of biochemical recurrence and timing of radiotherapy in pT3a N0 prostate cancer with positive surgical margin. A single center experience

    International Nuclear Information System (INIS)

    Hegemann, Nina-Sophie; Morcinek, Sebastian; Corradini, Stefanie; Li, Minglun; Belka, Claus; Ganswindt, Ute; Buchner, Alexander; Karl, Alexander; Stief, Christian; Knuechel, Ruth

    2016-01-01

    Despite improved biochemical recurrence-free survival rates by the use of immediate adjuvant radiotherapy (RT) in patients with locally advanced prostate cancer, disagreement about the need and timing of RT remains. From 2005-2009, 94 patients presenting with a stage pT3a N0 and microscopic positive resection margin were retrospectively analyzed after radical prostatectomy. Special attention was given to patients' outcome, the frequency of additive RT, and its efficacy. Median follow-up was 80 months. A total of 71 patients had a negative postoperative prostate-specific antigen (PSA) level (<0.07 ng/ml). Thirty-six of them did not experience any PSA relapse (subgroup 1). Fourteen of them received additive RT and during follow-up all 36 patients remained PSA negative. Of 71 initially PSA-negative patients, 35 had a biochemical relapse (subgroup 2); 28 patients underwent salvage RT. The median PSA value before salvage RT was 0.24 ng/ml and was subsequently negative (<0.07 ng/ml) in 23 patients after RT. Of the entire cohort, 23 patients had persisting PSA after surgery (subgroup 3). Of these, 18 patients received salvage RT at a median PSA level of 0.4 ng/ml. One patient in subgroup 1, 5 patients in subgroup 2, and 9 patients in subgroup 3 had ongoing androgen deprivation therapy. The present study of 94 pT3a N0 R1 prostate cancer patients provides insight into medical care of this patient cohort and underlines the need for additive RT for the majority of patients to achieve long-term biochemical control. Although immediate adjuvant RT was applied with restraint (20 %), during the observation period 60 of 94 patients (63.8 %) received RT - highlighting the need of postoperative treatment. (orig.) [de

  10. Results of Neoadjuvant Short-Course Radiation Therapy Followed by Transanal Endoscopic Microsurgery for T1-T2 N0 Extraperitoneal Rectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Arezzo, Alberto, E-mail: alberto.arezzo@unito.it [General Surgery I, Department of Surgical Sciences, University of Torino, Torino (Italy); Arolfo, Simone; Allaix, Marco Ettore [General Surgery I, Department of Surgical Sciences, University of Torino, Torino (Italy); Munoz, Fernando [Radiation Oncology, Department of Oncology, University of Torino, Torino (Italy); Cassoni, Paola [Pathology Unit, Department of Medical Sciences, University of Torino, Torino (Italy); Monagheddu, Chiara [Clinical Epidemiology Unit, Piedmont Reference Centre for Epidemiology and Cancer Prevention, City of Health and Science Hospital of Torino, Torino (Italy); Ricardi, Umberto [Radiation Oncology, Department of Oncology, University of Torino, Torino (Italy); Ciccone, Giovannino [Clinical Epidemiology Unit, Piedmont Reference Centre for Epidemiology and Cancer Prevention, City of Health and Science Hospital of Torino, Torino (Italy); Morino, Mario [General Surgery I, Department of Surgical Sciences, University of Torino, Torino (Italy)

    2015-06-01

    Purpose: This study was undertaken to assess the short-term outcomes of neoadjuvant short-course radiation therapy (SCRT) followed by transanal endoscopic microsurgery (TEM) for T1-T2 N0 extraperitoneal rectal cancer. Recent studies suggest that neoadjuvant radiation therapy followed by TEM is safe and has results similar to those with abdominal rectal resection for the treatment of extraperitoneal early rectal cancer. Methods and Materials: We planned a prospective pilot study including 25 consecutive patients with extraperitoneal T1-T2 N0 M0 rectal adenocarcinoma undergoing SCRT followed by TEM 4 to 10 weeks later (SCRT-TEM). Safety, efficacy, and acceptability of this treatment modality were compared with historical groups of patients with similar rectal cancer stage and treated with long-course radiation therapy (LCRT) followed by TEM (LCRT-TEM), TEM alone, or laparoscopic rectal resection with total mesorectal excision (TME) at our institution. Results: The study was interrupted after 14 patients underwent SCRT of 25 Gy in 5 fractions followed by TEM. Median time between SCRT and TEM was 7 weeks (range: 4-10 weeks). Although no preoperative complications occurred, rectal suture dehiscence was observed in 7 patients (50%) at 4 weeks follow-up, associated with an enterocutaneous fistula in the sacral area in 2 cases. One patient required a colostomy. Quality of life at 1-month follow-up, according to European Organization for Research and Treatment of Cancer QLQ-C30 survey score, was significantly worse in SCRT-TEM patients than in LCRT-TEM patients (P=.0277) or TEM patients (P=.0004), whereas no differences were observed with TME patients (P=.604). At a median follow-up of 10 months (range: 6-26 months), we observed 1 (7%) local recurrence at 6 months that was treated with abdominoperineal resection. Conclusions: SCRT followed by TEM for T1-T2 N0 rectal cancer is burdened by a high rate of painful dehiscence of the suture line and enterocutaneous

  11. Oral myiasis

    Directory of Open Access Journals (Sweden)

    Thalaimalai Saravanan

    2015-01-01

    Full Text Available Myiasis is a pathologic condition in humans occurring because of parasitic infestation. Parasites causing myiasis belong to the order Diptera. Oral myiasis is seen secondary to oral wounds, suppurative lesions, and extraction wounds, especially in individuals with neurological deficit. In such cases, neglected oral hygiene and halitosis attracts the flies to lay eggs in oral wounds resulting in oral myiasis. We present a case of oral myiasis in 40-year-old male patient with mental disability and history of epilepsy.

  12. 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

  13. Characteristics of Oral Problems and Effects of Oral Care in Terminally Ill Patients With Cancer.

    Science.gov (United States)

    Nakajima, Nobuhisa

    2017-06-01

    Various distresses appear in the terminal stage of cancer. Oral problems including dry mouth, stomatitis and candidiasis are one of the important problems which should be resolved. The purpose of this study was to investigate oral problems in this stage and improvement of dry mouth by oral care. The study subjects were consecutive terminally ill cancer patients admitted over the past 2 years. Patients were divided based on the status of oral food intake into good oral food intake group (≥30%) and poor oral food intake group. The following 3 items were retrospectively investigated: 1) The incidences of these oral problems, 2) Severity of dry mouth and complication with other oral problems, 3) Improvement of dry mouth using standard oral care by nursing staff and specialist oral care including dentists as needed. There were 115 and 158 patients in good and poor oral intake groups, respectively. 1) The incidences of dry mouth, stomatitis, and candidiasis were significantly higher in poor oral intake group ( p oral intake groups, respectively ( p oral intake group ( p = 0.0002). 3) The rate of dry mouth improvement by oral care was 100% in Grade-1, 86% in Grade-2 and 81% in Grade-3. Oral problems occur in many of terminally ill cancer patients. Accurate diagnosis of oral problems and corresponding appropriate interventions are important for improving quality of end-of-life care.

  14. Pharmacokinetics of a Single Oral Dose of the MEK1/2 Inhibitor Selumetinib in Subjects With End-Stage Renal Disease or Varying Degrees of Hepatic Impairment Compared With Healthy Subjects.

    Science.gov (United States)

    Dymond, Angela W; Martin, Paul; So, Karen; Huang, Yifan; Severin, Paul; Holmes, Victoria; Mariani, Gabriella; Marbury, Thomas

    2017-05-01

    Two phase I open-label studies were conducted to investigate the pharmacokinetics (PK), safety, and tolerability of single oral doses of selumetinib in subjects with end-stage renal disease (ESRD) undergoing hemodialysis and subjects with varying degrees of hepatic impairment; both studies included a matched control group comprised of healthy individuals. In the renal impairment study, subjects received single doses of selumetinib 50 mg; those with ESRD received selumetinib before and after dialysis (with a between-treatment washout period of ≥7 days). In the hepatic impairment study, subjects received varying single doses of selumetinib (20-50 mg) depending on liver dysfunction (mild, moderate, or severe as per Child-Pugh classification). PK, safety, and tolerability data were collected from both studies. Overall, 24 subjects were included in the renal impairment study (ESRD, N = 12; healthy subjects, N = 12). Selumetinib exposure (AUC and C max ) was not increased in the ESRD group vs healthy subjects. Selumetinib exposure was lower when selumetinib was dosed before vs after dialysis, although individual exposure was variable. Overall, 32 subjects were included in the hepatic impairment study (mild, moderate, and severe impairment, N = 8 per group; healthy subjects, N = 8). Generally, dose-normalized total selumetinib exposure was increased by 25% to 59% in subjects with moderate and severe hepatic impairment compared with healthy subjects. Increasing Child-Pugh score, decreasing serum albumin, and increasing prothrombin time correlated with increasing unbound selumetinib exposure. In both studies, selumetinib was well tolerated with no new safety concerns. These studies will inform dose adjustment considerations in patients. © 2016, The Authors. The Journal of Clinical Pharmacology Published by Wiley Periodicals, Inc. on behalf of American College of Clinical Pharmacology.

  15. Oral lipid-based nanoformulation of tafenoquine enhanced bioavailability and blood stage antimalarial efficacy and led to a reduction in human red blood cell loss in mice

    Directory of Open Access Journals (Sweden)

    Melariri P

    2015-02-01

    Full Text Available Paula Melariri,1 Lonji Kalombo,2 Patric Nkuna,2 Admire Dube,2,3 Rose Hayeshi,2 Benhards Ogutu,4,5 Liezl Gibhard,6 Carmen deKock,6 Peter Smith,6 Lubbe Wiesner,6 Hulda Swai2 1Polymers and Composites, Material Science and Manufacturing, Council for Scientific and Industrial Research, Port Elizabeth, South Africa; 2Polymer and Composites, Material Science and Manufacturing, Council for Scientific and Industrial Research, Pretoria, South Africa; 3School of Pharmacy, University of the Western Cape, Bellville, South Africa; 4Centre for Research in Therapeutic Sciences, Strathmore University, Nairobi, Kenya; 5Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya; 6Division of Pharmacology, University of Cape Town Medical School, Groote Schuur Hospital, Cape Town, South Africa Abstract: Tafenoquine (TQ, a new synthetic analog of primaquine, has relatively poor bioavailability and associated toxicity in glucose-6-phosphate dehydrogenase (G6PD-deficient individuals. A microemulsion formulation of TQ (MTQ with sizes <20 nm improved the solubility of TQ and enhanced the oral bioavailability from 55% to 99% in healthy mice (area under the curve 0 to infinity: 11,368±1,232 and 23,842±872 min·µmol/L for reference TQ and MTQ, respectively. Average parasitemia in Plasmodium berghei-infected mice was four- to tenfold lower in the MTQ-treated group. In vitro antiplasmodial activities against chloroquine-sensitive and chloroquine-resistant strains of Plasmodium falciparum indicated no change in half maximal inhibitory concentration, suggesting that the microemulsion did not affect the inherent activity of TQ. In a humanized mouse model of G6PD deficiency, we observed reduction in toxicity of TQ as delivered by MTQ at low but efficacious concentrations of TQ. We hereby report an enhancement in the solubility, bioavailibility, and efficacy of TQ against blood stages of Plasmodium parasites without a corresponding increase in toxicity

  16. Microsolvation for the Dicyanamide Anion: [N(CN)2-](H2O)n (n=0-12)

    Energy Technology Data Exchange (ETDEWEB)

    Jagoda-Cwiklik, Barbra; Wang, Xue B.; Woo, Hin-Koon; Yang, Jie; Wang, Guanjun; Zhou, Mingfei; Jungwirth, Pavel; Wang, Lai S.

    2007-08-16

    Photoelectron spectroscopy is combined with ab initio calculations to study the microsolvation of the dicyanamide anion, N(CN)2 -. Photoelectron spectra of [N(CN)2-] (H2O)n (n = 0-12) have been measured at room temperature and also at low temperature for n= 0-4. Vibrationally resolved photoelectron spectra are obtained for N(CN)2-, allowing the electron affinity of the N(CN)2 radical to be determined accurately as 4.135 ±0.010 eV. The electron binding energies and the spectral width of the hydrated clusters are observed to increase with the number of water molecules. The first five waters are observed to provide significant stabilization to the solute, whereas the stabilization becomes weaker for n > 5. The spectral width, which carries information about the solvent reorganization upon electron detachment in [N(CN)2-](H2O)n, levels off for n > 6. Theoretical calculations reveal several close-lying isomers for n= 1 and 2 due to the fact that the N(CN)2- anion possesses three almost equivalent hydration sites. In all the hydrated clusters, the most stable structures consist of a water cluster solvating one end of the N(CN)2- anion.

  17. First-principles study of Mg incorporation at wurtzite InN (0 0 0 1) and (0001-bar) surfaces

    International Nuclear Information System (INIS)

    Ding, S.F.; Qu, X.P.; Fan, G.H.

    2009-01-01

    In this article we investigate the energetics of Mg adsorption and incorporation at the InN(0 0 0 1) and InN(0001-bar) surfaces by the method of total energy plane-wave expansions with ultra-soft pseudo potential technology based on the density functional theory (DFT) in the generalized approximation (GGA). It is found that for a 1/4 monolayer (ML) coverage of the InN(0 0 0 1) surface, Mg atoms preferentially adsorb at the bridge sites and T4 sites, but they are unstable when compared with Mg incorporated in the first three layers. For a 1/4 ML coverage of the InN(0001-bar) surface, Mg atoms preferentially adsorb at the H3 sites with the formation energy of -3.49 (eV/(2x2) supercell), which is lower than that of the T4 sites, and the formation energy increases with increasing magnesium coverage. Further study shows that the formation energy for Mg atom is lower than that of In atom, which indicates that magnesium adsorption is more favorable in these conditions.

  18. Synthesis, crystal structure, electric and magnetic properties of LaVO2.78N0.10

    International Nuclear Information System (INIS)

    Yoon, Songhak; Maegli, Alexandra E.; Karvonen, Lassi; Shkabko, Andrey; Populoh, Sascha; Sagarna, Leyre; Aguirre, Myriam H.; Pokrant, Simone; Galazka, Krzysztof; Jakes, Peter; Eichel, Ruediger A.; Ebbinghaus, Stefan G.; Weidenkaff, Anke

    2014-01-01

    Perovskite-type LaVO 2.78 N 0.10 powder was synthesized by thermal ammonolysis of the oxide precursor LaVO 4 . By X-ray, neutron, and electron diffraction an orthorhombic crystal structure with space group Pnma was identified. XANES spectra showed that the oxidation state of vanadium changes from 5+ in LaVO 4 to approximately 3+ in LaVO 2.78 N 0.10 . The temperature dependence of the electrical conductivity revealed an Arrhenius-type behavior with an activation energy of 0.103 eV in the temperature range of 119-302 K indicating that the conduction process is thermally activated band transition. Based on the positive Seebeck coefficient, holes were identified as the dominant charge carriers in the temperature range of 100-302 K. Both the Seebeck coefficient and the thermal conductivity showed an anomaly at 138 K, which is attributed to the Neel temperature for antiferromagnetic ordering according to magnetic susceptibility measurements. (Copyright copyright 2014 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  19. Stage design

    International Nuclear Information System (INIS)

    Shacter, J.

    1975-01-01

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

  20. Phase 1b Food Based Modulation of Biomarkers in Human Tissues at High-Risk for Oral Cancer.

    Science.gov (United States)

    2018-03-05

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Salivary Gland Squamous Cell Carcinoma; Stage 0 Hypopharyngeal Cancer; Stage 0 Laryngeal Cancer; Stage 0 Lip and Oral Cavity Cancer; Stage 0 Nasopharyngeal Cancer; Stage 0 Oropharyngeal Cancer; Stage 0 Paranasal Sinus and Nasal Cavity Cancer; Stage I Salivary Gland Cancer; Stage I Squamous Cell Carcinoma of the Hypopharynx; Stage I Squamous Cell Carcinoma of the Larynx; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Nasopharynx; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage I Verrucous Carcinoma of the Larynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Salivary Gland Cancer; Stage II Squamous Cell Carcinoma of the Hypopharynx; Stage II Squamous Cell Carcinoma of the Larynx; Stage II Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage II Squamous Cell Carcinoma of the Nasopharynx; Stage II Squamous Cell Carcinoma of the Oropharynx; Stage II Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage II Verrucous Carcinoma of the Larynx; Stage II Verrucous Carcinoma of the Oral Cavity; Stage III Salivary Gland Cancer; 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 III Verrucous Carcinoma of the Larynx; Stage III Verrucous Carcinoma of the Oral Cavity; 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 Oral Cavity Squamous Cell Carcinoma; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Nasal Cavity and Paranasal Sinus Cancer; Stage IVA

  1. Association between US features of primary tumor and axillary lymph node metastasis in patients with clinical T1-T2N0 breast cancer.

    Science.gov (United States)

    Bae, Min Sun; Shin, Sung Ui; Song, Sung Eun; Ryu, Han Suk; Han, Wonshik; Moon, Woo Kyung

    2018-04-01

    Background Most patients with early-stage breast cancer have clinically negative lymph nodes (LNs). However, 15-20% of patients have axillary nodal metastasis based on the sentinel LN biopsy. Purpose To assess whether ultrasound (US) features of a primary tumor are associated with axillary LN metastasis in patients with clinical T1-T2N0 breast cancer. Material and Methods This retrospective study included 138 consecutive patients (median age = 51 years; age range = 27-78 years) who underwent breast surgery with axillary LN evaluation for clinically node-negative T1-T2 breast cancer. Three radiologists blinded to the axillary surgery results independently reviewed the US images. Tumor distance from the skin and distance from the nipple were determined based on the US report. Association between US features of a breast tumor and axillary LN metastasis was assessed using a multivariate logistic regression model after controlling for clinicopathologic variables. Results Of the 138 patients, 28 (20.3%) had nodal metastasis. At univariate analysis, tumor distance from the skin ( P = 0.019), tumor size on US ( P = 0.023), calcifications ( P = 0.036), architectural distortion ( P = 0.001), and lymphovascular invasion ( P = 0.049) were associated with axillary LN metastasis. At multivariate analysis, shorter skin-to-tumor distance (odds ratio [OR] = 4.15; 95% confidence interval [CI] = 1.01-16.19; P = 0.040) and masses with associated architectural distortion (OR = 3.80; 95% CI = 1.57-9.19; P = 0.003) were independent predictors of axillary LN metastasis. Conclusion US features of breast cancer can be promising factors associated with axillary LN metastasis in patients with clinically node-negative early-stage breast cancer.

  2. Induced (N,0) supergravity as a constrained Osp(N|2) WZWN model and its effective action

    CERN Document Server

    Delius, G W; van Nieuwenhuizen, P

    1993-01-01

    A chiral $(N,0) $ supergravity theory in d=2 dimensions for any $N$ and its induced action can be obtained by constraining the currents of an Osp(N$|$2) WZWN model. The underlying symmetry algebras are the nonlinear SO(N) superconformal algebras of Knizhnik and Bershadsky. The case $N=3$ is worked out in detail. We show that by adding quantum corrections to the classical transformation rules, the gauge algebra on gauge fields and currents closes. Integrability conditions on Ward identities are derived. The effective action is computed at one loop. It is finite, and can be obtained from the induced action by rescaling the central charge and fields by finite Z factors.

  3. Trading stages

    DEFF Research Database (Denmark)

    Steiner, Uli; Tuljapurkar, Shripad; Coulson, Tim

    2012-01-01

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

  4. Quality of life in T1-3N0 prostate cancer patients treated with radiation therapy with minimum 10-year follow-up

    International Nuclear Information System (INIS)

    Johnstone, Peter A.S.; Gray, Christine; Powell, Curt R.

    2000-01-01

    Purpose: To describe patient-reported quality of life using a validated survey in a cohort of patients who are long-term survivors of definitive radiotherapy for T1-3N0 prostate cancer. Methods and Materials: Survivors of a previously reported cohort of prostate cancer patients treated with staging pelvic lymphadenectomy and definitive radiotherapy between November 1974 and August 1988 were queried using a questionnaire incorporating the RAND 36-Item Health Survey and the University of California, Los Angeles Prostate Cancer Index. Responses were reviewed and analyzed. Of the 146 N0 patients, 88 have survived for 10 years postdiagnosis. Fifty-six (64%) of these patients were still alive with valid addresses and were mailed copies of the questionnaires, of which 46 (82%) responded. Median potential follow-up from date of diagnosis was 13.9 years, with a median age of responders of 80 years. Results: The mean sexual function score was 15.4, with a bother score of 42. The mean urinary function score was 65, with a bother score of 61. The mean bowel function score was 72.6, with a bother score of 64.8. The amount of patient bother reported in the sexual category is similar to that previously reported for cohorts of prostate cancer patients undergoing radiotherapy or observation. This is despite the fact that sexual function was similar to that previously reported for patients postprostatectomy. Patient-reported function and bother scores in urinary and bowel categories were somewhat more severe than a previously reported radiotherapy cohort with shorter follow-up. Conclusions: With long follow-up, most patients who underwent radiotherapy for prostate cancer in the era described exhibit somewhat worse bladder, bowel, and erectile function than recently published controls without prostate cancer. In this cohort of older men with long follow-up, erectile function is similar to reported prostatectomy series. However, patient bother related to erectile function is similar

  5. Oral histoplasmosis

    Directory of Open Access Journals (Sweden)

    Patil Karthikeya

    2009-01-01

    Full Text Available Histoplasmosis is a systemic fungal disease that takes various clinical forms, among which oral lesions are rare. The disseminated form of the disease that usually occurs in association with Human Immunodeficiency Virus (HIV is one of the AIDS-defining diseases. Isolated oral histoplasmosis, without systemic involvement, with underlying immunosuppression due to AIDS is very rare. We report one such case of isolated oral histoplasmosis in a HIV-infected patient.

  6. Theoretical-Experimental Analysis of the Workability of the Ni50Cr45N0.6 alloy

    Directory of Open Access Journals (Sweden)

    Łukaszek-Sołek A.

    2017-03-01

    Full Text Available In this paper, the results of investigations into, and of the analyses of, the hot deformation behaviour of the Ni50Cr45N0.6 alloy were presented. Compression tests were conducted on a Gleeble 3800 thermo-mechanical simulator within the following temperatures range 850-1200°C and within that of the strain rate 1-40 s-1 to the constant true strain of 0.9, for the purpose of fulfilling the objective of obtaining experimental stress date. Those data were taken advantage of for the purpose of calculating the workability parameters, and that means the efficiency of power dissipation η, the flow instability ξ and the strain rate sensitivity m. The processing maps based upon Murty’s criterion were drawn up for the following true strain range: 0.2-0.9, and, subsequently, both processing windows and the flow instability areas were determined. For the alloy being analysed, the most advantageous conditions of metal forming were ascertained within the following range of temperatures: 950-1000°C, and for that of the strain rate amounting to 10-40 s-1, and that because of (occurring at the temperature of 950°C the peak of the efficiency of power dissipation parameter η, amounting to 22% (in accordance with Murty’s criterion. The flow instability areas identified on the processing maps ought to be avoided in metal forming processes. Experimental rolling tests were also conducted.

  7. Structural stability and the electronic and magnetic properties of ferrimagnetic Mn4N(0 0 1) surfaces

    International Nuclear Information System (INIS)

    Guerrero-Sánchez, J.; Takeuchi, Noboru

    2017-01-01

    Highlights: • Surface formation energy calculations demonstrate a N-dependent stability. • The magnetic alignment of these surfaces remains bulk-like, in a ferrimagnetic fashion. • A ferrimagnetic behavior in both structures is confirmed by density of states calculations. - Abstract: We have carried out spin-polarized first principles calculations to describe the surface stability and the electronic and magnetic properties of Mn 4 N(0 0 1) surfaces. Results show two different surface terminations with different N content. The surface formation energies indicate that for manganese rich conditions the most stable structure is a MnN terminated surface. Whereas, from intermediate to nitrogen rich conditions, a MnN terminated surface with excess of nitrogen atoms is the most favorable. The stability of these surfaces can be traced to the formation of Mn–N bonds at the surface. The stable surfaces are Ferrimagnetic along the direction perpendicular to the surface, retaining a bulk-like behavior. However, there is a decrease in the Mn magnetic moments due to the presence of the surface. Density of states shows an asymmetric behavior, inherent of a Ferrimagnetic state. Finally, the surfaces are metallic with the main contributions around the Fermi level coming from the Mn-d orbitals. The knowledge about the atomic arrangements of the Mn 4 N surfaces may serve to explain and understand the formation of more complex and technologically applicable ferromagnetic/ferrimagnetic and antiferromagnetic/ferrimagnetic heterostructures.

  8. Evaluation of the prognostic factors in patients with pT3N0 or pT1N2-3 gastric cancer: a single institutional retrospective cohort study.

    Science.gov (United States)

    Terada, Mitsumi; Kinoshita, Takahiro; Kaito, Akio; Sugita, Shizuki; Watanabe, Masahiro; Hayashi, Ryuichi

    2018-03-01

    The impact of adjuvant chemotherapy on the survival of patients with the pT3N0/pT1N2-3 subset of Stage II gastric cancer is unclear. The aim of this study was to evaluate the survival rate of pT3N0/pT1N2-3 patients who were treated by surgery alone and to identify a high-risk group within this cohort. A total of 258 patients with pT3N0/pT1N2-3 gastric cancer who underwent gastrectomy alone in our hospital between January 1992 and December 2012 were enrolled in the present study. Their medical records were retrospectively reviewed to evaluate the survival rates and investigate prognostic factors. The 3- and 5-year recurrence-free survival rates of this cohort were 84 and 80%, respectively. The 3- and 5-year overall survival rates were 89 and 83%, respectively. A multivariate analysis revealed that pathological venous infiltration was an independent prognostic factor. The survival of patients with pathological venous infiltration was significantly worse than that of those without (5-year recurrence-free survival, 75 vs. 90%, p = 0.0005; 5-year overall survival, 78 vs. 91%, p = 0.0062). The prognosis of pT3N0/pT1N2-3 gastric cancer patients treated by surgery alone was relatively good; however, patients with pathological vessel infiltration may be at high risk of recurrence and could be candidates for adjuvant chemotherapy.

  9. Staging atmospheres

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  10. MR spectroscopy in diagnosis of local recurrence of T3N0M0 of prostate cancer after cryotherapy

    International Nuclear Information System (INIS)

    Liu Ming; Guo Zhi; Si Tongguo; Wang Haitao; Xiao Bohan

    2012-01-01

    Objective: To evaluate the usefulness of magnetic resonance spectroscopic imaging in detecting local recurrence in patients with T 3 N 0 M 0 prostate cancer after cryotherapy. Methods: Sixty-five patients with T 3 N 0 M 0 prostate cancer underwent cryotherapy. The preoperative data of conventional MRI, MRS, transrectal ultrasound (TRUS)-guided prostate biopsy were collected. After cryotherapy, the prostate specific antigen (PSA) of all patients was detected monthly.If PSA >5 μg/L, MRI, MRS, and TRUS-guided prostate biopsy were planned within a week. If PSA was unremarkable, MRI, MRS, and TRUS-guided prostate biopsy were planned 12 months after cryotherapy. The prostate was divided 6 regions and the cancerous and noncancerous were marked. The signal-to-noise ratio (S/N) of choline (Cho), citrate (Cit) and the ratios of Cho + creatine (Cre)/Cit of each regions were measured in pre-operation and postoperation. The patients were divided into non-recurrence and recurrence group according to TRUS-guided biopsy. The S/N of Cho, Cit, and the ratio of Cho + Cre/Cit were compared between the groups before and after cryotherapy by using independent samples t-test. Results: (1) Fifteen patients were confirmed local recurrence 12 months after cryotherapy, including 11 patients with an evaluate PSA level and 4 patients with PSA unremarkable. (2) The S/N of Cho, Cit and the ratios of Cho + Cre/Cit in the cancerous and noncancerous regions before cryotherapy in the sixty-five patients were 25±9, 11±5, and 18±5, and 39 ±12, 2.33±0.60, and 0.53 ± 0.19. There had significant difference between that of two groups (t values were 11.36, 9.81, and 13.39, respectively, P=0.00). (3) In the patients with non-recurrence, The S/N of Cho, Cit in the cancerous and noncancerous regions were 4 ± 2 and 3 ± 2 (t=1.024, P=0.305), and 2±2 and 4 ±3 (t=1.147, P=0.178) and no difference was found. In necrotic area,the ratios of Cho + Cre/Cit could not be calculated because of low level of the

  11. Neutron diffraction study of TiN0.40H0.19D0.19 solid solution

    International Nuclear Information System (INIS)

    Khidirov, I.; Mukhtarova, N.N.; Padurets, L.N.; Shilov, A.L.; Zaginaichenko, S.Yu.; Schur, D.V.; Pishuk, V.K.

    2006-01-01

    Full text: It is of interest to study the distribution of hydrogen isotopes in solid solutions of nitrogen and hydrogen in α-Ti lattice by neutron diffraction. Results of this research can give the important information about the role of hydrogen and solvent atoms as well as of strain interaction energy of interstitial atoms in the formation of structure and phase relationship in hydrogen - containing solid solutions of nitrogen in α-Ti. The aim of the present work is neutron and X-ray diffraction study of distribution of interstitial atoms in α-Ti lattice when isotopic compound of hydrogen atoms is shifted, namely in TiN 0.40 H 0.19 D 0.19 . Neutron diffraction patterns were obtained using the neutron diffractometer D N-500 of INP AS RUz ( λ = 1.085 A), X-ray patterns - using the X-ray diffractometer DRON-3M ( λ = 1.5418 A). The treatment of neutron diffraction patterns was carried out using the Rietveld full-profile analysis (program of DBW 3.2). The sample was prepared by Siverts method in the Institute of General and Inorganic Chemistry of RAS. According to X-ray diffraction pattern, the sample was single-phase and had hexagonal unit cell (a = 3.009; c = 4.875 A). Neutron diffraction pattern of the solid solution was indexed within the framework of space group. The neutron diffraction pattern can be accounted for only if to assume that all nitrogen atoms locate in the octahedral interstices 1(a) with coordinates 0, 0, 0; and hydrogen and deuterium isotopes locate in one type of tetrahedral interstices of two - 2 (d) - with coordinates 1/3, 2/3, z; 2/3, 1/3, z, but with different coordinate z: z H = 0.795± 0.007 and z D = 0.582± 0.004. At that, the divergence factors on Bragg maxima R Br = 5.9 %. If to assume that N and D have identical coordinate z, firstly, R Br increases up to 20 %; secondly, at that the error of determining z sharply increases, so that dz ≅ z. Therefore, the crystal structure of the sample under study is analogous with the structure

  12. Chemotherapy Significantly Improves Survival for Patients with T1c-T2N0M0 Medullary Breast Cancer: 3739 Cases From the National Cancer Data Base.

    Science.gov (United States)

    Mateo, Alina M; Pezzi, Todd A; Sundermeyer, Mark; Kelley, Cynthia A; Klimberg, V Suzanne; Pezzi, Christopher M

    2017-04-01

    Medullary breast cancer (MBC) is a rare tumor associated with a better prognosis compared with other breast cancers. The role of adjuvant chemotherapy has not been extensively studied. Female patients with invasive MBC reported to the National Cancer Data Base from 2004 to 2012 were analyzed. Overall survival (OS) and treatment were studied using the Kaplan-Meier method and the Cox proportional hazard model. Patients who had node-negative (N0), non-metastatic (M0) tumors 10 to 50 mm in size (T1cN0M0 and T2N0M0) treated with and without chemotherapy were analyzed using propensity score matching. Of 3739 patients with MBC, 2642 (71%) had T1b-T2N0M0 disease treated with and without chemotherapy. Multivariable analysis showed that for all MBC patients, the significant predictors of OS were age older than 65 years, one or more comorbidities, tumor larger than 2 cm, positive nodes, distant metastasis, and treatment with chemotherapy or radiation therapy. Patients with T1cN0M0 and T2N0M0 had improved OS if they received chemotherapy (p < 0.0005). Patients with T1bN0M0 who received chemotherapy did not show better OS than those who did not. Patients with T1c-T2N0M0 were then matched by propensity score based on age, presence of comorbidities, tumor size, and treatment methods used. After matching, the group receiving chemotherapy showed an improved OS (hazard ratio [HR], 0.40; 95% confidence interval [CI], 0.26-0.62; p < 0.0005) compared to the group that did not receive chemotherapy. For patients with T1c-T2N0M0 MBC, chemotherapy significantly improves OS.

