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Sample records for standard axillary fields

  1. Routine use of standard breast MRI compared to axillary ultrasound for differentiating between no, limited and advanced axillary nodal disease in newly diagnosed breast cancer patients

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    Nijnatten, T.J.A. van, E-mail: Thiemovn@gmail.com [Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht (Netherlands); Department of Surgery, Maastricht University Medical Center+, Maastricht (Netherlands); GROW – School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht (Netherlands); Ploumen, E.H. [Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht (Netherlands); Department of Surgery, Maastricht University Medical Center+, Maastricht (Netherlands); Schipper, RJ. [Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht (Netherlands); Department of Surgery, Maastricht University Medical Center+, Maastricht (Netherlands); GROW – School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht (Netherlands); Department of Surgery, Catharina Hospital, Eindhoven (Netherlands); Goorts, B. [Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht (Netherlands); Department of Surgery, Maastricht University Medical Center+, Maastricht (Netherlands); GROW – School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht (Netherlands); Andriessen, E.H. [Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht (Netherlands); Department of Surgery, Maastricht University Medical Center+, Maastricht (Netherlands); Vanwetswinkel, S.; Schavemaker, M. [Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht (Netherlands); Nelemans, P. [Department of Epidemiology, Maastricht University Medical Center+, Maastricht (Netherlands); Vries, B. de [Department of Pathology, Zuyderland Hospital, Heerlen (Netherlands); and others

    2016-12-15

    Objectives: To compare standard breast MRI to dedicated axillary ultrasound (with or without tissue sampling) for differentiating between no, limited and advanced axillary nodal disease in breast cancer patients. Methods: All patients who underwent breast MRI and dedicated axillary ultrasound between 2009 and 2014 were eligible. Exclusion criteria were recurrent disease, neoadjuvant systemic therapy and not receiving completion axillary lymph node dissection after positive sentinel lymph node biopsy (SLNB). Two radiologists independently reassessed all MRI exams. Axillary ultrasound findings were retrospectively collected. Probability of advanced axillary nodal disease (pN2-3) given clinically node negative (cN0) or limited (cN1) findings was calculated, with corresponding negative predictive value (NPV) to exclude pN2-3 and positive predictive value (PPV) to identify axillary nodal disease. Histopathology served as gold standard. Results: A total of 377 cases resulted in 81.4% no, 14.4% limited and 4.2% advanced axillary nodal disease at final histopathology. Probability of pN2-3 given cN0 for breast MRI and axillary ultrasound was 0.7–0.9% versus 1.5% and probability of pN2-3 given cN1 was 11.6–15.4% versus 29.0%. When cN1 on breast MRI was observed, PPV to identify positive axillary nodal disease was 50.7% and 59.0%. Conclusions: Evaluation of axillary nodal status on standard breast MRI is comparable to dedicated axillary ultrasound in breast cancer patients. In patients who underwent preoperative standard breast MRI, axillary ultrasound is only required in case of suspicious nodal findings on MRI.

  2. Evaluation of Breast Sentinel Lymph Node Coverage by Standard Radiation Therapy Fields

    International Nuclear Information System (INIS)

    Rabinovitch, Rachel; Ballonoff, Ari; Newman, Francis M.S.; Finlayson, Christina

    2008-01-01

    Background: Biopsy of the breast sentinel lymph node (SLN) is now a standard staging procedure for early-stage invasive breast cancer. The anatomic location of the breast SLN and its relationship to standard radiation fields has not been described. Methods and Materials: A retrospective review of radiotherapy treatment planning data sets was performed in patients with breast cancer who had undergone SLN biopsy, and those with a surgical clip at the SLN biopsy site were identified. The location of the clip was evaluated relative to vertebral body level on an anterior-posterior digitally reconstructed radiograph, treated whole-breast tangential radiation fields, and standard axillary fields in 106 data sets meeting these criteria. Results: The breast SLN varied in vertebral body level position, ranging from T2 to T7 but most commonly opposite T4. The SLN clip was located below the base of the clavicle in 90%, and hence would be excluded from standard axillary radiotherapy fields where the inferior border is placed at this level. The clip was within the irradiated whole-breast tangent fields in 78%, beneath the superior-posterior corner multileaf collimators in 12%, and outside the tangent field borders in 10%. Conclusions: Standard axillary fields do not encompass the lymph nodes at highest risk of containing tumor in breast cancer patients. Elimination of the superior-posterior corner MLCs from the tangent field design would result in inclusion of the breast SLN in 90% of patients treated with standard whole-breast irradiation

  3. Comparison between minimal right vertical infra-axillary thoracotomy and standard median sternotomy for repair of atrial septal defects

    Directory of Open Access Journals (Sweden)

    Hafize Yaliniz

    2015-10-01

    Conclusion: Minimal right vertical infra-axillary thoracotomy can be performed with favorable cosmetic and clinical results for atrial septal defects closure. Infra-axillary thoracotomy provides a good alternative to standard median sternotomy for patients with atrial septal defects.

  4. Added value of dedicated axillary hybrid 18F-FDG PET/MRI for improved axillary nodal staging in clinically node-positive breast cancer patients. A feasibility study

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    Nijnatten, Thiemo J.A. van; Goorts, B. [Maastricht University Medical Center+, Department of Radiology and Nuclear Medicine (Netherlands); Maastricht University Medical Center+, Department of Surgery, Maastricht (Netherlands); Maastricht University Medical Center+, GROW - School for Oncology and Developmental Biology, Maastricht (Netherlands); Voeoe, S.; Wildberger, J.E. [Maastricht University Medical Center+, Department of Radiology and Nuclear Medicine (Netherlands); Boer, M. de [Maastricht University Medical Center+, GROW - School for Oncology and Developmental Biology, Maastricht (Netherlands); Maastricht University Medical Center+, Division of Internal Medicine, Department of Medical Oncology, Maastricht (Netherlands); Kooreman, L.F.S. [Maastricht University Medical Center+, GROW - School for Oncology and Developmental Biology, Maastricht (Netherlands); Maastricht University Medical Center+, Department of Pathology, Maastricht (Netherlands); Heuts, E.M. [Maastricht University Medical Center+, Department of Surgery, Maastricht (Netherlands); Mottaghy, F.M. [Maastricht University Medical Center+, Department of Radiology and Nuclear Medicine (Netherlands); RWTH Aachen University, Department of Nuclear Medicine, University Hospital, Aachen (Germany); Lobbes, M.B.I. [Maastricht University Medical Center+, Department of Radiology and Nuclear Medicine (Netherlands); Maastricht University Medical Center+, GROW - School for Oncology and Developmental Biology, Maastricht (Netherlands); Smidt, M.L. [Maastricht University Medical Center+, Department of Surgery, Maastricht (Netherlands); Maastricht University Medical Center+, GROW - School for Oncology and Developmental Biology, Maastricht (Netherlands)

    2018-02-15

    To investigate the feasibility and potential added value of dedicated axillary 18F-FDG hybrid PET/MRI, compared to standard imaging modalities (i.e. ultrasound [US], MRI and PET/CT), for axillary nodal staging in clinically node-positive breast cancer. Twelve patients with clinically node-positive breast cancer underwent axillary US and dedicated axillary hybrid 18F-FDG PET/MRI. Nine of the 12 patients also underwent whole-body PET/CT. Maximum standardized uptake values (SUVmax) were measured for the primary breast tumor and the most FDG-avid axillary lymph node. A positive axillary lymph node on dedicated axillary hybrid PET/MRI was defined as a moderate to very intense FDG-avid lymph node. The diagnostic performance of dedicated axillary hybrid PET/MRI was calculated by comparing quantitative and its qualitative measurements to results of axillary US, MRI and PET/CT. The number of suspicious axillary lymph nodes was subdivided as follows: N0 (0 nodes), N1 (1-3 nodes), N2 (4-9 nodes) and N3 (≥ 10 nodes). According to dedicated axillary hybrid PET/MRI findings, seven patients were diagnosed with N1, four with N2 and one with N3. With regard to mean SUVmax, there was no significant difference in the primary tumor (9.0 [±5.0] vs. 8.6 [±5.7], p = 0.678) or the most FDG-avid axillary lymph node (7.8 [±5.3] vs. 7.7 [±4.3], p = 0.767) between dedicated axillary PET/MRI and PET/CT. Compared to standard imaging modalities, dedicated axillary hybrid PET/MRI resulted in changes in nodal status as follows: 40% compared to US, 75% compared to T2-weighted MRI, 40% compared to contrast-enhanced MRI, and 22% compared to PET/CT. Adding dedicated axillary 18F-FDG hybrid PET/MRI to diagnostic work-up may improve the diagnostic performance of axillary nodal staging in clinically node-positive breast cancer patients. (orig.)

  5. Added value of dedicated axillary hybrid 18F-FDG PET/MRI for improved axillary nodal staging in clinically node-positive breast cancer patients. A feasibility study

    International Nuclear Information System (INIS)

    Nijnatten, Thiemo J.A. van; Goorts, B.; Voeoe, S.; Wildberger, J.E.; Boer, M. de; Kooreman, L.F.S.; Heuts, E.M.; Mottaghy, F.M.; Lobbes, M.B.I.; Smidt, M.L.

    2018-01-01

    To investigate the feasibility and potential added value of dedicated axillary 18F-FDG hybrid PET/MRI, compared to standard imaging modalities (i.e. ultrasound [US], MRI and PET/CT), for axillary nodal staging in clinically node-positive breast cancer. Twelve patients with clinically node-positive breast cancer underwent axillary US and dedicated axillary hybrid 18F-FDG PET/MRI. Nine of the 12 patients also underwent whole-body PET/CT. Maximum standardized uptake values (SUVmax) were measured for the primary breast tumor and the most FDG-avid axillary lymph node. A positive axillary lymph node on dedicated axillary hybrid PET/MRI was defined as a moderate to very intense FDG-avid lymph node. The diagnostic performance of dedicated axillary hybrid PET/MRI was calculated by comparing quantitative and its qualitative measurements to results of axillary US, MRI and PET/CT. The number of suspicious axillary lymph nodes was subdivided as follows: N0 (0 nodes), N1 (1-3 nodes), N2 (4-9 nodes) and N3 (≥ 10 nodes). According to dedicated axillary hybrid PET/MRI findings, seven patients were diagnosed with N1, four with N2 and one with N3. With regard to mean SUVmax, there was no significant difference in the primary tumor (9.0 [±5.0] vs. 8.6 [±5.7], p = 0.678) or the most FDG-avid axillary lymph node (7.8 [±5.3] vs. 7.7 [±4.3], p = 0.767) between dedicated axillary PET/MRI and PET/CT. Compared to standard imaging modalities, dedicated axillary hybrid PET/MRI resulted in changes in nodal status as follows: 40% compared to US, 75% compared to T2-weighted MRI, 40% compared to contrast-enhanced MRI, and 22% compared to PET/CT. Adding dedicated axillary 18F-FDG hybrid PET/MRI to diagnostic work-up may improve the diagnostic performance of axillary nodal staging in clinically node-positive breast cancer patients. (orig.)

  6. Axillary irradiation omitting axillary dissection in breast cancer: is there a role for shoulder-sparing proton therapy?

    Science.gov (United States)

    Farace, P; Deidda, M A; Amichetti, M

    2015-10-01

    The recent EORTC 10981-22023 AMAROS trial showed that axillary radiotherapy and axillary lymph node dissection provide comparable local control and reduced lymphoedema in the irradiated group. However, no significant differences between the two groups in range of motion and quality of life were reported. It has been acknowledged that axillary irradiation could have induced some toxicity, particularly shoulder function impairment. In fact, conventional breast irradiation by tangential beams has to be modified to achieve full-dose coverage of the axillary nodes, including in the treatment field a larger portion of the shoulder structures. In this scenario, alternative irradiation techniques were discussed. Compared with modern photon techniques, axillary irradiation by proton therapy has the potential for sparing the shoulder without detrimental increase of the medium-to-low doses to the other normal tissues.

  7. Fenestration of axillary vein by a variant axillary artery.

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    Hadimani, S; Desai, S D; Bagoji, I B; Patil, B S

    2013-01-01

    Variations of venous pattern in the arm are common. In this case report, we present a variation of axillary artery and vein. During routine educational dissections of axillary region, it was observed that a fenestrated axillary vein was perforated by a variant axillary artery in right arm of an old male cadaver. The axillary artery which was fenestrated through axillary vein had only two branches arising from its second part and no branches from its remaining distal parts. The branches are thoraco-acromial (usual) and another large collateral (unusual) branch. This collateral branch is the origin of several important arteries as the subscapular, circumflex scapular, posterior circumflex humeral and lateral thoracic arteries. We propose to name this artery as collateral axillary arterial trunk. The course of this collateral axillary arterial trunk and its branches and also clinical significance of this variation are discussed in the paper.