  13. Oral cancer: A multicenter study.

    Science.gov (United States)

    Dhanuthai, K; Rojanawatsirivej, S; Thosaporn, W; Kintarak, S; Subarnbhesaj, A; Darling, M; Kryshtalskyj, E; Chiang, C-P; Shin, H-I; Choi, S-Y; Lee, S-S; Aminishakib, P

    2018-01-01

    To determine the prevalence and clinicopathologic features of the oral cancer patients. Biopsy records of the participating institutions were reviewed for oral cancer cases diagnosed from 2005 to 2014. Demographic data and site of the lesions were collected. Sites of the lesion were subdivided into lip, tongue, floor of the mouth, gingiva, alveolar mucosa, palate, buccal/labial mucosa, maxilla and mandible. Oral cancer was subdivided into 7 categories: epithelial tumors, salivary gland tumors, hematologic tumors, bone tumors, mesenchymal tumors, odontogenic tumors, and others. Data were analyzed by descriptive statistics using SPSS software version 17.0. Of the 474,851 accessioned cases, 6,151 cases (1.30%) were diagnosed in the category of oral cancer. The mean age of the patients was 58.37±15.77 years. A total of 4,238 cases (68.90%) were diagnosed in males, whereas 1911 cases (31.07%) were diagnosed in females. The male-to-female ratio was 2.22:1. The sites of predilection for oral cancer were tongue, labial/buccal mucosa, gingiva, palate, and alveolar mucosa, respectively. The three most common oral cancer in the descending order of frequency were squamous cell carcinoma, non-Hodgkin lymphoma and mucoepidermoid carcinoma. Although the prevalence of oral cancer is not high compared to other entities, oral cancer pose significant mortality and morbidity in the patients, especially when discovered late in the course of the disease. This study highlights some anatomical locations where oral cancers are frequently encountered. As a result, clinicians should pay attention to not only teeth, but oral mucosa especially in the high prevalence area as well since early detection of precancerous lesions or cancers in the early stage increase the chance of patient being cured and greatly reduce the mortality and morbidity. This study also shows some differences between pediatric and elderly oral cancer patients as well as between Asian and non-Asian oral cancer patients.

  14. Oral Hygiene

    DEFF Research Database (Denmark)

    Sørensen, Marie Toftdahl; Villadsen, Dorte Buxbom

    The aim of the study was to explore how adults with schizo- phrenia describe their lived experiences with oral hygiene. 23 adults with schizophrenia were interviewed within a period of four months in late 2015. Transcriptions of the interviews were analysed using the Reflective Lifeworld Research...... phenomenological approach of Dahlberg, Dahlberg, and Nyström. The essence of the phenomenon, oral hygiene, is described as a challenge: a mixture of ability and assigning priority; a challenge in which significant others, for better or worse, play an important role. We recommend a systematic cooperation between...... health care professionals and adults with schizophrenia in order to improve oral health, well-being and recovery....

  15. Oral Hygiene

    DEFF Research Database (Denmark)

    Villadsen, Dorte Buxbom; Sørensen, Marie Toftdahl

    2017-01-01

    The aim of the study is to explore how adults with schizophrenia describe their lived experiences with oral hygiene. 23 adults with schizophrenia were interviewed within a period of four months in late 2015. Transcriptions of the interviews were analysed using the Reflective Lifeworld Research...... phenomenological approach of Dahlberg, Dahlberg, and Nyström. The essence of the phenomenon, oral hygiene, is described as a challenge: a mixture of ability and assigning priority; a challenge in which significant others, for better or worse, play an important role. We recommend a systematic cooperation between...... health care professionals and adults with schizophrenia in order to improve oral health, well-being and recovery....

  16. Oral Histoplasmosis.

    Science.gov (United States)

    Folk, Gillian A; Nelson, Brenda L

    2017-12-01

    A 44-year-old female presented to her general dentist with the chief complaint of a painful mouth sore of 2 weeks duration. Clinical examination revealed an irregularly shaped ulcer of the buccal and lingual attached gingiva of the anterior mandible. A biopsy was performed and microscopic evaluation revealed histoplasmosis. Histoplasmosis, caused by Histoplasma capsulate, is the most common fungal infection in the United States. Oral lesions of histoplasmosis are generally associated with the disseminated form of histoplasmosis and may present as a fungating or ulcerative lesion of the oral mucosa. The histologic findings and differential diagnosis for oral histoplasmosis are discussed.

  17. How much does PSA matter after 10 years? Outcomes in 10-year clinical NED survivors after definitive radiotherapy for T1-3N0M0 prostate cancer

    International Nuclear Information System (INIS)

    Johnstone, Peter A. S.; Powell, Curt; Riffenburgh, Robert; Saunders, Eric L.; Bethel, Kelly J.; Huisman, Thomas

    1996-01-01

    Objective: Institutional policy in the 1970's and 80's dictated that patients with potentially curable prostate cancer undergo PLND prior to definitive XRT. Our group has reported 80% 15-year actuarial cause-specific survival for the 147 patients so treated. Analysis was made of PSA values and clinical outcomes of patients who were clinically without evidence of disease (NED) 10 years after a negative staging pelvic lymphadenectomy and definitive radiation therapy (XRT) for prostate cancer. Materials and Methods: One hundred patients underwent staging pelvic lymphadenectomy between 11/1/74 and 1/1/86, of which 98 had pathologically negative lymph nodes (N 0 ). These patients subsequently underwent definitive radiotherapy; a median dose of 66.6 Gy (range 63-70.2 Gy) was delivered. Forty-two N 0 patients with sufficient follow-up were alive and clinically NED 10 years post-operatively. None of these patients had ever received hormonal therapy. Distribution by disease stage at diagnosis was: Stage A2: 12 pts; Stage B: 19 pts; Stage B2/ C: 6 pts; Stage C: 5 pts. Median follow-up was 12 years 4 months, with a minimum follow-up of 10 years. Results: Of the 42 NED survivors at 10 years, 5 pts died subsequently without PSA data, remaining clinically NED (median 13y 3m post-operatively); 37 patients were alive and without evidence of disease off all therapy at 10 years post-operatively. Most recent PSA data reveal: Bone scans were performed on the 8 patients with elevated PSA. These revealed a single patient with diffuse but asymptomatic bone metastases. Ultrasound-guided sextant biopsies were performed on one 78-year-old patient with elevated PSA 19 years post-operatively, revealing an asymptomatic local recurrence. Conclusions: Radiation therapy delivered to a surgically staged population of prostate cancer patients contributes to normalization of PSA in 78% ((29(37))) of patients with ≥10 year follow-up. Most of these patients will have PSA levels ≤ 1.5 ng/ml. More

  18. Non-inferiority multicenter prospective randomized controlled study of rectal cancer T2-T3s(superficial) N0, M0undergoing neoadjuvant treatment and local excision (TEM) vs total mesorectal excision (TME).

    Science.gov (United States)

    Serra-Aracil, X; Pericay, C; Golda, T; Mora, L; Targarona, E; Delgado, S; Reina, A; Vallribera, F; Enriquez-Navascues, J M; Serra-Pla, S; Garcia-Pacheco, J C

    2018-02-01

    The standard treatment of rectal adenocarcinoma is total mesorectal excision (TME), in many cases requires a temporary or permanent stoma. TME is associated with high morbidity and genitourinary alterations. Transanal endoscopic microsurgery (TEM) allows access to tumors up to 20 cm from the anal verge, achieves minimal postoperative morbidity and mortality rates, and does not require an ostomy. The treatment of T2, N0, and M0 cancers remains controversial. Preoperative chemoradiotherapy (CRT) in association with TEM reduces local recurrence and increases survival. The TAU-TEM study aims to demonstrate the non-inferiority of the oncological outcomes and the improvement in morbidity and quality of life achieved with TEM compared with TME. Prospective, multicenter, randomized controlled non-inferiority trial includes patients with rectal adenocarcinoma less than 10 cm from the anal verge and up to 4 cm in size, staged as T2 or T3-superficial N0-M0. Patients will be randomized to two areas: CRT plus TEM or radical surgery (TME). Postoperative morbidity and mortality will be recorded and patients will complete the quality of life questionnaires before the start of treatment, after CRT in the CRT/TEM arm, and 6 months after surgery in both arms. The estimated sample size for the study is 173 patients. Patients will attend follow-up controls for local and systemic relapse. This study aims to demonstrate the preservation of the rectum after preoperative CRT and TEM in rectal cancer stages T2-3s, N0, M0 and to determine the ability of this strategy to avoid the need for radical surgery (TME). ClinicalTrials.gov identifier: NCT01308190. Número de registro del Comité de Etica e Investigación Clínica (CEIC) del Hospital universitario Parc Taulí: TAU-TEM-2009-01.

  19. Herpes - oral

    Science.gov (United States)

    ... virus type 2 (HSV-2) most often causes genital herpes . However, sometimes HSV-2 is spread to the ... the virus to the genitals. Both oral and genital herpes viruses can sometimes be spread, even when you ...

  20. [Oral contraceptives].

    Science.gov (United States)

    Rozenbaum, H

    1976-10-23

    The author presents an alphabetical list of oral contraceptives. To classify the commercial names of oral contraceptives all over the world is practically impossible for the following reasons: some agents are discontinued without the medical profession being aware of it; the same product can have various names depending on the country and the laboratory. Some products exist in different forms (21 pills including 7 inactive tablets). Finally, some laboratories change the posology of a product without changing its name.

  1. Disparities in Oral Health

    Science.gov (United States)

    ... 2020: Oral Health Objectives Site Map Disparities in Oral Health Recommend on Facebook Tweet Share Compartir Oral health ... to get and keep dental insurance. Disparities in Oral Health Some of the oral health disparities that exist ...

  2. [Expression of Prion protein and its clinical significance in oral squamous cells carcinoma and oral leukoplakia].

    Science.gov (United States)

    Zhang, Jie; Zeng, Yan; Zheng, Jun; Xu, Jiang

    2013-12-01

    To examine Prion protein(PrP) expression and its clinical significance in oral mucosa, oral leukoplakia, oral squamous cell carcinoma(OSCC) and its subgroups. Expression of PrP in OSCC, oral leukoplakia and mucosa specimen was detected by immunohistochemistry. The association between the expression and gender, TNM clinical stages, pathological grades was evaluated. The positive expression rate of PrP in normal, oral leukoplakia and OSCC tissues was 15% (3/20) , 42% (11/26) and 95% (80/84) , respectively. There was a significant difference between the expression of PrP in leukoplakia and in high, moderately and poorly differentiated OSCC(P 0.05). Between stages I+II and III+IV in the overa II expression of PrP, there was a significant difference(P leukoplakia to OSCC was closely related to the carcinogenesis of OSCC, pathologic stage and clinical TNM stage.

  3. Sentinel Node in Oral Cancer

    DEFF Research Database (Denmark)

    Tartaglione, Girolamo; Stoeckli, Sandro J; de Bree, Remco

    2016-01-01

    localization and estimated SN depth more efficiently. After pathological examination, 9.9% of the SN excised (138 of 1398 SNs) showed metastases. The first neck level (NL) containing SN+ was NL I in 28.6%, NL IIa in 44.8%, NL IIb in 2.8%, NL III in 17.1%, and NL IV in 6.7% of positive patients. Approximately...... 96% of positive SNs were localized in the first and second lymphatic basin visualized using lymphoscintigraphy. After neck dissection, the SN+ was the only lymph node containing metastasis in approximately 80% of patients. CONCLUSIONS: Best results were observed using a dynamic scan in combination......PURPOSE: Nuclear imaging plays a crucial role in lymphatic mapping of oral cancer. This evaluation represents a subanalysis of the original multicenter SENT trial data set, involving 434 patients with T1-T2, N0, and M0 oral squamous cell carcinoma. The impact of acquisition techniques, tracer...

  4. Imaging in oral cancers

    Directory of Open Access Journals (Sweden)

    Supreeta Arya

    2012-01-01

    Full Text Available Oral cavity squamous cell cancers form a significant percentage of the cancers seen in India. While clinical examination allows direct visualization, it cannot evaluate deep extension of disease. Cross-sectional imaging has become the cornerstone in the pretreatment evaluation of these cancers and provides accurate information about the extent and depth of disease that can help decide the appropriate management strategy and indicate prognosis. Early cancers are treated with a single modality, either surgery or radiotherapy while advanced cancers are offered a combination of surgery, radiotherapy and chemotherapy. Imaging can decide resectability, help plan the precise extent of resection, and indicate whether organ conservation therapy should be offered. Quality of life issues necessitate preservation of form and function and pretreatment imaging helps plan appropriate reconstruction and counsel patients regarding lifestyle changes. Oral cavity has several subsites and the focus of the review is squamous cancers of the gingivobuccal region, oral tongue and retromolar trigone as these are most frequently encountered in the subcontinent. References for this review were identified by searching Medline and PubMed databases. Only articles published in English language literature were selected. This review aims to familiarize the radiologist with the relevant anatomy of the oral cavity, discuss the specific issues that influence prognosis and management at the above subsites, the optimal imaging methods, the role of imaging in accurately staging these cancers and in influencing management. A checklist for reporting will emphasize the information to be conveyed by the radiologist.

  5. Prospective Trial of Stereotactic Body Radiation Therapy for Both Operable and Inoperable T1N0M0 Non-Small Cell Lung Cancer: Japan Clinical Oncology Group Study JCOG0403

    Energy Technology Data Exchange (ETDEWEB)

    Nagata, Yasushi, E-mail: nagat@hiroshima-u.ac.jp [Department of Radiation Oncology, Hiroshima University, Hiroshima (Japan); Hiraoka, Masahiro [Department of Radiation Oncology and Image-Applied Therapy, Kyoto University, Kyoto (Japan); Shibata, Taro [Japan Clinical Oncology Group Data Center, Center for Research Administration and Support, National Cancer Center, Tokyo (Japan); Onishi, Hiroshi [Department of Radiology, University of Yamanashi, Chuo (Japan); Kokubo, Masaki [Department of Image-Based Medicine, Institute of Biomedical Research and Innovation, Kobe (Japan); Karasawa, Katsuyuki [Department of Radiation Oncology, Tokyo Metropolitan Komagome Hospital, Tokyo (Japan); Shioyama, Yoshiyuki [Department of Clinical Radiology, Kyushu University, Fukuoka (Japan); Onimaru, Rikiya [Department of Radiology, Hokkaido University, Sapporo (Japan); Kozuka, Takuyo [Department of Radiation Oncology, The Cancer Institute Hospital, Tokyo (Japan); Kunieda, Etsuo [Department of Radiation Oncology, Keio University, Tokyo (Japan); Saito, Tsutomu [Department of Radiology, Nihon University Itabashi Hospital, Tokyo (Japan); Nakagawa, Keiichi [Department of Radiology, The University of Tokyo Hospital, Tokyo (Japan); Hareyama, Masato [Department of Radiology, Sapporo Medical University, Sapporo (Japan); Takai, Yoshihiro [Department of Radiation Oncology, Tohoku University, Sendai (Japan); Hayakawa, Kazushige [Department of Radiology and Radiation Oncology, Kitasato University, Sagamihara (Japan); Mitsuhashi, Norio [Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan); Ishikura, Satoshi [Department of Radiology, Koshigaya Municipal Hospital, Koshigaya (Japan)

    2015-12-01

    Purpose: To evaluate, in Japan Clinical Oncology Group study 0403, the safety and efficacy of stereotactic body radiation therapy (SBRT) in patients with T1N0M0 non-small cell lung cancer (NSCLC). Methods and Materials: Eligibility criteria included histologically or cytologically proven NSCLC, clinical T1N0M0. Prescribed dose was 48 Gy at the isocenter in 4 fractions. The primary endpoint was the percent (%) 3-year overall survival. The threshold % 3-year survival to be rejected was set at 35% for inoperable patients, whereas the expected % 3-year survival was 80% for operable patients. Results: Between July 2004 and November 2008, 169 patients from 15 institutions were registered. One hundred inoperable and 64 operable patients (total 164) were eligible. Patients' characteristics were 122 male, 47 female; median age 78 years (range, 50-91 years); adenocarcinomas, 90; squamous cell carcinomas, 61; others, 18. Of the 100 inoperable patients, the % 3-year OS was 59.9% (95% confidence interval 49.6%-68.8%). Grade 3 and 4 toxicities were observed in 10 and 2 patients, respectively. No grade 5 toxicity was observed. Of the 64 operable patients, the % 3-year OS was 76.5% (95% confidence interval 64.0%-85.1%). Grade 3 toxicities were observed in 5 patients. No grade 4 and 5 toxicities were observed. Conclusions: Stereotactic body radiation therapy for stage I NSCLC is effective, with low incidences of severe toxicity. This treatment can be considered a standard treatment for inoperable stage I NSCLC. This treatment is promising as an alternative to surgery for operable stage I NSCLC.

  6. Prospective Trial of Stereotactic Body Radiation Therapy for Both Operable and Inoperable T1N0M0 Non-Small Cell Lung Cancer: Japan Clinical Oncology Group Study JCOG0403.

    Science.gov (United States)

    Nagata, Yasushi; Hiraoka, Masahiro; Shibata, Taro; Onishi, Hiroshi; Kokubo, Masaki; Karasawa, Katsuyuki; Shioyama, Yoshiyuki; Onimaru, Rikiya; Kozuka, Takuyo; Kunieda, Etsuo; Saito, Tsutomu; Nakagawa, Keiichi; Hareyama, Masato; Takai, Yoshihiro; Hayakawa, Kazushige; Mitsuhashi, Norio; Ishikura, Satoshi

    2015-12-01

    To evaluate, in Japan Clinical Oncology Group study 0403, the safety and efficacy of stereotactic body radiation therapy (SBRT) in patients with T1N0M0 non-small cell lung cancer (NSCLC). Eligibility criteria included histologically or cytologically proven NSCLC, clinical T1N0M0. Prescribed dose was 48 Gy at the isocenter in 4 fractions. The primary endpoint was the percent (%) 3-year overall survival. The threshold % 3-year survival to be rejected was set at 35% for inoperable patients, whereas the expected % 3-year survival was 80% for operable patients. Between July 2004 and November 2008, 169 patients from 15 institutions were registered. One hundred inoperable and 64 operable patients (total 164) were eligible. Patients' characteristics were 122 male, 47 female; median age 78 years (range, 50-91 years); adenocarcinomas, 90; squamous cell carcinomas, 61; others, 18. Of the 100 inoperable patients, the % 3-year OS was 59.9% (95% confidence interval 49.6%-68.8%). Grade 3 and 4 toxicities were observed in 10 and 2 patients, respectively. No grade 5 toxicity was observed. Of the 64 operable patients, the % 3-year OS was 76.5% (95% confidence interval 64.0%-85.1%). Grade 3 toxicities were observed in 5 patients. No grade 4 and 5 toxicities were observed. Stereotactic body radiation therapy for stage I NSCLC is effective, with low incidences of severe toxicity. This treatment can be considered a standard treatment for inoperable stage I NSCLC. This treatment is promising as an alternative to surgery for operable stage I NSCLC. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Staging Mobilities

    DEFF Research Database (Denmark)

    Jensen, Ole B.

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

  8. Critical Appraisal of Nasolabial Flap for Reconstruction of Oral Cavity Defects in Cancer Patients

    International Nuclear Information System (INIS)

    Mebed, A.; Hussein, H.A.; Saber, T.Kh.

    2009-01-01

    Purpose: Re-evaluation of nasolabial flap in lip and oral cavity reconstruction and role of each of its variants in reconstructing various intermediate size defects was addressed. Patients and Methods: Case-series study was con-ducted in National Cancer Institute, Cairo University over the period from July 2005 - January 2009 which included 23 patients with clinically T-l N0, T-2 N0 invasive squamous cell carcinoma of buccal mucosa and the vermilion border of the lower lip. Immediately after surgical excision, one stage reconstruction of the defect was done using a type of nasolabial flap. All patients were followed and the median follow-up period was 7.5 month. Results: Twelve patients with the lower lip carcinoma and 11 patients with the carcinoma of buccal mucosa underwent surgical excision under frozen section control. 19 fasciocutaneous nasolabial flap and 4 facial artery musculomucosal flaps were used for reconstruction. Minor wound complications occurred in 2 flaps and one patient required secondary suture. Flap viability was reliable and was not affected by performance of a synchronous neck dissection. Functional results were satisfactory, cosmetic results were good in most of the patients and excellent when facial artery musculomucosal flap was used. Conclusion: The nasolabial flap is a reliable and minimally traumatic local flap for one stage reconstruction of medium size defects in the oral cavity. The abundant blood supply allowed its modification in order to cover larger defects or to obtain better cosmetic results. This versatility makes it more widely used thus minimizing the use of local tongue flaps and split thickness grafts for covering these medium size defects in cases of buccal mucosa cancer or affecting the other lip or commissure in cases of lip cancer. It has a high viability rate, low complication rate; it is quick and easy to perform in addition to its satisfactory functional and cosmetic results.

  9. Oral candidiasis.

    Science.gov (United States)

    Millsop, Jillian W; Fazel, Nasim

    2016-01-01

    Oral candidiasis (OC) is a common fungal disease encountered in dermatology, most commonly caused by an overgrowth of Candida albicans in the mouth. Although thrush is a well-recognized presentation of OC, it behooves clinicians to be aware of the many other presentations of this disease and how to accurately diagnose and manage these cases. The clinical presentations of OC can be broadly classified as white or erythematous candidiasis, with various subtypes in each category. The treatments include appropriate oral hygiene, topical agents, and systemic medications. This review focuses on the various clinical presentations of OC and treatment options. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Oral myiasis

    Directory of Open Access Journals (Sweden)

    Treville Pereira

    2010-01-01

    Full Text Available Myiasis is a relatively rare condition arising from the invasion of body tissues or cavities of living animals or humans by maggots or larvae of certain species of flies. It is an uncommon clinical condition, being more frequent in underdeveloped countries and hot climate regions, and is associated with poor hygiene, suppurative oral lesions; alcoholism and senility. Its diagnosis is made basically by the presence of larvae. The present article reports a case of oral myiasis involving 20 larvae in a patient with neurological deficiency.

  11. The prognosis of N2b and N2c lymph node disease in oral squamous cell carcinoma is determined by the number of metastatic lymph nodes rather than laterality: evidence to support a revision of the American Joint Committee on Cancer staging system.

    Science.gov (United States)

    Ebrahimi, Ardalan; Gil, Ziv; Amit, Moran; Yen, Tzu-Chen; Liao, Chun-Ta; Chaturvedi, Pankaj; Agarwal, Jai Prakash; Kowalski, Luiz P; Kohler, Hugo F; Kreppel, Matthias; Cernea, Claudio R; Brandao, Jose; Bachar, Gideon; Bolzoni Villaret, Andrea; Fliss, Dan; Fridman, Eran; Robbins, K Thomas; Shah, Jatin P; Patel, Snehal G; Clark, Jonathan R

    2014-07-01

    A study was conducted to assess for prognostic heterogeneity within the N2b and N2c classifications for oral cancer based on the number of metastatic lymph nodes and to determine whether laterality of neck disease provides additional prognostic information. An international multicenter study of 3704 patients with oral cancer undergoing surgery with curative intent was performed. The endpoints of interest were disease-specific survival and overall survival. Model fit was assessed by the Akaike Information Criterion and comparison of models with and without the covariate of interest using a likelihood ratio test. The median number of metastatic lymph nodes was significantly higher in patients with N2c disease compared to those with N2b disease (P number of metastatic lymph nodes improved model fit beyond existing N classification. Next, the authors confirmed significant heterogeneity in prognosis based on the number of metastatic lymph nodes (≤ 2, 3-4, and ≥ 5) in patients with both N2b and N2c disease (P number of metastatic lymph nodes demonstrated significant improvement in prognostic accuracy compared with the American Joint Committee on Cancer staging system, and no improvement was noted with the addition of a covariate for contralateral or bilateral neck disease (P = .472). The prognosis of patients with oral cancer with N2b and N2c disease appears to be similar after adequate adjustment for the burden of lymph node metastases, irrespective of laterality. Based on this finding, the authors propose a modified lymph node staging system that requires external validation before implementation in clinical practice. © 2014 American Cancer Society.

  12. Decree of the President of the Republic of 31 July 1980 concerning the Higher Institute for Safety at Work (Section 23 of Act N0 833 of 1978)

    International Nuclear Information System (INIS)

    1980-01-01

    This Decree is important as respects nuclear energy insofar as the tasks of the Institute which are mainly of an advisory nature, also concern radiation protection and safety in connection with nuclear activities. It provides for an advisory role to be played by the Institute as regards health protection in the field of nuclear power generation and radioactive materials, including use of and trade in such materials. On the other hand, it does not affect the regulations governing the use of nuclear energy, in particular as concerns Act N 0 1240 of 1971 reorganising the CNEN, Act N 0 1860 of 1962 on the peaceful uses of nuclear energy, Presidential Decree N 0 185 of 1964 on radiation protection and the decrees implementing these tests (NEA) [fr

  13. Ipsilateral irradiation for well lateralized carcinomas of the oral cavity and oropharynx: results on tumor control and xerostomia.

    Science.gov (United States)

    Cerezo, Laura; Martín, Margarita; López, Mario; Marín, Alicia; Gómez, Alberto

    2009-09-01

    In head and neck cancer, bilateral neck irradiation is the standard approach for many tumor locations and stages. Increasing knowledge on the pattern of nodal invasion leads to more precise targeting and normal tissue sparing. The aim of the present study was to evaluate the morbidity and tumor control for patients with well lateralized squamous cell carcinomas of the oral cavity and oropharynx treated with ipsilateral radiotherapy. Twenty consecutive patients with lateralized carcinomas of the oral cavity and oropharynx were treated with a prospective management approach using ipsilateral irradiation between 2000 and 2007. This included 8 radical oropharyngeal and 12 postoperative oral cavity carcinomas, with Stage T1-T2, N0-N2b disease. The actuarial freedom from contralateral nodal recurrence was determined. Late xerostomia was evaluated using the European Organization for Research and Treatment of Cancer QLQ-H&N35 questionnaire and the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE), version 3. At a median follow-up of 58 months, five-year overall survival and loco-regional control rates were 82.5% and 100%, respectively. No local or contralateral nodal recurrences were observed. Mean dose to the contralateral parotid gland was 4.72 Gy and to the contralateral submandibular gland was 15.30 Gy. Mean score for dry mouth was 28.1 on the 0-100 QLQ-H&N35 scale. According to CTCAE v3 scale, 87.5% of patients had grade 0-1 and 12.5% grade 2 subjective xerostomia. The unstimulated salivary flow was > 0.2 ml/min in 81.2% of patients and 0.1-0.2 ml/min in 19%. None of the patients showed grade 3 xerostomia. In selected patients with early and moderate stages, well lateralized oral and oropharyngeal carcinomas, ipsilateral irradiation treatment of the primary site and ipsilateral neck spares salivary gland function without compromising loco-regional control.

  14. Ipsilateral irradiation for well lateralized carcinomas of the oral cavity and oropharynx: results on tumor control and xerostomia

    International Nuclear Information System (INIS)

    Cerezo, Laura; Martín, Margarita; López, Mario; Marín, Alicia; Gómez, Alberto

    2009-01-01

    In head and neck cancer, bilateral neck irradiation is the standard approach for many tumor locations and stages. Increasing knowledge on the pattern of nodal invasion leads to more precise targeting and normal tissue sparing. The aim of the present study was to evaluate the morbidity and tumor control for patients with well lateralized squamous cell carcinomas of the oral cavity and oropharynx treated with ipsilateral radiotherapy. Twenty consecutive patients with lateralized carcinomas of the oral cavity and oropharynx were treated with a prospective management approach using ipsilateral irradiation between 2000 and 2007. This included 8 radical oropharyngeal and 12 postoperative oral cavity carcinomas, with Stage T1-T2, N0-N2b disease. The actuarial freedom from contralateral nodal recurrence was determined. Late xerostomia was evaluated using the European Organization for Research and Treatment of Cancer QLQ-H&N35 questionnaire and the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE), version 3. At a median follow-up of 58 months, five-year overall survival and loco-regional control rates were 82.5% and 100%, respectively. No local or contralateral nodal recurrences were observed. Mean dose to the contralateral parotid gland was 4.72 Gy and to the contralateral submandibular gland was 15.30 Gy. Mean score for dry mouth was 28.1 on the 0-100 QLQ-H&N35 scale. According to CTCAE v3 scale, 87.5% of patients had grade 0-1 and 12.5% grade 2 subjective xerostomia. The unstimulated salivary flow was > 0.2 ml/min in 81.2% of patients and 0.1-0.2 ml/min in 19%. None of the patients showed grade 3 xerostomia. In selected patients with early and moderate stages, well lateralized oral and oropharyngeal carcinomas, ipsilateral irradiation treatment of the primary site and ipsilateral neck spares salivary gland function without compromising loco-regional control

  15. Oral cancer

    Science.gov (United States)

    ... cancers tend to spread quickly. Smoking and other tobacco use are linked to most cases of oral cancer. Heavy alcohol use also increases the risk for ... cancer greatly increases the chance of survival. Prevention ... Avoiding smoking or other tobacco use Having dental problems corrected Limiting or avoiding alcohol ...

  16. Oral leukoplakia

    DEFF Research Database (Denmark)

    Holmstrup, Palle; Dabelsteen, Erik

    2016-01-01

    nature is oral leukoplakia, and for decades it has been discussed how to treat these lesions. Various treatment modalities, such as systemic therapies and surgical removal, have been suggested. The systemic therapies tested so far include retinoids, extracts of green tea, inhibitors of cyclooxygenase-2...

  17. Oral leukoplakia

    DEFF Research Database (Denmark)

    Kjærgaard Larsen, Marie; Sorensen, J. A.; Godballe, C.

    2016-01-01

    BACKGROUND AND AIM: Oral leukoplakia (OL) is a common premalignant lesion. The possible benefits of specific interventions in preventing a malignant transformation of OL are not well understood. This review assesses different invasive treatment techniques for OL and evaluate the optimal treatment...

  18. Effects of nutrition on oral health | Agbelusi | Nigerian Medical Journal

    African Journals Online (AJOL)

    Effects of nutrition on oral health. ... The effects of malnutrition can be seen in the oral structures in all stages of human growth and development from conception to old age. ... These oral lesions are painful; disturb food intake and mastication thereby further compromising the nutrition of the affected individuals. In Africa ...

  19. Oral calcitonin

    Directory of Open Access Journals (Sweden)

    Hamdy RC

    2012-09-01

    Full Text Available Ronald C Hamdy,1,2 Dane N Daley11Osteoporosis Center, College of Medicine, East Tennessee State University, 2Veterans Affairs Medical Center, Johnson City, TN, USAAbstract: Calcitonin is a hormone secreted by the C-cells of the thyroid gland in response to elevations of the plasma calcium level. It reduces bone resorption by inhibiting mature active osteoclasts and increases renal calcium excretion. It is used in the management of postmenopausal osteoporosis, Paget's disease of bone, and malignancy-associated hypercalcemia. Synthetic and recombinant calcitonin preparations are available; both have similar pharmacokinetic and pharmacodynamic profiles. As calcitonin is a peptide, the traditional method of administration has been parenteral or intranasal. This hinders its clinical use: adherence with therapy is notoriously low, and withdrawal from clinical trials has been problematic. An oral formulation would be more attractive, practical, and convenient to patients. In addition to its effect on active osteoclasts and renal tubules, calcitonin has an analgesic action, possibly mediated through β-endorphins and the central modulation of pain perception. It also exerts a protective action on cartilage and may be useful in the management of osteoarthritis and possibly rheumatoid arthritis. Oral formulations of calcitonin have been developed using different techniques. The most studied involves drug-delivery carriers such as Eligen® 8-(N-2hydroxy-5-chloro-benzoyl-amino-caprylic acid (5-CNAC (Emisphere Technologies, Cedar Knolls, NJ. Several factors affect the bioavailability and efficacy of orally administered calcitonin, including amount of water used to take the tablet, time of day the tablet is taken, and proximity to intake of a meal. Preliminary results looked promising. Unfortunately, in two Phase III studies, oral calcitonin (0.8 mg with 200 mg 5-CNAC, once a day for postmenopausal osteoporosis and twice a day for osteoarthritis failed to

  20. Measurement of the rates of reaction of the ground and metastable excited states of 02+, N0+ and 0+ with atmospheric gases at thermal energy

    International Nuclear Information System (INIS)

    Glosik, J.; Rakshit, A.B.; Twiddy, N.D.; Adams, N.G.; Smith, D.

    1978-01-01

    Thermal-energy reaction rate coefficients and product ion distributions have been measured for reactions of both the ground state and metastable electronic states of 0 2 + , N0 + and 0 + with several neutral species, using a selected-ion flow tube. In general the excited-ion reaction rates are fast, frequently approaching the Langevin limit. Collisional quenching occurs for the reactions of N0 + sup(star) with N 2 ,0 2 and H 2 and the quenching rates have been determined. The ion source also provided a substantial yield of doubly charged 0 2 permitting some measurements of reaction rates of 0 2 2+ . (author)

  1. Construction of a pathological risk model of occult lymph node metastases for prognostication by semi-automated image analysis of tumor budding in early-stage oral squamous cell carcinoma

    DEFF Research Database (Denmark)

    Pedersen, Nicklas Juel; Jensen, David Hebbelstrup; Lelkaitis, Giedrius

    2017-01-01

    It is challenging to identify at diagnosis those patients with early oral squamous cell carcinoma (OSCC), who have a poor prognosis and those that have a high risk of harboring occult lymph node metastases. The aim of this study was to develop a standardized and objective digital scoring method...... (PFS). We subsequently constructed and crossvalidated a binary logistic regression model and evaluated its clinical utility by decision curve analysis. A high DTBC was an independent predictor of both poor OS and PFS in a multivariate Cox regression model. The logistic regression model was able...