  8. A predictive tool to estimate the risk of axillary metastases in breast cancer patients with negative axillary ultrasound

    DEFF Research Database (Denmark)

    Meretoja, T J; Heikkilä, P S; Mansfield, A S

    2014-01-01

    of this study was to evaluate the risk factors for axillary metastases in breast cancer patients with negative preoperative axillary ultrasound. METHODS: A total of 1,395 consecutive patients with invasive breast cancer and SNB formed the original patient series. A univariate analysis was conducted to assess...... risk factors for axillary metastases. Binary logistic regression analysis was conducted to form a predictive model based on the risk factors. The predictive model was first validated internally in a patient series of 566 further patients and then externally in a patient series of 2,463 patients from......BACKGROUND: Sentinel node biopsy (SNB) is the "gold standard" in axillary staging in clinically node-negative breast cancer patients. However, axillary treatment is undergoing a paradigm shift and studies are being conducted on whether SNB may be omitted in low-risk patients. The purpose...

  9. Obesity predisposes to increased drainage following axillary node clearance: a prospective audit.

    OpenAIRE

    Banerjee, D.; Williams, E. V.; Ilott, J.; Monypenny, I. J.; Webster, D. J.

    2001-01-01

    BACKGROUND: Whilst sentinel node biopsy is being evaluated for optimising treatment of the axilla, axillary dissection remains the gold standard. Seroma formation, a common sequel to axillary dissection, has been shown to be associated with an increased incidence of wound infection, delayed healing, and lymphoedema. This study was conducted to evaluate the possible contributory role of obesity in axillary drainage following lymphatic dissection. PATIENTS AND METHODS: This study comprised a pr...

  10. Comparison of rectal and axillary temperatures in dogs and cats.

    Science.gov (United States)

    Goic, Joana B; Reineke, Erica L; Drobatz, Kenneth J

    2014-05-15

    To compare rectal versus axillary temperatures in dogs and cats. Prospective observational study. 94 dogs and 31 cats. Paired axillary and rectal temperatures were measured in random order with a standardized method. Animal signalment, initial complaint, blood pressure, blood lactate concentration, and variables associated with vascular perfusion and coat were evaluated for associations with axillary and rectal temperatures. Axillary temperature was positively correlated with rectal temperature (ρ = 0.75 in both species). Median axillary temperature (38.4°C [101.1°F] in dogs, and 38.4°C [101.2°F] in cats) was significantly different from median rectal temperature in dogs (38.9°C [102.0°F]) but not in cats (38.6°C [101.5°F]). Median rectal-axillary gradient (difference) was 0.4°C (0.7°F; range, -1.3° to 2.3°C [-2.4° to 4.1°F]) in dogs and 0.17°C (0.3°F; range -1.1° to 1.6°C [-1.9° to 3°F]) in cats. Sensitivity and specificity for detection of hyperthermia with axillary temperature were 57% and 100%, respectively, in dogs and 33% and 100%, respectively, in cats; sensitivity and specificity for detection of hypothermia were 86% and 87%, respectively, in dogs and 80% and 96%, respectively, in cats. Body weight (ρ = 0.514) and body condition score (ρ = 0.431) were correlated with rectal-axillary gradient in cats. Although axillary and rectal temperatures were correlated in dogs and cats, a large gradient was present between rectal temperature and axillary temperature, suggesting that axillary temperature should not be used as a substitute for rectal temperature.

  11. Axillary bud development in chrysanthemum

    NARCIS (Netherlands)

    Ruiter, de H.A.

    1996-01-01


    Each chrysanthemum cutting originates from an axillary bud. For an improvement of the cultivation of cuttings or more specific their quality, it is necessary that the development of an axillary bud can be controlled as good as possible. Axillary bud development can be distinguished into

  12. Midterm Experience of Ipsilateral Axillary-Axillary Arteriovenous Loop Graft as Tertiary Access for Haemodialysis

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    J. P. Hunter

    2014-01-01

    Full Text Available Objectives. To present a series of ipsilateral axillary artery to axillary vein loop arm grafts as an alternative vascular access procedure for haemodialysis in patients with difficult access. Design. Retrospective case series. Methods. Patients who underwent an axillary loop arteriovenous graft from September 2009 to September 2012 were included. Preoperative venous imaging to exclude central venous stenosis and to image arm/axillary veins was performed. A cuffed PTFE graft was anastomosed to the distal axillary artery and axillary vein and looped on the arm. Results. 25 procedures were performed on 22 patients. Median age was 51 years, with 9 males and 13 females. Median number of previous access procedures was 3 (range 0–7. Median followup was 16.4 months (range 1–35. At 3 months and 1 year, the primary and secondary patency rates were 70% and 72% and 36% and 37%, respectively. There were 11 radiological interventions in 6 grafts including 5 angioplasties and 6 thrombectomies. There were 19 surgical procedures in 10 grafts, including thrombectomy, revision, repair for bleeding, and excision. Conclusions. Our series demonstrates that the axillary loop arm graft yields acceptable early patency rates in a complex group of patients but to maintain graft patency required high rates of surgical and radiological intervention, in particular graft thrombectomy.

  13. Dose to level I and II axillary lymph nodes and lung by tangential field radiation in patients undergoing postmastectomy radiation with tissue expander reconstruction

    International Nuclear Information System (INIS)

    Russo, James K; Armeson, Kent E; Rhome, Ryan; Spanos, Michele; Harper, Jennifer L

    2011-01-01

    To define the dosimetric coverage of level I/II axillary volumes and the lung volume irradiated in postmastectomy radiotherapy (PMRT) following tissue expander placement. Twenty-three patients were identified who had undergone postmastectomy radiotherapy with tangent only fields. All patients had pre-radiation tissue expander placement and expansion. Thirteen patients had bilateral expander reconstruction. The level I/II axillary volumes were contoured using the RTOG contouring atlas. The patient-specific variables of expander volume, superior-to-inferior location of expander, distance between expanders, expander angle and axillary volume were analyzed to determine their relationship to the axillary volume and lung volume dose. The mean coverage of the level I/II axillary volume by the 95% isodose line (V D95% ) was 23.9% (range 0.3 - 65.4%). The mean Ipsilateral Lung V D50% was 8.8% (2.2-20.9). Ipsilateral and contralateral expander volume correlated to Axillary V D95% in patients with bilateral reconstruction (p = 0.01 and 0.006, respectively) but not those with ipsilateral only reconstruction (p = 0.60). Ipsilateral Lung V D50% correlated with angle of the expander from midline (p = 0.05). In patients undergoing PMRT with tissue expanders, incidental doses delivered by tangents to the axilla, as defined by the RTOG contouring atlas, do not provide adequate coverage. The posterior-superior region of level I and II is the region most commonly underdosed. Axillary volume coverage increased with increasing expander volumes in patients with bilateral reconstruction. Lung dose increased with increasing expander angle from midline. This information should be considered both when placing expanders and when designing PMRT tangent only treatment plans by contouring and targeting the axilla volume when axillary treatment is indicated

  14. [Axillary pathologic response after neoadjuvant chemotherapy in locally advanced breast cancer with axillary involvement].

    Science.gov (United States)

    Jiménez-Ballvé, A; Serrano-Palacio, A; García-Sáenz, J A; Ortega Candil, A; Salsidua-Arroyo, O; Román-Santamaría, J M; Pelayo Alarcón, A; Fuentes Ferrer, M E; Carreras-Delgado, J L

    2015-01-01

    To compare axillary involvement (N+) at initial staging in locally advanced breast cancer (LABC) with axillary lymphadenectomy histologic results after neoadjuvant chemotherapy treatment (NeoChemo). Retrospective study between November 2011 and September 2013 of LABC cases treated with neoadjuvant chemotherapy based on docetaxel (associated with trastuzumab in HER2 positive cases and carboplatin/adriamycin in HER2 negative cases). Those clinically or radiologically suspected cases of axillary involvement were histologically confirmed. When there was no suspicion of axillary involvement, sentinel lymph node radioguided biopsy (SLNRB) was performed using intradermal injection of (99m)Tc-nanocolloid albumin prior to neoadjuvant treatment. Axillary lymphadenectomy after NeoChemo was undertaken in all cases with positive axilla. Final pathologic response was classified as complete (pCR) when there was no evidence of tumoral disease and as non-pathologic complete response (no pCR) in the opposite case. A total of 346 patients treated with docetaxel were reviewed, identifying 105 LABC. Axillary involvement at initial staging was detected in 70 (67%) before starting NeoChemo. From these 70, 73% (n=51) were N+ (fine needle biopsy and/or biopsy) and the remaining 19 (27%) were occult N+ detected by SLNRB. Axillary lymphadenectomy detected pCR in 56% (39/70), increasing up to 84% pCR when initial N+ status was reached using SNLB. On the other hand, when N+ was detected using fine needle biopsy/lymph biopsy, pCR was only 45%. More than 50% of women affected by locally advanced breast cancer with tumoral axillary involvement at initial diagnosis present free metastatic axilla after therapeutic neoadjuvant chemotherapy effect. This increases up to almost 90% in case of occult metastatic axilla detected with sentinel node biopsy prior starting neoadjuvant chemotherapy. Copyright © 2014 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  15. The Clinical Value of Axillary Ultrasonogra- phy for Detection of Axillary Lymph Node Metastasis in Cases with Breast Cancer

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    Sedigheh Tahmasebi

    2014-10-01

    Full Text Available Background: The axillary lymph node stage is one of the single most important determinants in the prognosis of breast cancer patients. The disadvantages of the two previous methods used for evaluating axillary node metastasis, i.e., axillary lymph node dissection and sentinel lymph node biopsy, have directed researchers to investigate new techniques for this purpose. The aim of the current study was to evaluate the clinical usefulness of axillary ultrasonography in detecting axillary metastasis. Methods: This study was conducted during a 12-month period. The breast cancer cases included in this study were all clinically diagnosed as stages I and II, with no prior treatment to the axillary region by surgery and/or chemo-radiotherapy. Excluded from the study group were patients with palpable axillary lymph nodes, those who had major organ failure or concomitant malignancy. All included patients with non-palpable axillary lymph nodes underwent axillary ultrasound examination. An ultrasound- guided core needle biopsy was performed on patients with suspected metastasis. Results: There were 125 female patients with a mean age of 49.6 years included in this study. From these, 16 (12.8% cases had positive axillary sonographic findings. Pathologic evaluation of tissue specimens (taken by ultrasound-guided core needle biopsy in 10 (62.5% out of 16 patients were positive, and in the patient group of 6 (37.5% cases, studies were negative. Axillary ultrasonography had a sensitivity of 35.7%, specificity of 93.8%, positive predictive value of 62.5%, and negative predictive value of 83.5%. Conclusion: The axillary ultrasonogram is a reliable technique in the determination of axillary nodal metastatic involvement in breast cancer patients. By use of this method a significant amount of complications and costs related to the previous techniques can be avoided.

  16. Biofeedback device for patients on axillary crutches.

    Science.gov (United States)

    Ang, E J; Goh, J C; Bose, K; Toh, S L; Choo, A

    1989-08-01

    The axillary crutch is commonly prescribed as an ambulatory aid to patients with temporal or permanent disability in the lower extremity. When fitting the axillary crutch, it is important that the user be instructed not to bear excessive weight on the axillary bar. Excessive weight bearing on the axillary bar can result in a sevenfold increase in the reaction force under the armpit. This force may be a contributory factor to crutch paralysis or thrombosis of the axillobrachial artery. In order to prevent this occurrence an electronic biofeedback device was designed and developed for use in the training of 3-point swing-through axillary crutch ambulation. It detects excessive weight bearing on the axillary bar during crutch ambulation and produces an audible signal which prompts the patient to make necessary adjustment to relieve load bearing on the axillary bar. The design and development of the biofeedback device is discussed in this paper.