  2. Oral cancer: A multicenter study

    Science.gov (United States)

    Rojanawatsirivej, Somsri; Thosaporn, Watcharaporn; Kintarak, Sompid; Subarnbhesaj, Ajiravudh; Darling, Mark; Kryshtalskyj, Eugene; Chiang, Chun-Pin; Shin, Hong-In; Choi, So-Young; Lee, Sang-shin; Shakib, Pouyan-Amini

    2018-01-01

    Background To determine the prevalence and clinicopathologic features of the oral cancer patients. Material and Methods Biopsy records of the participating institutions were reviewed for oral cancer cases diagnosed from 2005 to 2014. Demographic data and site of the lesions were collected. Sites of the lesion were subdivided into lip, tongue, floor of the mouth, gingiva, alveolar mucosa, palate, buccal/labial mucosa, maxilla and mandible. Oral cancer was subdivided into 7 categories: epithelial tumors, salivary gland tumors, hematologic tumors, bone tumors, mesenchymal tumors, odontogenic tumors, and others. Data were analyzed by descriptive statistics using SPSS software version 17.0. Results Of the 474,851 accessioned cases, 6,151 cases (1.30%) were diagnosed in the category of oral cancer. The mean age of the patients was 58.37±15.77 years. A total of 4,238 cases (68.90%) were diagnosed in males, whereas 1911 cases (31.07%) were diagnosed in females. The male-to-female ratio was 2.22:1. The sites of predilection for oral cancer were tongue, labial/buccal mucosa, gingiva, palate, and alveolar mucosa, respectively. The three most common oral cancer in the descending order of frequency were squamous cell carcinoma, non-Hodgkin lymphoma and mucoepidermoid carcinoma. Conclusions Although the prevalence of oral cancer is not high compared to other entities, oral cancer pose significant mortality and morbidity in the patients, especially when discovered late in the course of the disease. This study highlights some anatomical locations where oral cancers are frequently encountered. As a result, clinicians should pay attention to not only teeth, but oral mucosa especially in the high prevalence area as well since early detection of precancerous lesions or cancers in the early stage increase the chance of patient being cured and greatly reduce the mortality and morbidity. This study also shows some differences between pediatric and elderly oral cancer patients as well as

  3. Long-term results of high-dose conformal radiotherapy for patients with medically inoperable T1-3N0 non-small-cell lung cancer: Is low incidence of regional failure due to incidental nodal irradiation?

    International Nuclear Information System (INIS)

    Chen Ming; Hayman, James A.; Haken, Randall K. ten; Tatro, Daniel; Fernando, Shaneli; Kong, F.-M.

    2006-01-01

    Purpose: To report the results of high-dose conformal irradiation and examine incidental nodal irradiation and nodal failure in patients with inoperable early-stage non-small-cell lung cancer (NSCLC). Methods and Materials: This analysis included patients with inoperable CT-staged T1-3N0M0 NSCLC treated on our prospective dose-escalation trial. Patients were treated with radiation alone (total dose, 63-102.9 Gy in 2.1-Gy daily fractions) with a three-dimensional conformal technique without intentional nodal irradiation. Bilateral highest mediastinal and upper/lower paratracheal, prevascular and retrotracheal, sub- and para-aortic, subcarinal, paraesophageal, and ipsilateral hilar regions were delineated individually. Nodal failure and doses of incidental irradiation were studied. Results: The potential median follow-up was 104 months. For patients who completed protocol treatment, median survival was 31 months. The actuarial overall survival rate was 86%, 61%, 43%, and 21% and the cause-specific survival rate was 89%, 70%, 53%, and 35% at 1, 2, 3, and 5 years, respectively. Weight loss (p = 0.008) and radiation dose in Gy (p = 0.013) were significantly associated with overall survival. In only 22% and 13% of patients examined did ipsilateral hilar and paratracheal (and subaortic for left-sided tumor) nodal regions receive a dose of ≥40 Gy, respectively. Less than 10% of all other nodal regions received a dose of ≥40 Gy. No patients failed initially at nodal sites. Conclusions: Radiation dose is positively associated with overall survival in patients with medically inoperable T1-3N0 NSCLC, though long-term results remain poor. The nodal failure rate is low and does not seem to be due to high-dose incidental irradiation

  4. Oral Histoplasmosis

    OpenAIRE

    Folk, Gillian A.; Nelson, Brenda L.

    2017-01-01

    A 44-year-old female presented to her general dentist with the chief complaint of a painful mouth sore of 2 weeks duration. Clinical examination revealed an irregularly shaped ulcer of the buccal and lingual attached gingiva of the anterior mandible. A biopsy was performed and microscopic evaluation revealed histoplasmosis. Histoplasmosis, caused by Histoplasma capsulate, is the most common fungal infection in the United States. Oral lesions of histoplasmosis are generally associated with the...

  5. Oral Leukoplakia as It Relates to HPV Infection: A Review

    OpenAIRE

    Feller, L.; Lemmer, J.

    2012-01-01

    Leukoplakia is the most common potentially malignant lesion of the oral cavity and can be categorised according to its clinical appearance as homogeneous or nonhomogenous. Tobacco and areca nut use, either alone or in combination are the most common risk factors for oral leukoplakia, but some oral leukoplakias are idiopathic. Some leukoplakias arise within fields of precancerized oral epithelium in which the keratinocytes may be at different stages of cytogenetic transformation. Leukoplakias ...

  6. Significant enhancement of 11-Hydroxy-THC detection by formation of picolinic acid esters and application of liquid chromatography/multi stage mass spectrometry (LC-MS(3) ): Application to hair and oral fluid analysis.

    Science.gov (United States)

    Thieme, Detlef; Sachs, Ulf; Sachs, Hans; Moore, Christine

    2015-07-01

    Formation of picolinic acid esters of hydroxylated drugs or their biotransformation products is a promising tool to improve their mass spectrometric ionization efficiency, alter their fragmentation behaviour and enhance sensitivity and specificity of their detection. The procedure was optimized and tested for the detection of cannabinoids, which proved to be most challenging when dealing with alternative specimens, for example hair and oral fluid. In particular, the detection of the THC metabolites hydroxyl-THC and carboxy-THC requires ultimate sensitivity because of their poor incorporation into hair or saliva. Both biotransformation products are widely accepted as incorporation markers to distinguish drug consumption from passive contamination. The derivatization procedure was carried out by adding a mixture of picolinic acid, 4-(dimethylamino)pyridine and 2-methyl-6-nitrobenzoic anhydride in tetrahydrofuran/triethylamine to the dry extraction residues. Resulting derivatives were found to be very stable and could be reconstituted in aqueous or organic buffers and subsequently analyzed by liquid chromatography-mass spectrometry (LC-MS). Owing to the complex consecutive fragmentation patterns, the application of multistage MS3 proved to be extremely useful for a sensitive identification of doubly picolinated hydroxy-THC in complex matrices. The detection limits - estimated by comparison of corresponding signal-to-noise ratios - increased by a factor of 100 following picolination. All other species examined, like cannabinol, THC, cannabidiol, and carboxy-THC, could also be derivatized exhibiting only moderate sensitivity improvements. The assay was systematically tested using hair samples and exemplarily applied to oral fluid. Concentrations of OH-THC identified in THC-positive hair samples ranged from 0.02 to 0.29pg/mg. Copyright © 2014 John Wiley & Sons, Ltd.

  7. Some photo-electric features of the characteristics two-base Ag–N0Al0,2Ga0,8As–n+GaAs–n0Ga0,9In0,1As–Au-structure

    Directory of Open Access Journals (Sweden)

    Yodgorova D. M.

    2008-06-01

    Full Text Available The photo-electric characteristics created two-side-sensitive two-base Ag–N0Al0,2Ga0,8As–n+GaAs–n0Ga0,9In0,1As–Au-structure in photodiode and photovoltaic modes are investigated at influence by radiation from own area of absorption of base areas. The received structures are of interest as silent photoreceivers for opto- and microelectronics.

  8. Oral symptoms and functional outcome related to oral and oropharyngeal cancer.

    Science.gov (United States)

    Kamstra, Jolanda I; Jager-Wittenaar, Harriet; Dijkstra, Pieter U; Huisman, Paulien M; van Oort, Rob P; van der Laan, Bernard F A M; Roodenburg, Jan L N

    2011-09-01

    This study aimed to assess: (1) oral symptoms of patients treated for oral or oropharyngeal cancer; (2) how patients rank the burden of oral symptoms; (3) the impact of the tumor, the treatment, and oral symptoms on functional outcome. Eighty-nine patients treated for oral or oropharyngeal cancer were asked about their oral symptoms related to mouth opening, dental status, oral sensory function, tongue mobility, salivary function, and pain. They were asked to rank these oral symptoms according to the degree of burden experienced. The Mandibular Function Impairment Questionnaire (MFIQ) was used to assess functional outcome. In a multivariate linear regression analyses, variables related to MFIQ scores (p≤0.10) were entered as predictors with MFIQ score as the outcome. Lack of saliva (52%), restricted mouth opening (48%), and restricted tongue mobility (46%) were the most frequently reported oral symptoms. Lack of saliva was most frequently (32%) ranked as the most burdensome oral symptom. For radiated patients, an inability to wear a dental prosthesis, a T3 or T4 stage, and a higher age were predictive of MFIQ scores. For non-radiated patients, a restricted mouth opening, an inability to wear a dental prosthesis, restricted tongue mobility, and surgery of the mandible were predictive of MFIQ scores. Lack of saliva was not only the most frequently reported oral symptom after treatment for oral or oropharyngeal cancer, but also the most burdensome. Functional outcome is strongly influenced by an inability to wear a dental prosthesis in both radiated and non-radiated patients.

  9. Radiotherapy for Oral Cavity Cancer

    International Nuclear Information System (INIS)

    Shim, Jae Won

    1993-01-01

    Eighty five patients of oral cavity cancer, treated with radiation at the Department of Therapeutic Radiology, Korea Cancer Center Hospital, during the period from March 1985 to September 1990 were analyzed retrospectively. Among 85 patients, 37 patients were treated with radiation only and 48 patients were treated with radiation following surgery And 70 patients received external irradiation only by 60 Co with or without electron, the others were 7 patients for external irradiation plus interstitial implantation and 8 patients for external irradiation plus oral cone electron therapy. Primary sites were mobile tongue for 40 patients, mouth floor for 17 patients, palate for 12 patients, gingiva including retromolar trigone for 10 patients, buccal mucosa for 5 patients, and lip for 1 patient. According to pathologic classification, squamous cell carcinoma was the most common (77 patients). According to AJC TNM stage, stage I + II were 28 patients and stage III + IV were 57 patients. Acturial overall survival rate at 3 years was 43.9%, 3 year survival rates were 60.9% for stage I + II, and 23.1% for stage III + IV, respectively. As a prognostic factor, primary T stage was a significant factor (p<0.01). The others, age, location, lymph node metastasis, surgery, radiation dose, and cell differentiation were not statistically significant. Among those factors, radiation plus surgery was more effective than radiation only in T3 + T4 or in any N stage although it was not statistically sufficient(p<0.1). From those results, it was conclusive that definitive radiotherapy was more effective than surgery especially in the view of pertaining of anatomical integrity and function in early stage, and radiation plus surgery was considered to be better therapeutic tool in advanced stage

  10. Randomized Trial of Mediastinal Lymph Node Sampling Versus Complete Lymphadenectomy During Pulmonary Resection in the Patient with N0 or N1 (Less Than Hilar) Non-Small Cell Carcinoma: Results of the ACOSOG Z0030 Trial

    Science.gov (United States)

    Darling, Gail E.; Allen, Mark S.; Decker, Paul A.; Ballman, Karla; Malthaner, Richard A.; Inculet, Richard.; Jones, David R.; McKenna, Robert J.; Landreneau, Rodney J.; Rusch, Valerie W.; Putnam, Joe B.

    2016-01-01

    Objective To determine if mediastinal lymph node dissection (MLND) improves survival compared to mediastinal lymph node sampling (MLNS) in patients undergoing resection for N0 or non-hilar N1, T1 or T2 non-small cell lung cancer (NSCLC). Methods Patients with NSCLC underwent sampling of 2R, 4R, 7 and 10R for right sided tumors, and 5, 6, 7 and 10L for left sided tumors. If all were negative for malignancy, patients were randomized to no further lymph node sampling (MLNS) or complete MLND. Results Of 1,111 patients randomized, 1,023 (498 MLNS, 525 MLND) were eligible/evaluable. There were no significant differences between the two groups in terms of demographics, ECOG status, histology, location of the cancer, type or extent of resection, or pathological stage. Occult N2 disease was found in 21 patients in the MLND group. At median follow-up of 6.5 years, 435 (43%) patients have died; (MLNS: 217 (44%);MLND:218 (42%)). The median survival for MLNS is8.1 years, and 8.5 years for MLND (p=0.25). The 5-year disease free survival rate was 69% (95% CI: 64%-74%) in the MLNS group versus 68%(95% CI: 64%-73%) years in the MLND group (p=0.92). There was no difference for local (p=0.52), regional (p=0.10), or distant (p=0.76) recurrence between the two groups. Conclusions If systematic, thorough presection sampling of the mediastinal and hilar lymph nodes is negative, MLND does not improve survival in patients with early stage NSCLC but these results are not generalizable to patients staged radiographically or those with higher stage tumors. PMID:21335122

  11. Follow up after IMRT in oral cavity cancer: update

    Directory of Open Access Journals (Sweden)

    Studer Gabriela

    2012-06-01

    Full Text Available Abstract Purpose Except for early stages (T1/2 N0, the prognosis for patients with oral cavity cancer (OCC is known to be worse than for those with pharyngeal carcinoma. While definitive intensity modulated radiation therapy (IMRT-chemotherapy affords loco-regional control rates (LRC of approximately 80% in advanced pharyngeal cancer, corresponding rates are reported to be much lower for OCC. The aim of this work was to evaluate loco-regional disease control and overall survival (OAS in a relatively large OCC patient cohort treated in the IMRT era. Methods and materials Between October 2002 and June 2011, 160 OCC patients were treated with curative intention IMRT at our department. 122 patients (76% were referred with primary disease and 38 patients (24% with a recurrent OCC at least 3 months after surgery alone. Definitive IMRT was performed in 44/160 patients (28%, whilst 116 patients underwent previous surgery. Simultaneous systemic therapy was administered in 72%. Results Patients with postoperative IMRT (+/−systemic therapy with R0-1 status (n = 99 reached significantly higher LRC/OAS rates than patients following IMRT for macroscopic disease (n = 61, with 84%/80% versus 38%/33% at 3 years, respectively (p  Conclusions IMRT for R0-1 situations translated into a highly significant superior LRC and OAS compared to the IMRT cohort treated for macroscopic disease. Treatment was well tolerated.

  12. Are we able to reduce the mortality and morbidity of oral cancer; Some considerations

    NARCIS (Netherlands)

    van der Waal, I.

    2013-01-01

    Oral cancer makes up 1%-2% of all cancers that may arise in the body. The majority of oral cancers consists of squamous cell carcinomas. Oral cancer carries a considerable mortality rate, being mainly dependent on the stage of the disease at admission. Worldwide some 50% of the patients with oral

  13. Predictive factors of occult neck metastasis in patients with oral squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Renato Fortes Bittar

    Full Text Available ABSTRACT INTRODUCTION: It is well established that cervical lymph node metastasis is the most important prognostic factor in patients with oral squamous cell carcinoma of the upper aerodigestive tract. The definition of parameters and classifications that could separate patients in groups of low, intermediate and high-risk is being attempted for several years. OBJECTIVE: The objective of this study was to determine possible predictive factors related to the occurrence of occult cervical lymph node metastasis through the analysis of histopathological reports of surgical specimens obtained after oral squamous cell carcinoma resection and selective neck dissections of patients initially classified as N0. METHODS: This was a primary, retrospective, observational, case-control study. Histopathological reports were reviewed to determine if some findings were related to the occurrence of occult lymph node metastasis. The events analyzed were oral cavity subsites, pT-stage, muscular infiltration, desmoplasia, vascular emboli, perineural infiltration, tumor thickness and compromised margins. RESULTS: Occult cervical metastasis accounted for 19.10 percent of the cases. Desmoplasia, perineural infiltration, tumor thickness and pT4a stage are predictive factors of occult neck metastasis (p-value = 0.0488, 0.0326, 0.0395, 0.0488, respectively. CONCLUSION: The accurate definition of predictive factors of occult cervical metastasis may guide the selection of patients that should be referred to radiotherapy, avoiding the unnecessary exposure of low-risk patients to radiation and allowing a better regional control of the disease in those of moderate or high risk.

  14. Estimation of cross sections of hypotetical 8n0, 10He2, 13Li3 nuclei production in the framework of fast fragmentation model

    International Nuclear Information System (INIS)

    Lozhkin, O.V.; Oplavin, V.S.; Yakovlev, Yu.P.

    1983-01-01

    The possibilities of search for 8 n 0 , 10 He 2 , 13 Li 3 nuclides in the products of nuclear fragmentation under the action of high energy particles are analysed. Conclusions have been drawn that: available experimental data on determination of the upper boundary of a cross section of 8 n 0 fragments production exclude an existence of this nuclide in the form ''usual'' nuclear system; available experimental estimations of cross sections of 10 He and 13 Li production among fragmentation products are, for the present, insufficient to solve a problem of 13 Li nucleus existence in a bound state but testify on 10 He nucleus nuclear instability; serious model estimations of have functions and nuclide binding energy are necessary

  15. Computational study of adsorption, diffusion, and dissociation of precursor species on the GaN (0 0 0 1) surface during GaN MOCVD

    Science.gov (United States)

    Won, Yong Sun; Lee, Jinuk; Kim, Changsung Sean; Park, Sung-Soo

    2009-02-01

    The adsorption, diffusion, and dissociation of precursor species, MMGa (monomethylgallium) and NH 3, on the GaN (0 0 0 1) surface have been investigated using the DFT (density functional theory) calculation combined with a GaN (0 0 0 1) surface cluster model. The energetics of NH 3(ad) dissociation on the surface proposed of NH 3(ad) via NH 2(ad) to NH(ad) was facile with small activation barriers. A combined analysis with surface diffusion of adatoms demonstrated Ga(ad) and NH(ad) become primary reactant species for 2D film growth, and N(ad) develops into a nucleation center. Our studies suggest the control of NH 3(ad) dissociation are essential to improve epitaxial film quality as well as Ga-rich condition. In addition, the adsorbability of H(ad)s resulted from NH 3(ad) dissociation were found to influence on the surface chemistry during film growth.

  16. A non-randomized confirmatory trial of segmentectomy for clinical T1N0 lung cancer with dominant ground glass opacity based on thin-section computed tomography (JCOG1211).

    Science.gov (United States)

    Aokage, Keiju; Saji, Hisashi; Suzuki, Kenji; Mizutani, Tomonori; Katayama, Hiroshi; Shibata, Taro; Watanabe, Syunichi; Asamura, Hisao

    2017-05-01

    Lobectomy has been the standard surgery for even stage I lung cancer since the validity of limited resection for stage I lung cancer was denied by the randomized study reported in 1995. The aim of this non-randomized confirmatory going on since September 2013 is to confirm the efficacy of a segmentectomy for clinical T1N0 lung cancer with dominant ground glass opacity based on thin-slice computed tomography. A total of 390 patients from 42 Japanese institutions are recruited within 4 years. The primary endpoint of this study is a 5-year relapse-free survival in all of the patients who undergo a segmentectomy for a lung nodule. The secondary endpoints are overall survival, annual relapse-free survival, disease-free survival, proportion of local relapse, postoperative pulmonary function, proportion of segmentectomy completion, proportion of R0 resection completion by segmentectomy, adverse events, and serious adverse events. This trial has been registered at the UMIN Clinical Trials Registry as UMIN000011819 ( http://www.umin.ac.jp/ctr/ ). Patient's accrual has been already finished in November, 2015 and the primary analysis will be performed in 2021. This study is one of the pivotal trial of lung segmentectomy for early lung cancer. The result will provide a clear evidence for our daily clinics and will be possible contribution to preserving pulmonary function for lung cancer patients.

  17. Oral Thrush (For Parents)

    Science.gov (United States)

    ... For Parents / Oral Thrush Print en español Muguet (candidiasis oral) What Is Oral Thrush? Oral thrush is a ... Candida overgrowth also causes diaper rash and vaginal yeast infections . Babies can have oral thrush and a diaper rash at the same ...

  18. Towards understanding oral health

    NARCIS (Netherlands)

    Zaura, E.; ten Cate, J.M.

    2015-01-01

    During the last century, dental research has focused on unraveling the mechanisms behind various oral pathologies, while oral health was typically described as the mere absence of oral diseases. The term ‘oral microbial homeostasis' is used to describe the capacity of the oral ecosystem to maintain

  19. Sentinel node biopsy after primary chemotherapy in cT2 N0/1 breast cancer patients: Long-term results of a retrospective study.

    Science.gov (United States)

    Martelli, G; Miceli, R; Folli, S; Guzzetti, E; Chifu, C; Maugeri, I; Ferranti, C; Bianchi, G; Capri, G; Carcangiu, M L; Paolini, B; Agresti, R; Ferraris, C; Piromalli, D; Greco, M

    2017-11-01

    It is controversial whether sentinel node biopsy (SNB) is adequate in breast cancer patients who become cN0 after primary chemotherapy. To address this we retrospectively compared outcomes in T2 cases given primary chemotherapy, comparing those given axillary dissection (AD) with those given SNB but no AD if sentinel nodes were clinically negative post-chemotherapy. We examined overall survival (OS), disease-free survival (DFS), and axillary failure in 317 consecutive cT2 cN0/1 patients given primary chemotherapy followed by quadrantectomy/mastectomy, between January 2002 and December 2007. The approach to the axilla changed over time allowing division into three groups: 101 (31.9%) given upfront AD; 139 (43.8%) given SNB + AD; and 77 (24.3%) given SNB only because the SNs were negative. After median follow-ups of 92 (AD), 99 (SNB + AD) and 72 months (SNB-only), OS (p = 0.131) and DFS (p = 0.087) did not differ between the 3 groups, or between SNB-only and the ypN1 and ypN0 subgroups of SNB + AD, or between the cN0 and cN1 subgroups (before chemotherapy) of the SNB-only group. No SNB-only patient had axillary failure. OS (p = 0.004) and DFS (p = 0.002) were better in patients with complete response than those with partial response or stable/progressive disease. SNB is adequate in T2 patients who are cN0 after primary chemotherapy, irrespective of axillary status before. Better outcomes after complete pathological remission confirm the prognostic importance of response to primary chemotherapy, and suggest that all T2 patients should receive primary chemotherapy. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  20. Evolution of Si-2N2Nb island configuration on NbN (0 0 1) surface: A first-principles calculation

    International Nuclear Information System (INIS)

    Ren, Yuan; Xia, Qing; Zhang, Chao; Liu, Xuejie; Li, Zhi; Zhang, Fucheng

    2015-01-01

    Graphical abstract: - Highlights: • We investigate the separation and gathering of Nb, Si and N atom around come to NbN grain. • The adsorption and diffusion of single atom around 2N2Nb island were calculated by DFT. • The adsorption behavior of Si-2N2Nb island on NbN (0 0 1) surface were investigated. • The evolution of Si-2N2Nb island on NbN (0 0 1) were calculated by nudged elastic band. - Abstract: The separation and aggregation of Nb, Si, and N atoms around the NbN grain during the deposition of the Nb–Si–N nanocomposite film were discussed. The evolution behavior of the 2N2Nb island and the adsorption and diffusion energy of Nb, Si, and N atoms around the island on the NbN (0 0 1) surface were investigated using the first-principles method based on density functional theory. Results indicated that the most stable configuration of the Nb–Si–N island was the combination of Nb and N atoms to form the island and the possible aggregation of the Si atom to diagonal Nb atom outside the island. Substitution solid solution was eventually formed, in which the Nb atom of the 2N2Nb island was replaced by the Si atom during deposition. However, the Si atom was easily replaced by the Nb atom at the site with abundant Nb atoms. The diffusion energy of the evolution from Nb-2N1Nb1Si to Si-2N2Nb was 1.58 eV, and the total energy of the configuration decreased. Moreover, the interface of Si and NbN grains tended to separate. The highest energy adsorption sites for Nb, Si, N atoms adsorbed on the NbN (0 0 1) surface around the 2N2Nb island were P3, P1, and P2, respectively. The adsorption energies of Nb, Si, and N atoms on the NbN (0 0 1) surface around the 2N2Nb island were 7.3067, 5.3521, and 6.7113 eV, respectively, and their diffusion energies around the 2N2Nb island were 2.62, 1.35, and 5.094 eV, respectively. The low adsorption and diffusion energies of active Si atoms promoted the distribution of Nb and N atoms during deposition. Furthermore, the Nb

  1. Oral Cysticercosis: A Diagnostic Difficulty

    OpenAIRE

    Joshi, Jaya; Sharanesha, Manjunatha Bhari; Jatwa, Rameshwar; Khetrapal, Shaleen

    2014-01-01

    Cysticercosis is a rare disease caused by the ingestion of the parasite Cysticercus cellulosae, a larval stage of Taenia solium. The definitive host is human who harbors the adult worm and may accidentally or incidentally become the host. The larval form of cyst is commonly seen in the brain, meninges and eyes. Cases in the maxillofacial region including oral cavity and cheek muscles are rarely reported. Cysticercosis is not commonly considered in the diagnosis of swellings of the head and ne...

  2. 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

  3. Oral sex, oral health and orogenital infections

    Directory of Open Access Journals (Sweden)

    Saini Rajiv

    2010-01-01

    Full Text Available Oral sex is commonly practiced by sexually active male-female and same-gender couples of various ages, including adolescents. The various type of oral sex practices are fellatio, cunnilingus and analingus. Oral sex is infrequently examined in research on adolescents; oral sex can transmit oral, respiratory, and genital pathogens. Oral health has a direct impact on the transmission of infection; a cut in your mouth, bleeding gums, lip sores or broken skin increases chances of infection. Although oral sex is considered a low risk activity, it is important to use protection and safer sex precautions. There are various methods of preventing infection during oral sex such as physical barriers, health and medical issues, ethical issues and oral hygiene and dental issues. The lesions or unhealthy periodontal status of oral cavity accelerates the phenomenon of transmission of infections into the circulation. Thus consequences of unhealthy or painful oral cavity are significant and oral health should be given paramount importance for the practice of oral sex.

  4. The role of dental care providers and oral and maxillofacial surgeons in the surgical and medical management of oral cancer in the United States.

    Science.gov (United States)

    Kim, Beomjune B; Kim, Dongsoo D

    2013-01-01

    Oral cancer results in significant morbidity and mortality in those afflicted. Despite modern treatments, mortality is high, with overall 5-year survival rates that approximate 50%. However, early stage disease (Stages 1 and 2) carries a significantly better prognosis than late stage disease (Stages 3 and 4), therefore, prevention and early detection continue to be important in improving oral cancer control. The role of dental care providers in routine oral cancer screenings, smoking cessation, treatment, and rehabilitation of oral cancer patients is emphasized in this article. This article also discusses the epidemiology, etiology, diagnosis, and treatment of oral cancer and the role of oral and maxillofacial surgeons in the surgical and medical management of oral cancer patients in the United States.

  5. Oral Health Glossary

    Science.gov (United States)

    ... 2018 About | Contact InfoBites Quick Reference Learn more Oral Health and Overal Health Gum Disease and Cardiovascular Health ... news feeds delivered directly to your desktop! more... Oral Health Glossary Article Chapters Oral Health Glossary print full ...

  6. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Us Home Health Info Health Information The Oral Cancer Exam See a step-by-step video explaining what happens during an oral cancer examination. An oral cancer exam is painless and ...

  7. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Contact Us Home Health Info Health Information The Oral Cancer Exam See a step-by-step video explaining what happens during an oral cancer examination. An oral cancer exam is painless and ...

  8. Features of phase and structure formation on liquid-phase sintering of TiC0.5N0.5-TiNi-Nb and TiC0.5N0.5-TiNi-Ti-Nb alloys

    International Nuclear Information System (INIS)

    Askarova, L.Kh.; Grigorov, I.G.; Zajnulin, Yu.G.

    2000-01-01

    Using methods of X-ray diffraction analysis, electron microscopy and X-ray spectrum microanalysis the features of phase- and structure formation in the presence of liquid phase are investigated for TiC 0.5 N 0.5 -TiNi-Nb and TiC 0.5 N 0.5 -TiNi-Ti-Nb alloys. It is shown that in the process of liquid-phase sintering base and a binding constituent takes place with the formation of a three-phase alloy of Ti 1-n Nb n C 0.5 N 0.5 -TiNi-Nb z Ni. The composition and the structure of a refractory grain are determined by niobium concentration in the alloy and by annealing conditions [ru

  9. Understanding cancer staging

    Science.gov (United States)

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

  10. Beta decay rate of 16N(0-, 120 keV): meson exchange currents and the value of the induced pseudoscalar-coupling constant

    International Nuclear Information System (INIS)

    Gagliardi, C.A. III.

    1982-10-01

    The beta-decay branching ratio R(#betta#) for the transition 16 N(0 - , 120 keV) → 16 O (0 + , g.s.) + e - + anti nu is remeasured. The rate of this 0 - → 0 + transition #betta#(#betta#) is expected to receive a large enhancement from pion-exchange-current contributions to the weak axial-vector time component. The beta-decay rate may also be combined with the muon-capture rate #betta#(μ) for the inverse reaction μ - + 16 O(0 + , g.s.) → 16 N(0 - , 120 keV) + nu/sub μ/ to obtain the induced pseudoscalar coupling constant g/sub P/ in finite nuclei. The experimental results are compared to recent realistic calculations of #betta#(#betta#) and #betta#(μ) in which 2-particle, 2-hole components are included in the 16 O ground state and 3-particle, 3-hole components are included in the 16 N 0 - state, while three different residual interactions are utilized to determine the wavefunctions. We find R(#betta#) = (3.42 +- 0.37) x 10 - 6 . This agrees with the only previous measurement R(#betta#) = (3.5 +- 0.7) x 10 - 6 . The beta-decay rate #betta#(#betta#) = (0.45 +- 0.05) sec - 1 , which agrees with the calculations only when pion-exchange currents are included. The nucleons-only impulse approximation underestimates #betta#(#betta#) by more than a factor of 3, independent of the residual interaction. This confirms the important role of pion exchange in the weak axial-vector time component. The measured ratio #betta#(μ)/#betta#(#betta#) implies that g/sub P//g/sub A/ = 11 +- 2 for the nucleon in finite nuclei. This result is model dependent. It assumes that #betta#(μ)/#betta#(#betta#) is independent of the nuclear model used in its calculation, as is approximately true in the recent calculations

  11. Role of Adjuvant Chemotherapy in ypT0-2N0 Patients Treated with Preoperative Chemoradiation Therapy and Radical Resection for Rectal Cancer.

    Science.gov (United States)

    Park, In Ja; Kim, Dae Yong; Kim, Hee Cheol; Kim, Nam Kyu; Kim, Hyeong-Rok; Kang, Sung-Bum; Choi, Gyu-Seog; Lee, Kang Young; Kim, Seon-Hahn; Oh, Seung Taek; Lim, Seok-Byung; Kim, Jin Cheon; Oh, Jae Hwan; Kim, Sun Young; Lee, Woo Yong; Lee, Jung Bok; Yu, Chang Sik

    2015-07-01

    To explore the role of adjuvant chemotherapy for patients with ypT0-2N0 rectal cancer treated by preoperative chemoradiation therapy (PCRT) and radical resection. A national consortium of 10 institutions was formed, and patients with ypT0-2N0 mid- and low-rectal cancer after PCRT and radical resection from 2004 to 2009 were included. Patients were categorized into 2 groups according to receipt of additional adjuvant chemotherapy: Adj CTx (+) versus Adj CTx (-). Propensity scores were calculated and used to perform matched and adjusted analyses comparing relapse-free survival (RFS) between treatment groups while controlling for potential confounding. A total of 1016 patients, who met the selection criteria, were evaluated. Of these, 106 (10.4%) did not receive adjuvant chemotherapy. There was no overall improvement in 5-year RFS as a result of adjuvant chemotherapy [91.6% for Adj CTx (+) vs 87.5% for Adj CTx (-), P=.18]. There were no differences in 5-year local recurrence and distant metastasis rate between the 2 groups. In patients who show moderate, minimal, or no regression in tumor regression grade, however, possible association of adjuvant chemotherapy with RFS would be considered (hazard ratio 0.35; 95% confidence interval 0.14-0.88; P=.03). Cox regression analysis after propensity score matching failed to show that addition of adjuvant chemotherapy was associated with improved RFS (hazard ratio 0.81; 95% confidence interval 0.39-1.70; P=.58). Adjuvant chemotherapy seemed to not influence the RFS of patients with ypT0-2N0 rectal cancer after PCRT followed by radical resection. Thus, the addition of adjuvant chemotherapy needs to be weighed against its oncologic benefits. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Role of Adjuvant Chemotherapy in ypT0-2N0 Patients Treated with Preoperative Chemoradiation Therapy and Radical Resection for Rectal Cancer

    International Nuclear Information System (INIS)

    Park, In Ja; Kim, Dae Yong; Kim, Hee Cheol; Kim, Nam Kyu; Kim, Hyeong-Rok; Kang, Sung-Bum; Choi, Gyu-Seog; Lee, Kang Young; Kim, Seon-Hahn; Oh, Seung Taek; Lim, Seok-Byung; Kim, Jin Cheon; Oh, Jae Hwan; Kim, Sun Young; Lee, Woo Yong; Lee, Jung Bok; Yu, Chang Sik

    2015-01-01

    Objective: To explore the role of adjuvant chemotherapy for patients with ypT0-2N0 rectal cancer treated by preoperative chemoradiation therapy (PCRT) and radical resection. Patients and Methods: A national consortium of 10 institutions was formed, and patients with ypT0-2N0 mid- and low-rectal cancer after PCRT and radical resection from 2004 to 2009 were included. Patients were categorized into 2 groups according to receipt of additional adjuvant chemotherapy: Adj CTx (+) versus Adj CTx (−). Propensity scores were calculated and used to perform matched and adjusted analyses comparing relapse-free survival (RFS) between treatment groups while controlling for potential confounding. Results: A total of 1016 patients, who met the selection criteria, were evaluated. Of these, 106 (10.4%) did not receive adjuvant chemotherapy. There was no overall improvement in 5-year RFS as a result of adjuvant chemotherapy [91.6% for Adj CTx (+) vs 87.5% for Adj CTx (−), P=.18]. There were no differences in 5-year local recurrence and distant metastasis rate between the 2 groups. In patients who show moderate, minimal, or no regression in tumor regression grade, however, possible association of adjuvant chemotherapy with RFS would be considered (hazard ratio 0.35; 95% confidence interval 0.14-0.88; P=.03). Cox regression analysis after propensity score matching failed to show that addition of adjuvant chemotherapy was associated with improved RFS (hazard ratio 0.81; 95% confidence interval 0.39-1.70; P=.58). Conclusions: Adjuvant chemotherapy seemed to not influence the RFS of patients with ypT0-2N0 rectal cancer after PCRT followed by radical resection. Thus, the addition of adjuvant chemotherapy needs to be weighed against its oncologic benefits

  13. Role of Adjuvant Chemotherapy in ypT0-2N0 Patients Treated with Preoperative Chemoradiation Therapy and Radical Resection for Rectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Park, In Ja [Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul (Korea, Republic of); Kim, Dae Yong [Center for Colorectal Cancer, National Cancer Center, Goyang-si (Korea, Republic of); Kim, Hee Cheol [Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Nam Kyu [Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Hyeong-Rok [Department of Surgery, Chonnam National University Hwansun Hospital, Gwangju (Korea, Republic of); Kang, Sung-Bum [Department of Surgery, Seoul National University Bungdang Hospital, Bundang (Korea, Republic of); Choi, Gyu-Seog [Division of Colorectal Cancer Center, Kyungpook National University Medical Center, Daegu (Korea, Republic of); Lee, Kang Young [Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Seon-Hahn [Department of Surgery, Korea University Anam Hospital, Seoul (Korea, Republic of); Oh, Seung Taek [Department of Surgery, Seoul St. Mary Hospital, Catholic University, Seoul (Korea, Republic of); Lim, Seok-Byung; Kim, Jin Cheon [Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul (Korea, Republic of); Oh, Jae Hwan; Kim, Sun Young [Center for Colorectal Cancer, National Cancer Center, Goyang-si (Korea, Republic of); Lee, Woo Yong [Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Jung Bok [Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine and Asan Medical Center, Seoul (Korea, Republic of); Yu, Chang Sik, E-mail: csyu@amc.seoul.kr [Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul (Korea, Republic of)

    2015-07-01

    Objective: To explore the role of adjuvant chemotherapy for patients with ypT0-2N0 rectal cancer treated by preoperative chemoradiation therapy (PCRT) and radical resection. Patients and Methods: A national consortium of 10 institutions was formed, and patients with ypT0-2N0 mid- and low-rectal cancer after PCRT and radical resection from 2004 to 2009 were included. Patients were categorized into 2 groups according to receipt of additional adjuvant chemotherapy: Adj CTx (+) versus Adj CTx (−). Propensity scores were calculated and used to perform matched and adjusted analyses comparing relapse-free survival (RFS) between treatment groups while controlling for potential confounding. Results: A total of 1016 patients, who met the selection criteria, were evaluated. Of these, 106 (10.4%) did not receive adjuvant chemotherapy. There was no overall improvement in 5-year RFS as a result of adjuvant chemotherapy [91.6% for Adj CTx (+) vs 87.5% for Adj CTx (−), P=.18]. There were no differences in 5-year local recurrence and distant metastasis rate between the 2 groups. In patients who show moderate, minimal, or no regression in tumor regression grade, however, possible association of adjuvant chemotherapy with RFS would be considered (hazard ratio 0.35; 95% confidence interval 0.14-0.88; P=.03). Cox regression analysis after propensity score matching failed to show that addition of adjuvant chemotherapy was associated with improved RFS (hazard ratio 0.81; 95% confidence interval 0.39-1.70; P=.58). Conclusions: Adjuvant chemotherapy seemed to not influence the RFS of patients with ypT0-2N0 rectal cancer after PCRT followed by radical resection. Thus, the addition of adjuvant chemotherapy needs to be weighed against its oncologic benefits.

  14. Coping with uncertainty: T1a,bN0M0 HER2-positive breast cancer, do we have a treatment threshold?

    LENUS (Irish Health Repository)

    Kelly, C M

    2012-02-01

    BACKGROUND: Recent retrospective studies have suggested that patients with T1a,bN0M0 human epidermal growth factor receptor 2 (HER2)-positive breast cancer are at a higher risk for recurrence and might benefit from adjuvant trastuzumab. The absolute benefits associated with treating this subgroup are uncertain. Design: We reviewed recent studies examining the prognostic value of HER2 in patients with node-negative T1a,b HER2-positive breast cancer. We calculated the number needed to treat (NNT) using baseline risk estimates for untreated T1a,bN0M0 breast cancer and the number needed to harm (NNH) using the incidence of cardiac events in each of the adjuvant trastuzumab clinical trials. RESULTS: Several studies were identified, each with limitations inherent to retrospective database analyses: small cohort sizes, lack of systematic HER2 testing in older specimens, variations in the use of adjuvant therapy and definitions of study end points, and lack of information relating to comorbidities. The 5-year disease-free survival in the pre-trastuzumab era ranged from 77% to 95%. Comparisons between small HER2 -positive and small HER2 -negative cancers showed numerically worse outcome for the HER2-positive cohort in some but not all studies. In many instances, the NNH was larger (26-250) than the NNT (13-35); however, in a subset of patients, the NNH was lower (6) than the NNT (13-35). CONCLUSIONS: Better prediction tools to estimate more precisely the risk for death due to comorbid illness versus breast cancer are needed. In some patients, the risks of therapy could outweigh the benefits. Treatment selection for T1a,bN0 HER2-positive cancers remains in the transition area between evidence- and subjective judgment-based medicine.

  15. Californium-252 neutron intracavity brachytherapy alone for T1N0 low-lying rectal adenocarcinoma: A definitive anal sphincter-preserving radiotherapy.

    Science.gov (United States)

    Xiong, Yanli; Shan, Jinlu; Liu, Jia; Zhao, Kewei; Chen, Shu; Xu, Wenjing; Zhou, Qian; Yang, Mei; Lei, Xin

    2017-01-17

    This study evaluated the 4-year results of 32 patients with T1N0 low-lying rectal adenocarcinoma treated solely with californium-252 (Cf-252) neutron intracavity brachytherapy (ICBT). Patients were solicited into the study from January 2008 to June 2011. All the patients had refused surgery or surgery was contraindicated. The patients were treated with Cf-252 neutron ICBT using a novel 3.5-cm diameter off-axis 4-channel intrarectal applicator designed by the authors. The dose reference point was defined on the mucosa surface, with a total dose of 55-62 Gy-eq/4 f (13-16 Gy-eq/f/wk). All the patients completed the radiotherapy in accordance with our protocol. The rectal lesions regressed completely, and the acute rectal toxicity was mild (≤G2). The 4-year local control, overall survival, disease-free survival, and late complication (≥G2) rates were 96.9%, 90.6%, 87.5% and 15.6%, respectively. No severe late complication (≥G3) occurred. The mean follow-up was 56.1 ± 16.0 months. At the end of last follow-up, 29 patients remained alive. The mean survival time was 82.1 ± 2.7 months. Cf-252 neutron ICBT administered as the sole treatment (without surgery) for patients with T1N0 low-lying rectal adenocarcinoma is effective with acceptable late complications. Our study and method offers a definitive anal sphincter-preserving radiotherapy for T1N0 low-lying rectal adenocarcinoma patients.

  16. Californium-252 neutron intracavity brachytherapy alone for T1N0 low-lying rectal adenocarcinoma: A definitive anal sphincter-preserving radiotherapy

    OpenAIRE

    Yanli Xiong; Jinlu Shan; Jia Liu; Kewei Zhao; Shu Chen; Wenjing Xu; Qian Zhou; Mei Yang; Xin Lei

    2017-01-01

    This study evaluated the 4-year results of 32 patients with T1N0 low-lying rectal adenocarcinoma treated solely with californium-252 (Cf-252) neutron intracavity brachytherapy (ICBT). Patients were solicited into the study from January 2008 to June 2011. All the patients had refused surgery or surgery was contraindicated. The patients were treated with Cf-252 neutron ICBT using a novel 3.5-cm diameter off-axis 4-channel intrarectal applicator designed by the authors. The dose reference point ...

  17. Mucosite oral

    Directory of Open Access Journals (Sweden)

    Sérgio Spezzia

    2016-04-01

    Full Text Available A mucosite consta de irritação ou inflamação da mucosa bucal, provocada por ação da radioterapia de cabeça e pescoço e da quimioterapia. O objetivo deste artigo foi verificar como a ocorrência de mucosite oral pode influir na saúde bucal dos pacientes com câncer. Para tratamento odontológico o laser de baixa intensidade é o de opção. O emprego do laser de baixa potência tem cunho, tanto preventivo, como curativo para tratamento das lesões causadas. Concluiu-se que se pode evitar intercorrências no transcorrer do tratamento oncológico radioterápico e quimioterápico, fazendo-se uso da terapia laser, o que vai permitir melhores condições e qualidade de vida aos pacientes acometidos por mucosite.

  18. Synthesis of carbon nitride powder by selective etching of TiC0.3N0.7 in chlorine-containing atmosphere at moderate temperature

    International Nuclear Information System (INIS)

    Sui Jian; Lu Jinjun

    2010-01-01

    We reported the synthesis of carbon nitride powder by extracting titanium from single inorganic precursor TiC 0.3 N 0.7 in chlorine-containing atmosphere at ambient pressure and temperature not exceeding 500 deg. C. The TiC 0.3 N 0.7 crystalline structure acted as a template, supplying active carbon and nitrogen atoms for carbon nitride when it was destroyed in chlorination. X-ray diffraction data showed that the obtained carbon nitride powders were amorphous, which was in good agreement with transmission electron microscope analysis. The composition and structure of carbon nitride powders were analyzed by employing Fourier transform infrared spectroscopy, Raman spectroscopy, and X-ray photoelectron spectroscopy. Results indicated that disorder structure was most likely for the carbon nitride powders and the N content depended greatly on the chlorination temperature. Thermal analysis in flowing N 2 indicated that the mass loss started from 300 deg. C and the complete decomposition occurred at around 650 deg. C, confirming the low thermal stability of the carbon nitride material.

  19. Effects of bias voltage and annealing on the structure and mechanical properties of WC0.75N0.25 thin films

    International Nuclear Information System (INIS)

    Su, Y.D.; Hu, C.Q.; Wen, M.; Wang, C.; Liu, D.S.; Zheng, W.T.

    2009-01-01

    We investigated the effects of both bias voltage and annealing on the structure and mechanical properties of WC 0.75 N 0.25 thin films, deposited on Si (1 0 0) substrates by a direct current reactive magnetron sputtering system, in which the negative substrate bias voltage (V b ) was varied from floating (-1.6 V) to -200 V, and the deposited films were annealed at 800 deg. C for 2 h. The X-ray photoelectron spectroscopy and selected area electron diffraction analyses, along with the density-functional theory (DFT) calculations on the electronic structure, showed that WC 0.75 N 0.25 films were a single-phase of carbonitrides. After annealing, a significant decrease in hardness for the films was observed, being a result of point-defect annihilation as V b was in the range of floating to -120 V. However, when V b was in the range of -160 to -200 V, the hardness increased from ∼37 GPa for the as-deposited film to a maximum of ∼43 GPa for the annealed one. This increase in hardness after annealing might be attributed to age-hardening.

  20. Self-rated oral health status, oral health service utilization, and oral hygiene practices among adult Nigerians.

    Science.gov (United States)

    Olusile, Adeyemi Oluniyi; Adeniyi, Abiola Adetokunbo; Orebanjo, Olufemi

    2014-11-27

    There is scarce information available on oral health service utilization patterns and common oral hygiene practices among adult Nigerians. We conducted the 2010-2011 national oral health survey before the introduction of the national oral health policy to determine the prevalence of oral health service utilization, patterns of oral hygiene practices, and self reported oral health status, among adults in various social classes, educational strata, ethnic groups and geopolitical zones in Nigeria. We conducted a cross-sectional survey in North-Central, North-West, South-East, South-South and South-West geopolitical zones of Nigeria. Multi-stage cluster sampling method was used for the sample selection. We administered a structured questionnaire to a total of 7,630 participants. Information on the socio-demographic characteristics, oral hygiene practices and oral health services utilization pattern of participants was obtained. We interviewed 7, 630 participants (55.6% female). The participants ages ranged between 18 and 81 years, mean age was 37.96 (SD = 13.2). Overall 21.2% of the participants rated their oral health status as very good, 37.1% as good and 27.4% as fair. Only 26.4% reported having visited the dentist at least once prior to the conduct of the survey. More than half of these visits (54.9%) were for treatment purpose. Utilization of oral health services was significantly (p educated and being engaged in a skilled profession. More educated persons, females and younger persons used toothbrushes for daily tooth cleaning. Age, sex, marital status, level of education and occupation were significantly related to daily frequency of tooth cleaning (p educated persons displayed poorer oral hygiene practices. The study findings suggest that there is low oral health service utilization among adult Nigerians and that socio-demographic variables influence oral health utilization habits and oral hygiene behavior among adult Nigerians Further studies to

  1. Light-based headways: An innovation in oral cancer espial

    Directory of Open Access Journals (Sweden)

    Mankirat Kaur Gill

    2017-02-01

    Full Text Available Oral cancer is one of the most common malignancies in the world, mainly because of the widespread consumption of tobacco and related products. Early detection is very important in the management of oral cancer. However, when the lesion is detected in the oral cavity, it is at a much advanced stage for effective management, resulting in morbidity and mortality. A majority of deaths related to cancer are due in part to late diagnosis. In order to improve the clinical outcome of oral cancer, early detection is very important. One of the emerging technologies in the early detection of oral cancer is the use of noninvasive in vivo tissue imaging that captures the molecular changes at high resolution to improve the detection capability of oral cancer at an early stage.

  2. Sentinel Ganglions in Malignant Tumors of the Oral Cavity

    International Nuclear Information System (INIS)

    Cambrea, M.; Vlad, D.; Hincu, Mihaela; Sivoglo, V.

    2006-01-01

    Full text: Objectives: The use of lymphoscintigraphy in order to show lymphatic invasion, for a better precision of the surgical act as well as for the delimitation of the volumes-target to settle the radio therapeutic treatment. Material And Method: A group of 20 patients (18 men and 2 women) diagnosed with malign tumors of the oral cavity with no clinical adenopathy (N0), investigated clinically and para clinically (laboratory examinations and lymphoscintigraphy associated with bone scintigraphy). The lymphoscintigraphy was performed by the pritumoral injection of 18.5MBq 99m Tc-Nanocoll in 4 points. Before the lymphoscintigraphy was performed each patient had been injected with 750MBq Medronat. The images were taken with a GE eNTEGRA 2.5202. system. Pre-operatory (20 min.) intra vital coloring was performed with metilen blue by peritumoral injection. The surgery addressed to the primary tumor was completed by a supraomohioidian cervical vacuuming. Results: The lymphoscintigraphy showed the lymphatic drain of the malign tumors in 95% of the cases. All malign tumors of the oral cavity drain in the latero-cervical lymphatic ganglions (bilateral), most frequently the sentinel ganglions being found at the level IIb (48%), followed by level III (32%), level I-a (16%) and others (4%).The identification of the lymphatic ganglions pre-operatory by inter vital coloration was of 90.62%. The morphology of the satellite lymphoganglions is closely related to the histological type and the degree of differentiation of the tumors. In the invasive forms the frequency of the nodal metastases varies with the clinical stage of the tumor. In a single case multiple bone metastases were found by scintigraphy fact that led to the change of therapeutic attitude. Conclusions: Lymphoscintigraphy is essential for the settling of the therapeutic attitude towards the malign tumors of the oral cavity, due to: - the early detection of the invaded lymphatic ganglions (83 sentinel ganglions found

  3. Is Biological Subtype Prognostic of Locoregional Recurrence Risk in Women With pT1-2N0 Breast Cancer Treated With Mastectomy?

    Energy Technology Data Exchange (ETDEWEB)

    Truong, Pauline T., E-mail: ptruong@bccancer.bc.ca [Radiation Therapy Program, British Columbia Cancer Agency, Vancouver Island Centre, University of British Columbia, Victoria, BC (Canada); Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver Island Centre, University of British Columbia, Victoria, BC (Canada); Sadek, Betro T. [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Lesperance, Maria F. [Radiation Therapy Program, British Columbia Cancer Agency, Vancouver Island Centre, University of British Columbia, Victoria, BC (Canada); Alexander, Cheryl S. [Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver Island Centre, University of British Columbia, Victoria, BC (Canada); Shenouda, Mina; Raad, Rita Abi; Taghian, Alphonse G. [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States)

    2014-01-01

    Purpose: To examine locoregional and distant recurrence (LRR and DR) in women with pT1-2N0 breast cancer according to approximated subtype and clinicopathologic characteristics. Methods and Materials: Two independent datasets were pooled and analyzed. The study participants were 1994 patients with pT1-2N0M0 breast cancer, treated with mastectomy without radiation therapy. The patients were classified into 1 of 5 subtypes: luminal A (ER+ or PR+/HER 2−/grade 1-2, n=1202); luminal B (ER+ or PR+/HER 2−/grade 3, n=294); luminal HER 2 (ER+ or PR+/HER 2+, n=221); HER 2 (ER−/PR−/HER 2+, n=105) and triple-negative breast cancer (TNBC) (ER−/PR−/HER 2−, n=172). Results: The median follow-up time was 4.3 years. The 5-year Kaplan-Meier (KM) LRR were 1.8% in luminal A, 3.1% in luminal B, 1.7% in luminal HER 2, 1.9% in HER 2, and 1.9% in TNBC cohorts (P=.81). The 5-year KM DR was highest among women with TNBC: 1.8% in luminal A, 5.0% in luminal B, 2.4% in luminal HER 2, 1.1% in HER 2, and 9.6% in TNBC cohorts (P<.001). Among 172 women with TNBC, the 5-year KM LRR were 1.3% with clear margins versus 12.5% with close or positive margins (P=.04). On multivariable analysis, factors that conferred higher LRR risk were tumors >2 cm, lobular histology, and close/positive surgical margins. Conclusions: The 5-year risk of LRR in our pT1-2N0 cohort treated with mastectomy was generally low, with no significant differences observed between approximated subtypes. Among the subtypes, TNBC conferred the highest risk of DR and an elevated risk of LRR in the presence of positive or close margins. Our data suggest that although subtype alone cannot be used as the sole criterion to offer postmastectomy radiation therapy, it may reasonably be considered in conjunction with other clinicopathologic factors including tumor size, histology, and margin status. Larger cohorts and longer follow-up times are needed to define which women with node-negative disease have high postmastectomy LRR

  4. Axillary lymph node dissection versus no dissection in patients with T1N0 breast cancer: a randomized clinical trial (INT09/98).

    Science.gov (United States)

    Agresti, Roberto; Martelli, Gabriele; Sandri, Marco; Tagliabue, Elda; Carcangiu, Maria Luisa; Maugeri, Ilaria; Pellitteri, Cristina; Ferraris, Cristina; Capri, Giuseppe; Moliterni, Angela; Bianchi, Giulia; Mariani, Gabriella; Trecate, Giovanna; Lozza, Laura; Langer, Martin; Rampa, Mario; Gennaro, Massimiliano; Greco, Marco; Menard, Sylvie; Pierotti, Marco A

    2014-03-15

    Although axillary surgery is still considered to be a fundamental part of the management of early breast cancer, it may no longer be necessary either as treatment or as a guide to adjuvant treatment. The authors conducted a single-center randomized trial (INT09/98) to determine the impact of avoiding axillary surgery in patients with T1N0 breast cancer and planning chemotherapy based on biological factors of the primary tumor on long-term disease control. From June 1998 to June 2003, 565 patients aged 30 years to 65 years with T1N0 breast cancer were randomized to either quadrantectomy with (QUAD) or without (QU) axillary lymph node dissection; a total of 517 patients finally were evaluated. All patients received radiotherapy to the residual breast only. Chemotherapy for patients in the QUAD treatment arm was determined based on lymph node status, estrogen receptor status, and tumor grade. Chemotherapy for patients in the QU treatment arm was based on estrogen receptor status, tumor grade, and human epidermal growth factor receptor 2 and laminin receptor status. Overall survival (OS) was the primary endpoint. Disease-free survival (DFS) and rate and time of axillary lymph node recurrence in the QU treatment arm were the secondary endpoints. After a median follow-up of >10 years, the estimated adjusted hazards ratio of the QUAD versus QU treatment arms for OS was 1.09 (95% confidence interval, 0.59-2.00; P = .783) and was 1.04 (95% confidence interval, 0.56-1.94; P = .898) for DFS. Of the 245 patients in the QU treatment arm, 22 (9.0%) experienced axillary lymph node recurrence. The median time to axillary lymph node recurrence from breast surgery was 30.0 months (interquartile range, 24.2 months-73.4 months). Patients with T1N0 breast cancer did not appear to benefit in terms of DFS and OS from immediate axillary lymph node dissection in the current randomized trial. The biological characteristics of the primary tumor appear adequate for guiding adjuvant

  5. 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.

    2016-01-01

    We report analytic and consensus processes that produced recommendations for neoadjuvant pathologic stage groups (ypTNM) of esophageal and esophagogastric junction cancer for AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration (WECC) 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. PMID:27905170

  6. 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.

  7. Effect of GaN template thickness and morphology on Al{sub x}Ga{sub 1−x}N (0 < x < 0.2) growth by MOVPE

    Energy Technology Data Exchange (ETDEWEB)

    Halidou, I., E-mail: ibrahim.halidou@fsm.rnu.tn [Université de Monastir, Faculté des Sciences, Unité de Recherche sur les Hétéro-Epitaxies et Applications (URHEA) 5000 Monastir (Tunisia); Touré, A. [Université de Monastir, Faculté des Sciences, Unité de Recherche sur les Hétéro-Epitaxies et Applications (URHEA) 5000 Monastir (Tunisia); Fouzri, A. [Université de Monastir, Faculté des Sciences, Laboratoire de Physico-Chimie des Matériaux, Unité de service commun de recherche “High Resolution X-ray Diffractometer”, 5000 Monastir (Tunisia); Ramonda, M. [Laboratoire de Microscopie à Champ Proche, Université de Montpellier II, 34095 Montpellier Cedex 5 (France); El Jani, B. [Université de Monastir, Faculté des Sciences, Unité de Recherche sur les Hétéro-Epitaxies et Applications (URHEA) 5000 Monastir (Tunisia)

    2013-09-01

    We have grown Al{sub x}Ga{sub 1−x}N/GaN (0 < x < 0.2) films by MOVPE at atmospheric pressure in a home-made vertical reactor. The films were deposited on high temperature GaN templates which were grown on in situ nano-masked (0 0 0 1) sapphire substrates by using Si/N treatment. This process presents advantages of ELO technology without its ex situ complicated steps and induces a transition from 3D mode (initial stage) to 2D growth mode. We investigate systematically the effect of the template thickness and morphology on structural and morphological properties of AlGaN films. Four 0.5 μm-thick Al{sub 0.07}Ga{sub 0.93}N samples grown on different GaN templates have been studied. The HRXD and the AFM results show a better film quality when the AlGaN layer is grown on a 1.3 μm-thick 2D GaN template. It is possible to control the stress in the layers. The crystalline quality is also showed to degrade with Al solid content increase.

  8. Nuclear factor κB and cyclooxygenase-2 immunoexpression in oral dysplasia and oral squamous cell carcinoma.

    Science.gov (United States)

    Pontes, Hélder Antônio Rebelo; Pontes, Flávia Sirotheau Corrêa; Fonseca, Felipe Paiva; de Carvalho, Pedro Luiz; Pereira, Erika Martins; de Abreu, Michelle Carvalho; de Freitas Silva, Brunno Santos; dos Santos Pinto, Décio

    2013-02-01

    Oral leukoplakia is the main potentially malignant oral lesion, and oral squamous cell carcinoma accounts for more than 95% of all malignant neoplasms in the oral cavity. Therefore, the aim of this study was to verify the immunoexpression of nuclear factor κB (NF-κB) and cyclooxygenase-2 (COX-2) proteins in dysplastic oral lesions and oral squamous cell carcinoma. Immunohistochemical reactions were performed on 6 inflammatory fibrous hyperplasia, 28 oral leukoplakia, and 15 oral squamous cell carcinoma paraffin-embedded samples. Immunoperoxidase reaction for NF-κB and COX-2 was applied on the specimens, and the positivity of the reactions was calculated for 1000 epithelial cells. Using the analysis of variance and the Tukey post hoc statistical analyses, a significantly increased immunoexpression for NF-κB was observed when oral squamous cell carcinoma samples were compared with the other groups studied. However, using the Kruskal-Wallis and the Dunn post hoc tests, a statistically significant result for COX-2 expression was obtained only when the moderate dysplasia group was compared with the inflammatory fibrous hyperplasia group. Nuclear factor κB may participate in the malignant phenotype acquisition process of the oral squamous cell carcinoma in its late stages, whereas COX-2 may be involved in the early stages of oral carcinogenesis process. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. General Information about Lip and Oral Cavity Cancer

    Science.gov (United States)

    ... machine in the same position before each treatment. Internal radiation therapy uses a radioactive substance sealed in needles, seeds , ... stage of the cancer being treated. External and internal radiation therapy are used to treat lip and oral cavity ...

  10. Prognostic value of Twist, Snail and E-cadherin expression in pathological N0 non-small-cell lung cancer: a retrospective cohort study.

    Science.gov (United States)

    Wang, Guanghui; Ma, Wei; Li, Yun; Jiang, Yuanzhu; Ma, Guoyuan; Zhang, Xiangwei; Meng, Long; Du, Jiajun

    2018-02-05

    Lung cancer is the leading cause of cancer-related death worldwide. The 5-year survival rate for patients after curative surgery with pathological N0 non-small-cell lung cancer (NSCLC) is as low as 56%, which is due to recurrence and metastasis. Emerging evidence suggests that epithelial-mesenchymal transition is important for cancer metastasis. Twist and Snail are epithelial-mesenchymal transition regulators that induce metastasis by down-regulating E-cadherin. The aim of this study was to evaluate the prognostic value of Twist, Snail and E-cadherin expression in patients with resectable pathological N0 NSCLC. The expression levels of Twist, Snail and E-cadherin in 78 patients with resected pathological N0 NSCLC were assessed using immunohistochemistry. The association between the expression of Twist/Snail/E-cadherin and overall survival (OS) and recurrence-free survival (RFS) was investigated. High expression of Twist, Snail and E-cadherin was detected in 18%, 21% and 53% of NSCLC samples, respectively. High expression of Twist and Snail and low expression of E-cadherin were associated with worse RFS [hazard ratio (HR) 2.29, 95% confidence interval (CI) 1.07-4.87, P = 0.026; HR 2.54, 95% CI 1.24-5.20, P = 0.008 and HR 2.41, 95% CI 1.23-4.73, P = 0.007, respectively] and worse OS (HR 2.26, 95% CI 1.01-5.04, P = 0.040; HR 2.56, 95% CI 1.20-5.43, P = 0.011 and HR 2.42, 95% CI 1.18-4.95, P = 0.012, respectively). Co-expression of at least 2 markers from the combination of high Twist/high Snail/low E-cadherin expression predicted poor RFS and OS (HR 4.12, 95% CI 2.08-8.16, P < 0.001 and HR 4.28, 95% CI 2.08-8.77, P < 0.001, respectively), and it was an independent predictor of RFS and OS (HR 3.99, 95% CI 1.89-8.44, P < 0.001 and HR 4.16, 95% CI 1.88-9.18, P < 0.001, respectively). Co-expression of at least 2 markers from the combination of high Twist/high Snail/low E-cadherin expression was a significant prognostic predictor in

  11. Ferroelectric and impedance response of lead-free (B0.5N0.5) TiO3-BaZrO3 piezoelectric ceramics

    Science.gov (United States)

    Rahman, Jamil ur; Hussain, Ali; Maqbool, Adnan; Kim, Jin Soo; Song, Tae Kwon; Lee, Je Hyun; Kim, Won Jeong; Kim, Myong Ho

    2014-06-01

    Lead-free piezoelectric (0.96B0.5N0.5TiO3)-0.04BaZrO3 (BNT-BZ4) was synthesized by using a solid-state reaction method. SEM micrograph shows dense microstructure. X-ray diffraction (XRD) indicated the formation of a BNB-BZ4 single phase having pseudocubic symmetry. A maximum value of remnant polarization (30μC/cm2) and piezoelectric constant (112 pC/N) was observed for BNT-BZ4 ceramic. The temperature dependences of the dielectric properties of BNT-BZ4 were investigated in the temperature range of 25-600°C at various frequencies (0.1 Hz-1 MHz). The maximum dielectric constant value (epsilonr) reaches a highest value of 4046 (at 10 kHz). The electrical properties were investigated by using complex impedance spectroscopy and provided better understanding of relaxation process.

  12. Practice variation in defining sentinel lymph nodes on lymphoscintigrams in oral cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Flach, Geke B.; Bree, Remco de [VU University Medical Center, Department of Otolaryngology-Head and Neck Surgery, De Boelelaan 1117, 1081 HV Amsterdam, PO Box 7057, Amsterdam (Netherlands); Schie, Annelies van; Hoekstra, Otto S. [VU University Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam (Netherlands); Witte, Birgit I. [VU University Medical Center, Department of Epidemiology and Biostatistics, Amsterdam (Netherlands); Olmos, Renato A.V. [VU University Medical Center, Department of Nuclear Medicine, Amsterdam (Netherlands); Klop, W.M.C. [Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Department of Head and Neck Surgery and Oncology, Amsterdam (Netherlands)

    2014-12-15

    Lymphoscintigraphic imaging and adequate interpretation of the lymphatic drainage pattern is an essential step in the sentinel lymph node biopsy (SLNB) procedure. In oral cancer, identification of the sentinel lymph node (SLN) can be challenging. In this study, interobserver variability in defining SLNs on lymphoscintigrams was evaluated in patients with T1-T2 stage N0 oral cancer. Sixteen observers (head and neck surgeons, nuclear medicine physicians or teams of both) from various institutes were asked which criteria they use to consider a hot focus on the lymphoscintigram as SLN. Lymphoscintigrams of 9 patients with 47 hot foci (3-9 per patient) were assessed, using a scale of 'yes/equivocal/no'. Bilateral drainage was seen in four of nine cases. In three cases additional late single photon emission computed tomography (SPECT)/CT scanning was performed. Interobserver variability was evaluated by kappa (κ) analysis, using linear weighted pairwise comparison of the observers. Conservative (equivocal analysed as no) and sensitive (equivocal analysed as yes) assessment strategies were investigated using pairwise kappa analysis. Various definitions of SLN on lymphoscintigrams were given. Interobserver variability of all cases using a 3-point scale showed fair agreement (71 %, κ{sub w} = 0.29). The conservative and sensitive analyses both showed moderate agreement: conservative approach κ = 0.44 (in 80 % of the hot foci the observers agreed) and sensitive approach κ = 0.42 (81 %) respectively. Multidisciplinary involvement in image interpretation and higher levels of observer experience appeared to increase agreement. Among 16 observers, there is practice variation in defining SLNs on lymphoscintigrams in oral cancer patients. Interobserver variability of lymphoscintigraphic interpretation shows moderate agreement. In order to achieve better agreement in defining SLNs on lymphoscintigrams specific guidelines are warranted. (orig.)

  13. Prognostic factors in stage IB gastric cancer.

    Science.gov (United States)

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

    2014-06-07

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

  14. Prostate cancer staging

    Science.gov (United States)

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

  15. The Oral Microbiome of Children: Development, Disease, and Implications Beyond Oral Health.

    Science.gov (United States)

    Gomez, Andres; Nelson, Karen E

    2017-02-01

    In the era of applied meta-omics and personalized medicine, the oral microbiome is a valuable asset. From biomarker discovery to being a powerful source of therapeutic targets and to presenting an opportunity for developing non-invasive approaches to health care, it has become clear that oral microbes may hold the answer for understanding disease, even beyond the oral cavity. Although our understanding of oral microbiome diversity has come a long way in the past 50 years, there are still many areas that need to be fine-tuned for better risk assessment and diagnosis, especially in early developmental stages of human life. Here, we discuss the factors that impact development of the oral microbiome and explore oral markers of disease, with a focus on the early oral cavity. Our ultimate goal is to put different experimental and methodological views into perspective for better assessment of early oral and systemic disease at an early age and discuss how oral microbiomes-at the community level-could provide improved assessment in individuals and populations at risk.