  17. Impact and evaluation of the use of tri-dimensional over bi-dimensional plan for the breast and axillary lymph node irradiation with tangential fields for conservative breast cancer treatment

    International Nuclear Information System (INIS)

    Pellizzon, Antonio Cassio Assis; Boccaletti Karina; Belletti Fernanda

    2011-01-01

    A comparative study of dose distribution delivered to the anatomically defined breast, axillary levels I-III, supra clavicle nodal, cardiac and left lung volumes treated by standard tangent fields using conventional technique, planned by either two dimensional (2D) or tri-dimensional (3D) radiotherapy treatment-plan was performed to determine if the dosimetry for the breast, regional lymph nodes and normal tissues at risk can be improved. Material And Methods: Data of the charts and images of 10 consecutive patients who underwent breast-conserving surgery for left-sided breast cancer and received post-operative RT at the Department of Radiation Oncology, Hospital A.C. Camargo, Sao Paulo, Brazil were reviewed and re-planned. All sets of images used for the study were saved separately and no modification was performed to the initial programmed plan for each patient. For 2D irradiation plans, two opposed fields to treat the breast volume were used and one appositional field was used to treat the supra clavicle nodes. After 2D dosimetric planning, a second 3D treatment plan, with CT tomography at 5-mm intervals in the same position as predetermined in the 2D simulation, was used for plan dose coverage comparison. Results: The breast CTV dose coverage evaluated by the D85%, D90% and D100% presented statically significant differences favoring the 3D plan (p = 0.017; 0.011 and 0.005), with correlation indexes ranging from 42.6% to 57.2%. The same was observed for the supra clavicle nodes (p = 0.003; < 0.001 and 0.045) with correlation indexes ranging from 19.4% to 37.4%. For the axillary levels, a statistical significant difference on dose coverage was observed only for the axillary level III D100%, p 0.001 and correlation index of 72.5%. For the cardiac area there was a statistical significant difference between the maximum and median given, p 0.002 and p = 0.01, favoring the 3D plan. Conclusion: The use of 3D plan is necessary to include not only the breast but also the

  18. Partial axillary dissection in early breast cancer

    Directory of Open Access Journals (Sweden)

    Tarek Abdel Halim El-Fayoumi

    2013-09-01

    Full Text Available Background: In order to reduce the probability of later clinical involvement of the axilla and at establishing a sound basis for adjuvant treatment planning axillary dissection is an important operative procedure. So, partial axillary dissection has been applied to decrease the morbidity and postoperative axillary complications.Aim of the work was to study the reliability of partial axillary lymph node dissection in patients with breast carcinoma with clinically negative axilla. Methods: Eighteen patients underwent modified radical mastectomy, while the other two patients who were fulfilling the criteria for conservative breast surgery underwent lumpectomy. All patients did complete axillary lymph nodes dissection. Intraoperative leveling of the axilla was performed and level I axillary lymph nodes were identified according to their relation to pectoralis minor muscle; then they were subjected to intraoperative pathological examination by frozen section examination followed by complete axillary clearance. Then post operative histopathological examination of the tumor and all lymph nodes was done. Results: By intraoperative pathological examination; five patients (25% were found positive for malignant invasion, while 15 patients (75% were pathologically free. While paraffin section showed six patients (30% with malignant invasion, and 14 patients (70% were pathologically free. There was a false negative rate of 5% in level I axillary lymph nodes by intraoperative pathological examination which was positive for metastasis by paraffin section that revealed microinvasion in one lymph node out of 8 in level I. Only two cases out of 20 were found positive for metastasis in level II and III. Conclusion: Partial axillary lymph node dissection is a minimally invasive, feasible and sufficient technique that can predict the axillary lymph node status. KEYWORDS: Breast cancer, Axillary lymph nodes clearance

  19. Computed tomography image of the mediastinal and axillary lymph nodes in clinically sound Rottweilers

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    Ana Carolina B. Fonseca Pinto

    2013-03-01

    Full Text Available Trough computed tomography (CT, it is possible to evaluate lymph nodes in detail and to detect changes in these structures earlier than with radiographs and ultrasound. Lack of information in the veterinary literature directed the focus of this report to normal aspects of the axillary and mediastinal lymph nodes of adult dogs on CT imaging. A CT scan of 15 normal adult male and female Rottweilers was done. To define them as clinically sound, anamnesis, physical examination, complete blood count, renal and hepatic biochemistry, ECG, and thoracic radiographs were performed. After the intravenous injection of hydrosoluble ionic iodine contrast medium contiguous 10mm in thickness thoracic transverse images were obtained with an axial scanner. In the obtained images mediastinal and axillary lymph nodes were sought and when found measured in their smallest diameter and their attenuation was compared to musculature. Mean and standard deviation of: age, weight, body length and the smallest diameter of the axillary and mediastinal lymph nodes were determined. Mean and standard deviation of parameters: age 3.87±2.03 years, weight 41.13±5.12, and body length 89.61±2.63cm. Axillary lymph nodes were seen in 60% of the animals, mean of the smallest diameter was 3.58mm with a standard deviation of 2.02 and a minimum value of 1mm and a maximum value of 7mm. From 13 observed lymph nodes 61.53% were hypopodense when compared with musculature, and 30.77% were isodense. Mediastinal lymph nodes were identified in 73.33% of the dogs; mean measure of the smallest diameter was 4.71mm with a standard deviation of 2.61mm and a minimum value of 1mm, and a maximum value of 8mm. From 14 observed lymph nodes 85.71% were isodense when compared with musculature and 14.28% were hypodense. The results show that it is possible to visualize axillary and mediastinal lymph nodes in adult clinically sound Rottweilers with CT using a slice thickness and interval of 10mm. The

  20. Fibroadenoma in axillary supernumerary breast: case report

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    Délio Marques Conde

    Full Text Available CONTEXT: Supernumerary breast tissue may be affected by the same diseases and alterations that compromise topical breast tissue. Nevertheless, reports of fibroadenoma in supernumerary breast tissue in the axillae are rare. OBJECTIVE: To describe a case of fibroadenoma in an axillary supernumerary breast. DESIGN: Case report. CASE REPORT: A 39-year-old woman was referred to the gynecology and obstetrics outpatient clinic at Hospital Estadual Sumaré, complaining of bilateral axillary masses. The patient reported cosmetic problems and local pain and discomfort. On physical examination, alterations compatible with bilateral axillary accessory breasts, without palpable nodules, were observed. Supplementary examinations (mammography and ultrasonography revealed a 1.1 cm mass in the right axillary breast. The patient underwent resection of the supernumerary breasts and histopathological examination revealed fibroadenoma of the right axillary breast tissue.

  1. Ultrasound-guided block of the axillary nerve

    DEFF Research Database (Denmark)

    Rothe, C; Lund, J; Jenstrup, M T

    2012-01-01

    The specific blocking of the axillary nerve has never been investigated clinically. We present four cases illustrating potential applications of the axillary nerve block in the perioperative setting and discuss possible directions for future research in this area. The axillary nerve blocks were all...... performed using a newly developed in-plane ultrasound-guided technique. In one patient undergoing arthroscopic shoulder surgery, we used the axillary nerve block as the only analgesic combined with propofol sedation and spontaneous breathing. Chronic shoulder pain was eliminated after the axillary nerve...... block in two patients. The pain score after arthroscopic shoulder surgery in these two patients remained low until termination of the nerve block. In a fourth patient, severe post-operative pain after osteosynthesis of a displaced proximal humerus fracture was almost eliminated after performing...

  2. Axillary bud development in rose

    NARCIS (Netherlands)

    Marcelis - van Acker, C.A.M.

    1994-01-01

    Axillary buds form the basis of flower production of a rose crop. Within a rose crop there exists an undesired large variation in shoot number and size, which affects flower yield. Part of this variation may be traced back to early variation in axillary buds. The aim of the research

  3. Breast-axillary complex in HIV/AIDS patients.

    Science.gov (United States)

    Eni, U E; Naaya, H U; Yawe, K D T; Lawan, M A; Bakari, A A

    2010-01-01

    HIV/AIDS have not only increased the health care burden especially in developing countries, it equally complicates the presentation of many diseases. Some well known disease entities now occur in fulminant complexities not previously described or known as such. The objective of this article is to report an unusual presentation of HIV/AIDS patients to the surgeon with Axillary and ipsilateral breast swelling. This is a report of three cases seen and managed by the authors. Three adult female patients presented with progressively increasing axillary and ipsilateral breast swellings. They also had associated fevers and weight loss. Their main concern had been development of breast cancer. One of the patients was a known retroviral positive on Highly Active Anti-Retroviral Therapy (HAART). Examination revealed axillary abscess and ipsilateral breast oedema in two cases. The patient on HAART had a hard breast-axillary mass complex. Biopsy (FNAB) revealed inflammatory cells and no malignancy in all three cases. HIV screening was positive in all cases. One of the patients had excision of breast-axillary mass complex, and the histology showed features of chronic inflammation, with no malignant cells. The other two had incision and drainage of their axillary abscess. This shows the ubiquitous presentation of HIV/AIDS in our environment and surgeons should be aware of the breast axillary complex in HIV/AIDS. Medical practitioners should be careful to obtain accurate diagnosis before embarking on treatment especially mutilating surgical procedures.

  4. Factors associated with involvement of four or more axillary nodes for sentinel lymph node-positive patients

    International Nuclear Information System (INIS)

    Katz, Angela; Niemierko, Andrzej; Gage, Irene; Evans, Sheila; Shaffer, Margaret; Smith, Frederick P.; Taghian, Alphonse; Magnant, Colette

    2006-01-01

    Purpose: Sentinel lymph node-positive (SLN+) patients who are unlikely to have 4 or more involved axillary nodes might be treated with less extensive regional nodal radiation. The purpose of this study was to define possible predictors of having 4 or more involved axillary nodes. Methods and Materials: The records of 224 patients with breast cancer and 1 to 3 involved SLNs, who underwent completion axillary dissection without neoadjuvant chemotherapy or hormonal therapy were reviewed. Factors associated with the presence of 4 or more involved axillary nodes (SLNs plus non-SLNs) were evaluated by Pearson chi-square test of association and by simple and multiple logistic-regression analysis. Results: Of 224 patients, 42 had involvement of 4 or more axillary nodes. On univariate analysis, the presence of 4 or more involved axillary nodes was positively associated with increased tumor size, lobular histology, lymphovascular space invasion (LVSI), increased number of involved SLNs, decreased number of uninvolved SLNs, and increased size of SLN metastasis. On multivariate analysis, the presence of 4 or more involved axillary nodes was associated with LVSI, increased number of involved SLNs, increased size of SLN metastasis, and lobular histology. Conclusions: Patients with 1 or more involved SLN, LVSI, or SLN macrometastasis should be treated to the supraclavicular fossa/axillary apex if they do not undergo completion axillary dissection. Other SLN+ patients might be adequately treated with less extensive radiation fields

  5. Perforation of Axillary Vein by a Branch of the Axillary Artery: an Anatomical Study

    OpenAIRE

    Mahajan, Anita; Rana, K. K; Saha, S

    2012-01-01

    Anatomical variations in the region of axilla and pectoral region are very common. These variations need attention to avoid complications arising during surgeries and diagnostic and interventional invasive procedures in this region such as surgeries for breast carcinoma, venous access during central venous line, pacemaker and cardiac defibrillator implantation etc. During routine cadaveric dissection we had noticed a rare variation of axillary vein and artery. In this case axillary vein, just...

  6. Harmonic Scalpel Versus Electrocautery in Axillary Dissection in Carcinoma Breast.

    Science.gov (United States)

    Nawaz, Allah; Waqar, Sadaf; Khan, Ahsan; Mansoor, Rashid; Butt, Usman Ismat; Ayyaz, Mahmood

    2015-12-01

    To compare the results between harmonics scalpel and electrocautery use in axillary dissection for carcinoma breast. Randomized controlled trial. Department of Surgery, Services Hospital, Lahore, from December 2013 to June 2014. Eighty patients fulfilling the inclusion criteria were selected and equally divided in two groups. Axillary dissection for carcinoma breast was performed by using the harmonic scalpel in one group and by using electrocautery in the other group. Total mean axillary drain output and frequency of axillary numbness were noted in both groups and compared. All the patients were females with mean age of 53.52 ± 9.8. Mean axillary drain output in harmonic scalpel group was 167.75 ± 43.90 as compared to 310.00 ± 60.09 in electrocautery group while only 12.5% of patients were positive for axillary numbness in harmonic scalpel group as compared to 100% of patients who were positive for electrocautery group. Use of harmonic scalpel in axillary dissection resulted in decreased total mean axillary drain output and lowered frequency of axillary numbness when compared to utilizing electrocautery.

  7. Postoperative peri-axillary seroma following axillary artery cannulation for surgical treatment of acute type A aortic dissection

    Directory of Open Access Journals (Sweden)

    Katsanos Konstantinos

    2010-05-01

    Full Text Available Abstract The arterial cannulation site for optimal tissue perfusion and cerebral protection during cardiopulmonary bypass (CPB for surgical treatment of acute type A aortic dissection remains controversial. Right axillary artery cannulation confers significant advantages, because it provides antegrade arterial perfusion during cardiopulmonary bypass, and allows continuous antegrade cerebral perfusion during hypothermic circulatory arrest, thereby minimizing global cerebral ischemia. However, right axillary artery cannulation has been associated with serious complications, including problems with systemic perfusion during cardiopulmonary bypass, problems with postoperative patency of the artery due to stenosis, thrombosis or dissection, and brachial plexus injury. We herein present the case of a 36-year-old Caucasian man with known Marfan syndrome and acute type A aortic dissection, who had direct right axillary artery cannulation for surgery of the ascending aorta. Postoperatively, the patient developed an axillary perigraft seroma. As this complication has, not, to our knowledge, been reported before in cardiothoracic surgery, we describe this unusual complication and discuss conservative and surgical treatment options.

  8. Harmonic scalpel versus electrocautery in axillary dissection in carcinoma breast

    International Nuclear Information System (INIS)

    Nawaz, A.; Khan, A.; Mansoor, R.; Butt, U.I.

    2015-01-01

    To compare the results between harmonics scalpel and electrocautery use in axillary dissection for carcinoma breast. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Surgery, Services Hospital, Lahore, from December 2013 to June 2014. Methodology: Eighty patients fulfilling the inclusion criteria were selected and equally divided in two groups. Axillary dissection for carcinoma breast was performed by using the harmonic scalpel in one group and by using electrocautery in the other group. Total mean axillary drain output and frequency of axillary numbness were noted in both groups and compared. Results: All the patients were females with mean age of 53.52 ± 9.8. Mean axillary drain output in harmonic scalpel group was 167.75 ± 43.90 as compared to 310.00 ± 60.09 in electrocautery group while only 12.5% of patients were positive for axillary numbness in harmonic scalpel group as compared to 100% of patients who were positive for electrocautery group. Conclusion: Use of harmonic scalpel in axillary dissection resulted in decreased total mean axillary drain output and lowered frequency of axillary numbness when compared to utilizing electrocautery. (author)

  9. Muscular Variations During Axillary Dissection: A Clinical Study in ...

    African Journals Online (AJOL)

    muscle and the coracoid process, without interruption by any type of tendinous fibres. The axillary arch muscle crossed anteriorly over the axillary vein [Figure 1]. The mastectomy along with axillary dissection was completed uneventfully. There was left sided absence of pectoralis major and minor muscles in a 45 years old ...

  10. Partial axillary dissection in early breast cancer

    African Journals Online (AJOL)

    Tarek Abdel Halim El-Fayoumi

    ORIGINAL ARTICLE. Partial axillary dissection in early breast cancer. Tarek Abdel Halim El-Fayoumi *. Department of General Surgery, Faculty of Medicine, Alexandria University, Egypt. Received 16 October 2012; accepted 7 January 2013. Available online 7 March 2013. KEYWORDS. Breast cancer;. Axillary lymph nodes.

  11. Axillary Hodgkin's disease in manual workers.

    Science.gov (United States)

    Andrieu, J M; Weh, H J; Teillet, F; Asselain, B

    1979-01-01

    Between 1965 and 1974, 16 patients were clinically staged as having unique axillary localizations of Hodgkin's disease. Sex ratio (4.3), mean age (40.8 years) and professional occupations (12 out of the 16 patients were engaged in manual work) were significantly different from that of all patients observed during the same period. These facts lead us to suppose the existence of a link between manual work and initial axillary localizations.

  12. Posttraumatic True Aneurysm of the Axillary Artery Following Blunt Trauma

    Directory of Open Access Journals (Sweden)

    Tugrul Goncu

    2010-01-01

    Full Text Available The majority of the axillary artery aneurysm cases arise as pseudoaneurysms secondary to blunt or iatrogenic trauma. Isolated traumatic true axillary artery aneurysm is a relatively unusual disorder and generally occurs with repetitive blunt trauma. A 22-year-old female patient with distal axillary artery true aneurysm due to simple blunt axillothoracic trauma is presented. The aneurysm was excised with subpectoral-axillary approach and saphenous vein graft interposition was applied. Long-term follow-up with the patient was uneventful.

  13. The clinical value of 99mTc-MIBI imaging for axillary lymph node metastasis of breast cancer

    International Nuclear Information System (INIS)

    Song Bangkun; Yang Jisheng; Shen Dawei; Zuo Lei; Jiang Ling; Zhou Ya

    2001-01-01

    Objective: To observe the clinical value of 99m Tc-MIBI imaging for axillary lymph node metastasis of breast cancer. Methods: 56 patients with breast cancer proven by pathology were imaged with 99m Tc-MIBI. Images were taken at 5, 30, 60 minutes. The axillary area of affected side was included in imaging field. Results: The primary foci in 55 cases were positive and one case was negative in uptake. Of the 56 cases, 35 had histologically proven axillary lymph node metastases. MIBI uptake was seen in 30 cases and negative in 5 cases. The sensitivity was 85.7% (30/35 cases). In 21 cases who had no metastasis, 3 cases showed false positive uptake and 18 cases were true negative, making the specificity 85.7%. In the case who had negative imaging for primary focus, which was non-palpable, had an enlarged axillary lymphatic node. Positive MIBI uptake of the node area was seen in this case. Conclusion: 99m Tc-MIBI imaging is valuable for the diagnosis of axillary nodal metastasis of breast cancer. Even though there is no palpable primary focus, if there is an enlarged axillary lymphatic node and positive MIBI uptake, metastasis should be considered

  14. Axillary lymph nodes and arm lymphatic drainage pathways are spared during routine complete axillary clearance in majority of women undergoing breast cancer surgery.

    Science.gov (United States)

    Szuba, A; Chachaj, Z; Koba-Wszedybylb, M; Hawro, R; Jasinski, R; Tarkowski, R; Szewczyk, K; Bebenek, M; Forgacz, J; Jodkowska, A; Jedrzejuk, D; Janczak, D; Mrozinska, M; Pilch, U; Wozniewski, M

    2011-09-01

    Alterations in axillary lymph nodes (ALNs) after complete axillary lymph node dissection (ALND) in comparison to the preoperative status were evaluated using lymphoscintigraphy performed preoperatively and 1-6 weeks after surgery in 30 women with a new diagnosis of unilateral, invasive breast carcinoma. Analysis of lymphoscintigrams revealed that ALNs after surgery were present in 26 of 30 examined women. In comparison to preoperative status, they were visualized in the same location (12 women), in the same and additionally in different locations (9 women), or only in different locations (4 women). No lymph nodes were visualized in one woman and lymphocoele were in 4 women. Thus, after ALND, a variable number of axillary lymph nodes remain and were visualized on lymphoscintigraphy in the majority of women. The classical ALND, therefore, does not allow complete dissection and removal of axillary nodes with total disruption of axillary lymphatic pathways, accounting in part for the variable incidence and severity of lymphedema after the procedure.

  15. Comparison of the diagnostic value of FDG-PET/CT and axillary ultrasound for the detection of lymph node metastases in breast cancer patients

    International Nuclear Information System (INIS)

    Riegger, Carolin; Heusner, Till A.; Koeninger, Angela; Kimmig, Rainer; Hartung, Verena; Bockisch, Andreas; Otterbach, Friedrich; Forsting, Michael; Antoch, Gerald

    2012-01-01

    Background. FDG-PET/CT is increasingly being used for breast cancer staging. Its diagnostic accuracy in comparison to ultrasound as the standard non-invasive imaging modality for the evaluation of axillary lymph nodes has yet not been evaluated. Purpose. To retrospectively compare the diagnostic value of full-dose, intravenously contrast-enhanced FDG-PET/CT and ultrasound for the detection of lymph node metastases in breast cancer patients. Material and Methods. Ninety patients (one patient with a bilateral carcinoma) (89 women, one man; mean age, 55.5 ± 16.6 years) suffering from primary breast cancer underwent whole-body FDG-PET/CT and axillary ultrasound. The ipsilateral axillary fossa (n = 91) was evaluated for metastatic spread. The sensitivity, specificity, the positive predictive value (PPV), negative predictive value (NPV), and accuracy of both methods were calculated. The sensitivity and accuracy were statistically compared using the McNemar Test (P <0.05). Analyses were made on a patient basis. The number of patients with extra-axillary locoregional lymph node metastases exclusively detected by FDG-PET/CT was evaluated. For axillary lymph node metastases histopathology served as the reference standard. Results. The sensitivity, specificity, PPV, NPV, and accuracy of FDG-PET/CT for the detection of axillary lymph node metastases were 54%, 89%, 77%, 74%, and 75%, respectively. For ultrasound it was 38%, 78%, 54%, 65%, and 62%, respectively. FDG-PET/CT was significantly more accurate than ultrasound for the detection of axillary lymph node metastases (P = 0.019). There was no statistically significant difference between the sensitivity of both modalities (P = 0.0578). FDG-PET/CT detected extra-axillary locoregional lymph node metastases in seven patients (8%) that had not been detected by another imaging modality. Conclusion. Though more accurate compared to ultrasound for evaluating the axillary lymph node status FDG-PET/CT is only as sensitive as

  16. Origin and distribution of the axillary nerve in the giant anteater (Myrmecophaga tridactyla

    Directory of Open Access Journals (Sweden)

    Daniela Cristina de Oliveira Silva

    2012-09-01

    Full Text Available The giant anteater (Myrmecophaga tridactyla, a mammal belonging to the order Xenarthra and family Myrmecophagidae, is an endangered species. For this reason, additional knowledge about its anatomy is of interest, especially the forelimb, which plays important roles in feeding and defense. The goal of this study was to learn more about the origin and distribution of the axillary nerve of Myrmecophaga tridactyla by studying two individuals (one male and one female that belong to the Research Laboratory of Wild Animals (UFU. The study material consisted of corpses fixed and preserved in 10% aqueous formalin solution. Dissection of the material followed standard procedures. In both animals, the axillary nerve was found in the ventral branch of the sixth cervical (C6 and seventh (C7 spinal nerve. This nerve showed symmetry in relation to its position in the two specimens and branched into the teres major, teres minor and deltoid muscles. In both specimens the axillary nerve originated in the cranial cutaneous branch of the lower leg.

  17. Presentation of Axillary Metastases from Occult Breast Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Xin Wang

    2007-01-01

    Axillary presentation from occult breast cancer is uncommon and continues to be a diagnostic and therapeutic challenge to physicians.Once the diagnosis of adenocarcinoma metastatic to an axillary lymph node has been confirmed,a preoperative workup should be done.The current experience is based on several relatively small retrospective reviews and case reports.It is difficult to determine the best management of occult breast cancer.However,treatmenl of axillary Iymph node dissection is recommended for local control and complete staging information.Treatment of breast should be a choice between breast conservation with whole-breast radiotherapy and mastectomy.Adjuvant systemic treatment should be offered.

  18. Breast cancer with axillary lymph node involvement

    International Nuclear Information System (INIS)

    Belaid, A.; Kanoun, S.; Kallel, A.; Ghorbel, I.; Azoury, F.; Heymann, S.; Marsiglia, H.; Bourgier, C.; Belaid, A.; Ghorbel, I.; Kanoun, S.; Kallel, A.; Pichenot, C.; Verstraet, R.; Marsiglia, H.

    2010-01-01

    Breast cancer is the most frequent cancer of women in western countries. There are one million new cases per year in the world which represents 22% of all female cancers, and more than 370.000 deaths due to breast cancer per year (14% of cancer mortality). More than half of breast cancers are associated with axillary nodal involvement. Post-operative radiation therapy (XRT) is a crucial part of locoregional treatment in axillary nodal involvement breast cancer owing to a 15-years risk reduction of locoregional recurrence of 70% and to a 5.4% risk reduction of specific mortality. In 3D-conformal irradiation in such breast cancers, target volumes are chest wall when mastectomy was performed or breast and boost of tumor bed in case of breast conservative surgery, and supra-clavicular and/or axillary and/or internal mammary node areas. The main organs at risk are ipsilateral lung, heart and brachial plexus. The aim of this article is to describe epidemiologic, radio anatomic and prognostic features of axillary nodal involvement breast cancer and to propose guidelines for 3D-conformal treatment planning in locally advanced breast cancers. This review is illustrated by a case report. (authors)

  19. Muscular variations during axillary dissection: A clinical study in fifty patients

    Directory of Open Access Journals (Sweden)

    Upasna

    2015-01-01

    Methods: The anatomy of axilla regarding muscular variations was studied in 50 patients who had an axillary dissection for the staging and treatment of invasive primary breast cancer over one year. Results: In a period of one year, two patients (4% with axillary arch and one patient (2% with absent pectoralis major and minor muscles among fifty patients undergoing axillary surgery for breast cancer were identified. Conclusions: Axillary arch when present should always be identified and formally divided to allow adequate exposure of axillary contents, in order to achieve a complete lymphatic dissection. Complete absence of pectoralis major and minor muscles precludes the insertion of breast implants and worsens the prognosis of breast cancer.