  16. Breast cancer relapse stage I and II

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  17. Estadios precoces de cancer oral: pronóstico en relación con gradación histológica, linfagiogénesis intratumoral y expresión de factor de crecimiento endotelial vascular Tipo-C (VEGF-C Early stage oral cancer: prognosis with regard to histological grading, intratumoral lymphangiogenesis, and the expression of vascular endothelial growth factor-C (VEGF-C

    Directory of Open Access Journals (Sweden)

    M.F. Muñoz-Guerra

    2006-02-01

    relación estadísticamente significativa entre los sistemas de Broders y Anneroth (pObjectives. Histological grading systems have been classically used as a prognostic factor and clinical behavior markers in oral squamous cell carcinoma (OSCC. However, their prognostic usefulness remains controversial. Our aim was to evaluate the presence of intratumoral lymphangiogenesis (IL, a new morphological finding, in a retrospective analysis of paraffin embedded tissue samples that corresponded to a group of early stage oral squamous cell carcinoma cases, and to relate this with histological grading systems while keeping in mind their prognostic significance. We also wanted to determine if the expression of vascular endothelial growth factor-C (VEGF-C is correlated with the evolution of the disease. Design. We performed a retrospective analysis of 96 patients with OSCC. All cases were T1-T2 neoplasms and were treated primarily by local resection and elective neck dissection that showed no neck involvement. In the group of 96 specimens, we analyzed IL using the specific marker PA2.26 for lymphatic endothelium. Also, we studied the expression of (VEGF-C. All cases were classified according to the histological grading systems described by Broders, Anneroth and Bryne. The statistical analysis was based on the univariate analysis of cause-specific survival and disease recurrence free-survival according to the Kaplan-Meier method. Results. The group of patients without intratumoral lymphangiogenesis showed a better prognosis with regard to survival and disease- free period, but the difference was not statistically significant. The study showed no relationship between VEGF-C expression and the presence of intratumoral lymphangiogenesis. However, no recurrences were observed in the group without VEGF-C expression. The comparative analysis of the histological grading system showed a statistical relationship between the Broders and Anneroth systems (p<0.01 and between the Broders and

  18. TWIST and p-Akt immunoexpression in normal oral epithelium oral dysplasia and in oral squamous cell carcinoma

    Science.gov (United States)

    Yamamoto, Fernanda-Paula; Corrêa Pontes, Flávia-Sirotheau; Cury, Sérgio-Elias; Fonseca, Felipe-Paiva; Rebelo-Pontes, Hélder; Pinto-Júnior, Décio-dos Santos

    2012-01-01

    Objectives: The aim of this study was to evaluate the immunoexpression of TWIST and p-Akt proteins in oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC), correlating their expressions with the histological features of the lesions. Study design: Immunohistochemical studies were carried out on 10 normal oral epithelium, 30 OL and 20 OSCC formalin-fixed, paraffin-embedded tissue samples. Immunoperoxidase reactions for TWIST and p-Akt proteins were applied on the specimens and the positivity of the reactions was calculated for 1000 epithelial cells. Results: Kruskal-Wallis and Dunn’s post tests revealed a significant difference in TWIST and p-Akt immunoexpression among normal oral mucosa, OL and OSCC. In addition, a significant positive correlation was found between TWIST and p-Akt expressions according to the Pearson’s correlation test. Conclusions: The results obtained in the current study suggest that TWIST and p-Akt may participate of the multi-step process of oral carcinogenesis since its early stages. Key words: Oral cancer, oral leukoplakia, dysplasia, immunohistochemistry. PMID:21743395

  19. Preoperative staging of rectal cancer.

    Science.gov (United States)

    Smith, Neil; Brown, Gina

    2008-01-01

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

  20. Oral Contraceptives and Cancer Risk

    Science.gov (United States)

    ... Genetics Services Directory Cancer Prevention Overview Research Oral Contraceptives and Cancer Risk On This Page What are oral contraceptives? What is known about the relationship between oral ...

  1. Reactions of BBr(n)(+) (n = 0--2) at fluorinated and hydrocarbon self-assembled monolayer surfaces: observations of chemical selectivity in ion--surface scattering.

    Science.gov (United States)

    Wade, N; Shen, J; Koskinen, J; Cooks, R G

    2001-07-01

    Ion-surface reactions involving BBr(n)(+) (n = 0--2) with a fluorinated self-assembled monolayer (F-SAM) surface were investigated using a multi-sector scattering mass spectrometer. Collisions of the B(+) ion yield BF(2)(+) at threshold energy with the simpler product ion BF(+)* appearing at higher collision energies and remaining of lower abundance than BF(2)(+) at all energies examined. In addition, the reactively sputtered ion CF(+) accompanies the formation of BF(2)(+) at low collision energies. These results stand in contrast with previous data on the ion-surface reactions of atomic ions with the F-SAM surface in that the threshold and most abundant reaction products in those cases involved the abstraction of a single fluorine atom. Gas-phase enthalpy data are consistent with BF(2)(+) being the thermodynamically favored product. The fact that the abundance of BF(2)(+) is relatively low and relatively insensitive to changes in collision energy suggests that this reaction proceeds through an entropically demanding intermediate at the vacuum--surface interface, one which involves interaction of the B(+) ion simultaneously with two fluorine atoms. By contrast with the reaction of B(+), the odd-electron species BBr(+)* reacts with the F-SAM surface to yield an abundant single-fluorine abstraction product, BBrF(+). Corresponding gas-phase ion--molecule experiments involving B(+) and BBr(+)* with C(6)F(14) also yield the products BF(+)* and BF(2)(+), but only in extremely low abundances and with no preference for double fluorine abstraction. Ion--surface reactions were also investigated for BBr(n)(+) (n = 0-2) with a hydrocarbon self-assembled monolayer (H-SAM) surface. Reaction of the B(+) ion and dissociative reactions of BBr(+)* result in the formation of BH(2)(+), while the thermodynamically less favorable product BH(+)* is not observed. Collisions of BBr(2)(+) with the H-SAM surface yield the dissociative ion-surface reaction products, BBrH(+) and BBrCH(3

  2. Salivary RNA Signatures in Oral Cancer Detection

    Directory of Open Access Journals (Sweden)

    Prashanth Panta

    2014-01-01

    Full Text Available Oral squamous cell carcinomas (OSCC are common malignancies that affect almost a million people every year. The key issue in reducing mortality and morbidity associated with OSCC is to develop novel strategies to identify OSCC at an early stage. One such strategy is the identification of biomarkers. So far, more than 100 biomarkers are recognized in the detection of oral cancer and they range from proteins to nucleic acids (DNAs, RNAs. Detection of ribose nucleic acids in saliva is a recent trend in diagnosing oral cancer. Studies have shown statistically significant changes in the levels of salivary transcriptomes in patients with oral squamous cell carcinomas. These biomarkers have displayed high sensitivity and specificity. Also, new point-of-care platforms such as oral fluid nanosensor test are now available that will soon emerge as chair-side tools for early detection of oral cancer. The aim of this review is to highlight the importance of salivary transcriptomes in oral cancer detection.

  3. Between Stage and Screen

    NARCIS (Netherlands)

    Tornqvist, Egil

    1996-01-01

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

  4. Culture Clash Invades Miami: Oral Histories and Ethnography Center Stage

    Science.gov (United States)

    Garcia, David G.

    2008-01-01

    Using a critical race theory (CRT) framework, this article compares the playwriting methods of the Chicano--Latino theater trio, Culture Clash, to a counterstorytelling methodology. The author uncovers the tenets of a critical race theater in the trio's site-specific ethnographic play, "Radio Mambo: Culture Clash Invades Miami". He…

  5. Delays in Referral of Oral Cancer Patients, A10 yr Retrospective ...

    African Journals Online (AJOL)

    In conclusion, a public enlightenment programme to increase awareness of oral cancer is stressed. In addition, a 3 monthly review of suspicious lesions such as oral leukoplakia, candidiasis, erythroplakia by practitioners is suggested. A yearly oral screen for the over 40's with papaconilau 2- stage staining procedure is ...

  6. Caregivers' perception of oral health‑related quality of life in a group ...

    African Journals Online (AJOL)

    2015-06-25

    Jun 25, 2015 ... virus (HIV) infection commonly present with oral lesions such as oral candidiasis, gingivitis, periodontal disease, and dental caries, and these lesions are sometimes seen in the early stages of the infection.[7‑9] Oral conditions in such persons are considered useful markers of disease progression.

  7. A clinical case of single-stage correction of penetration combined orofacial defect with two microsurgical autografts

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2015-01-01

    Full Text Available After surgical treatment for locally advanced oral tumors with resection of soft tissues, mucosal membrane, and facial skeletal structures, there are penetration combined defects, removal of which is a challenge for reconstructive surgeons. Mandibular repair is one of the problems in the correction of combined oral defects. Surgeons use different grafts to remove mandibular defects. One-flap transplantation does not always solve all reconstruction problems and ensure the repair of the mucosal membrane, a soft-tissue component, skin integuments, and facial skeleton.The authors describe a clinical case of successful single-stage correction of penetration combined orofacial defect after resection of the tongue, mouth floor, en bloc resection of the lower jaw and mental soft tissues, bilateral cervical supramyochoroidal lymphadenectomy, stage LCL CM mandibular defect formation after J. Boyd, by using two microsurgical autografts (a peroneal skin-muscle-skin autograft and a radial skin-fascia one in a 39-year-old female patient clinically diagnosed with carcinoma of the left mandibular alveolar ridge mucosa, Stage IVA (T4аN0M0.The Department of Microsurgery, P.A. Herzen Moscow Oncology Research Institute, Ministry of Health of Russia, has gained experience in comprehensively correcting extensive combined maxillofacial defects with two or more grafts in 27 patients who underwent autografting with a total of 73 flaps. The most functionally incapacitating and life-incompatible defect was removed at Stage 1 of reconstructive treatment. Delayed reconstruction was made after a complex of specialized antitumor therapy and assessment of treatment results in the absence of progressive growth. A great problem during multi-stage defect correction is presented by the lack of recipient vessels after cervical lymphadenectomy, the presence of soft tissue scar changes, trismus, temporomandibular joint ankylosis, contractures and displacement of the edges of the

  8. Nicotine Oral Inhalation

    Science.gov (United States)

    Nicotine oral inhalation is used to help people stop smoking. Nicotine oral inhalation should be used together with a ... support groups, counseling, or specific behavioral change techniques. Nicotine inhalation is in a class of medications called ...

  9. Oral Cancer Exam

    Medline Plus

    Full Text Available ... Advancing the nation's oral health through research and innovation Health Info Research Grants & Funding Careers & Training News & ... Advancing the nation's oral health through research and innovation Health Info Research Grants & Funding Careers & Training News & ...

  10. Oral Cancer - Multiple Languages

    Science.gov (United States)

    ... Are Here: Home → Multiple Languages → All Health Topics → Oral Cancer URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Oral Cancer - Multiple Languages To use the sharing features on ...

  11. Spin-orbit coupling effect on structural and magnetic properties of ConRh13-n (n = 0-13) clusters

    Science.gov (United States)

    Bai, Xi; Lv, Jin; Zhang, Fu-Qiang; Jia, Jian-Feng; Wu, Hai-Shun

    2018-04-01

    The effect of spin-orbit interaction on the structures and magnetism of ConRh13-n (n = 0-13) clusters have been systematically investigated by using the spin-orbit coupling (SOC) implementation of the density functional theory (DFT). The results calculated without SOC (NSOC) show that Rh13 prefers the double simple-cubic configuration, and icosahedron is the favorable structure for n = 1-9, while n ≥ 10, clusters favor the hexagonal bilayer structure. The inclusion of SOC in calculation does not change the geometries of clusters. Compared with that in NSOC calculation, although the binding energy per atom in clusters with same composition decreases in SOC calculation, the relative stability of clusters with different compositions does not change. An interesting result is that the spin moments of clusters for n = 1-9 are almost constant (21 μB). Spin-orbit interaction recovers orbital moment and its anisotropy by removing crystal-field effect in calculation. The destruction of bonding symmetry and relaxation of bonding account for high anisotropies of orbital moments in Co11Rh2 and CoRh12 clusters. With atomic composition (Co/Rh) around 4/9-5/8 and 9/4, the Co-Rh clusters exhibit high magnetic anisotropy energies.

  12. First principles study of structural, electronic and magnetic properties of SnGe n (0, ±1) ( n = 1–17) clusters

    Science.gov (United States)

    Djaadi, Soumaia; Eddine Aiadi, Kamal; Mahtout, Sofiane

    2018-04-01

    The structures, relative stability and magnetic properties of pure Ge n +1, neutral cationic and anionic SnGe n (n = 1–17) clusters have been investigated by using the first principles density functional theory implemented in SIESTA packages. We find that with the increasing of cluster size, the Ge n +1 and SnGe n (0, ±1) clusters tend to adopt compact structures. It has been also found that the Sn atom occupied a peripheral position for SnGe n clusters when n 12. The structural and electronic properties such as optimized geometries, fragmentation energy, binding energy per atom, HOMO–LUMO gaps and second-order differences in energy of the pure Ge n +1 and SnGe n clusters in their ground state are calculated and analyzed. All isomers of neutral SnGe n clusters are generally nonmagnetic except for n = 1 and 4, where the total spin magnetic moments is 2μ b. The total (DOS) and partial density of states of these clusters have been calculated to understand the origin of peculiar magnetic properties. The cluster size dependence of vertical ionization potentials, vertical electronic affinities, chemical hardness, adiabatic electron affinities and adiabatic ionization potentials have been calculated and discussed.

  13. Effects of Cr Substitution on Negative Thermal Expansion and Magnetic Properties of Antiperovskite Ga1−xCrxN0.83Mn3 Compounds

    Science.gov (United States)

    Guo, Xinge; Tong, Peng; Lin, Jianchao; Yang, Cheng; Zhang, Kui; Lin, Shuai; Song, Wenhai; Sun, Yuping

    2018-01-01

    Negative thermal expansion (NTE) and magnetic properties were investigated for antiperovskite Ga1−xCrxN0.83Mn3 compounds. As x increases, the temperature span (ΔT) of NTE related with Γ5g antiferromagnetic (AFM) order is expanded and shifted to lower temperatures. At x = 0.1, NTE happens between 256 and 318 K (ΔT = 62 K) with an average linear coefficient of thermal expansion, αL = −46 ppm/K. The ΔT is expanded to 81 K (151–232 K) in x = 0.2 with αL = −22.6 ppm/K. Finally, NTE is no longer visible for x ≥ 0.3. Ferromagnetic order is introduced by Cr doping and continuously strengthened with increasing x, which may impede the AFM ordering and thus account for the broadening of NTE temperature window. Moreover, our specific heat measurement suggests the electronic density of states at the Fermi level is enhanced upon Cr doping, which favors the FM order rather than the AFM one. PMID:29619367

  14. Effects of Cr Substitution on Negative Thermal Expansion and Magnetic Properties of Antiperovskite Ga1-x Cr x N0.83Mn3 Compounds.

    Science.gov (United States)

    Guo, Xinge; Tong, Peng; Lin, Jianchao; Yang, Cheng; Zhang, Kui; Lin, Shuai; Song, Wenhai; Sun, Yuping

    2018-01-01

    Negative thermal expansion (NTE) and magnetic properties were investigated for antiperovskite Ga 1- x Cr x N 0.83 Mn 3 compounds. As x increases, the temperature span (Δ T ) of NTE related with Γ 5g antiferromagnetic (AFM) order is expanded and shifted to lower temperatures. At x = 0.1, NTE happens between 256 and 318 K (Δ T = 62 K) with an average linear coefficient of thermal expansion, α L = -46 ppm/K. The Δ T is expanded to 81 K (151-232 K) in x = 0.2 with α L = -22.6 ppm/K. Finally, NTE is no longer visible for x ≥ 0.3. Ferromagnetic order is introduced by Cr doping and continuously strengthened with increasing x , which may impede the AFM ordering and thus account for the broadening of NTE temperature window. Moreover, our specific heat measurement suggests the electronic density of states at the Fermi level is enhanced upon Cr doping, which favors the FM order rather than the AFM one.

  15. Structural and magnetic properties of Fe{sub 7−n}Pt{sub n} with n = 0, 1, 2, . . . 7, bimetallic clusters

    Energy Technology Data Exchange (ETDEWEB)

    Ponce-Tadeo, A. P.; Morán-López, J. L., E-mail: joseluis.moran@ipicyt.edu.mx [Instituto Potosino de Investigación Científica y Tenológica, División de Materiales Avanzados (Mexico); Ricardo-Chavez, J. L. [Benemérita Universidad Autónoma de Puebla, Laboratorio Nacional de Supercómputo (Mexico)

    2016-11-15

    An exhaustive study of the structural and magnetic properties of Fe{sub 7−n}Pt{sub n} with n = 0, 1, 2, …7, bimetallic clusters is presented. Based on ab initio density functional theory that includes spin-orbit coupling (SOC) and graph theory, the ground state geometry, the local chemical order, and the orbital and spin magnetic moments are calculated. We show how the systems evolves from the 3-d Fe to the quasi-planar Pt clusters. These calculations show that SOC are necessary to describe correctly the composition dependence of the binding energy of these nanoalloys. We observe that the ground state geometries on the Fe rich side resemble the fcc structure adopted by bulk samples. Furthermore, we observe how the spin and orbital magnetic moments depend on the chemical concentration and chemical order. Based on these results, we estimated the magnetic anisotropy energy and found that the largest values correspond to some of the most symmetric structures, Fe{sub 5}Pt{sub 2} and FePt{sub 6}. To determine the degree of non-collinearity, we define an index that shows that in FePt{sub 6} the total magnetic moments, on each atom, are the less collinear.

  16. Oral vaccination of fish

    OpenAIRE

    Embregts, Carmen W.E.; Forlenza, Maria

    2016-01-01

    The limited number of oral vaccines currently approved for use in humans and veterinary species clearly illustrates that development of efficacious and safe oral vaccines has been a challenge not only for fish immunologists. The insufficient efficacy of oral vaccines is partly due to antigen breakdown in the harsh gastric environment, but also to the high tolerogenic gut environment and to inadequate vaccine design. In this review we discuss current approaches used to develop oral vaccines fo...

  17. Management of cancers of the oral cavity and oropharynx

    International Nuclear Information System (INIS)

    Vikram, Bhadrasain

    1997-01-01

    Objective: To review the general principles and the specific techniques employed in the management of cancers of the oral cavity and oropharynx, for the judicious utilization of external radiotherapy, brachytherapy, surgery and chemotherapy, in order to maximize both the cure rates and the quality of life. The oral cavity consists of lips, buccal mucosae, lower and upper alveolar ridges, floor of the mouth, hard palate and anterior two-thirds of the tongue. The oropharynx consists of the base of tongue, tonsillar regions, soft palate and posterior pharyngeal wall. This anatomical complexity means that the choice of treatment can be significantly influenced by just a few millimeters difference in the site of the origin or spread of the cancer. The choice can be critical not only for the cure but also the patients' subsequent quality of life. It can have a tremendous impact on the appearance, the ability to eat and the ability to talk. The great majority of cancers in the oral cavity and oropharynx are squamous cell carcinomas, but cancers arising from minor salivary glands are not infrequently seen. The staging system, though useful in treatment planning, has shortcomings which will be discussed. For purposes of discussion it is useful to divide the cancers broadly into Early (T1, T2, N0 N1), Advanced Resectable, and Advanced Unresectable. Early cancers can be cured, in a large proportion of the patients, by either surgery or irradiation; the latter is particularly successful when brachytherapy can be employed to administer a significant part of the dose. Brachytherapy is usually not feasible when the cancer involves bone or is in close proximity to it, due to a high risk of osteoradionecrosis. Poor oral hygiene, in general, and poor dentition, in particular, also increases the risk of osteoradionecrosis. It is, therefore, important to be proactive with regard to dental prophylaxis for any patient contemplating irradiation for oral or pharyngeal cancer. Another

  18. Management of cancers of the oral cavity and oropharynx

    International Nuclear Information System (INIS)

    Vikram, Bhadrasain

    1996-01-01

    Objective: To review the general principles and the specific techniques employed in the management of cancers of the oral cavity and oropharynx, for the judicious utilization of external radiotherapy, brachytherapy, surgery and chemotherapy, in order to maximize both the cure rates and the quality of life. The oral cavity consists of lips, buccal mucosae, lower and upper alveolar ridges, floor of the mouth, hard palate and anterior two-thirds of the tongue. The oropharynx consists of the base of tongue, tonsillar regions, soft palate and posterior pharyngeal wall. This anatomical complexity means that the choice of treatment can be significantly influenced by just a few millimeters difference in the site of the origin or spread of the cancer. The choice can be critical not only for the cure but also the patients' subsequent quality of life. It can have a tremendous impact on the appearance, the ability to eat and the ability to talk. The great majority of cancers in the oral cavity and oropharynx are squamous cell carcinomas, but cancers arising from minor salivary glands are not infrequently seen. The staging system, though useful in treatment planning, has shortcomings which will be discussed. For purposes of discussion it is useful to divide the cancers broadly into Early (T1, T2, N0 N1), Advanced Resectable, and Advanced Unresectable. Early cancers can be cured, in a large proportion of the patients, by either surgery or irradiation; the latter is particularly successful when brachytherapy can be employed to administer a significant part of the dose. Brachytherapy is usually not feasible when the cancer involves bone or is in close proximity to it, due to a high risk of osteoradionecrosis. Poor oral hygiene, in general, and poor dentition, in particular, also increases the risk of osteoradionecrosis. It is, therefore, important to be proactive with regard to dental prophylaxis for any patient contemplating irradiation for oral or pharyngeal cancer. Another

  19. Management of cancers of the oral cavity and oropharynx

    International Nuclear Information System (INIS)

    Vikram, Bhadrasain

    1995-01-01

    Objective: To review the general principles and the specific techniques employed in the management of cancers of the oral cavity and oropharynx, for the judicious utilization of external radiotherapy, brachytherapy, surgery and chemotherapy, in order to maximize both the cure rates and the quality of life. The oral cavity consists of lips, buccal mucosae, lower and upper alveolar ridges, floor of the mouth, hard palate and anterior two-thirds of the tongue. The oropharynx consists of the base of tongue, tonsillar regions, soft palate and posterior pharyngeal wall. This anatomical complexity means that the choice of treatment can be significantly influenced by just a few millimeters difference in the site of the origin or spread of the cancer. The choice can be critical not only for the cure but also the patients' subsequent quality of life. It can have a tremendous impact on the appearance, the ability to eat and the ability to talk. The great majority of cancers in the oral cavity and oropharynx are squamous cell carcinomas, but cancers arising from minor salivary glands are not infrequently seen. The staging system, though useful in treatment planning, has shortcomings which will be discussed. For purposes of discussion it is useful to divide the cancers broadly into Early (T1, T2, N0 N1), Advanced Resectable, and Advanced Unresectable. Early cancers can be cured, in a large proportion of the patients, by either surgery or irradiation; the latter is particularly successful when brachytherapy can be employed to administer a significant part of the dose. Brachytherapy is usually not feasible when the cancer involves bone or is in close proximity to it, due to a high risk of osteoradionecrosis. Poor oral hygiene, in general, and poor dentition, in particular, also increases the risk of osteoradionecrosis. It is, therefore, important to be proactive with regard to dental prophylaxis for any patient contemplating irradiation for oral or pharyngeal cancer. Another

  20. Two-stage repair in hypospadias

    Directory of Open Access Journals (Sweden)

    K N Haxhirexha

    2008-01-01

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

  1. Oral and neck examination for early detection of oral cancer--a practical guide.

    LENUS (Irish Health Repository)

    MacCarthy, Denise

    2011-08-01

    Cancer of the head and neck region presents a challenge since, unlike other areas of the body, the boundaries are not always easy to delineate. The functional morbidity associated with head and neck cancer and its treatment are considerable. Head and neck cancer is described as cancer of the lip, mouth, tongue, tonsil, pharynx (unspecified), salivary gland, hypopharynx, larynx and other. Oral cancer refers to cancers of the lip, tongue, gingivae, floor of the mouth, palate (hard and soft), maxilla, vestibule and retromolar area up to the anterior pillar of the fauces (tonsil). When patients present with oral cancer, over 60% of them have regional (lymph node) and sometimes distant (metastatic) spread. The overall five-year survival rates for oral cancer average at between 50 and 80%, depending on the stage of the disease, varying from 86% for stage I to 12-16% for stage IV. The incidence of \\'field cancerisation\\'\\/unstable oral epithelium is high (17%), and even after successful treatment our patients need to be monitored for dental care and further disease. Unlike other areas in the body, the oral epithelium is readily accessible for examination and even self-examination. Dentists and dental hygienists are effective clinicians in the examination of the oral cavity for mouth cancer. An oral and neck examination must be part of every dental examination. An examination protocol is suggested here, which is similar to, but more detailed than, the standardised oral examination method recommended by the World Health Organisation, and consistent with those protocols followed by the Centres for Disease Control and Prevention and the National Institutes of Health.

  2. Oral Health and Aging

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Oral Health and Aging Oral Health and Aging Past Issues / Summer 2016 Table of ... years. He spoke with NIH MedlinePlus magazine about oral health issues common in older adults. What has been ...

  3. Oral Manifestations of Menopause

    African Journals Online (AJOL)

    manifested in the oral cavity.[9] The teeth and gums are more affected by the hormonal changes occurring before menopause, which decrease the body's ability to fight minor infections or maintain a healthy balance of useful and harmful bacteria within the oral environment.[10] The dentist needs to be aware of oral ...

  4. Oral vaccination of fish

    NARCIS (Netherlands)

    Embregts, Carmen W.E.; Forlenza, Maria

    2016-01-01

    The limited number of oral vaccines currently approved for use in humans and veterinary species clearly illustrates that development of efficacious and safe oral vaccines has been a challenge not only for fish immunologists. The insufficient efficacy of oral vaccines is partly due to antigen

  5. Relationship between oral health knowledge, practices and oral ...

    African Journals Online (AJOL)

    Background: Studies have shown that strong knowledge on oral health demonstrates better oral care practice and an association between increased knowledge and better oral health exists. Aim: To assess the influence of oral health knowledge and oral care practices to oral health status of secondary school students in ...

  6. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans ... out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans ...

  7. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed with oral or ... Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed with oral or ...

  8. Oral Health in Rural Communities

    Science.gov (United States)

    ... Guide Rural Health Topics & States Topics View more Oral Health in Rural Communities Adequate access to oral healthcare ... about oral health programs in my area? What oral health disparities are present in rural America? According to ...

  9. Ipsilateral irradiation for well lateralized carcinomas of the oral cavity and oropharynx: results on tumor control and xerostomia

    Directory of Open Access Journals (Sweden)

    Marín Alicia

    2009-09-01

    Full Text Available Abstract Background In head and neck cancer, bilateral neck irradiation is the standard approach for many tumor locations and stages. Increasing knowledge on the pattern of nodal invasion leads to more precise targeting and normal tissue sparing. The aim of the present study was to evaluate the morbidity and tumor control for patients with well lateralized squamous cell carcinomas of the oral cavity and oropharynx treated with ipsilateral radiotherapy. Methods Twenty consecutive patients with lateralized carcinomas of the oral cavity and oropharynx were treated with a prospective management approach using ipsilateral irradiation between 2000 and 2007. This included 8 radical oropharyngeal and 12 postoperative oral cavity carcinomas, with Stage T1-T2, N0-N2b disease. The actuarial freedom from contralateral nodal recurrence was determined. Late xerostomia was evaluated using the European Organization for Research and Treatment of Cancer QLQ-H&N35 questionnaire and the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE, version 3. Results At a median follow-up of 58 months, five-year overall survival and loco-regional control rates were 82.5% and 100%, respectively. No local or contralateral nodal recurrences were observed. Mean dose to the contralateral parotid gland was 4.72 Gy and to the contralateral submandibular gland was 15.30 Gy. Mean score for dry mouth was 28.1 on the 0-100 QLQ-H&N35 scale. According to CTCAE v3 scale, 87.5% of patients had grade 0-1 and 12.5% grade 2 subjective xerostomia. The unstimulated salivary flow was > 0.2 ml/min in 81.2% of patients and 0.1-0.2 ml/min in 19%. None of the patients showed grade 3 xerostomia. Conclusion In selected patients with early and moderate stages, well lateralized oral and oropharyngeal carcinomas, ipsilateral irradiation treatment of the primary site and ipsilateral neck spares salivary gland function without compromising loco-regional control.

  10. Ipsilateral irradiation for well lateralized carcinomas of the oral cavity and oropharynx: results on tumor control and xerostomia

    Science.gov (United States)

    Cerezo, Laura; Martín, Margarita; López, Mario; Marín, Alicia; Gómez, Alberto

    2009-01-01

    Background In head and neck cancer, bilateral neck irradiation is the standard approach for many tumor locations and stages. Increasing knowledge on the pattern of nodal invasion leads to more precise targeting and normal tissue sparing. The aim of the present study was to evaluate the morbidity and tumor control for patients with well lateralized squamous cell carcinomas of the oral cavity and oropharynx treated with ipsilateral radiotherapy. Methods Twenty consecutive patients with lateralized carcinomas of the oral cavity and oropharynx were treated with a prospective management approach using ipsilateral irradiation between 2000 and 2007. This included 8 radical oropharyngeal and 12 postoperative oral cavity carcinomas, with Stage T1-T2, N0-N2b disease. The actuarial freedom from contralateral nodal recurrence was determined. Late xerostomia was evaluated using the European Organization for Research and Treatment of Cancer QLQ-H&N35 questionnaire and the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE), version 3. Results At a median follow-up of 58 months, five-year overall survival and loco-regional control rates were 82.5% and 100%, respectively. No local or contralateral nodal recurrences were observed. Mean dose to the contralateral parotid gland was 4.72 Gy and to the contralateral submandibular gland was 15.30 Gy. Mean score for dry mouth was 28.1 on the 0-100 QLQ-H&N35 scale. According to CTCAE v3 scale, 87.5% of patients had grade 0-1 and 12.5% grade 2 subjective xerostomia. The unstimulated salivary flow was > 0.2 ml/min in 81.2% of patients and 0.1-0.2 ml/min in 19%. None of the patients showed grade 3 xerostomia. Conclusion In selected patients with early and moderate stages, well lateralized oral and oropharyngeal carcinomas, ipsilateral irradiation treatment of the primary site and ipsilateral neck spares salivary gland function without compromising loco-regional control. PMID:19723329

  11. Oral Health and Swallowing Problems

    OpenAIRE

    Furuta, Michiko; Yamashita, Yoshihisa

    2013-01-01

    Oral health impacts systemic health. Therefore, oral care is an important consideration in maintaining quality of life (QOL). Previously, maintenance and improvement of oral hygiene was considered essential for achieving oral health. In addition to oral hygiene, oral care in terms of oral function is now considered to maintain QOL. Ingestion of exogenous nutrients via the oral cavity is fundamental to the function of all higher animals, not only human beings. Chewing and swallowing processes ...

  12. Feasibility and diagnostic performance of dual-tracer-guided sentinel lymph node biopsy in cT1-2N0M0 gastric cancer: a systematic review and meta-analysis of diagnostic studies.

    Science.gov (United States)

    Huang, Ling; Wei, Tao; Chen, Junjun; Zhou, Donghui

    2017-05-16

    Dual-tracer-guided sentinel lymph node (SLN) biopsy may provide a promising diagnostic tool to assess accurately the status of lymph node metastasis in the surgical operation and assure the oncologic safety of the function or stomach preserving surgery. The diagnostic performance of this technology in recent studies varied. Thus, we conducted this meta-analysis. This systematic review and meta-analysis was registered at the PROSPERO. Eligible studies were searched in the PubMed, EMBASE, Web of Knowledge, and Cochrane Library databases. A random-effect model was used to pool the data. Summary receiver operator characteristic curves, analysis for publication bias, meta-regression, and subgroup analysis were also performed. The pooled SLN identification rate and sensitivity were 0.97 and 0.89. 99m Tc-human serum albumin with indocyanine green (ICG), 99m Tc-antimony sulfur colloid with ICG, performing SLN biopsy ≥15 min after dye injection, an SLN ≥5, the basin dissection, laparoscopic surgery, in studies conducted in Japan and studies published after 2012, were associated with higher sensitivity. CT1 stage, performing SLN biopsy ≥15 min after dye injection, in studies conducted in Japan and studies published after 2012, were related with a higher identification rate. Dual tracer is promising in SLN biopsy in gastric cancer, and the clinical application of SLN biopsy should be limited to the patients of cT1N0M0 gastric cancer. The combination of 99m Tc-human serum albumin and ICG as well as the combination of 99m Tc-antimony sulfur colloid and ICG may be the optimal tracer combination. However, it seems not justified to put this technique into routine clinical application recently. Some factors that might enhance diagnostic value are identified.

  13. [Determination of human papillomavirus in oral leukoplakia,oral lichen planus and oral squamous cell carcinoma].