  20. Axillary nerve injury associated with sports.

    Science.gov (United States)

    Lee, Sangkook; Saetia, Kriangsak; Saha, Suparna; Kline, David G; Kim, Daniel H

    2011-11-01

    The aim of this retrospective study was to present and investigate axillary nerve injuries associated with sports. This study retrospectively reviewed 26 axillary nerve injuries associated with sports between the years 1985 and 2010. Preoperative status of the axillary nerve was evaluated by using the Louisiana State University Health Science Center (LSUHSC) grading system published by the senior authors. Intraoperative nerve action potential recordings were performed to check nerve conduction and assess the possibility of resection. Neurolysis, suture, and nerve grafts were used for the surgical repair of the injured nerves. In 9 patients with partial loss of function and 3 with complete loss, neurolysis based on nerve action potential recordings was the primary treatment. Two patients with complete loss of function were treated with resection and suturing and 12 with resection and nerve grafting. The minimum follow-up period was 16 months (mean 20 months). The injuries were associated with the following sports: skiing (12 cases), football (5), rugby (2), baseball (2), ice hockey (2), soccer (1), weightlifting (1), and wrestling (1). Functional recovery was excellent. Neurolysis was performed in 9 cases, resulting in an average functional recovery of LSUHSC Grade 4.2. Recovery with graft repairs averaged LSUHSC Grade 3 or better in 11 of 12 cases Surgical repair can restore useful deltoid function in patients with sports-associated axillary nerve injuries, even in cases of severe stretch-contusion injury.

  1. Correction of accessory axillary breast tissue without visible scar.

    Science.gov (United States)

    Kim, Young Soo

    2004-01-01

    Various methods for correction of accessory axillary breast tissue have been proposed, including simple excision, diamond-shaped excision, a Y-V technique, and lipoplasty. We present an effective method for correction of a prominent axillary mound that combines lipoplasty with excision of accessory breast tissue along the axillary transverse line. Preoperative markings included an incision within the natural wrinkle line in the axillary fold, and demarcation of areas in which lipoplasty and excision were to be performed. After lipoplasty, deep dissection was performed to isolate and remove accessory breast tissue and excess fat tissue. A compression dressing was applied for 1 to 2 weeks postoperatively, and the patient was instructed to wear a sports bra for 1 to 2 months after removal of the dressing. We treated 7 patients using this procedure between October 1999 and March 2003. No major postoperative complications were detected and recurrence was not noted during the follow-up periods. Aesthetic results were satisfactory. We believe that a procedure that combines lipoplasty and excision provides numerous advantages as a surgical option in treating a prominent axillary mound. The main advantage is that the final scar is laid in the natural axillary fold, rendering scars less conspicuous and eliminating the need to remove excess skin. The one disadvantage was that elevation of the skin flap via small, remote incisions initially produced surgical difficulties, but these were overcome with experience.

  2. Axillary arthrotomography of the glenoid labrum

    International Nuclear Information System (INIS)

    Kleinman, P.K.; Kanzaria, P.K.; Goss, T.P.; Pappas, A.M.

    1984-01-01

    In a study of 67 shoulders evaluated by axillary arthrotomography, tears of the glenoid labrum were accurately detected in all 26 surgically confirmed cases. One false-positive case was identified in the five patients without labral tears; there were no false-negative cases. Only 40% of the patients had clinical evidence of subluxation or dislocation. Axillary arthrotomography provides important information about the integrity of the labrum that may be helpful in planning surgery for patients without clinical subluxation or dislocation but with pain, clicking, or vague shoulder discomfort secondary to labral pathology (functional instability)

  3. Characterization of Staphylococcus and Corynebacterium clusters in the human axillary region.

    Directory of Open Access Journals (Sweden)

    Chris Callewaert

    Full Text Available The skin microbial community is regarded as essential for human health and well-being, but likewise plays an important role in the formation of body odor in, for instance, the axillae. Few molecular-based research was done on the axillary microbiome. This study typified the axillary microbiome of a group of 53 healthy subjects. A profound view was obtained of the interpersonal, intrapersonal and temporal diversity of the human axillary microbiota. Denaturing gradient gel electrophoresis (DGGE and next generation sequencing on 16S rRNA gene region were combined and used as extent to each other. Two important clusters were characterized, where Staphylococcus and Corynebacterium species were the abundant species. Females predominantly clustered within the Staphylococcus cluster (87%, n = 17, whereas males clustered more in the Corynebacterium cluster (39%, n = 36. The axillary microbiota was unique to each individual. Left-right asymmetry occurred in about half of the human population. For the first time, an elaborate study was performed on the dynamics of the axillary microbiome. A relatively stable axillary microbiome was noticed, although a few subjects evolved towards another stable community. The deodorant usage had a proportional linear influence on the species diversity of the axillary microbiome.

  4. Technique for axillary radiotherapy using computer-assisted planning for high-risk skin cancerΤ

    International Nuclear Information System (INIS)

    Fogarty, G.B.; Martin, J.M.; Fay, M.; Ainslie J; Cassumbhoy, R.

    2007-01-01

    High-risk skin cancer arising on the upper limb or trunk can cause axillary nodal metastases. Previous studies have shown that axillary radiotherapy improves regional control. There is little published work on technique. Technique standardization is important in quality assurance and comparison of results especially for trials. Our technique, planned with CT assistance, is presented. To assess efficacy, an audit of patients treated in our institution over a 15-month period was conducted. Of 24 patients treated, 13 were treated with radical intent, 11 with this technique. With a follow up of over 2 years, the technique had more than a 90% (10/11) regional control in this radical group. Both of the radical patients who were not treated according to the technique had regional failure. One case of late toxicity was found, of asymptomatic lymphoedema in a radically treated patient. This technique for axillary radiotherapy for regional control of skin cancer is acceptable in terms of disease control and toxicity as validated by audit at 2 years

  5. Potential bud bank responses to apical meristem damage and environmental variables: matching or complementing axillary meristems?

    Science.gov (United States)

    Klimešová, Jitka; Malíková, Lenka; Rosenthal, Jonathan; Šmilauer, Petr

    2014-01-01

    Soil nutrients, dormant axillary meristem availability, and competition can influence plant tolerance to damage. However, the role of potential bud banks (adventitious meristems initiated only after injury) is not known. Examining Central European field populations of 22 species of short-lived monocarpic herbs exposed to various sources of damage, we hypothesized that: (1) with increasing injury severity, the number of axillary branches would decrease, due to axillary meristem limitation, whereas the number of adventitious shoots (typically induced by severe injury) would increase; (2) favorable environmental conditions would allow intact plants to branch more, resulting in stronger axillary meristem limitation than in unfavorable conditions; and (3) consequently, adventitious sprouting would be better enabled in favorable than unfavorable conditions. We found strong support for the first hypothesis, only limited support for the second, and none for the third. Our results imply that whereas soil nutrients and competition marginally influence plant tolerance to damage, potential bud banks enable plants to overcome meristem limitation from severe damage, and therefore better tolerate it. All the significant effects were found in intraspecific comparisons, whereas interspecific differences were not found. Monocarpic plants with potential bud banks therefore represent a distinct strategy occupying a narrow environmental niche. The disturbance regime typical for this niche remains to be examined, as do the costs associated with the banks of adventitious and axillary reserve meristems.

  6. Potential bud bank responses to apical meristem damage and environmental variables: matching or complementing axillary meristems?

    Directory of Open Access Journals (Sweden)

    Jitka Klimešová

    Full Text Available Soil nutrients, dormant axillary meristem availability, and competition can influence plant tolerance to damage. However, the role of potential bud banks (adventitious meristems initiated only after injury is not known. Examining Central European field populations of 22 species of short-lived monocarpic herbs exposed to various sources of damage, we hypothesized that: (1 with increasing injury severity, the number of axillary branches would decrease, due to axillary meristem limitation, whereas the number of adventitious shoots (typically induced by severe injury would increase; (2 favorable environmental conditions would allow intact plants to branch more, resulting in stronger axillary meristem limitation than in unfavorable conditions; and (3 consequently, adventitious sprouting would be better enabled in favorable than unfavorable conditions. We found strong support for the first hypothesis, only limited support for the second, and none for the third. Our results imply that whereas soil nutrients and competition marginally influence plant tolerance to damage, potential bud banks enable plants to overcome meristem limitation from severe damage, and therefore better tolerate it. All the significant effects were found in intraspecific comparisons, whereas interspecific differences were not found. Monocarpic plants with potential bud banks therefore represent a distinct strategy occupying a narrow environmental niche. The disturbance regime typical for this niche remains to be examined, as do the costs associated with the banks of adventitious and axillary reserve meristems.

  7. Axillary artery injury secondary to inferior shoulder dislocation.

    Science.gov (United States)

    Plaga, Brad R; Looby, Peter; Feldhaus, Steven J; Kreutzmann, Karl; Babb, Aaron

    2010-11-01

    Dislocation injuries of the glenohumeral joint are common in the general public and generally are corrected without complication. One serious complication with shoulder dislocations, or the subsequent reduction, is a lesion to the axillary artery. This specific complication is most frequently seen in the elderly population, where vascular structures have become less flexible. Also, these injuries are most common in association with anterior dislocations of the shoulder. To bring awareness to the possibility of axillary artery injury with inferior dislocation of the shoulder, the treatment options, and a review. We report a 15-year-old male athlete who inferiorly dislocated his shoulder during wrestling practice. The injury was reduced at the scene with manual traction and the patient was transferred to our clinic for evaluation. The patient was determined to have a pseudoaneurysm of the axillary artery, and the history and treatment of the illness are presented. Axillary artery injuries secondary to shoulder dislocations are rare, especially in the young athlete, and proper recognition and treatment offer patients a full recovery. Copyright © 2010. Published by Elsevier Inc.

  8. Detection of axillary lymph node metastases in breast carcinoma by technetium-99m sestamibi breast scintigraphy, ultrasound and conventional mammography

    International Nuclear Information System (INIS)

    Lam, W.W.M.; Yang, W.T.; Chan, Y.L.; Stewart, I.E.T.; Metreweli, C.; King, W.

    1996-01-01

    Axillary lymph node status is important in the staging of breast carcinoma. To evaluate the accuracy of technetium-99m sestamibi breast scintigraphy in detecting metastatic axillary lymph nodes as compared with other accepted imaging modalities, we performed 99m Tc-sestamibi breast scintigraphy, conventional mammography and ultrasound in 36 patients with primary untreated breast cardinoma. With histopathology as the gold standard, 99m Tc-sestamibi breast scintigraphy was found to yield true-positive results in 7 of 11 cases (64%) of axillary lymph nodes metastases and true-negative results in 18 of 20 cases (90%); it has an accuracy of 81%, a positive predictive value of 77.8% and a negative predicive value of 81.8%. (orig.)

  9. Axillary Phlebography; An analysis of 33 cases of healthy person

    International Nuclear Information System (INIS)

    Kim, Chu Wan

    1974-01-01

    It has been well established that axillary phlebography is excellent method in diagnosis of the primary and secondary thrombotic conditions of axillary vein. But the evaluation of veins of axilla is often difficult due to individual variation of veins and to various methods of venography. Axillary phlebographies were made in thirty-three normal Korean adults by modified bolus technique and various measurements and consideration were done for the evaluation of normal anatomical variations. Results were as follows; 1. Axillary vein was visualized satisfactory in 32 cases among 33 cases, basilic vein in 28 cases, and cephalic vein and brachial vein in 15 cases. 2. Bifid basilic vein was observed in 4 cases and trifid basilic vein in 1 case. Anastomosis between cephalic and brachial vein was observed in 5 case. In 1 case, anastomotic site of median cubital vein with basilic vein is more proximal than usual. 3. Average diameter of axillary vein were 9 mm (7-11 mm) in male and 8 mm (5-10 mm) in female at axillary border of scapula and 14 mm (11-18 mm) in male and 13 mm (11-15 mm) in female at midportion of first rib. 4. Streaming and dilution of contrast media, and deformities by valve action were observed in many cases, which may be mistaken as abnormality

  10. Blunt traumatic axillary artery truncation, in the absence of associated fracture.

    Science.gov (United States)

    Bokser, Emily; Caputo, William; Hahn, Barry; Greenstein, Josh

    2018-02-01

    Axillary artery injuries can be associated with both proximal humeral fractures (Naouli et al., 2016; Ng et al., 2016) [1,2] as well as shoulder dislocations (Leclerc et al., 2017; Karnes et al., 2016) [3,4]. We report a rare case of an isolated axillary artery truncation following blunt trauma without any associated fracture or dislocation. A 58-year-old male presented to the emergency department for evaluation after falling on his outstretched right arm. The patient was found to have an absent right radial pulse with decreased sensation to the right arm. Point of care ultrasound showed findings suspicious for traumatic axillary artery injury, and X-rays did not demonstrate any fracture. Computed tomography with angiography confirmed axillary artery truncation with active extravasation. The patient underwent successful vascular repair with an axillary artery bypass. Although extremity injuries are common in emergency departments, emergency physicians need to recognize the risk for vascular injuries, even without associated fracture or dislocation. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. In vitro PROLIFERATION ABILITY OF AXILLARY BUDS IN Musa spp

    African Journals Online (AJOL)

    AISA

    The proliferation rate of Axillary and apical buds and other growth parameters ... types of buds after four to five sub cultures in all the varieties except for CRBP 39 where the axillary bud exhibits ..... propagation, conservation and exchange.