    Science.gov (United States)

    Cao, Jie; Jin, Jian-qiu; Deng, Da-jun; Liu, Hong-wei

    2016-02-18

    To investigate the possibility for human papillomavirus (HPV) infection to be a predictable signal for the carcinogenesis of oral mucosa by comparing the prevalences of HPV in each stage of oral mucosal carcinogenesis and to compare the sensitivity differences of the two methods in detecting HPV infection in oral cavity. The hybrid capture (HC-II) was used to detect infection of HPV in 255 samples taken from 12 cases of healthy oral mucosa, 211 cases of patients with pathological diagnosis and 32 cases of patients with clinical diagnosis. The diagnosed cases included 8 cases of benign lesions of the oral mucosa, precancerous lesions [74 cases of oral leukoplakia (OLK) with hyperplasia and 42 cases of OLK with oral epithelial dysplasia (OED)], 91 cases of precancerous condition [oral lichen planus (OLP)] and 28 cases of oral squamous cell carcinoma (OSCC). And in situ hybridization (ISH) was used to detect infection of HPV in 33 cases of OSCC and 76 cases of OLK, including 30 cases of hyperplasia, 15 cases of mild OED, 15 cases of moderate OED and 16 cases of severe OED. The prevalence of HPV in OLP samples was higher (12.12%, 8/66) than that of OLK (2.59%, 3/116) (χ(2)=4.666, P=0.031) and OSCC(7.14%, 2/28, χ(2)=0.513, P=0.474). The prevalence of HPV in OSCC (7.14%, 2/28) was higher than that of OLK (2.59%, 3/116), and no significant difference was found. There was only one case of smoke spot and statistical analysis was not carried out. ISH was used to detect type 16/18 and type 31/33 HPV DNA in 109 cases of oral mucosal lesions in paraffin sections and only one case of OSCC was HPV positive. Thirty-seven cases were detected by HC-II and ISH methods at the same time. The same negative results by the two methods were found in 94.6% samples (35/37). In the other two samples, one was OSCC with early infiltration and the other was OLK with hyperplasia, The HC-II results were positive while the ISH results were negative. The patients with OLP and HPV testing results

  14. Worldwide Esophageal Cancer Collaboration: clinical staging data.

    Science.gov (United States)

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

    2016-10-01

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

  15. Oral steroid contraception.

    Science.gov (United States)

    Sech, Laura A; Mishell, Daniel R

    2015-11-01

    Oral steroid contraception is a popular method of family planning worldwide. Over the past several decades, this method of contraception has changed significantly by decreasing the estrogen dose, changing the progestin component, and reducing the hormone free interval. Despite the popularity of oral steroid contraception, there has been much criticism regarding the associated risks of venous thromboembolism and stroke. Despite these established, yet uncommon risks, oral steroid contraception has many important health benefits. This review highlights the available formulations of oral contraceptives along with their evidence-based associated risks and benefits. Highlights regarding future directions for development of novel oral contraceptives are also addressed.

  16. Essentials of oral cancer.

    Science.gov (United States)

    Rivera, César

    2015-01-01

    Oral cancer is one of the 10 most common cancers in the world, with a delayed clinical detection, poor prognosis, without specific biomarkers for the disease and expensive therapeutic alternatives. This review aims to present the fundamental aspects of this cancer, focused on squamous cell carcinoma of the oral cavity (OSCC), moving from its definition and epidemiological aspects, addressing the oral carcinogenesis, oral potentially malignant disorders, epithelial precursor lesions and experimental methods for its study, therapies and future challenges. Oral cancer is a preventable disease, risk factors and natural history is already being known, where biomedical sciences and dentistry in particular are likely to improve their poor clinical indicators.

  17. Management of oral feeding in children undergoing airway reconstruction.

    Science.gov (United States)

    Smith, Lee P; Otto, Staci E; Wagner, Kathrine A; Chewaproug, Linda; Jacobs, Ian N; Zur, Karen B

    2009-05-01

    To systematically evaluate perioperative management of oral feeding in children undergoing airway reconstruction. A retrospective chart review of all patients who underwent open airway reconstruction from February 1, 2006 through July 31, 2008 at a tertiary care children's hospital. During the study period, a multidisciplinary protocol for perioperative management of alimentation was instituted. Swallowing function was evaluated pre- and postoperatively as part of a clinical management protocol. Fifty-one patients underwent 55 reconstructions. Forty-eight of the patients (94%) have been decannulated. Eighteen single-stage procedures were performed on patients who were considered oral feeders, and oral feeding was successfully completed for three patients while the endotracheal tube was in place. Twenty-two double-stage procedures were performed on patients who were considered oral feeders. Oral feeding was initiated while the stent was in place for 16 patients. Nine patients (56%) did not tolerate oral feeding with the stent in place, five of whom had evidence of gross aspiration. Thirty-four of the 40 patients (85%) who were considered oral feeders at the time of their reconstruction returned to their preoperative diet with minimal therapy from the speech pathology service 1.9 days (range, 0-8 days) following extubation or stent removal. Six patients (15%) had clinically significant dysphagia. Safe oral alimentation early in the postoperative period is possible with a rigorous multidisciplinary approach. To minimize complications, postoperative oral feeding should be initiated in conjunction with a speech pathologist.

  18. 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.

  19. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft tissues of the ... and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft tissues of the ...

  20. [Oral treatments in multiple sclerosis].

    Science.gov (United States)

    Meca-Lallana, José Eustasio; Hernández-Clares, Rocío; Carreón-Guarnizo, Ester

    2014-12-01

    The development of new disease-modifying drugs (DMD) in relapsing-remitting multiple sclerosis (RRMS), which share the common denominator of oral administration, considerably improves patient expectations in terms of effectiveness, tolerability and treatment adherence compared with currently available drugs. However, the common route of administration of these drugs does not mean that they are equivalent, since the heading of "oral route" encompasses drugs with distinct indications and mechanisms of action, as well as heterogeneous results in terms of efficacy and safety, allowing treatment to be personalized according to the each patient' s characteristics. Currently, four oral DMD are available or in an advanced stage of clinical development: fingolimod, teriflunomide, dimethyl fumarate and laquinimod. In pivotal trials versus placebo, these molecules reduced the annualized rate of exacerbations versus placebo by 54%, 31%, 53% and 23%, respectively, the risk of progression of disability by 31%, 30%, 38% and 36%, and the number of active lesions showing contrast uptake on magnetic resonance imaging by 82%, 80%, 90% and 37%, respectively. Based on the risk/benefit ratio, fingolimod is indicated in patients with suboptimal response to initial DMD or in severe rapidly progressing RRMS, while the remaining drugs can be used as first-line options. Clinical experience with these treatments will provide new data on safety and effectiveness, which will be determinant when establishing therapeutic algorithms. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  1. Oral manifestations of syphilis Manifestações orais da sífilis

    OpenAIRE

    Jair Carneiro Leão; Luiz Alcino Gueiros; Stephen R. Porter

    2006-01-01

    The past decade has shown a significant rise in the prevalence of infective syphilis in the developed world, and striking increases in its frequency have occurred in Eastern Europe, particularly the UK, and in the US. Although oral manifestations of syphilis are most likely to be observed during secondary disease, all stages of the disease can give rise to oral lesions. Significant oral lesions such as gumma-associated bony destruction and a possible predisposition to oral squamous cell carci...

  2. Breast cancer staging

    Science.gov (United States)

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

  3. Seven Stages of Alzheimer's

    Science.gov (United States)

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

  4. Stages of Adolescence

    Science.gov (United States)

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

  5. Beyond Erikson's Eight Stages.

    Science.gov (United States)

    Whitney, Ruth

    1979-01-01

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

  6. Cervical Cancer Stage IIIA

    Science.gov (United States)

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

  7. Cervical Cancer Stage IVA

    Science.gov (United States)

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

  8. Cervical Cancer Stage IVB

    Science.gov (United States)

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

  9. Cervical Cancer Stage IIIB

    Science.gov (United States)

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

  10. Cervical Cancer Stage IB

    Science.gov (United States)

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

  11. Cervical Cancer Stage IA

    Science.gov (United States)

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

  12. Improving oral health and oral health care delivery for children.

    Science.gov (United States)

    Crall, James J

    2011-02-01

    National and state-level evidence has documented ongoing disparities in children's health and utilization of oral health care services, prompting a re-examination of factors associated with poor oral health and low use of oral health services. These efforts have yielded a wide array of proposals for improving children's oral health and oral health care delivery. This paper offers a perspective on the current context of efforts to improve children's oral health and oral health care delivery.

  13. Pentaatomic planar tetracoordinate carbon molecules [XCAl(3)](q) [(X,q) = (B,-2), (C,-1), (N,0)] with C-X multiple bonding.

    Science.gov (United States)

    Cui, Zhong-Hua; Shao, Chang-Bin; Gao, Si-Meng; Ding, Yi-Hong

    2010-11-07

    Among the fascinating planar tetracoordinate carbon (ptC) species, pentaatomic molecules belong to the smallest class, well-known as "pptC". It has been generally accepted that the planarity of pptC structure is realized via the "delocalization" of the p(z) lone pair at the central carbon and the ligand-ligand bonding interaction. Although "localization" is as key driving force in organic chemistry as "delocalization", the "localization" concept has not been applied to the design of pptC molecules, to the best of our knowledge. In this paper, we apply the "localization" strategy to design computationally a series of new pptC. It is shown that the central carbon atom and one "electronegative" ligand atom X (compared to the Al ligand) effectively form a highly localized C-X multiple bond, converting the lone pair at the central carbon to a two-center two-electron π-bond. At the aug-cc-pVTZ-B3LYP, MP2 and CCSD(T) levels, the designed 18-valence-electron pptC species [XCAl(3)](q); [(X,q) = (B,-2), (C,-1), (N,0)] are found to each possess a stable ptC structure bearing a C-X double bond, indicated by the structural, molecular orbital, Wiberg bonding, potential energy surface and Born-Oppenheimer molecular dynamics (BOMD) analysis. Moreover, our OVGF calculations showed that the presently disclosed (yet previously unconsidered) pptC structure of [C(2)Al(3)](-) could well account for the observed photoelectron spectrum (previously only ascribed to a close-energy fan-like structure). Therefore, [C(2)Al(3)](-) could be the first pptC that bears the highly localized C-X double bond that has been experimentally generated. Notably, the pptC structure is the respective global minimum point for [BCAl(3)](2-) and [NCAl(3)], and the counterion(s) would further stabilize [BCAl(3)](2-) and [C(2)Al(3)](-). Thus, these newly designed pptC species with interesting bonding structure should be viable for future experimental characterization. The presently applied "localization" approach

  14. The combination of Ki67, histological grade and estrogen receptor status identifies a low-risk group among 1,854 chemo-naïve women with N0/N1 primary breast cancer

    DEFF Research Database (Denmark)

    Strand, Carina; Bak, Martin; Borgquist, Signe

    2013-01-01

    The aim was to confirm a previously defined prognostic index, combining a proliferation marker, histological grade, and estrogen receptor (ER) in different subsets of primary N0/N1 chemo-naïve breast cancer patients.......The aim was to confirm a previously defined prognostic index, combining a proliferation marker, histological grade, and estrogen receptor (ER) in different subsets of primary N0/N1 chemo-naïve breast cancer patients....

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

    Science.gov (United States)

    2014-12-29

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

  16. [The origin of hydrogen peroxide in oral cavity and its role in oral microecology balance].

    Science.gov (United States)

    Keke, Zhang; Xuedong, Zhou; Xin, Xu

    2017-04-01

    Hydrogen peroxide, an important antimicrobial agent in oral cavity, plays a significant role in the balance of oral microecology. At the early stage of biofilm formation, about 80% of the detected initial colonizers belong to the genus Streptococcus. These oral streptococci use different oxidase to produce hydrogen peroxide. Recent studies showed that the produced hydrogen peroxide plays a critical role in modulating oral microecology. Hydrogen peroxide modulates biofilm development attributed to its growth inhibitory nature. Hydrogen peroxide production is closely associated with extracellular DNA(eDNA) release from microbe and the development of its competent cell which are critical for biofilm development and also serves as source for horizontal gene transfer. Microbe also can reduce the damage to themselves through several detoxification mechanisms. Moreover, hydrogen peroxide is also involved in the regulation of interactions between oral microorganisms and host. Taken together, hydrogen peroxide is an imperative ecological factor that contributes to the microbial equilibrium in the oral cavity. Here we will give a brief review of both the origin and the function in the oral microecology balance of hydrogen peroxide.

  17. Radiation induced oral mucositis

    Directory of Open Access Journals (Sweden)

    P S Satheesh Kumar

    2009-01-01

    Full Text Available Patients receiving radiotherapy or chemotherapy will receive some degree of oral mucositis The incidence of oral mucositis was especially high in patients: (i With primary tumors in the oral cavity, oropharynx, or nasopharynx; (ii who also received concomitant chemotherapy; (iii who received a total dose over 5,000 cGy; and (iv who were treated with altered fractionation radiation schedules. Radiation-induced oral mucositis affects the quality of life of the patients and the family concerned. The present day management of oral mucositis is mostly palliative and or supportive care. The newer guidelines are suggesting Palifermin, which is the first active mucositis drug as well as Amifostine, for radiation protection and cryotherapy. The current management should focus more on palliative measures, such as pain management, nutritional support, and maintenance, of good oral hygiene

  18. Improved clinical staging of esophageal cancer with FDG-PET

    International Nuclear Information System (INIS)

    Kim, Young Hwan; Choi, Joon Young; Lee, Kyung Soo; Choi, Yong Soo; Lee, Eun Jeong; Chung, Hyun Woo; Lee, Su Jin; Lee, Kyung Han; Shim, Young Mog; Kim, Byung Tae

    2004-01-01

    Since preoperative staging in esophageal cancer is important in both therapy and prognosis, there had been many efforts to improve its accuracy. Recent studies indicate that whole body FDG-PET has high sensitivity in detection of metastasis in esophageal cancer. Therefore, we added FDG-PET to other conventional methods in staging esophageal cancer to evaluate the usefulness of this method. Subjects were 142 esophageal cancer patients (average 62.3±8.3 yrs) who received CT and PET just before operation. First, we compared N stage and M stage of the CT or PET with those of the post-operative results. Then we compared the stage according to the EUS (T stage) and CT (N and M stage) or EUS (T stage) and CT and PET (N and M stage) to that according to the post-operative results. Among 142 patients, surgical staging of 69 were N0 and 73 were N1. In M staging, 128 were M0 and 14 were M1. Sensitivity, specificity, and accuracy of N staging were 35.6%, 89.9%, 62.0% with CT and 58.9%, 71.0%, 64.7% with PET, respectively. In M staging, 14.3%, 96.9%, 88.7% with CT and 50.0%, 94.5%, 90.1% with PET, respectively. The concordances of [EUS+CT] and [EUS+CT+PET] with post-operative results were 41.2% and 54.6%, respectively and there was significant improvement of staging with additional PET scan (p<0.005). The concordance of [EUS+CT+PET] with post-operative result was significantly increased compared to that of [EUS+CT]. Thus, the addition of FDG-PET with other conventional methods may enable more accurate preoperative staging

  19. African Journal of Oral Health Sciences

    African Journals Online (AJOL)

    The African Journal of Oral Health Sciences is devoted to research into oral diseases and encourages a multidisciplinary approach. Emphasis is on oral pathology, oral microbiology, oral medicine, oral physiology and biochemistry and related clinical sciences.

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

    Science.gov (United States)

    2018-04-09

    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

  1. Towards understanding oral health.

    Science.gov (United States)

    Zaura, Egija; ten Cate, Jacob M

    2015-01-01

    During the last century, dental research has focused on unraveling the mechanisms behind various oral pathologies, while oral health was typically described as the mere absence of oral diseases. The term 'oral microbial homeostasis' is used to describe the capacity of the oral ecosystem to maintain microbial community stability in health. However, the oral ecosystem itself is not stable: throughout life an individual undergoes multiple physiological changes while progressing through infancy, childhood, adolescence, adulthood and old age. Recent discussions on the definition of general health have led to the proposal that health is the ability of the individual to adapt to physiological changes, a condition known as allostasis. In this paper the allostasis principle is applied to the oral ecosystem. The multidimensionality of the host factors contributing to allostasis in the oral cavity is illustrated with an example on changes occurring in puberty. The complex phenomenon of oral health and the processes that prevent the ecosystem from collapsing during allostatic changes in the entire body are far from being understood. As yet individual components (e.g. hard tissues, microbiome, saliva, host response) have been investigated, while only by consolidating these and assessing their multidimensional interactions should we be able to obtain a comprehensive understanding of the ecosystem, which in turn could serve to develop rational schemes to maintain health. Adapting such a 'system approach' comes with major practical challenges for the entire research field and will require vast resources and large-scale multidisciplinary collaborations. 2015 S. Karger AG, Basel

  2. Global Oral Health Inequalities

    Science.gov (United States)

    Garcia, I.; Tabak, L.A.

    2011-01-01

    Despite impressive worldwide improvements in oral health, inequalities in oral health status among and within countries remain a daunting public health challenge. Oral health inequalities arise from a complex web of health determinants, including social, behavioral, economic, genetic, environmental, and health system factors. Eliminating these inequalities cannot be accomplished in isolation of oral health from overall health, or without recognizing that oral health is influenced at multiple individual, family, community, and health systems levels. For several reasons, this is an opportune time for global efforts targeted at reducing oral health inequalities. Global health is increasingly viewed not just as a humanitarian obligation, but also as a vehicle for health diplomacy and part of the broader mission to reduce poverty, build stronger economies, and strengthen global security. Despite the global economic recession, there are trends that portend well for support of global health efforts: increased globalization of research and development, growing investment from private philanthropy, an absolute growth of spending in research and innovation, and an enhanced interest in global health among young people. More systematic and far-reaching efforts will be required to address oral health inequalities through the engagement of oral health funders and sponsors of research, with partners from multiple public and private sectors. The oral health community must be “at the table” with other health disciplines and create opportunities for eliminating inequalities through collaborations that can harness both the intellectual and financial resources of multiple sectors and institutions. PMID:21490232

  3. 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

  4. Regional nodal relapse in surgically staged Merkel cell carcinoma

    International Nuclear Information System (INIS)

    Hoeller, Ulrike; Mueller, Thomas; Schubert, Tina; Budach, Volker; Ghadjar, Pirus; Brenner, Winfried; Kiecker, Felix; Schicke, Bernd; Haase, Oliver

    2015-01-01

    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.) [de

  5. Multiple stage railgun

    International Nuclear Information System (INIS)

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

    1982-01-01

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

  6. Coal derivates for reduction of SO{sub 2} N0{sub x}; Derivados del Carbon para la Reduccion de SO{sub 2}-NO{sub x}

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    The project was divided in two well-differentiated parts: SO{sub 2} removal and NO{sub x} reduction. In both cases, carbon materials play a unique role in the processes, either as calcium sorbent support (SO{sub 2} removal) or as catalyst support and reducing agent (NO{sub x} reduction). Removal of SO{sub 2}. This process was carried out by calcium sorbents at relatively low temperature (T<300 degree centigree), forming CaSO{sub 3} (instead of CaSO{sub 4}) that decomposes at lower temperatures, making regeneration easier. High dispersion of the active species, CaO, has been obtained using carbon materials (activated carbons, chars, etc) and other inorganic compounds as supports. The effect of oxygen, carbon dioxide and steam in the reaction atmosphere and the regeneration process have been also investigated. Thermal regeneration is possible for several cycles, however, carbon gasification also takes place. To control, and to void that effect the reaction and regeneration temperatures should be carefully controlled and carbons with low reactivity should be selected. The process was scaled (100-2000) using briquette samples obtained by physical mixture of char and Ca(OH){sub 2}. The SO{sub 2} removal levels were similar to those found in the laboratory scale. NO{sub x} reduction. The possibility of using potassium containing coal-briquettes for NO and NO{sub x} reduction has been investigated. The preparation method of briquettes presents the advantage of using a binder agent (humic acid) which contains the catalyst (potassium). The system catalyst-binder-coal stays intimately joined by a moulding stage and subsequent pyrolysis, providing proper mechanical resistance to the coal-briquettes. With the purpose to improve the briquettes activity, different variables of the preparation process have been investigated (potassium content-added with the binder and/or KOH-. rank and mineral matter content of the coal precursor, pyrolysis temperature and pressure of the

  7. Turbine stage model

    International Nuclear Information System (INIS)

    Kazantsev, A.A.

    2009-01-01

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

  8. Oral Microbiology and Immunology

    DEFF Research Database (Denmark)

    Dahlén, Gunnar; Fiehn, Nils-Erik; Olsen, Ingar

    , dental assistants and trainees may find it a useful source of reference. The contents are based on general microbiology and immunology. Oral microbiology is given particular attention, with examples relevant to oral infectious diseases. Each chapter opens with a relatively short pre-reading section...

  9. Shared Oral Care

    DEFF Research Database (Denmark)

    Hede, Børge; Elmelund Poulsen,, Johan; Christophersen, Rasmus

    2014-01-01

    Shared Oral Care - Forebyggelse af orale sygdomme på plejecentre Introduktion og formål: Mangelfuld mundhygiejne hos plejekrævende ældre er et alment og veldokumenteret sundhedsproblem, der kan føre til massiv udvikling af tandsygdomme, og som yderligere kan være medvirkende årsag til alvorlige...

  10. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Oral Surgeries Facial Cosmetic Surgery Facial Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ...

  11. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Other Oral Surgeries Facial Cosmetic Surgery Facial Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons ...

  12. What Is an Oral Piercing?

    Science.gov (United States)

    ... to your desktop! more... What Is an Oral Piercing? Article Chapters What Is an Oral Piercing? print full article print this chapter email this article Oral piercing can cause pain, swelling, infection, drooling, taste loss, ...

  13. American Academy of Oral Medicine

    Science.gov (United States)

    ... Statements Newsletters AAOM: Representing the Discipline of Oral Medicine Oral Medicine is the discipline of dentistry concerned with the ... offers credentialing, resources and professional community for oral medicine practitioners. Our membership provides care to thousands. We ...

  14. Literatura Oral Hispanica (Hispanic Oral Literature).

    Science.gov (United States)

    McAlpine, Dave

    As part of a class in Hispanic Oral Literature, students collected pieces of folklore from various Hispanic residents in the region known as "Siouxland" in Iowa. Consisting of some of the folklore recorded from the residents, this paper includes 18 "cuentos y leyendas" (tales and legends), 48 "refranes" (proverbs), 17…

  15. Estimation of salivary sialic acid in oral premalignancy and oral squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Vishakha Chaudhari

    2016-01-01

    Full Text Available Aims: Oral cancer is the most life-threatening disease of oral tissues. In societies where the incidence of oral cancer is high, clinically recognizable premalignant lesions are particularly common. Diagnosing oral cancers at an early stage is critical in improving the survival rate and reducing the morbidity associated with the disease. Alterations in the sialic acid levels in cancer patients have stimulated interest in this sugar residue as a possible tumor marker. Settings and Design: The purpose of this study was to estimate the salivary sialic acid levels in patients with oral premalignancy and squamous cell carcinoma and to correlate it with their grades to develop a cost-effective and noninvasive diagnostic parameter. Materials and Methods: Unstimulated whole saliva was collected from the groups under study and subjected to biochemical analysis for determination of sialic acid levels. Statistical Analysis Used: The salivary sialic acid levels were correlated with the clinical stage and histological grade by one-way ANOVA (SPSS software version 15. Results: Salivary sialic acid was elevated in oral squamous cell carcinoma (OSCC compared to oral premalignancy and control group. A statistically significant correlation was observed between the grades of squamous cell carcinoma, grades of dysplasia in premalignancy, and sialic acid level. Conclusion and Clinical Significance: Evaluation of salivary sialic acid levels in premalignant and malignant lesions can serve as a screening tool. The mortality and morbidity of OSCC can be reduced if the lesions are diagnosed in early precancerous states using such noninvasive diagnostic methods for screening and monitoring of the population.

  16. Staging of cutaneous melanoma

    NARCIS (Netherlands)

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

    2009-01-01

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

  17. Role and models for compensation of tobacco use prevention and cessation by oral health professionals.

    Science.gov (United States)

    Crail, Jon; Lahtinen, Aira; Beck-Mannagetta, Johann; Benzian, Habib; Enmarks, Birgitta; Jenner, Tony; Knevel, Ron; Lulic, Martina; Wickholm, Seppo

    2010-02-01

    Appropriate compensation of tobacco use prevention and cessation (TUPAC) would give oral health professionals better incentives to provide TUPAC, which is considered part of their professional and ethical responsibility and improves quality of care. Barriers for compensation are that tobacco addiction is not recognised as a chronic disease but rather as a behavioural disorder or merely as a risk factor for other diseases. TUPAC-related compensation should be available to oral health professionals, be in appropriate relation to other dental therapeutic interventions and should not be funded from existing oral health care budgets alone. We recommend modifying existing treatment and billing codes or creating new codes for TUPAC. Furthermore, we suggest a four-staged model for TUPAC compensation. Stages 1 and 2 are basic care, stage 3 is intermediate care and stage 4 is advanced care. Proceeding from stage 1 to other stages may happen immediately or over many years. Stage 1: Identification and documentation of tobacco use is part of each patient's medical history and included into oral examination with no extra compensation. Stage 2: Brief intervention consists of a motivational interview and providing information about existing support. This stage should be coded/reimbursed as a short preventive intervention similar to other advice for oral care. Stage 3: Intermediate care consists of a motivational interview, assessment of tobacco dependency, informing about possible support and pharmacotherapy, if appropriate. This stage should be coded as preventive intervention similar to an oral hygiene instruction. Stage 4: Advanced care. Treatment codes should be created for advanced interventions by oral health professionals with adequate qualification. Interventions should follow established guidelines and use the most cost-effective approaches.

  18. From Page to Stage.

    Science.gov (United States)

    Gauweiler, Cher N.

    2003-01-01

    Extends readers' theater to movie theater by asking the students to make a video production of the book "The Outsiders" by S.E. Hinton. Notes that the educational objectives for the project included increasing reading fluency, developing oral presentation skills, identifying the basic elements of a novel including setting, character, and plot, and…

  19. Evaluation of argyrophilic nucleolar organizer regions in oral tumor progression.

    Science.gov (United States)

    Spolidorio, L C; Neves, K A; Soares, C P; Spolidorio, D M P; Basso, M F M; Malavazzi, I; Almeida, O P

    2002-01-01

    The aim of this study was to compare the presence of nucleolar organizer regions (NORs) in normal oral mucosa, dysplasia and microinvasive carcinoma. All histological specimens were reviewed according to the modified classification and staging system for oral leukoplakia described by van-der-Waal et al. [Oral Oncol. 36 (2000) 264]. NOR quantification was performed with an image analyzer after staining by the argyrophilic nucleolar region technique. The morphometric results were statistically different for normal mucosa, dysplasia and microinvasive carcinoma. It was concluded that an increase of NOR activity follows the disease progression and may reflect the degree of cellular proliferation and malignancy.

  20. Oral manifestations and their management in children undergoing haemodialysis treatment

    Directory of Open Access Journals (Sweden)

    Arlette Suzy Puspa Pertiwi

    2007-11-01

    Full Text Available Haemodialysis is a medical procedure that artificially filters blood. This procedure is carried out to treat children with end-stage renal disease (ESRD. Although haemodialysis is a lifesaving treatment, it also raises many severe oral manifestations associated with ESDR. Among these are increased hypoplasia, enamel opacities, uremic stomatitis, oral bleeding, increased periodontal disease, reduced salivary flow, xerostomia, and an increased tendency of calculus deposition. This paper will discuss the oral manifestations associated with ESRD and their management in children undergoing haemodialysis treatment.

  1. Immunoexpression of programmed cell death 4 protein in normal oral mucosa, oral epithelial dysplasia and oral squamous cell carcinoma.

    Science.gov (United States)

    Desai, Karishma M; Kale, Alka D

    2017-01-01

    Oral squamous cell carcinoma (OSCC) is the frequently reported cancer of the head and neck. Recent studies are being conducted to evaluate the role of potential markers for diagnosing the stages of development of OSCC from normal cells. The aim of this study is to evaluate and compare the immunoexpression of programmed cell death 4 (PDCD4) protein in normal oral mucosa, oral epithelial dysplasia (OED) and OSCC. Histologically diagnosed, formalin-fixed paraffin-embedded archived cases ( n = 100) of normal mucosa ( n = 10), OED ( n = 60) and OSCC ( n = 30) were analyzed immunohistochemically in the present retrospective study using monoclonal rabbit antihuman PDCD4. OED and squamous cell carcinoma were graded according to the World Health Organization and Broder's histological grading criteria, respectively. Clinical parameters and immunohistochemical results were analyzed by Fisher exact test using SPSS software. P oral mucosa, OED and OSCC. The maximum expression was observed in the normal oral mucosa, which reduced significantly in OED and OSCC ( P = 0.017). With the increase in the transformation from normal cells to cancer cells, a shift from nuclear to cytoplasmic staining was observed indicating predominant cytoplasmic localization of stain as a feature of altered cells. The present study delineates the molecular difference between the normal, dysplastic and carcinomatous cells; and points toward the role of PDCD4 localization in the proliferation of cells. This study thus highlights the need for further research with inclusion of long follow-up period and other pathological criteria such as inflammation and microenvironment, immune status of patient and tumor stage, which could aid in the development of prospective diagnostic options.

  2. Examining the association between oral health and oral HPV infection.

    Science.gov (United States)

    Bui, Thanh Cong; Markham, Christine M; Ross, Michael Wallis; Mullen, Patricia Dolan

    2013-09-01

    Oral human papillomavirus (HPV) infection is the cause of 40% to 80% of oropharyngeal cancers; yet, no published study has examined the role of oral health in oral HPV infection, either independently or in conjunction with other risk factors. This study examined the relation between oral health and oral HPV infection and the interactive effects of oral health, smoking, and oral sex on oral HPV infection. Our analyses comprised 3,439 participants ages 30 to 69 years for whom data on oral HPV and oral health were available from the nationally representative 2009-2010 National Health and Nutrition Examination Survey. Results showed that higher unadjusted prevalence of oral HPV infection was associated with four measures of oral health, including self-rated oral health as poor-to-fair [prevalence ratio (PR) = 1.56; 95% confidence interval (CI), 1.25-1.95], indicated the possibility of gum disease (PR = 1.51; 95% CI, 1.13-2.01), reported use of mouthwash to treat dental problems in the past week (PR = 1.28; 95% CI, 1.07-1.52), and higher number of teeth lost (Ptrend = 0.035). In multivariable logistic regression models, oral HPV infection had a statistically significant association with self-rated overall oral health (OR = 1.55; 95% CI, 1.15-2.09), independent of smoking and oral sex. In conclusion, poor oral health was an independent risk factor of oral HPV infection, irrespective of smoking and oral sex practices. Public health interventions may aim to promote oral hygiene and oral health as an additional measure to prevent HPV-related oral cancers.

  3. Worldwide Esophageal Cancer Collaboration: pathologic staging data.

    Science.gov (United States)

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

    2016-10-01

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

  4. O{sub 2} adsorption and dissociation on the Pd{sub 13-n}Ni{sub n}@Pt{sub 42} (n = 0, 1, 12, and 13) tri-metallic nanoparticles: A DFT study

    Energy Technology Data Exchange (ETDEWEB)

    Li, Sha; Yang, Yongpeng; Huang, Shiping, E-mail: huangsp@mail.buct.edu.cn

    2017-07-15

    Highlights: • O{sub 2} adsorption and dissociation on Pd{sub 13-n}Ni{sub n}@Pt{sub 42} NPs are performed by DFT. • Adsorption energies of O{sub 2} and O are strongly affected by the coordination number. • Adsorption energy and d-band center displays the opposite change tendency. • Ni{sub 13}@Pt{sub 42} is the most active catalyst among Pd{sub 13-n}Ni{sub n}@Pt{sub 42} (n = 0, 1, 12, and 13) NPs. - Abstract: Density functional theory calculations are performed to investigate O{sub 2} adsorption and dissociation on the icosahedral Pd{sub 13-n}Ni{sub n}@Pt{sub 42} (n = 0, 1, 12, and 13) tri-metallic nanoparticles. The parallel adsorption of O{sub 2} on Pd{sub 13-n}Ni{sub n}@Pt{sub 42} (n = 0, 1, 12, and 13) is stronger than the vertical adsorption. The adsorption of O{sub 2} on the bridge site (B1) is favorable in the Pd{sub 13-n}Ni{sub n}@Pt{sub 42} (n = 0, 1, 12, and 13) nanoparticles, while the adsorption of O atom on the hollow site (H1) is preferred. The adsorption energies of O{sub 2} and O are strongly affected by the coordination number. Low coordination site shows strong adsorption of O{sub 2} and O on the Pd{sub 13-n}Ni{sub n}@Pt{sub 42} (n = 0, 1, 12, and 13) nanoparticles. The adsorption energies of O{sub 2} and O atoms are found to be correlated well with the d-band center of surface Pt. For the Pd{sub 13-n}Ni{sub n}@Pt{sub 42} (n = 0, 1, 12, and13) nanoparticles catalysts, the ORR activity follows the order of Ni{sub 13}@Pt{sub 42} > Pd{sub 13}@Pt{sub 42} > Pd{sub 12}Ni{sub 1}@Pt{sub 42} > Pd{sub 1}Ni{sub 12}@Pt{sub 42}, illustrating that the Ni{sub 13}@Pt{sub 42} is the strongest ORR activity among the Pd{sub 13-n}Ni{sub n}@Pt{sub 42} (n = 0, 1, 12, and13) nanoparticles catalysts. Our results have important significance to understand the mechanism of O{sub 2} dissociation on the Pd{sub 13-n}Ni{sub n}@Pt{sub 42} (n = 0, 1, 12, and 13) tri-metallic nanoparticles.

  5. Mucoadhesive Oral Wound Rinse in Preventing and Treating Stomatitis in Patients With ER- or PR-Positive Metastatic or Locally Recurrent Breast Cancer That Cannot be Removed by Surgery Receiving Everolimus

    Science.gov (United States)

    2017-04-25

    Estrogen Receptor-positive Breast Cancer; HER2-negative Breast Cancer; Oral Complications; Progesterone Receptor-positive Breast Cancer; Recurrent Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Stage IV Breast Cancer

  6. Staging for vulvar cancer.

    Science.gov (United States)

    Hacker, Neville F; Barlow, Ellen L

    2015-08-01

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

  7. Staging for vaginal cancer.

    Science.gov (United States)

    Rajaram, Shalini; Maheshwari, Amita; Srivastava, Astha

    2015-08-01

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

  8. Staged bilateral carotid endarterectomy

    DEFF Research Database (Denmark)

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

    1986-01-01

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

  9. Staging of lung cancer.

    Science.gov (United States)

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

    2015-06-01

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

  10. Staging Mobilities / Designing Mobilities

    DEFF Research Database (Denmark)

    Jensen, Ole B.