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

    Science.gov (United States)

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

    2016-01-01

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

  13. Assessment of axillary temperature for the evaluation of normal body temperature of healthy young adults at rest in a thermoneutral environment.

    Science.gov (United States)

    Marui, Shuri; Misawa, Ayaka; Tanaka, Yuki; Nagashima, Kei

    2017-02-22

    The aims of this study were to (1) evaluate whether recently introduced methods of measuring axillary temperature are reliable, (2) examine if individuals know their baseline body temperature based on an actual measurement, and (3) assess the factors affecting axillary temperature and reevaluate the meaning of the axillary temperature. Subjects were healthy young men and women (n = 76 and n = 65, respectively). Three measurements were obtained: (1) axillary temperature using a digital thermometer in a predictive mode requiring 10 s (T ax-10 s ), (2) axillary temperature using a digital thermometer in a standard mode requiring 10 min (T ax-10 min ), and (3) tympanic membrane temperature continuously measured by infrared thermometry (T ty ). The subjects answered questions about eating and exercise habits, sleep and menstrual cycles, and thermoregulation and reported what they believed their regular body temperature to be (T reg ). T reg , T ax-10 s , T ax-10 min , and T ty were 36.2 ± 0.4, 36.4 ± 0.5, 36.5 ± 0.4, and 36.8 ± 0.3 °C (mean ± SD), respectively. There were correlations between T ty and T ax-10 min , T ty and T ax-10 s , and T ax-10 min and T ax-10 s (r = .62, r = .46, and r = .59, respectively, P body mass indices and irregular menstrual cycles. Modern devices for measuring axillary temperature may have changed the range of body temperature that is recognized as normal. Core body temperature variations estimated by tympanic measurements were smaller than those estimated by axillary measurements. This variation of axillary temperature may be due to changes in the measurement methods introduced by modern devices and techniques. However, axillary temperature values correlated well with those of tympanic measurements, suggesting that the technique may reliably report an individual's state of health. It is important for individuals to know their baseline axillary temperature to evaluate subsequent

  14. The efficacy of physiotherapy upon shoulder function following axillary dissection in breast cancer, a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Oostendorp Rob AB

    2007-08-01

    Full Text Available Abstract Background Many patients suffer from severe shoulder complaints after breast cancer surgery and axillary lymph node dissection. Physiotherapy has been clinically observed to improve treatment of these patients. However, it is not a standard treatment regime. The purpose of this study is to investigate the efficacy of physiotherapy treatment of shoulder function, pain and quality of life in patients who have undergone breast cancer surgery and axillary lymph node dissection. Methods Thirty patients following breast cancer surgery and axillary lymph node dissection were included in a randomised controlled study. Assessments were made at baseline and after three and six months. The treatment group received standardised physiotherapy treatment of advice and exercises for the arm and shoulder for three months; the control group received a leaflet containing advice and exercises. If necessary soft tissue massage to the surgical scar was applied. Primary outcome variables were amount of pain in the shoulder/arm recorded on the Visual Analogue Scale, and shoulder mobility (flexion, abduction measured using a digital inclinometer under standardized conditions. Secondary outcome measures were shoulder disabilities during daily activities, edema, grip strength of both hands and quality of life. The researcher was blinded to treatment allocation. Results All thirty patients completed the trial. After three and six months the treatment group showed a significant improvement in shoulder mobility and had significantly less pain than the control group. Quality of life improved significantly, however, handgrip strength and arm volume did not alter significantly. Conclusion Physiotherapy reduces pain and improves shoulder function and quality of life following axillary dissection after breast cancer. Trial registration ISRCTN31186536

  15. A systematic review of microwave-based therapy for axillary hyperhidrosis.

    Science.gov (United States)

    Hsu, Tzu-Herng; Chen, Yu-Tsung; Tu, Yu-Kang; Li, Chien-Nien

    2017-10-01

    To systematically analyse the literature on the use of the microwave-based device for subdermal thermolysis of the axilla and its efficacy for the treatment of axillary hyperhidrosis. A systematic review was conducted using PubMed, Embase, SCOPUS and Cochrane databases on 2 June 2016. The inclusion criteria including: (1) studies with human subjects, (2) full-text articles published in English, (3) a microwave-based device used to treat axillary hyperhidrosis and (4) trials that precisely evaluated axillary hyperhidrosis. Exclusion criteria were the following: (1) studies that did not fit the inclusion criteria mentioned above and (2) case reports and reviews. We reviewed five clinical trials and 189 patients, all of which were published between 2012 and 2016. There was one randomized controlled trial, one retrospective study and the remainder were prospective studies. Although all of the studies were conducted with a small sample size, the results indicated that microwave-based device treatment of axillary hyperhidrosis had long-term efficacy with mild adverse effects. In addition, most patients were satisfied with the outcomes in these studies. Microwave-based device treatment may be an effective alternative treatment for axillary hyperhidrosis. However, further investigation is necessary to determine its long-term efficacy and safety.

  16. Effect of temperature on development and growth potential of axillary buds in roses

    NARCIS (Netherlands)

    Marcelis-van Acker, C.A.M.

    1995-01-01

    The effect of temperature during axillary bud formation on axillary bud development and subsequent shoot growth was investigated. Growth potential of the axillary buds was studied either in situ, by pruning the parent shoot above the bud, or in isolation, by grafting the bud or by culturing the bud

  17. Axillary web syndrome following sentinel node biopsy for breast cancer.

    Science.gov (United States)

    Nieves Maldonado, S M; Pubul Núñez, V; Argibay Vázquez, S; Macías Cortiñas, M; Ruibal Morell, Á

    2016-01-01

    A 49 year-old woman diagnosed with infiltrating lobular breast carcinoma, underwent a right mastectomy and sentinel node biopsy (SLNB). The resected sentinel lymph nodes were negative for malignancy, with an axillary lymphadenectomy not being performed. In the early post-operative period, the patient reported an axillary skin tension sensation, associated with a painful palpable cord. These are typical manifestations of axillary web syndrome (AWS), a poorly known axillary surgery complication, from both invasive and conservative interventions. By presenting this case we want to focus the attention on a pathological condition, for which its incidence may be underestimated by not including it in SLNB studies. It is important for nuclear medicine physicians to be aware of AWS as a more common complication than infection, seroma, or lymphoedema, and to discuss this possible event with the patient who is consenting to the procedure. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  18. Energy expenditure during ambulation with ortho crutches and axillary crutches.

    Science.gov (United States)

    Hinton, C A; Cullen, K E

    1982-06-01

    Thirteen normal male college students were studied during unassisted ambulation and nonweight-bearing ambulation with Ortho crutches and axillary crutches to determine energy expenditure. Subjects walked at self-selected velocities. Energy expenditure was determined by analyzing expired air collected by a calorimeter. Heart rate was monitored by telemetry. During the first 2.5 minutes of walking, heart rate and energy expenditure were significantly greater for ambulation with axillary crutches than with Ortho crutches. After 11.5 minutes of walking, no difference in energy cost was found between crutch types; however, heart rate increased significantly (p less than .01) during ambulation with axillary crutches. Differences in energy cost and heart rate were attributed to increased upper extremity work performed when using axillary crutches. We concluded that during nonweight-bearing ambulation for short periods of time or over a short distance, the Ortho crutch is less taxing in terms of energy cost and heart rate demands.

  19. Indications for axillary ultrasound use in breast cancer patients.

    Science.gov (United States)

    Joh, Jennifer E; Han, Gang; Kiluk, John V; Laronga, Christine; Khakpour, Nazanin; Lee, M Catherine

    2012-12-01

    Axillary ultrasound has been adopted for preoperative planning in breast cancer. Our objective was to determine features predictive of abnormal AUS and/or positive axillary node needle biopsy (NBx). Single-institution database of breast cancer patients identified patients with preoperative AUS. Patient characteristics and outcomes were correlated with AUS and NBx. Significant features were identified using univariable and multivariable analysis and correlative statistics. Three hundred thirteen breast cancers were evaluated. Abnormal AUS was demonstrated in 250 cases (80%). Node needle biopsy was performed in 247 cases (79%). Sensitivity and specificity was 93% and 48% for AUS and 86% and 100% for NBx, respectively. Palpable axillary adenopathy was significant in logistic regression model (P AUS and NBx (P AUS. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. The efficacy of physiotherapy upon shoulder function following axillary dissection in breast cancer, a randomized controlled study.

    NARCIS (Netherlands)

    Beurskens, C.H.G.; Uden, C. van; Strobbe, L.J.; Oostendorp, R.A.B.; Wobbes, Th.

    2007-01-01

    BACKGROUND: Many patients suffer from severe shoulder complaints after breast cancer surgery and axillary lymph node dissection. Physiotherapy has been clinically observed to improve treatment of these patients. However, it is not a standard treatment regime. The purpose of this study is to

  1. Primary infiltrating ductal carcinoma of the axillary breast with metastasis to the contralateral chest wall

    Directory of Open Access Journals (Sweden)

    Li-Min Sun

    2013-06-01

    Full Text Available Primary infiltrating ductal carcinoma of the axillary breast is rare and has a high frequency of lymph node (LN involvement. We report a woman with primary infiltrating ductal carcinoma arising from the right axillary breast with metastasis to the contralateral chest wall. Excisional biopsy of the left chest wall nodule and the right axillary mass was carried out and both showed invasive ductal carcinomas histologically. The lesion of the right axillary mass arose from the breast tissue, rather than the LN. Further surgery proved the right axillary LN metastasis. After further review, a primary infiltrating ductal carcinoma of the right axillary breast with metastasis to axillary LNs and contralateral chest wall was diagnosed. The patient also received chemotherapy and radiation and there was no evidence of tumor recurrence after treatment. The present report demonstrated a rare case with uncommon manifestation. Lesions of uncertain origin around the periphery of the breast should be suspected for breast carcinoma.

  2. SOME ASPECTS OF THE ANATOMY OF AXILLARY LYMPH NODES

    Directory of Open Access Journals (Sweden)

    A. I. Shvedavchenko

    2009-01-01

    Full Text Available The paper concisely reviews the classifications of axillary lymph nodes (LN and considers various approaches to their formation. The authors identify the axillary lymph chain consisting of lateral, central, and apical groups of nodes through which lymph outflows into the overlying lymph collectors, as well as of subscapular and medial groups of nodes from where lymph makes its way into the auxil- lary lymph chain.

  3. Cytokinins and polar transport of auxin in axillary pea buds

    Directory of Open Access Journals (Sweden)

    Petr Kalousek

    2010-01-01

    Full Text Available The influence of cytokinin on auxin transport during release of axillary buds from apical dominance was studied. Expression of auxin-carrier coding genes PsAUX1 (AUXIN RESISTANT 1 and PsPIN1 (PIN-FORMED 1 was explored in axillary buds of the 2nd node of 7-day pea plants (Pisum sativum L. cv. Vladan after decapitation or after exogenous application of benzyladenine (6-benzylaminopurine onto axillary buds of intact plants. Localization of the PsPIN1 protein, the key factor for polar transport of auxin in axillary buds, was visualised by immunohistochemistry. After exogenous application of cytokinin the expression of PsAUX1 and PsPIN1 rapidly increased with a simultaneous rapid decrease in PsDRM1 and PsAD1 expression – genes related to bud dormancy. The same changes in expression were observed after decapitation, however they were markedly slower. The PsPIN1 auxin efflux carrier in the inhibited axillary buds of intact plants was localised in a non-polar manner. After exogenous application of cytokinin gradual polarisation of the PsPIN1 protein occurred on the basal pole of polar auxin transport competent cells. Despite the fact that direct auxin application to buds of intact plants led to an increase in PsAUX1 and PsPIN1 expression, the buds remained dormant (non-growing what was accompanied by persistent expression of the dormancy markers PsDRM1 and PsAD1. The results indicate a possible effect of cytokinins on biosynthesis, and/or transport of auxin in axillary buds and they highlight the importance of auxin-cytokinin crosstalk in the regulation of bud outgrowth after breaking of apical dominance.

  4. Partial lower axillary dissection for patients with clinically node-negative breast cancer.

    Science.gov (United States)

    Kodama, H; Mise, K; Kan, N

    2012-01-01

    To evaluate retrospectively the outcomes of partial lower axillary lymph node dissection caudal to the intercostobrachial nerve in patients with clinically node-negative (N(0)) breast cancer. Numbers of dissected and metastatic nodes, overall and disease-free survival rates, postoperative complication rates, and axillary recurrence were compared between patients who underwent breast cancer surgery with partial axillary node dissection (n = 1043) and historical controls who underwent conventional dissection (n = 1084). The 5-year overall and disease-free survival rates were 95.6% and 89.7%, and 94.9% and 88.4%, respectively, in the partial dissection and conventional dissection groups; the differences were not significant. Mean duration of surgery (41.6 min versus 60.9 min), intraoperative blood loss (28.0 ml versus 51.3 ml), volume of lymphatic drainage at 2 weeks postoperatively (488 ml versus 836 ml), and persistent arm lymphoedema (0.0% versus 11.8%) were significantly different between the partial and conventional dissection groups, respectively. Partial axillary lymph node dissection was associated with similar survival rates (but lower postoperative complication rates) compared with conventional axillary dissection and is recommended in patients with N(0) breast cancer.