    2015-01-01

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

  11. Prevention of gingival trauma : Oral hygiene devices and oral piercings

    NARCIS (Netherlands)

    Hoenderdos, N.L.

    2017-01-01

    Maintaining healthy teeth and soft oral tissues for life is important. Oral hygiene devices and oral piercings can damage the soft oral tissues. This thesis investigates the safety of manual toothbrushes, interdental brushes and rubber bristles interdental cleaners by analysing the gingival abrasion

  12. Stages of Colon Cancer

    Science.gov (United States)

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

  13. Stages of Labor

    Science.gov (United States)

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

  14. Multiple Stages 2

    DEFF Research Database (Denmark)

    Andreasen, John

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

  15. Stages of Esophageal Cancer

    Science.gov (United States)

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

  16. Stages of Anal Cancer

    Science.gov (United States)

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

  17. Stages of Penile Cancer

    Science.gov (United States)

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

  18. Staging interrail mobilities

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  19. Amiloidosis oral nodular Oral nodular amyloidosis

    Directory of Open Access Journals (Sweden)

    P. Martos Díaz

    2008-02-01

    Full Text Available Introducción. La amiloidosis constituye una entidad marcada por el depósito de amiloide en diferentes tejidos. En la cavidad oral se manifiesta habitualmente en forma de macroglosia, y más raramente, como nódulos dispuestos en la superficie. Caso clínico. Varón afecto de Mieloma Múltiple, que comienza con lesiones nodulares en labio inferior y lengua. A raíz de estas lesiones, mediante estudio histológico, es diagnosticado de Amiloidosis Sistémica. Discusión. Los nódulos amiloideos en la cavidad oral, constituyen una manifestación rara de la amiloidosis sistémica. Su aparición conlleva la necesidad de realizar un diagnostico diferencial con otras entidades y el diagnostico de certeza se obtiene mediante el análisis histológico.Introduction. Amyloidosis is a condition characterized by the deposit of amyloid in different tissues. In the oral cavity it is usually manifested as macroglossia and, more rarely, as nodules on the surface. Clinical case. A man had multiple myeloma that began with nodular lesions of the lower lip and tongue. As a result of these lesions, the patient was diagnosed of systemic amyloidosis by histological study. Discussion. Amyloid nodules in the oral cavity are a rare manifestation of systemic amyloidosis. Its appearance entails the necessity to make I diagnose differential with other organizations and I diagnose of certainty is obtained by means of the histological analysis.

  20. Oral Cancer Exam

    Medline Plus

    Full Text Available ... to NIDCR Contact Us Home Health Info Health Information The Oral Cancer Exam See a step-by- ... National Institutes of Health in Bethesda, Md. This information is not copyrighted. Make as many copies as ...

  1. Ipratropium Oral Inhalation

    Science.gov (United States)

    Ipratropium oral inhalation is used to prevent wheezing, shortness of breath, coughing, and chest tightness in people with chronic obstructive pulmonary disease (COPD; a group of diseases that affect the lungs and airways) such as chronic bronchitis (swelling of ...

  2. Oral Appliances Therapy

    Science.gov (United States)

    ... is an effective treatment option for snoring and obstructive sleep apnea (OSA). A custom-fit oral sleep appliance can improve your sleep, restore your alertness and revitalize your health. Here is a guide to help you get ...

  3. [Oral precancer and cancer].

    Science.gov (United States)

    López-López, José; Omaña-Cepeda, Carlos; Jané-Salas, Enric

    2015-11-06

    We reviewed the concept of oral precancerous lesions, oral cancer, and the possibility of early diagnosis. With the keywords: premalignant oral lesions prevention, a search was performed over the past 10 years. Also clinical trials are searched from January 2011 until today with the keywords: oral cancer prevention AND dentistry. It is emphasized that there can be no significant changes related to the concept of precancerous lesions and cancer, and those relating to the early diagnosis. Despite the numerous described methods of screening, biopsy remains the most useful test, and therefore it is essential, mainly if we consider the new possibilities of molecular studies. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  4. Cromolyn Oral Inhalation

    Science.gov (United States)

    ... your doctor.Cromolyn oral inhalation helps to prevent asthma attacks (sudden episodes of shortness of breath, wheezing, and coughing) but will not stop an asthma attack that has already started. Your doctor will prescribe ...

  5. Fostering oral presentation performance

    NARCIS (Netherlands)

    Ginkel, van Stan; Gulikers, Judith; Biemans, Harm; Mulder, Martin

    2017-01-01

    Previous research revealed significant differences in the effectiveness of various feedback sources for encouraging students’ oral presentation performance. While former studies emphasised the superiority of teacher feedback, it remains unclear whether the quality of feedback actually differs

  6. Oral Cancer Foundation

    Science.gov (United States)

    ... 14T22:05:33+00:00 October, 2016 | This last weekend the OCF 3rd Annual Southern California Oral Cancer Walk for Awareness took place in Fountain Valley at Mile Square Park. The walk is a little different ...

  7. Intravenous versus oral etoposide

    DEFF Research Database (Denmark)

    Ali, Abir Salwa; Grönberg, Malin; Langer, Seppo W.

    2018-01-01

    High-grade gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs, G3) are aggressive cancers of the digestive system with poor prognosis and survival. Platinum-based chemotherapy (cisplatin/carboplatin + etoposide) is considered the first-line palliative treatment. Etoposide is frequently...... administered intravenously; however, oral etoposide may be used as an alternative. Concerns for oral etoposide include decreased bioavailability, inter- and intra-patient variability and patient compliance. We aimed to evaluate possible differences in progression-free survival (PFS) and overall survival (OS......) in patients treated with oral etoposide compared to etoposide given as infusion. Patients (n = 236) from the Nordic NEC study were divided into three groups receiving etoposide as a long infusion (24 h, n = 170), short infusion (≤ 5 h, n = 33) or oral etoposide (n = 33) according to hospital tradition. PFS...

  8. Stages of ores formation

    International Nuclear Information System (INIS)

    Khasanov, A.Kh.

    1988-01-01

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

  9. Sentinel lymph nodes in cancer of the oral cavity

    DEFF Research Database (Denmark)

    Thomsen, Jørn Bo; Christensen, Rikke Kølby; Sørensen, Jens Ahm

    2007-01-01

    BACKGROUND: Extended histopathologic work-up has increased the detection of micrometastasis in sentinel lymph nodes in malignant melanoma and breast cancer. The aim of this study was to examine if (A) step-sectioning of the central 1000 microM at 250 microM levels with immunostaining were accurate...... when compared with (B) step-sectioning and immunostaining of the entire sentinel lymph node at 250 microM levels. METHODS: Forty patients with T1/T2 cN0 oral cancer were enrolled. Three patients were excluded. In one patient no sentinel lymph node was identified. The remaining two had unidentified...

  10. Oral vs. salivary diagnostics

    Science.gov (United States)

    Marques, Joana; Corby, Patricia M.; Barber, Cheryl A.; Abrams, William R.; Malamud, Daniel

    2015-05-01

    The field of "salivary diagnostics" includes studies utilizing samples obtained from a variety of sources within the oral cavity. These samples include; whole unstimulated saliva, stimulated whole saliva, duct saliva collected directly from the parotid, submandibular/sublingual glands or minor salivary glands, swabs of the buccal mucosa, tongue or tonsils, and gingival crevicular fluid. Many publications state "we collected saliva from subjects" without fully describing the process or source of the oral fluid. Factors that need to be documented in any study include the time of day of the collection, the method used to stimulate and collect the fluid, and how much fluid is being collected and for how long. The handling of the oral fluid during and post-collection is also critical and may include addition of protease or nuclease inhibitors, centrifugation, and cold or frozen storage prior to assay. In an effort to create a standard protocol for determining a biomarker's origin we carried out a pilot study collecting oral fluid from 5 different sites in the mouth and monitoring the concentrations of pro- and anti-inflammatory cytokines detected using MesoScaleDiscovery (MSD) electrochemiluminesence assays. Our data suggested that 3 of the cytokines are primarily derived from the submandibular gland, while 7 of the cytokines come from a source other than the major salivary glands such as the minor salivary glands or cells in the oral mucosae. Here we review the literature on monitoring biomarkers in oral samples and stress the need for determining the blood/saliva ratio when a quantitative determination is needed and suggest that the term oral diagnostic be used if the source of an analyte in the oral cavity is unknown.

  11. Immunologically mediated oral diseases

    OpenAIRE

    Jimson, Sudha; Balachader, N.; Anita, N.; Babu, R.

    2015-01-01

    Immune mediated diseases of oral cavity are uncommon. The lesions may be self-limiting and undergo remission spontaneously. Among the immune mediated oral lesions the most important are lichen planus, pemphigus, erythema multiformi, epidermolysis bullosa, systemic lupus erythematosis. Cellular and humoral mediated immunity play a major role directed against epithelial and connective tissue in chronic and recurrent patterns. Confirmatory diagnosis can be made by biopsy, direct and indirect imm...

  12. ON ORAL CANCER

    Directory of Open Access Journals (Sweden)

    P. V. Svetitsky

    2012-01-01

    Full Text Available The paper analyzes a rise in the incidence of oral cancer in the Rostov Region since the 1990s. The study has indicated that this rise is associated with regional population growth due to the forced migrants after the collapse of the USSR. Financial problems, unbalanced nutrition, poor oral hygiene, and depression in this group of patients have contributed to the higher incidence of precancers and cancers.

  13. Diabetes and oral health

    OpenAIRE

    Kjersti Skjold Rønningen; Morten Enersen

    2012-01-01

    Background: Diabetes describes a group of disorders characterized by elevated levels of glucose in the blood and abnormalities of carbohydrate, fat and protein metabolism. A number of oral diseases and disorders have been associated with diabetes, and periodontitis has been identified as a possible risk factor for poor metabolic control in subjects with diabetes.Methods: This paper reviews the scientific literature to identify oral conditions that have been proposed and are known to be affect...

  14. Oral sex and oral health: An enigma in itself

    OpenAIRE

    Kumar, Tarun; Puri, Gagan; Aravinda, Konidena; Arora, Neha; Patil, Deepa; Gupta, Rajesh

    2015-01-01

    Oral sex is commonly practiced by sexually active couples of various age groups, including male-female and same-gender adolescents. The various type of oral sex practices are fellatio, cunnilingus, and analingus. Oral sex can transmit oral, respiratory, and genital infections from one site in body to the other. Oral health has a direct correlation on the transmission of infection; a cut in the mouth, bleeding gums, lip sores or broken skin increases chances of life-threatening infections. Alt...

  15. Oral microbiome and oral and gastrointestinal cancer risk

    OpenAIRE

    Ahn, Jiyoung; Chen, Calvin Y.; Hayes, Richard B.

    2012-01-01

    A growing body of evidence implicates human oral bacteria in the etiology of oral and gastrointestinal cancers. Epidemiological studies consistently report increased risks of these cancers in men and women with periodontal disease or tooth loss, conditions caused by oral bacteria. More than 700 bacterial species inhabit the oral cavity, including at least 11 bacterial phyla and 70 genera. Oral bacteria may activate alcohol and smoking-related carcinogens locally or act systemically, through c...

  16. Prevention of gingival trauma: Oral hygiene devices and oral piercings

    OpenAIRE

    Hoenderdos, N.L.

    2017-01-01

    Maintaining healthy teeth and soft oral tissues for life is important. Oral hygiene devices and oral piercings can damage the soft oral tissues. This thesis investigates the safety of manual toothbrushes, interdental brushes and rubber bristles interdental cleaners by analysing the gingival abrasion score. The efficacy of the various oral hygiene devices is measured by the use of dental plaque scores and gingivitis scores. In addition, the prevalence, the short- and long-term effects and the ...

  17. Determinants of Oral Health: Does Oral Health Literacy Matter?

    OpenAIRE

    Naghibi Sistani, Mohammad Mehdi; Yazdani, Reza; Virtanen, Jorma; Pakdaman, Afsaneh; Murtomaa, Heikki

    2013-01-01

    Objective. To evaluate oral health literacy, independent of other oral health determinants, as a risk indicator for self-reported oral health. Methods. A cross-sectional population-based survey conducted in Tehran, Iran. Multiple logistic regression analysis served to estimate the predictive effect of oral health literacy on self-reported oral health status (good versus poor) controlling for socioeconomic and demographic factors and tooth-brushing behavior. Results. In all, among 1031 partici...

  18. The Outcome for Patients With Pathologic Node-Positive Prostate Cancer Treated With Intensity Modulated Radiation Therapy and Androgen Deprivation Therapy: A Case-Matched Analysis of pN1 and pN0 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Van Hemelryk, Annelies [Department of Urology, Ghent University Hospital, Ghent (Belgium); De Meerleer, Gert; Ost, Piet [Department of Radiation Oncology, Ghent University Hospital, Ghent (Belgium); Poelaert, Filip [Department of Urology, Ghent University Hospital, Ghent (Belgium); De Gersem, Werner [Department of Radiation Oncology, Ghent University Hospital, Ghent (Belgium); Decaestecker, Karel [Department of Urology, Ghent University Hospital, Ghent (Belgium); De Visschere, Pieter [Department of Radiology, Ghent University Hospital, Ghent (Belgium); Fonteyne, Valérie, E-mail: valerie.fonteyne@uzgent.be [Department of Radiation Oncology, Ghent University Hospital, Ghent (Belgium)

    2016-10-01

    Purpose: Improved outcome is reported after surgery or external beam radiation therapy (EBRT) plus androgen deprivation therapy (ADT) for patients with lymph node (LN) positive (N1) prostate cancer (PC). Surgical series have shown that pathologic (p)N1 PC does not behave the same in all patients. The aim of this study was to perform a matched-case analysis to compare the outcome of pN1 and pN0 PC after high-dose EBRT plus ADT. Methods and Materials: Radiation therapy up to 80 Gy was delivered to the prostate with a minimal dose of 45 Gy to the pelvis for pN1 patients. After matching, Kaplan-Meier statistics were used to compare the 5-year biochemical and clinical relapse-free survival (bRFS and cRFS), prostate cancer–specific survival (PCSS), and overall survival (OS). Acute and late rectal and urinary toxicity was evaluated. Results: Sixty-nine pN1 PC patients were matched 1:1 with pN0 PC patients. The median follow-up time was 60 months. The 5-year bRFS and cRFS for pN1 versus pN0 PC patients were 65% ± 7% versus 79% ± 5% (P=.08) and 70% ± 6% versus 83% ± 5% (P=.04) respectively. No significant difference was found in bRFS or cRFS rates between low volume pN1 (≤2 positive LNs) and pN0 patients. The 5-year PCSS and OS were comparable between pN1 and pN0 PC patients: PCSS: 92% ± 4% versus 93% ± 3% (P=.66); OS: 82% ± 5% versus 80% ± 5% (P=.58). Severe toxicity was rare for both groups, although pN1 patients experienced significantly more acute grade 2 rectal toxicity. Conclusion: Primary EBRT plus 2 to 3 years of ADT is a legitimate treatment option for pN1 PC patients, especially those with ≤2 positive LNs, and this with bRFS and cRFS rates comparable to those in pN0 PC patients. For pN1 PC patients with >2 positive LNs, bRFS and cRFS are worse than in pN0 patients, but even in this subgroup, long-term disease control is obtained.

  19. Bladder Involvement in Stage I Endometriosis.

    Science.gov (United States)

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

    2017-08-01

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

  20. Refugee child oral health.

    Science.gov (United States)

    Riggs, E; Rajan, S; Casey, S; Kilpatrick, N

    2017-04-01

    The number of people forced to flee their homes and move around the world is increasing rapidly. Such refugee populations are not only more likely to have poor physical, mental and social health outcomes but also to experience difficulties accessing health services in their new country. In particular, children from refugee backgrounds are at increased risk of poor oral health which in time is associated with poor adult oral health and impacts on child health (e.g. growth and development) and well-being. To date, there is little evidence about the nature and extent of their oral health problems nor interventions to improve their oral health status. This article summarises the evidence surrounding the oral health status of children from refugee backgrounds. In addition, a systematic review of the international literature over the past 10 years is presented which identifies interventions to improve the oral health of these vulnerable paediatric populations. Based on this evidence, potential strategies available to dental service providers to optimise provision of responsive dental care are discussed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. 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

  2. Strengthening of oral health systems

    DEFF Research Database (Denmark)

    Petersen, Poul Erik

    2014-01-01

    Around the globe many people are suffering from oral pain and other problems of the mouth or teeth. This public health problem is growing rapidly in developing countries where oral health services are limited. Significant proportions of people are underserved; insufficient oral health care...... is either due to low availability and accessibility of oral health care or because oral health care is costly. In all countries, the poor and disadvantaged population groups are heavily affected by a high burden of oral disease compared to well-off people. Promotion of oral health and prevention of oral...... diseases must be provided through financially fair primary health care and public health intervention. Integrated approaches are the most cost-effective and realistic way to close the gap in oral health between rich and poor. The World Health Organization (WHO) Oral Health Programme will work...

  3. First report of HIV-related oral manifestations in Mali

    African Journals Online (AJOL)

    raoul

    2012-01-31

    Jan 31, 2012 ... OM prevalence during the first month of HIV care was 31.4%, being oral candidiasis the commonest lesion. 73.2% and 82.5% of the patients with OM had CD4 count < 200 cells/mm3 and were classified as WHO clinical stage III or IV. WHO clinical stage III and VI patients had 5.4-fold increased odds of ...

  4. Graphite oral tattoo: case report

    OpenAIRE

    Moraes, Renata Mendonça; Gouvêa Lima, Gabriela de Morais; Guilhermino, Marinaldo; Vieira, Mayana Soares; Carvalho, Yasmin Rodarte; Anbinder, Ana Lia

    2015-01-01

    Pigmented oral lesions compose a large number of pathological entities, including exogenous pigmentat oral tattoos, such as amalgam and graphite tattoos. We report a rare case of a graphite tattoo on the palate of a 62-year-old patient with a history of pencil injury, compare it with amalgam tattoos, and determine the prevalence of oral tattoos in our Oral Pathology Service. We also compare the clinical and histological findings of grafite and amalgam tattoos. Oral tattoos affect women more f...

  5. Staging of extrahepatic cholangiocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-10-15

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

  6. Treatments of the oral leukoplakia by laser

    Science.gov (United States)

    Capocci, M.; Mohsen, M.; Lo Giudice, R.; Del Vecchio, A.; Gaimari, G.; Tribolati, L.; Palaia, G.; Romeo, U.

    2016-03-01

    Oral leukoplakia is catalogued under the group of "potentially malignant disorders". In daily practice, the World Health Organization definition "white patch or plaque that cannot be characterized clinically or histologically as any other disease" is completed by including the observation that it cannot be removed by simple scraping, thereby distinguishing it from pseudo-membranous candidiasis. The aim of this study is to find a definitive treatment of oral leukoplakia, because of its recurrence and its potentiality to the malignant transformation. There are currently different approaches to oral leukoplakia: scalpel surgery, systemic therapy (carotenoids, vitamins, etc.), electro-cauterization, cryotherapy and the use of the laser. In every lesion, biopsy and histological analysis has been performed to identify the stage and classification of the oral leukoplakia. Laser can be used for the complete excision of the lesion (which is more effective, but also more invasive), for the photodynamic therapy (non-invasive procedure, which requires several applications) or for the vaporization of the lesion (very precise treatment and relatively easy to perform). Laser treatments have shown better healing, less soft tissues retraction and less post-operative pain, comparing with traditional surgery. The use of systemic therapies and smoking habit interruption (where present) has been also useful to reduce the lesions before the clinical treatments. The treatment has always to be supported by histological analysis to identify the risk and consequently planning the clinical approach.

  7. ORAL MYIASIS CONVERTING TO ORAL SQUAMOUS CELL CARCINOMA

    Directory of Open Access Journals (Sweden)

    Akshay

    2015-10-01

    Full Text Available INTRODUCTION: Oral Myiasis, a condition of infestation of the body by fly larvae (maggots is a rare pathology in humans. It is associated with poor oral hygiene, alcoholism, senility, suppurating lesions, severe halitosis. It is seen frequently in tropical countries and hot climatic regions. The reported cases in literature of oral Myiasis associated with oral cancer are few. The treatment is a mechanical removal of the maggots but a systemic treatment with Ivermectin, a semi - synthetic macrolide antibiotic, has been used successfully for treatment for oral m yiasis. We present a case of 55 yr old male alcoholic patient with oral myiasis with extensive proliferative growth of oral cavity. Our patient was managed with manual debridement and administration of systemic ivermect in along with antibiotic coverage. Incisional biopsy of the proliferative lesion showed well differentiated squamous cell carcinoma. Thus our patient showed presence of oral myiasis in association with oral squamous cell carcinoma.

  8. Oral care practices for orally intubated critically ill adults.

    Science.gov (United States)

    Feider, Laura L; Mitchell, Pamela; Bridges, Elizabeth

    2010-03-01

    Ventilator-associated pneumonia is a major threat to patients receiving mechanical ventilation in hospitals. Oral care is a nursing intervention that may help prevent ventilator-associated pneumonia. To describe oral care practices performed by critical care nurses for orally intubated critically ill patients and compare these practices with recommendations for oral care in the 2005 AACN Procedure Manual for Critical Care and the guidelines from the Centers for Disease Control and Prevention. A descriptive, cross-sectional design with a 31-item Web-based survey was used to describe oral care practices reported by 347 randomly selected members of the American Association of Critical-Care Nurses. Oral care was performed every 2 (50%) or 4 (42%) hours, usually with foam swabs (97%). Oral care was reported as a high priority (47%). Nurses with 7 years or more of critical care experience performed oral care more often (P=.008) than did less experienced nurses. Nurses with a bachelor's degree in nursing used foam swabs (P=.001), suctioned the mouth before the endotracheal tube (P=.02), and suctioned after oral care (Ptoothpaste (40%), brushing with a foam swab (90%), using chlorhexidine gluconate oral rinse (49%), suctioning the oral cavity (84%), and assessing the oral cavity (73%). Oral care practices and policies differed for all those items. Survey results indicate that discrepancies exist between reported practices and policies. Oral care policies appear to be present, but not well used.

  9. Trends in oral cavity cancer incidence, mortality, survival and treatment in the Netherlands

    NARCIS (Netherlands)

    van Dijk, Boukje A. C.; Brands, Marieke T.; Geurts, Sandra M. E.; Merkx, Matthias A. W.; Roodenburg, Jan L. N.

    2016-01-01

    Information on epidemiology is essential to evaluate care for the growing group of oral cancer patients. We investigated trends in incidence, mortality and relative survival rates for oral cavity cancer (OCC) and its subsites in the Netherlands from 1991 to 2010, and relate these to changes in stage

  10. Composers on stage

    DEFF Research Database (Denmark)

    Groth, Sanne Krogh

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

  11. Screening for Oral Cavity Cancer: A 1-year Experience of a Regional Hospital in Taiwan.

    Science.gov (United States)

    Chi, T H; Yuan, C H; Chen, R F

    2014-01-01

    The purpose of this study was to analyze the risk factors affecting precancerous lesions, and cancer of oral cavity, and to assess efficacy of visual screening for oral mucosal lesions. The medical records of patients older than 30 years of age with history of habitual cigarette smoking or betel quid chewing that received screening for oral mucosal lesions between January 2012 and December 2012 were retrospectively reviewed. The patients' age, gender, risk factors, screening findings, and histopathology results of biopsy were included for further analysis. A total of 1341 patients were enrolled in this study. There were 1080 males and 261 females ranging from 30 to 96 years of age, with a mean age of 53.9±13.6 years. After screening, 226 (16.9%) were found to be positive of oral lesions. Among these 226 patients, 69 (30.5%) underwent biopsy under local anesthesia, and the histopathology showed malignancy in 13 (5.8%). All of the confirmed malignant cases were squamous cell carcinoma. Among them, 12 received further staging examination and one was lost to follow-up resulting in unknown stage. The early stage oral cavity cancer (stage I and II) accounted for 84.6% (11/13). The detection rate of early stage oral cavity cancer in our study was reasonable. Therefore, visual screening for oral cavity cancer is recommended for patients with habitual cigarette smoking or betel quid chewing.

  12. Aberrant DKK3 expression in the oral leukoplakia and oral submucous fibrosis: a comparative immunohistochemical study

    Directory of Open Access Journals (Sweden)

    T. Al-dhohorah

    2016-06-01

    Full Text Available We aimed to assess and compare the expression of Dickkopf homolog 3 (DKK3, a possible tumor suppressor gene (TSG, in oral leukoplakia (OLK and oral submucous fibrosis (OSF using immunohistochemistry. Seventy-five cases of normal oral mucosa (NOM, OLK, OSF, and squamous cell carcinoma (OSCC were studied. DKK3 was expressed in all cases of NOM, OLK and OSCC. There was steady increases in the percentage of the positive cells progressing toward OSCC. The expression was localized in the cytoplasm and cell membrane of cell affected by OLK with mild dysplasia and OLK with severe dysplasia. No significant association was observed between DKK3 expression and dysplastic status of OLK. Loss of DKK3 expression was observed in 15 of 30 cases in the OSF group, which was significantly associated with histological grade of OSF (P<0.0001. The percentage of positive cells gradually declined with the increasing severity of epithelial atrophy. A significant difference (P<0.01 was observed when comparing DKK3 expression among different groups of OLK and OSF cases. DKK3 may have diverse expressions in oral premalignant lesions. Loss of DKK3 expression in dysplastic/advanced stage of OSF may imply a high risk of progression to oral cancer.

  13. As-yet-uncultivated oral bacteria: breadth and association with oral and extra-oral diseases

    OpenAIRE

    Siqueira Jr, José F.; Rôças, Isabela N.

    2013-01-01

    It has been shown that 40-60% of the bacteria found in different healthy and diseased oral sites still remain to be grown in vitro, phenotypically characterized, and formally named as species. The possibility exists that these as-yet-uncultivated bacteria play important ecological roles in oral bacterial communities and may participate in the pathogenesis of several oral infectious diseases. There is also a potential for these as-yetuncultivated oral bacteria to take part in extra-oral infect...

  14. Staging Collaborative Innovation Processes

    DEFF Research Database (Denmark)

    Pedersen, Signe; Clausen, Christian

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

  15. The Oral Microbiota.

    Science.gov (United States)

    Arweiler, Nicole B; Netuschil, Lutz

    2016-01-01

    The oral microbiota represents an important part of the human microbiota, and includes several hundred to several thousand diverse species. It is a normal part of the oral cavity and has an important function to protect against colonization of extrinsic bacteria which could affect systemic health. On the other hand, the most common oral diseases caries, gingivitis and periodontitis are based on microorganisms. While (medical) research focused on the planktonic phase of bacteria over the last 100 years, it is nowadays generally known, that oral microorganisms are organised as biofilms. On any non-shedding surfaces of the oral cavity dental plaque starts to form, which meets all criteria for a microbial biofilm and is subject to the so-called succession. When the sensitive ecosystem turns out of balance - either by overload or weak immune system - it becomes a challenge for local or systemic health. Therefore, the most common strategy and the golden standard for the prevention of caries, gingivitis and periodontitis is the mechanical removal of this biofilms from teeth, restorations or dental prosthesis by regular toothbrushing.

  16. Probiotics and oral health.

    Science.gov (United States)

    Bizzini, Bernard; Pizzo, Giuseppe; Scapagnini, Giovanni; Nuzzo, Domenico; Vasto, Sonya

    2012-01-01

    Probiotics are living microorganisms (e.g., bacteria) that are either the same as or similar to organisms found naturally in the human body and may be beneficial to health. Current researches have shown that the balance between beneficial and pathogenic bacteria is essential in order to maintain the oral health. Therefore, oral cavity has recently been suggested as a relevant target for probiotic applications. Dental caries can be seen as a microbial imbalance where the oral microbiota shift towards community dominance which produces acidogenic and acid-tolerant gram positive bacteria. Similarly, the accumulation of bacteria within the biofilm, facilitated by poor oral hygiene, predisposes to allogenic shifts in the microbial community, leading to the onset of periodontal inflammation. Probiotic bacteria belonging to the genus of Lactobacillus, Bifidobacterium and Streptococcus have been proven effective for preventing caries by reducing the number of cariogenic bacteria in saliva after a short period of consuming the probiotic. In contrast, the effect of probiotics on improving gingivitis and periodontitis has been less investigated. The currently available studies on the effect of probiotics on periodontal pathogens and clinical periodontal parameters showed differing results depending on the strains used and the endpoints analyzed. Many of the clinical studies are pilot in nature and with low quality, therefore, properly conducted clinical trials, using probiotic strains with in vitro proven periodontal probiotic effects, are needed. The putative beneficial effects of probiotics on oral malodour have also been evaluated, but further evidence is needed to fully explore the potential of probiotics for preventing malodour.

  17. Oral health during pregnancy.

    Science.gov (United States)

    Silk, Hugh; Douglass, Alan B; Douglass, Joanna M; Silk, Laura

    2008-04-15

    Oral health care in pregnancy is often avoided and misunderstood by physicians, dentists, and patients. Evidence-based practice guidelines are still being developed. Research suggests that some prenatal oral conditions may have adverse consequences for the child. Periodontitis is associated with preterm birth and low birth weight, and high levels of cariogenic bacteria in mothers can lead to increased dental caries in the infant. Other oral lesions, such as gingivitis and pregnancy tumors, are benign and require only reassurance and monitoring. Every pregnant woman should be screened for oral risks, counseled on proper oral hygiene, and referred for dental treatment when necessary. Dental procedures such as diagnostic radiography, periodontal treatment, restorations, and extractions are safe and are best performed during the second trimester. Xylitol and chlorhexidine may be used as adjuvant therapy for high-risk mothers in the early postpartum period to reduce transmission of cariogenic bacteria to their infants. Appropriate dental care and prevention during pregnancy may reduce poor prenatal outcomes and decrease infant caries.

  18. 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

  19. Squamous cell carcinoma of the oral cavity

    International Nuclear Information System (INIS)

    Lindeloev, B.; Kirkegaard, J.; Hansen, H.S.; Copenhagen Univ. Hospital

    1990-01-01

    Three hundred and four patients with squamous cell carcinomas of the oral cavity were treated at the Finsen Institute in cooperation with the ENT-surgical departments between 1978 and 1982. The primary treatment consisted of radiotherapy alone in 74%, surgery alone in 4%, and a combination of radiotherapy and surgery in 15% of the patients. 2% received other treatment (cryotherapy), 5% did not complete the planned radiotherapy, and 1% were not treated at all. Of 203 patients with tumour remnant or first recurrence, 45% were operated, 2% received radiotherapy, and 2% combined treatment. This treatment strategy made 38% of the patients free of disease in the follow-up period (3 1/2 to 8 years) or until the patients died from other causes. Fifty-nine percent of the patients died from their oral carcinomas. Tumour size (T), lymph node status (N), and tumour stage were as expected important prognostic factors. (orig.)

  20. Early diagnosis in primary oral cancer: is it possible?

    NARCIS (Netherlands)

    van der Waal, I.; de Bree, R.; Brakenhoff, R.; Coebergh, J.W.

    2011-01-01

    In this treatise oral carcinogenesis is briefly discussed, particularly with regard to the number of cell divisions that is required before cancer reaches a measurable size. At that stage, metastatic spread may have already taken place. Therefore, the term "early diagnosis" is somewhat misleading.

  1. Defining the healthy "core microbiome" of oral microbial communities

    NARCIS (Netherlands)

    Zaura, E.; Keijser, B.J.; Huse, S.M.; Crielaard, W.

    2009-01-01

    Background. Most studies examining the commensal human oral microbiome are focused on disease or are limited in methodology. In order to diagnose and treat diseases at an early and reversible stage an in-depth definition of health is indispensible. The aim of this study therefore was to define the

  2. Defining the healthy "core microbiome" of oral microbial communities

    NARCIS (Netherlands)

    Zaura, E.; Keijser, B.J.F.; Huse, S.M.; Crielaard, W.

    2009-01-01

    Background: Most studies examining the commensal human oral microbiome are focused on disease or are limited in methodology. In order to diagnose and treat diseases at an early and reversible stage an in-depth definition of health is indispensible. The aim of this study therefore was to define the

  3. Treponemicidal levels of amoxicillin in cerebrospinal fluid after oral administration

    NARCIS (Netherlands)

    Faber, W. R.; Bos, J. D.; Rietra, P. J.; Fass, H.; van Eijk, R. V.

    1983-01-01

    Seven patients in various stages of syphilis were treated by oral administration of amoxicillin (6 g daily) and probenecid (2 g daily) for 15 days. The treponemicidal level of amoxicillin was studied by a Treponema pallidum immobilization assay and found to be 0.070 micrograms/ml, as compared with

  4. Alzheimer’s disease: oral manifestations, treatment and preventive measures.

    Directory of Open Access Journals (Sweden)

    Jordi Ortega-Martínez

    2014-08-01

    Full Text Available In the treatment of patients with dementia types such as Alzheimer’s, non-current and tough situations are faced. Treatment should be tailored to each stage of the disease and for each patient. In this type of disease, it is very important to involve families and caregivers to improve the patients´ quality of life. The main goal with these patients is prevention. All oral manifestations caused by the lack of inadequate oral hygiene, xerostomia and manifestations derived from taking drugs should be controlled. The aim of this review is to describe the main oral manifestations which can result from this disease and the best treatment options taking into account the patients’ clinical stages.