  5. Primary breast lymphoma presenting as non-healing axillary abscess.

    Science.gov (United States)

    Anele, Chukwuemeka; Phan, Yih Chyn; Wong, Suanne; Poddar, Anil

    2015-10-07

    A 67-year-old woman with non-insulin dependent diabetes mellitus with a history consistent with a right axillary abscess, presented to her general practitioner (GP). A diagnosis of folliculitis was made and the GP started a course of flucloxacillin. Despite antibiotics, the patient's symptoms worsened and the abscess increased in size. This prompted her GP to perform an incision and drainage procedure of the abscess. The practice nurse subsequently oversaw the follow-up care of the wound. Two months after the incision and drainage, and after regular wound dressing, the patient was referred to the acute surgical team with a complicated, non-healing right axillary abscess cavity and associated generalised right breast cellulitis. There was no history of breast symptoms prior to the onset of the axillary abscess. The patient underwent wound debridement, washout and application of negative pressure vacuum therapy. Biopsies revealed primary breast lymphoma (B-cell). She underwent radical chemotherapy and is currently in remission. 2015 BMJ Publishing Group Ltd.

  6. Short versus long-term postoperative drainage of the axilla after axillary lymph node dissection. A prospective randomized study

    NARCIS (Netherlands)

    Baas-Vrancken Peeters, Marie-Jeanne T. F. D.; Kluit, Ariane B.; Merkus, Jos W. S.; Breslau, Paul J.

    2005-01-01

    Background. Axillary lymph node dissection (ALND) is a standard procedure in the treatment of breast cancer. Current practice following ALND involves several days of drainage of the axilla to reduce the formation of seroma. The aim of this study is to investigate the feasibility of 24 h drainage.

  7. Biomechanical study on axillary crutches during single-leg swing-through gait.

    Science.gov (United States)

    Goh, J C; Toh, S L; Bose, K

    1986-08-01

    This paper describes a kinetic and kinematic study on axillary crutches during one-leg swing-through gait. The primary objective is to evaluate the interplay of forces at the crutch and body interfaces and to relate them in the understanding of problems associated with the use of axillary crutches. Ten normal adult male subjects with simulated left leg impairment participated in the study. For data acquisition, the VICON kinematic system, a Kistler force plate and an instrumented crutch (with force transducers at the two upper struts close to the axillary bar and one near the crutch tip) were used. Results showed that the peak ground reaction force on the weight-bearing leg during lower limb stance increased by 21.6 percent bodyweight. The peak reaction force transmitted to the arm during crutch stance was 44.4 percent bodyweight. These increased loadings could be detrimental to patients with unsound weight-bearing leg and upper extremities respectively. When the crutches were used incorrectly, 34 percent bodyweight was carried by the underarm. This could cause undue pressure over the neurovascular structures at the axillary region.

  8. Comparison of the effect of diode laser versus intense pulsed light in axillary hair removal.

    Science.gov (United States)

    Ormiga, Patricia; Ishida, Cleide Eiko; Boechat, Alvaro; Ramos-E-Silva, Marcia

    2014-10-01

    Devices such as diode laser and intense pulsed light (IPL) are in constant development aiming at permanent hair removal, but there are few comparative studies between these technologies. The objective was to comparatively assess axillary hair removal performed by diode laser and IPL and to obtain parameters of referred pain and evolution response for each method. A comparative prospective, double-blind, and randomized study of axillary hair removal performed by the diode laser and IPL was conducted in 21 females. Six sessions were held with application of the diode laser in one axilla and the IPL in the other, with intervals of 30 days and follow-up of 6 months after the last session. Clinical photographs and digital dermoscopy for hair counts in predefined and fixed fields of the treated areas were performed before, 2 weeks after the sixth session, and 6 months after the end of treatment. A questionnaire to assess the pain was applied. The number of hair shafts was significantly reduced with the diode laser and IPL. The diode laser was more effective, although more painful than the IPL. No serious, adverse, or permanent effects were observed with both technologies. Both diode laser and the IPL are effective, safe, and able to produce lasting results in axillary hair removal.

  9. Comparison of rectal, tympanic membrane and axillary temperature measurement methods in dogs.

    Science.gov (United States)

    Lamb, V; McBrearty, A R

    2013-11-30

    The aim of this study was to compare axillary and tympanic membrane (TM) temperature measurements to rectal temperature in a large group of clinical canine patients. We also sought to ascertain whether certain factors affected the differences between the measurements and to compare the ease of measurement. Axillary temperatures were easy to obtain but tended to be lower than rectal readings (median difference 0.6°C). In 54.7 per cent of dogs there was a difference of >0.5°C between the two readings. Weight, coat length, body condition score and breed size were significantly associated with the difference between the rectal and axillary temperature. TM temperatures were more similar to rectal temperatures (median difference 0°C) but in 25 per cent of dogs, there was a difference of >0.5°C between rectal and TM readings. TM measurements were less well tolerated than axillary measurements. None of the factors assessed were associated with the difference between the rectal and TM temperature. As a difference of >0.5°C has previously been described as unacceptable for different methods of temperature measurement, neither axillary nor TM temperatures are interchangeable with rectal temperatures for the measurement of body temperature.

  10. Deodorant effects of a sage extract stick: Antibacterial activity and sensory evaluation of axillary deodorancy.

    Science.gov (United States)

    Shahtalebi, Mohammad Ali; Ghanadian, Mustafa; Farzan, Ali; Shiri, Niloufar; Shokri, Dariush; Fatemi, Syed Ali

    2013-10-01

    Deodorant products prevent the growth and activity of the degrading apocrine gland bacteria living in the armpit. Common antibacterial agents in the market like triclosan and aluminum salts, in spite of their suitable antibacterial effects, increase the risk of Alzheimer's disease, breast and prostate cancers or induce contact dermatitis. Therefore, plant extracts possessing antibacterial effects are of interest. The aim of the present study was to verify the in vitro antimicrobial effects of different sage extracts against two major bacteria responsible for axillary odor, and to evaluate the deodorant effect of a silicon-based stick containing sage extracts in different densities in humans. Different fractions of methanolic extract of Salvia officinalis (sage) were evaluated on a culture of armpit skin surface of volunteers through agar microdilution antimicrobial assay. Then, randomized, double-blind placebo-controlled clinical trial with the best antibacterial fraction was conducted on 45 female healthy volunteers. Participants were treated with a single dose in four groups, each containing 15 individuals: Group 1 (200 μg/mL), 2 (400 μg/mL), 3 (600 μg/mL) of dichloromethane sage extract, and placebo (without extract). A standard sensory evaluation method for the evaluation of deodorant efficacy was used before, and two hours, four hours, and eight hours after single application of a deodorant or placebo (ASTM method E 1207-87 Standard Practice for the Sensory Evaluation of Axillary Deodorancy). The data were analyzed with two factors relating to densities and time. In 45 participants with a mean [± standard deviation (SD)] age of 61.5±11.8 years, statistically significant within-group differences were observed before and two, four, and eight hours after deodorant treatment for groups 1, 2, and 3. Groups 1, 2, and 3 had a significantly smaller odor score than placebo after two, four, and eight hours (P sage extract sticks (P sage extract of 200, 400, or 600

  11. Single incision thoracoscopic sympathectomy for palmar and axillary hyperhidrosis

    Directory of Open Access Journals (Sweden)

    Aram Baram

    2014-02-01

    Full Text Available Background: Primary hyperhidrosis is characterized by excessive sweating beyond physiological needs. It is a common disease (incidence 2.8% that causes intense discomfort for patients. In the last decade, advantages of Single-Incision Thoracoscopic Sympathectomy have become clear, particularly in decreasing morbidity of sympathectomy. Patients and methods: From January 2010 to December 2012, 39 patients (29 females and 10 males with primary palmar or axillary hyperhidrosis were treated by thoracoscopic sympathectomy. The age ranged from 18 to 40 years with a mean of 26.28 years. We used single incision thoracoscopic electrocoagulation through 10 mm incision for thoracic sympathetic chain (T2–T4. Results: The mean follow-up was 23.6 ± 14.2 months (range = 4–24 months. A total of 97.42% of patients were satisfied with the results. A total of 72.5% of patients had cure, one patient (2.5% and another patient (2.5% presented with recurrent axillary hyperhidrosis. The morbidity was 10.2% with no mortality. Percentage of compensatory sweating and gustatory sweating were 5.1% (p = .353 and 2.5% (p = .552, respectively. The result of sympathectomy in patients with both palmar and axillary hyperhidrosis was significantly better (17, 43.58% compared to palmar type (14, 35.89% or axillary type (7, 17.94%. Conclusion: Thoracoscopic sympathectomy is a simple, safe, and cost-effective therapy with good results and low complications.

  12. Comparison of axillary and rectal temperatures for healthy Beagles in a temperature- and humidity-controlled environment.

    Science.gov (United States)

    Mathis, Justin C; Campbell, Vicki L

    2015-07-01

    To compare axillary and rectal temperature measurements obtained with a digital thermometer for Beagles in a temperature- and humidity-controlled environment. 26 healthy Beagles (17 sexually intact males and 9 sexually intact females). Dogs were maintained in a temperature- and humidity-controlled environment for 56 days before rectal and axillary temperatures were measured. Axillary and rectal temperatures were obtained in triplicate for each dog by use of a single commercially available manufacturer-calibrated digital thermometer. Mean rectal and axillary temperatures of Beagles maintained in a temperature- and humidity-controlled environment were significantly different, with a median ± SD difference of 1.4° ± 0.15°C (range, 0.7° to 2.1°C). Mean rectal and axillary temperatures were 38.7°C (range, 37.6° to 39.5°C) and 37.2°C (range, 36.6° to 38.3°C), respectively. Results of this study indicated that the historical reference of a 0.55°C gradient between rectal and axillary temperatures that has been clinically used for veterinary patients was inaccurate for healthy Beagles in a temperature- and humidity-controlled environment. Rectal and axillary temperatures can be measured in veterinary patients. Reliable interpretation of axillary temperatures may accommodate patient comfort and reduce patient anxiety when serial measurement of temperatures is necessary. Further clinical studies will be needed.

  13. Tangential vs. defined radiotherapy in early breast cancer treatment without axillary lymph node dissection. A comparative study

    Energy Technology Data Exchange (ETDEWEB)

    Nitsche, Mirko [Zentrum fuer Strahlentherapie und Radioonkologie, Bremen (Germany); Universitaet Kiel, Klinik fuer Strahlentherapie, Karl-Lennert-Krebscentrum, Kiel (Germany); Temme, Nils; Foerster, Manuela; Reible, Michael [Zentrum fuer Strahlentherapie und Radioonkologie, Bremen (Germany); Hermann, Robert Michael [Zentrum fuer Strahlentherapie und Radioonkologie, Bremen (Germany); Medizinische Hochschule Hannover, Abteilung Strahlentherapie und Spezielle Onkologie, Hannover (Germany)

    2014-08-15

    Recent studies have demonstrated low regional recurrence rates in early-stage breast cancer omitting axillary lymph node dissection (ALND) in patients who have positive nodes in sentinel lymph node dissection (SLND). This finding has triggered an active discussion about the effect of radiotherapy within this approach. The purpose of this study was to analyze the dose distribution in the axilla in standard tangential radiotherapy (SRT) for breast cancer and the effects on normal tissue exposure when anatomic level I-III axillary lymph node areas are included in the tangential radiotherapy field configuration. We prospectively analyzed the dosimetric treatment plans from 51 consecutive women with early-stage breast cancer undergoing radiotherapy. We compared and analyzed the SRT and the defined radiotherapy (DRT) methods for each patient. The clinical target volume (CTV) of SRT included the breast tissue without specific contouring of lymph node areas, whereas the CTV of DRT included the level I-III lymph node areas. We evaluated the dose given in SRT covering the axillary lymph node areas of level I-III as contoured in DRT. The mean V{sub D95} {sub %} of the entire level I-III lymph node area in SRT was 50.28 % (range, 37.31-63.24 %), V{sub D45} {sub Gy} was 70.1 % (54.8-85.4 %), and V{sub D40} {sub Gy} was 83.5 % (72.3-94.8 %). A significant difference was observed between lung dose and heart toxicity in SRT vs. DRT. The V{sub 20} {sub Gy} and V{sub 30} {sub Gy} of the right and the left lung in DRT were significantly higher in DRT than in SRT (p < 0.001). The mean heart dose in SRT was significantly lower (3.93 vs. 4.72 Gy, p = 0.005). We demonstrated a relevant dose exposure of the axilla in SRT that should substantially reduce local recurrences. Furthermore, we demonstrated a significant increase in lung and heart exposure when including the axillary lymph nodes regions in the tangential radiotherapy field set-up. (orig.) [German] Aktuelle Studien zeigen

  14. Comparison of ultrasound and ultrasound plus nerve stimulator guidance axillary plexus block

    International Nuclear Information System (INIS)

    Demirelli, G.; Baskan, S.; Karabeyoglu, I.; Aytac, I.; Omek, D.H.; Erdogmus, A.; Baydar, M.