  5. Malignant melanoma of the oral cavity: Report of two cases

    Directory of Open Access Journals (Sweden)

    Anita Munde

    2014-01-01

    Full Text Available Primary malignant melanoma is a rare and aggressive neoplasm that originates from the proliferation of melanocytes. Although, it comprises 1.3% of all cancers, malignant melanoma of the oral cavity accounts for only 0.2-8% of all reported melanomas and occurs approximately 4 times more frequently in the oral mucosa of the upper jaw, usually on the palate or alveolar gingivae. Most of the mucosal melanomas are usually asymptomatic in early stages, and presents as pigmented patch or a mass delaying the diagnosis until symptoms of swelling, ulceration, bleeding, or loosening of teeth are noted. The prognosis is extremely poor, especially in advanced stages. Therefore, any pigmented lesion of undetermined origin should always be biopsied. We herewith report of two cases of oral malignant melanoma in a 60 and 75-year-old female.

  6. End-stage kidney disease

    Science.gov (United States)

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

  7. Effect of Tetracycline on Late-stage African trypanosomiasis in Rats

    African Journals Online (AJOL)

    Dr. J. T. Ekanem

    bone marrow and tissue fluids, and in the second stage (late-stage) it penetrate the central nervous system and cerebrospinal fluid. (Masake et al, 1997). Therapy .... drug in the spinal fluid over a period of 6 hours. Oral therapy yields very low spinal fluid concentrations. The rickettsial disorders which are diseases involving ...

  8. Fluoride and Oral Health

    DEFF Research Database (Denmark)

    O'Mullane, D M; Baez, R J; Jones, S

    2016-01-01

    The discovery during the first half of the 20th century of the link between natural fl uoride, adjusted fl uoride levels in drinking water and reduced dental caries prevalence proved to be a stimulus for worldwide on-going research into the role of fl uoride in improving oral health...... including salt, milk, tablets, toothpaste, gels and varnishes. In 1993, the World Health Organization convened an Expert Committee to provide authoritative information on the role of fl uorides in the promotion of oral health throughout the world (WHO TRS 846, 1994). This present publication is a revision...... of the original 1994 document, again using the expertise of researchers from the extensive fi elds of knowledge required to successfully implement complex interventions such as the use of fl uorides to improve dental and oral health. Financial support for research into the development of these new fl uoride...

  9. Oral pregnancy tumor

    Directory of Open Access Journals (Sweden)

    Shailesh M Gondivkar

    2010-01-01

    Full Text Available Pyogenic granuloma is one of the inflammatory hyperplasias seen in the oral cavity. This term is a misnomer because the lesion is unrelated to infection and in reality arises in response to various stimuli such as low-grade local irritation, traumatic injury, or hormonal factors. It predominantly occurs in the second decade of life in young females, possibly because of the vascular effects of female hormones. Clinically, oral pyogenic granuloma is a smooth or lobulated exophytic lesion manifesting as small, red erythematous growth on a pedunculated or sometimes sessile base, which is usually hemorrhagic. Although excisional surgery is the treatment of choice , some other treatment protocols such as the use of Nd:YAG laser, flash lamp pulsed dye laser, cryosurgery, intralesional injection of ethanol or corticosteroids, and sodium tetradecyl sulfate sclerotherapy have been proposed. We present the case of a 25-year-old pregnant woman with large oral pyogenic granuloma.

  10. Oral varix: a review.

    Science.gov (United States)

    Lazos, Jerónimo P; Piemonte, Eduardo D; Panico, René L

    2015-06-01

    Ageing produces several changes on the oral cavity, and oral varix (OV) is among the most common, and they are related with some medical diseases; however, this association is not clear. The aim of this article is to offer a review of OV, regarding aetiology, clinical and histological features, associated factors, treatment and its clinical significance. Except for a higher incidence of OV in elder individuals, there is limited evidence that supports its relationship with medical conditions such us cardiovascular diseases or portal hypertension. Also, there is no consensus regarding its pathogenesis, but the hemodynamic theory embodies the most comprehensive approach. The high prevalence in elderly people stresses the need for regular oral examination, but more detailed studies regarding OV in relation to systemic diseases are needed. © 2013 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

  11. Stage theta pinch experiments

    International Nuclear Information System (INIS)

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

    1975-01-01

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

  12. "Stage 40" Handbook.

    Science.gov (United States)

    Mill River Union High School, North Clarendon, VT.

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

  13. World Stage Design

    Index Scriptorium Estoniae

    2005-01-01

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

  14. Linac project - actual stage

    International Nuclear Information System (INIS)

    Carlin Filho, N.

    1990-01-01

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

  15. stage/page/play

    DEFF Research Database (Denmark)

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

  16. Rationality in prophylactic central neck dissection in clinically node-negative (cN0) papillary thyroid carcinoma: Is there anything more to say? A decade experience in a single-center.

    Science.gov (United States)

    Dobrinja, C; Troian, M; Cipolat Mis, T; Rebez, G; Bernardi, S; Fabris, B; Piscopello, L; Makovac, P; Di Gregorio, F; de Manzini, N

    2017-05-01

    Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. Despite its extremely favorable prognosis, cervical lymph node metastases are a common feature of PTC and a known independent risk factor for local recurrence. However, the role of prophylactic central neck dissection (PCND) remains a matter of debate in patients with clinically node-negative (cN0) PTC. To better clarify the current role of PCND in the surgical treatment of PTC, evaluating advantages and disadvantages of PCND and outcome of cN0 PTC patients who have been treated with either total thyroidectomy alone or in combination with PCND. A review of recent literature data is performed. Between January 2000 and December 2015, 186 consecutive patients with cN0 PTC were identified to be included in the present study. 74 of these underwent total thyroidectomy associated with PCND, while 112 patients underwent total thyroidectomy alone. The epidemiological and clinical-pathological data of all patients included were collected at diagnosis and during follow-up. Overall complication rate was significantly higher in the group of patients undergoing PCND (39.2% vs. 17.8%, p = 0.0006). To be specific, they presented a considerably increased risk of temporary recurrent laryngeal nerve injury (p = 0.009) and of permanent hypothyroidism (p = 0.016). Overall survival and recurrence rates did not differ between those undergoing PCND and those undergoing total thyroidectomy alone (p = 1.000 and p = 0.715, respectively). The results of the present study do not support the routine use of PCND in the treatment of cN0 PTC patients. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Oral Microbiology and Immunology

    DEFF Research Database (Denmark)

    Dahlén, Gunnar; Fiehn, Nils-Erik; Olsen, Ingar

    , dental assistants and trainees may find it a useful source of reference. The contents are based on general microbiology and immunology. Oral microbiology is given particular attention, with examples relevant to oral infectious diseases. Each chapter opens with a relatively short pre-reading section......This textbook is based on the curricula for dental students in the Nordic countries, and the authors teach the subject at three universities in Denmark, Norway and Sweden. Although primarily for undergraduates, the book may also appeal to Ph.D. students and general practitioners. In addition...

  18. Sclerotherapy for oral hemangioma

    Directory of Open Access Journals (Sweden)

    Navadeepak Korvipati

    2016-01-01

    Full Text Available Hemangiomas are well-known benign neoplasms of the body most commonly occurring in the head and neck region and less commonly in the oral cavity. The predominant site of occurrence, in the oral cavity, is lips followed by gingiva, tongue and palate. Treatment is primarily dependent on correct diagnosis of the lesion and its anatomic location. Here, we report a case of hemangioma on posterior third of the tongue in 34-year-old male patient, who was treated by sclerotherapy with sodium tetradecylsulphate (setrol sclerosing agent.

  19. Oral lichen planus

    International Nuclear Information System (INIS)

    Rasool, S.; Katpar, S.; Ali, A.

    2007-01-01

    Lichen planus is a mucocutaneous dermatological disorder, with intraoral manifestation. Skin lesions prevail with oral mucosal lesions. Prevalence of lichen planus, as an oral pre-malignant lesion, is 1-2 % population. Lateral border, dorsal tongue, gingiva, hard palate and vermilion border are common sites and lesions appear as reticular, plaque-like and papular intraoral types. Skin presents with pururitic, polygonal papules. Atrophic and erosive are the known intraoral pre-malignant types. A case report is presented, which responded well to steroid therapy. (author)

  20. Maintaining oral health after stroke.

    Science.gov (United States)

    Dickinson, Hazel

    Oral care is essential to maintain oral health and prevent complications such as tooth loss, gingivitis and periodontitis. Poor oral hygiene in dependent, hospitalised patients could lead to serious complications such as chest infection, pneumonia, poor nutritional intake and increased length of hospital stay. Patients who have had a stroke may have physical and cognitive problems that make them dependent on others for their personal care, including oral care. It is essential that nurses and carers understand why maintaining oral hygiene is important following stroke and the consequences of poor oral care.

  1. C13. Invasão Vascular como factor prognóstico em carcinomas do pulmão não pequenas células (CPNPC, completamente ressecados (pT1-2N0M0

    Directory of Open Access Journals (Sweden)

    Fernando Barata

    2003-11-01

    ão vascular parece preditivo duma ocorrência mais precoce de doença recidivante local ou sistémica. : The complete resection of local limited non-small cell lung cancer (NSCLC represents the therapy of choice. Nevertheless 35% of patients with a stage I and 60% with a stage II, have a local or systemic relapse.It was our aim to evaluate the influence of vessels invasion (blood vessels and lymphatic on survival rate.We made a retrospective study including 58 patients, with pathologic stage I (pT1-2 N0 M0; 42 men, 16 women; median age=63 (35-81. Smokers=36 (62%. T1N0M0=6, T2N0M0=52.In these patients were performed 49 lobectomies, 1 bilobectomie and 8 pneumectomies, always with systematic lymphadenectomy. We found 29 (50% adenocarcinomas, 5 (8% bronquioloalveolar carcinomas, 21 (37% squamous carcinomas and 3 (5% large cell carcinomas. 6 of these cases had exclusive vascular invasion, 11 exclusive visceral pleural invasion, 13 visceral and vascular invasion and the last 28 cases had no vascular or visceral invasion. In the 30 patients with vascular or pleural invasion, were performed adjuvant chemotherapy: four patients carboplatin with etoposide; fifteen patients carboplatin with gemcitabine and eleven patients carboplatin with vinorelbine.Only nineteen of the patients have a 5 year follow-up (five-year survival rate=79%. 42 patients have already a 2-year follow-up. The global 2-year survival rate is 83% being 40% for those with vascular invasion, in opposition to 94% for those without vascular invasion (statistically significant.In conclusion, for NSCLC, stage I, the presence of vascular invasion seems to be predictive of a more premature local or systemic metastatic disease. Palavras-chave: Carcinoma pulmonar não-pequenas células, prognóstico, invasão vascular, Key-words: Non-small cell lung carcinoma, prognosis, vascular invasion

  2. Oral and written instruction of oral hygiene: a randomized trial.

    Science.gov (United States)

    Harnacke, Daniela; Beldoch, Magdalena; Bohn, Gertrude-Heidi; Seghaoui, Ouarda; Hegel, Nicole; Deinzer, Renate

    2012-10-01

    This randomized, evaluator-masked, controlled study evaluates the effectiveness of oral in contrast to written instruction of oral hygiene. Eighty-three students without clinical signs of periodontitis were randomly assigned to either a control group or one of three experimental conditions: 1) written instruction, 2) standardized oral instruction, or 3) individualized oral instruction. Plaque and bleeding indices were assessed to analyze intervention effects on oral health and oral hygiene skills. Measurements took place at baseline and 4 weeks after intervention. Groups differed significantly with respect to gingival bleeding and were tentatively significant with respect to oral hygiene skills. Participants who had received oral individualized instructions showed the best results. A gradient of effectiveness of the instruction methods was observed with most favorable results for the individualized instruction.

  3. Inequalities in oral health and oral health promotion

    OpenAIRE

    Moysés, Samuel Jorge

    2012-01-01

    This article offers a critical review of the problem of inequalities in oral health and discusses strategies for disease prevention and oral health promotion. It shows that oral health is not merely a result of individual biological, psychological, and behavioral factors; rather, it is the sum of collective social conditions created when people interact with the social environment. Oral health status is directly related to socioeconomic position across the socioeconomic gradient in almost all...

  4. Probiotics as oral health biotherapeutics.

    Science.gov (United States)

    Saha, Shyamali; Tomaro-Duchesneau, Catherine; Tabrizian, Maryam; Prakash, Satya

    2012-09-01

    Oral health is affected by its resident microorganisms. Three prominent oral disorders are dental caries, gingivitis and periodontitis, with the oral microbiota playing a key role in the initiation/progression of all three. Understanding the microbiota and the diseases they may cause is critical to the development of new therapeutics. This review is focused on probiotics for the prevention and/or treatment of oral diseases. This review describes the oral ecosystem and its correlation with oral health/disease. The pathogenesis and current prevention/treatment strategies of periodontal diseases (PD) and dental caries (DC) are depicted. An introduction of probiotics is followed by an analysis of their role in PD and DC, and their potential role(s) in oral health. Finally, a discussion ensues on the future research directions and limitations of probiotics for oral health. An effective oral probiotic formulation should contribute to the prevention/treatment of microbial diseases of the oral cavity. Understanding the oral microbiota's role in oral disease is important for the development of a therapeutic to prevent/treat dental diseases. However, investigations into clinical efficacy, delivery/dose optimization, mechanism(s) of action and other related parameters are yet to be fully explored. Keeping this in mind, investigations into oral probiotic therapies are proving promising.

  5. Early diagnosis in primary oral cancer: is it possible?

    Science.gov (United States)

    van der Waal, Isaäc; de Bree, Remco; Brakenhoff, Ruud; Coebergh, Jan-Willem

    2011-05-01

    In this treatise oral carcinogenesis is briefly discussed, particularly with regard to the number of cell divisions that is required before cancer reaches a measurable size. At that stage, metastatic spread may have already taken place. Therefore, the term "early diagnosis" is somewhat misleading. The delay in diagnosis of oral cancer is caused both by patients' delay and doctors' delay. The total delay, including scheduling delay, work-up delay and treatment planning delay, varies in different studies, but averages some six months. The total delay is more or less evenly distributed between patients' and doctors' delay and is partly due to the unawareness of oral cancer among the public and professionals, and partly to barriers in the health care system that may prevent patients from seeking dental and medical care. Due to the relatively low incidence of oral cancer it will be difficult to increase the awareness of this cancer type among the public, thereby reducing patients' delay. However, it should be possible to considerably reduce doctors' delay by increasing the awareness of oral cancer among professionals and by improving their diagnostic ability. Population-based annual or semi-annual screening for oral cancer is not cost-effective, high-risk groups such as heavy smokers and drinkers perhaps excluded. Dentists and physicians, and also oral hygienists and nurse practitioners, may play a valuable role in such screening programs.

  6. Fine oral filaments in Paramecium: a biochemical and immunological analysis.

    Science.gov (United States)

    Clerot, J; Iftode, F; Budin, K; Jeanmaire-Wolf, R; Coffe, G; Fleury-Aubusson, A

    2001-01-01

    In Paramecium, several kinds of the oral networks of fine filaments are defined at the ultrastructural level. Using the sodium chloride-treated oral apparatus of Paramecium as an antigen to produce monoclonal antibodies, we have begun to identify the proteins constituting these networks. Immunoblotting showed that all positive antibodies were directed against three bands (70-, 75-and 83-kD), which corresponded to quantitatively minor components of the antigen; there was no antibody specific for the quantitatively major components (58- and 62-kD). Immunolocalization with four of these antibodies directed against one or several of these three bands showed that these proteins are components of the fine filaments supporting the oral area; a decoration of the basal bodies and the outer lattice was also observed on the cortex. Immunofluorescence on interphase cells suggested that the three proteins colocalized on the left side of the oral apparatus, whereas only the 70-kD band was detected on the right side. During division, the antigens of the antibodies were detected at different stages after oral basal body assembly. The antibodies cross-reacted with the tetrins, which are oral filament-forming proteins in Tetrahymena, demonstrating that tetrin-related proteins are quantitatively minor components of the oral and the somatic cytoskeleton of Paramecium.

  7. Oral biofilms, oral and periodontal infections, and systemic disease.

    Science.gov (United States)

    Maddi, Abhiram; Scannapieco, Frank A

    2013-10-01

    Oral biofilms harbor several hundreds of species of bacteria as well as spirochetes, protozoa, fungi and viruses. The composition of the oral biofilm varies from health to disease. It is the source of microorganisms that cause dental and periodontal infections. Oral infections and periodontal disease have been implicated in the etiopathogenesis of several important chronic systemic diseases.

  8. Oral hygiene practices and risk of oral leukoplakia | Macigo | East ...

    African Journals Online (AJOL)

    Objective: To determine the influence of oral hygiene habits and practices on the risk of developing oral leukoplakia. Design: Case control study. Setting: Githongo sublocation in Meru District. Subjects: Eighty five cases and 141 controls identified in a house-to-house screening. Results: The relative risk (RR) of oral ...

  9. The New Orality: Oral Characteristics of Computer-Mediated Communication.

    Science.gov (United States)

    Ferris, Sharmila Pixy; Montgomery, Maureen

    1996-01-01

    Considers the characteristics of orality and literacy developed in the work of scholars such as Walter Ong to consider computer-mediated communication (CMC) as the potential site of a "new orality" which is neither purely oral or literate. Notes that the medium of CMC is writing, which has traditionally represented the…

  10. Metabolomic Studies of Oral Biofilm, Oral Cancer, and Beyond.

    Science.gov (United States)

    Washio, Jumpei; Takahashi, Nobuhiro

    2016-06-02

    Oral diseases are known to be closely associated with oral biofilm metabolism, while cancer tissue is reported to possess specific metabolism such as the 'Warburg effect'. Metabolomics might be a useful method for clarifying the whole metabolic systems that operate in oral biofilm and oral cancer, however, technical limitations have hampered such research. Fortunately, metabolomics techniques have developed rapidly in the past decade, which has helped to solve these difficulties. In vivo metabolomic analyses of the oral biofilm have produced various findings. Some of these findings agreed with the in vitro results obtained in conventional metabolic studies using representative oral bacteria, while others differed markedly from them. Metabolomic analyses of oral cancer tissue not only revealed differences between metabolomic profiles of cancer and normal tissue, but have also suggested a specific metabolic system operates in oral cancer tissue. Saliva contains a variety of metabolites, some of which might be associated with oral or systemic disease; therefore, metabolomics analysis of saliva could be useful for identifying disease-specific biomarkers. Metabolomic analyses of the oral biofilm, oral cancer, and saliva could contribute to the development of accurate diagnostic, techniques, safe and effective treatments, and preventive strategies for oral and systemic diseases.

  11. ORAL HYGIENE PRACTICES AND RISK OF ORAL LEUKOPLAKIA

    African Journals Online (AJOL)

    2006-04-01

    Apr 1, 2006 ... Results: The relative risk (RR) of oral leukoplakia increased gradually across the various brushing .... results of the assessment of other oral leukoplakia ... survey of persons aged 15 years and above aimed at identifying the study subjects. The screening yielded 85 oral leukoplakia cases identified on the.

  12. [Oral lymphomas in AIDS].

    Science.gov (United States)

    Llanes, F; López, G; Asenjo, J A; Martín, C

    1989-05-01

    We present two cases of AIDS in drug-addicts, with mouth lymphoma. The diagnosis was established by a gum biopsy which gave high-grade non-Hodgkin lymphoma lymphoblastic "B" type. It is very rare that the oral mucous is affected by lymphomas, but in AIDS and immunodeficiencies it is more common.

  13. Oral Health and Women

    Centers for Disease Control (CDC) Podcasts

    2009-05-12

    This women's health podcast focuses on the importance of maintaining good oral health during pregnancy.  Created: 5/12/2009 by Office of Women’s Health (OWH) and National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/12/2009.

  14. Evaluation and Oral Communication.

    Science.gov (United States)

    McLeod, Alan M., Ed.

    1984-01-01

    Articles in this journal issue focus primarily on evaluation in the language arts and oral communication. Following an introduction to the two themes, the articles discuss the following: (1) pop quizzes in literature, (2) holistic scoring, (3) self-evaluation strategies in prewriting and rewriting, (4) what not to do in student/teacher…

  15. Choosing an oral contraceptive.

    Science.gov (United States)

    Weisberg, E

    1988-10-01

    This article serves as a summary of the principles of prescription, hormone content, minor side effects, prescriptions for atypical individuals and significant drug interactions for oral contraceptives. There are 5 principles for prescribing oral contraceptives: the lowest possible dose should be given that is effective and produces the least side effects: adequate instructions should be given about the mode of action, taking the medication and possible side effects; adequate instructions about managing missed pills should be given; adequate supervision and explanations should be given if side effects occur; remember that each woman is different and idiosyncratic reactions to different formulations can occur. Possible side effects include: breakthrough bleeding, amenorrhoea, dysmenorrhoea, breast fullness and tenderness, nausea, chloasma, depression, acne, migraines and weight gain. Certain individuals such as epileptics, diabetics, women over 35 and women who have recently given birth need special care. Rifampicin, the phenytoins and barbiturates can all decrease the effectiveness of oral contraceptives. Oral contraceptives may effect the action of anticoagulants, antidiabetic agents and imipramine.

  16. Oral heparin (Emisphere).

    Science.gov (United States)

    Dunn, A

    2000-07-01

    Emisphere (formerly in collaboration with Elan) is developing an oral heparin formulation for the potential treatment of deep vein thrombosis (DVT). The formulation uses Emisphere's proprietary carrier molecule, P-414, and had started phase III trials by January 2000 [353372]. The protocol for the trials was finalized in December 1999, and aims to demonstrate the safety and superior efficacy of oral heparin dosed for 30 days post-operatively compared to injectable enoxaparin sodium for 10 days, in the prevention of DVT following hip-replacement surgery. The studies will take place in 95 centers in the US, UK and Canada, and are expected to enroll 2250 patients [350778]. The two trials involved are expected to be completed by mid-2001 [353372]. In May 1998, Emisphere initiated a phase II study for its oral heparin product for the prevention of DVT. The study had three arms of approximately 40 patients each, who had undergone surgery for hip replacement, and was conducted at approximately 20 sites in the US and Canada. Two different doses of oral heparin were compared to subcutaneous heparin. The objective was to demonstrate that the orally administered heparin is well tolerated and comparable to subcutaneous heparin in preventing DVT [288267]. Positive preliminary results were reported in January 1999, showing that the oral formulations were comparable to injectable heparin [311218]. Final results, reported in August 1999, demonstrated that heparin administered orally via a novel carrier system (P-414; SNAC) was comparable, in both safety and activity, to subcutaneous heparin when used to prevent venous thromboembolic events following elective hip arthroplasty [337262,337712]. The heparin formulation was developed as part of a collaboration between Emisphere and Elan investigating oral formulations of heparin and heparinoids. By January 1998, the lead product had completed four phase I trials in patients following knee and hip surgery [274905]. Results from phase I

  17. Oral cancer pain.

    Science.gov (United States)

    Dios, Pedro Diz; Lestón, Juan Seoane

    2010-06-01

    Pain may be the initial symptom in oral cancer, and is a common complaint both in patients awaiting treatment and in those already in treatment. However, little has been published in the literature on the management of oral cancer pain. Effective pain control requires a multimodal approach in which pharmacological management based on the World Health Organization (WHO) analgesic ladder continues to play an essential role. Although different routes are available for the administration of analgesics, oral delivery continues to be the principal route for pain control in the first instance. Interventional approaches include blockade of a peripheral nerve or of the relevant ganglion, and the use of central neuraxial blockade. The intraventricular or intrathecal administration of opioids, with or without local anaesthetics, has been indicated for severe intractable pain. The development of new treatment modalities provides additional options, though further clinical research is required. There is no evidence of the efficacy of non-pharmacological methods such as acupuncture or transcutaneous nerve stimulation in the management of oral cancer pain. Surgery, radiation therapy, and chemotherapy have also been suggested, but their results have not been quantified. Copyright 2010 Elsevier Ltd. All rights reserved.

  18. Staging Collaborative Innovation Processes

    DEFF Research Database (Denmark)

    Pedersen, Signe; Clausen, Christian

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

  19. Staging Sociotechnical Spaces

    DEFF Research Database (Denmark)

    Clausen, Christian; Yoshinaka, Yutaka

    2007-01-01

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

  20. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... tissues of the face, mouth and gums to improve function, appearance and oral health. Click here to ... tissues of the face, mouth and gums to improve function, appearance and oral health. Click here to ...

  1. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Contact Find a Surgeon What We Do Anesthesia Anesthesia Oral and maxillofacial surgeons are extensively trained to ... and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are extensively trained to ...

  2. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... mouth and gums to improve function, appearance and oral health. Click here to find out more. Facial Cosmetic ... mouth and gums to improve function, appearance and oral health. Click here to find out more. Facial Cosmetic ...

  3. Oral epithelial dysplasia classification systems

    DEFF Research Database (Denmark)

    Warnakulasuriya, S; Reibel, J; Bouquot, J

    2008-01-01

    . In this report, we review the oral epithelial dysplasia classification systems. The three classification schemes [oral epithelial dysplasia scoring system, squamous intraepithelial neoplasia and Ljubljana classification] were presented and the Working Group recommended epithelial dysplasia grading for routine...

  4. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... at risk for oral cancer? Learn the facts. White patches of the oral tissues — leukoplakia Red patches — erythroplakia Red and white patches — erythroleukoplakia A sore that fails to heal ...

  5. Cryogun cryotherapy for oral leukoplakia.

    Science.gov (United States)

    Lin, Hung-Pin; Chen, Hsin-Ming; Cheng, Shih-Jung; Yu, Chuan-Hang; Chiang, Chun-Pin

    2012-09-01

    Our previous study showed that cotton-swab cryotherapy is an alternative treatment modality for oral leukoplakia. This study used liquid nitrogen spray with a cryogun (cryogun cryotherapy) to treat 60 oral leukoplakia lesions. Complete regression was achieved in all 60 oral leukoplakia lesions after cryogun cryotherapy. We found that 60 oral leukoplakia lesions treated with cryogen cryotherapy needed significantly fewer mean treatments (3.1 ± 1.3) to achieve complete regression than 60 previously reported oral leukoplakia lesions treated with cotton-swab cryotherapy (mean, 6.3 ± 3.8 treatments). Oral leukoplakia lesions on oral mucosal sites other than the tongue, oral leukoplakia, the cryogun cryotherapy needed fewer mean treatments to achieve complete regression of the lesions than the cotton-swab cryotherapy. Copyright © 2011 Wiley Periodicals, Inc.

  6. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... for further information Your oral and maxillofacial surgeon (OMS) is the expert for diagnosing and surgically treating ... late in its development. Your family dentist or OMS is in the best position to detect oral ...

  7. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... and training in surgical procedures involving skin, muscle, bone and cartilage finely attune the oral and maxillofacial ... and training in surgical procedures involving skin, muscle, bone and cartilage finely attune the oral and maxillofacial ...

  8. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... finely attune the oral and maxillofacial surgeon to the need for harmony between facial appearance and function. As ... finely attune the oral and maxillofacial surgeon to the need for harmony between facial appearance and function. As ...

  9. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

  10. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Oral and maxillofacial surgeons surgically treat the soft tissues of the face, mouth and gums to improve ... Oral and maxillofacial surgeons surgically treat the soft tissues of the face, mouth and gums to improve ...

  11. Calibration of Nanopositioning Stages

    Directory of Open Access Journals (Sweden)

    Ning Tan

    2015-12-01

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

  12. Different effects of ERβ and TROP2 expression in Chinese patients with early-stage colon cancer.

    Science.gov (United States)

    Fang, Yu-Jing; Wang, Guo-Qiang; Lu, Zhen-Hai; Zhang, Lin; Li, Ji-Bin; Wu, Xiao-Jun; Ding, Pei-Rong; Ou, Qing-Jian; Zhang, Mei-Fang; Jiang, Wu; Pan, Zhi-Zhong; Wan, De-Sen

    2012-12-01

    Estrogen receptor beta (ERβ) and TROP2 expressed in colon carcinoma and might play an important role there. We explored the relationship of ERβ and TROP2 expression with the prognosis of early-stage colon cancer. ERβ and TROP2 levels were assessed by immunohistochemistry in normal mucosa and tumoral tissues from 220 Chinese patients with T(3)N(0)M(0) (stage IIa) and T(4)N(0)M(0) (stage IIb) colon cancer in the Cancer Center, Sun Yat-sen University, who underwent curative surgical resection between 1995 and 2003. The Cox proportional hazards regression model was applied to analyze the overall survival (OS) data, and the ROC curve, Kaplan-Meier estimate, log rank test, and Jackknife method were used to show the effect of ERβ and TROP2 expression at different stages of cancer. The 5-year survival rates were not significantly different between the patients with stage IIa and stage IIb colon cancer (83 vs. 80 %, respectively). The high expression of ERβ was related to decreasing OS in stage IIa and stage IIb colon cancer, while the high expression of TROP2 was related to decreasing OS in stage IIb colon cancer. The expression of ERβ and TROP2 has tumor-suppressive and tumor-promoting effect in stage IIa and stage IIb colon cancer, respectively.

  13. Correlation of serum biomarkers (TSA & LSA) and epithelial dysplasia in early diagnosis of oral precancer and oral cancer.

    Science.gov (United States)

    Sawhney, Hemant; Kumar, C Anand

    Oral cancer is currently the most frequent cause of cancer-related deaths, which is usually preceded by oral pre-cancerous lesions and conditions. Altered glycosylation of glycoconjugates, such as sialic acid, fucose, etc. are amongst the important molecular changes that accompany malignant transformation. The purpose of our study was to evaluate usefulness of serum Total Sialic Acid (TSA) and serum Lipid-Bound Sialic Acid (LSA) as markers of oral precancerous lesions and histopathologically correlating them with grades of epithelial dysplasia. Blood samples were collected from 50 patients with oral precancer (Leukoplakia & OSMF), 25 patients with untreated oral cancer and 25 healthy subjects. Serum sialic acid (total and lipid bound) levels were measured spectrophotometrically. Tissue samples from all the patients were evaluated for dysplasia. Serum levels of total and lipid bound sialic acid were significantly elevated in patients with oral precancer and cancer when compared with healthy subjects. Analysis of variance test documented that there is progressive rise in serum levels of sialic acid with the degree of dysplastic changes in oral precancer patients. We observed positive correlation between serum levels of the markers and the extent of malignant disease (TNM Clinical staging) as well as histopathological grades. The results suggested that serum levels of TSA and LSA progressively increases with grades of dysplasia in precancerous groups and cancer group, when compared with healthy controls. These glycoconjugates, especially LSA has the clinical utility in indicating a premalignant change.

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

    Directory of Open Access Journals (Sweden)

    Pruijt Hans FM

    2011-05-01

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

  15. Oral care of hospitalized children

    OpenAIRE

    Machalová, Andrea

    2013-01-01

    This bachelor's thesis deals with the care of oral cavity for hospitalized children and compares the standards of oral cavity care for children hospitalized in standard pediatric wards with those for children hospitalized in the pediatric bone marrow transplant unit. The thesis provides the anatomical and physiological beckground information on oral care, describes the most common pathological issues, stresses the importance of proper mouth care and explains how to practise oral hygiene and s...

  16. Changeability of Oral Cavity Environment

    OpenAIRE

    Surdacka, Anna; Strzyka?a, Krystyna; Rydzewska, Anna

    2007-01-01

    Objectives In dentistry, the results of in vivo studies on drugs, dental fillings or prostheses are routinely evaluated based on selected oral cavity environment parameters at specific time points. Such evaluation may be confounded by ongoing changes in the oral cavity environment induced by diet, drug use, stress and other factors. The study aimed to confirm oral cavity environment changeability. Methods 24 healthy individuals aged 20?30 had their oral cavity environment prepared by having p...

  17. Age-related oral changes.

    LENUS (Irish Health Repository)

    Mckenna, Gerald

    2010-10-01

    Age-related oral changes are seen in the oral hard and soft tissues as well as in bone, the temporomandibular joints and the oral mucosa. As older patients retain their natural teeth for longer, the clinical picture consists of normal physiological age changes in combination with pathological and iatrogenic effects. Clinical Relevance: With an ageing population retaining more of its natural teeth for longer, dental professionals should expect to observe oral age changes more frequently.

  18. Clinical consequences of oral mucositis.

    Science.gov (United States)

    Brown, Carlton G; Wingard, John

    2004-02-01

    To identify the clinical manifestations, risk factors, secondary complications, and assessment and management of oral mucositis. Professional journals, websites, and books. Secondary consequences of oral mucositis include infection, xerostomia, hemorrhage, and nutritional deficits. Nurses should have an extensive knowledge base about the appropriate interventions that can be used to alleviate or lessen the consequences often associated with oral mucositis.

  19. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... cancer of the head, neck and mouth. The Oral Cancer Foundation estimates that close to 42,000 Americans ... diagnosed with oral or pharyngeal cancer this year. Oral cancer’s mortality is particularly high, not because it is ...

  20. EAMJ-MArch Oral health

    African Journals Online (AJOL)

    iMac User

    2008-03-01

    Mar 1, 2008 ...