    2017-01-01

    To evaluate the characteristics of axillary plexus blockade applied using ultrasound only and using ultrasound together with nerve stimulator in patients undergoing planned forearm, wrist or hand surgery. Methods: This randomised, prospective, double-blinded, single-centre study was conducted at Ankara Numune Training and Research Hospital, Ankara, Turkey, from November 2014 to August 2015, and comprised patients undergoing forearm, wrist or hand surgery. Participants were separated into 2 groups. In Group 1, the nerve roots required for the surgical site were located one by one and local anaesthetic was applied separately to each nerve for the block. In Group 2, the vascular nerve bundle was located under ultrasound guidance and a total block was achieved by administering all the local anaesthetic within the nerve sheath. In the operating room, standard monitorisation was applied. Following preparation of the skin, the axillary region nerve roots and branches and vascular structures were observed by examination with a high-frequency ultrasound probe. In both groups, a 22-gauge, 5cm block needle was entered to the axillary region with visualisation of the whole needle on ultrasound and 20ml local anaesthetic of 0.5% bupivacaine was injected. SPSS 19 was used for data analysis. Results: Of the 60 participants, there were 30(50%) in each group. The mean age was 39.1+-15 years in the group 1 which was the ultrasound nerve stimulation group, and 41.5+-14.3 years in group 2. The duration of the procedure was longer in group I than in group 2 (p<0.05). Patient satisfaction values during the procedure were higher in group 2(p<0.05). In the ulnar sensory examination, the values of the patients in group 1 were higher at 10, 15, 20 and 25 minutes (p<0.05). In the median, radial and ulnar motor examination, the values of the patients in group 1were higher at 15 and 20 minutes (p<0.05). Conclusion: Brachial plexus blockade via axillary approach guided by ultrasound offered

  15. Value of FNAC in abnormal axillary lymph nodes with non specific mammograms

    Directory of Open Access Journals (Sweden)

    Rania S.M. Ibrahim

    2018-06-01

    Conclusions: FNAC was a good cytological predictor in the majority of patients with abnormal lymph nodes and nonspecific mammography. FNAC is cost effective in assessing axillary lymph node status especially in limited resource setting like in our developing country. FNAC is preferred diagnostic tool in all cases of abnormal axillary lymph adenopathy.

  16. Axillary Lymph Node Evaluation Utilizing Convolutional Neural Networks Using MRI Dataset.

    Science.gov (United States)

    Ha, Richard; Chang, Peter; Karcich, Jenika; Mutasa, Simukayi; Fardanesh, Reza; Wynn, Ralph T; Liu, Michael Z; Jambawalikar, Sachin

    2018-04-25

    The aim of this study is to evaluate the role of convolutional neural network (CNN) in predicting axillary lymph node metastasis, using a breast MRI dataset. An institutional review board (IRB)-approved retrospective review of our database from 1/2013 to 6/2016 identified 275 axillary lymph nodes for this study. Biopsy-proven 133 metastatic axillary lymph nodes and 142 negative control lymph nodes were identified based on benign biopsies (100) and from healthy MRI screening patients (42) with at least 3 years of negative follow-up. For each breast MRI, axillary lymph node was identified on first T1 post contrast dynamic images and underwent 3D segmentation using an open source software platform 3D Slicer. A 32 × 32 patch was then extracted from the center slice of the segmented tumor data. A CNN was designed for lymph node prediction based on each of these cropped images. The CNN consisted of seven convolutional layers and max-pooling layers with 50% dropout applied in the linear layer. In addition, data augmentation and L2 regularization were performed to limit overfitting. Training was implemented using the Adam optimizer, an algorithm for first-order gradient-based optimization of stochastic objective functions, based on adaptive estimates of lower-order moments. Code for this study was written in Python using the TensorFlow module (1.0.0). Experiments and CNN training were done on a Linux workstation with NVIDIA GTX 1070 Pascal GPU. Two class axillary lymph node metastasis prediction models were evaluated. For each lymph node, a final softmax score threshold of 0.5 was used for classification. Based on this, CNN achieved a mean five-fold cross-validation accuracy of 84.3%. It is feasible for current deep CNN architectures to be trained to predict likelihood of axillary lymph node metastasis. Larger dataset will likely improve our prediction model and can potentially be a non-invasive alternative to core needle biopsy and even sentinel lymph node

  17. Axillary Temperature, as Recorded by the iThermonitor WT701, Well Represents Core Temperature in Adults Having Noncardiac Surgery.

    Science.gov (United States)

    Pei, Lijian; Huang, Yuguang; Mao, Guangmei; Sessler, Daniel I

    2018-03-01

    Core temperature can be accurately measured from the esophagus or nasopharynx during general anesthesia, but neither site is suitable for neuraxial anesthesia. We therefore determined the precision and accuracy of a novel wireless axillary thermometer, the iThermonitor, to determine its suitability for use during neuraxial anesthesia and in other patients who are not intubated. We enrolled 80 adults having upper abdominal surgery with endotracheal intubation. Intraoperative core temperature was measured in distal esophagus and was estimated at the axilla with a wireless iThermonitor WT701 (Raiing Medical, Boston MA) at 5-minute intervals. Pairs of axillary and reference distal esophageal temperatures were compared and summarized using linear regression and repeated-measured Bland-Altman methods. We a priori determined that the iThermonitor would have clinically acceptable accuracy if most estimates were within ±0.5°C of the esophageal reference, and suitable precision if the limits of agreement were within ±0.5°C. There were 3339 sets of paired temperatures. Axillary and esophageal temperatures were similar, with a mean difference (esophageal minus axillary) of only 0.14°C ± 0.26°C (standard deviation). The Bland-Altman 95% limits of agreement were reasonably narrow, with the estimated upper limit at 0.66°C and the lower limit at -0.38°C, thus ±0.52°C, indicating good agreement across the range of mean temperatures from 34.9°C to 38.1°C. The absolute difference was within 0.5°C in 91% of the measurements (95% confidence interval, 88%-93%). Axillary temperature, as recorded by the iThermonitor WT701, well represents core temperature in adults having noncardiac surgery and thus appears suitable for clinical use.

  18. Rapid on-site evaluation of axillary fine-needle aspiration cytology in breast cancer.

    LENUS (Irish Health Repository)

    O'Leary, D P

    2012-06-01

    Axillary ultrasonography (AUS) and fine-needle aspiration cytology (FNAC) can establish axillary lymph node status before surgery, although this technique is hampered by poor adequacy rates. To achieve consistently high rates of FNAC adequacy, rapid on-site evaluation (ROSE) of FNAC samples was introduced.

  19. Axillary iodine-131 accumulation due to perspiration

    International Nuclear Information System (INIS)

    Camponovo, E.J.; Goyer, P.F.; Silverman, E.D.; Kistler, A.M.; Yudt, W.M.

    1989-01-01

    A case of spurious axillary uptake of I-131 proven to be caused by perspiration is presented. False-positive localizations of radioiodine, both pathologic and physiologic, are reviewed to avoid confusion of these entities with functioning thyroid carcinoma metastases

  20. Self-taught axillary vein access without venography for pacemaker implantation: prospective randomized comparison with the cephalic vein access.

    Science.gov (United States)

    Squara, Fabien; Tomi, Julien; Scarlatti, Didier; Theodore, Guillaume; Moceri, Pamela; Ferrari, Emile

    2017-12-01

    Axillary vein access for pacemaker implantation is uncommon in many centres because of the lack of training in this technique. We assessed whether the introduction of the axillary vein technique was safe and efficient as compared with cephalic vein access, in a centre where no operators had any previous experience in axillary vein puncture. Patients undergoing pacemaker implantation were randomized to axillary or cephalic vein access. All three operators had no experience nor training in axillary vein puncture, and self-learned the technique by reading a published review. Axillary vein puncture was fluoroscopy-guided without contrast venography. Cephalic access was performed by dissection of delto-pectoral groove. Venous access success, venous access duration (from skin incision to guidewire or lead in superior vena cava), procedure duration, X-ray exposure, and peri-procedural (1 month) complications were recorded. results We randomized 74 consecutive patients to axillary (n = 37) or cephalic vein access (n = 37). Axillary vein was successfully accessed in 30/37 (81.1%) patients vs. 28/37 (75.7%) of cephalic veins (P = 0.57). Venous access time was shorter in axillary group than in cephalic group [5.7 (4.4-8.3) vs. 12.2 (10.5-14.8) min, P < 0.001], as well as procedure duration [34.8 (30.6-38.4) vs. 42.0 (39.1-46.6) min, P = 0.043]. X-ray exposure and peri-procedural overall complications were comparable in both groups. Axillary puncture was safe and faster than cephalic access even for the five first procedures performed by each operator. Self-taught axillary vein puncture for pacemaker implantation seems immediately safe and faster than cephalic vein access, when performed by electrophysiologists trained to pacemaker implantation but not to axillary vein puncture. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissions@oup.com.

  1. Pretreatment axillary ultrasonography and core biopsy in patients with suspected breast cancer: Diagnostic accuracy and impact on management

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Ortega, Maria Jose, E-mail: rserranogan@telefonica.net [Breast Imaging Center, Radiology Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Alvarez Benito, Marina, E-mail: marinaalvarezbenito@telefonica.net [Breast Imaging Center, Radiology Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Fuentes Vahamonde, Elena, E-mail: elena.fuentes.sspa@juntadeandalucia.es [Pathology Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Rioja Torres, Pilar, E-mail: priojat@yahoo.es [Clinical Management Unit, Department of General and Digestive Surgery, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Benitez Velasco, Ana, E-mail: abvelazco@yahoo.es [Nuclear Medicine Department, Hospital Universitario Reina Sofia, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain); Martinez Paredes, Maria, E-mail: mariaparedes@uco.es [Radiology and Physical Medicine Area, University of Cordoba Medical School, Avda. Menendez Pidal s/n, 14004 Cordoba (Spain)

    2011-07-15

    Preoperative diagnosis of axillary metastases in breast cancer patients enables treatment planning. We aimed to evaluate the diagnostic accuracy of axillary ultrasonography and percutaneous biopsy, both alone and in combination, in detecting axillary metastases in patients with breast cancer and to assess the impact of these techniques on the patients' management. Materials and methods: Retrospective study of consecutive patients with suspected breast cancer examined between October 2006 and December 2008. The diagnosis of a primary tumor was histologically confirmed in all patients. All patients underwent axillary ultrasonography and percutaneous core biopsy (14G) of suspicious lymph nodes. We evaluated the morphological characteristics of the lymph nodes by ultrasonography. We calculated the diagnostic accuracy of ultrasonography and of core biopsy, and assessed the impact of these techniques on patients' treatment. Results: We evaluated 675 axillary regions and performed 291 core biopsies of axillary lymph nodes in 662 patients. In 650 patients, breast cancer was histologically confirmed and in 12 patients malignant tumors in other locations were confirmed. The sensitivity and specificity of axillary ultrasonography were 63.2% and 88.7%, respectively. The absence of a fatty hilum within the lymph node was the ultrasonographic finding with the highest positive predictive value for malignancy (93.1%). The sensitivity and specificity of axillary core biopsy were 69.1% and 100%, respectively. Sentinel lymph node biopsy was avoided in 33% of initial candidates and immediate breast reconstruction was undertaken in 35.1% of the patients with mastectomy and negative axillary core biopsy. Conclusions: Ultrasonography and axillary core biopsy enable adequate pretreatment staging in patients with breast cancer and has a positive impact on their management.

  2. Bilateral axillary artery aneurysms after Bentall procedure in Marfan syndrome.

    Science.gov (United States)

    Haruki, Takashi; Ito, Hiroshi; Sakata, Kensuke; Kobayashi, Yurio

    2015-11-01

    A man with Marfan syndrome underwent a Bentall procedure for annuloaortic ectasia and severe aortic regurgitation at 43 years of age. Twenty-eight years after the Bentall procedure, he developed bilateral axillary artery aneurysms (length × diameter: right: 80 × 39 mm; left: 103 × 45 mm). Aneurysmectomy and reconstruction of the axillary artery were performed using an artificial vascular graft. Histological examination revealed cystic medial necrosis. The postoperative course was uneventful, but long-term follow-up is necessary. © The Author(s) 2014.

  3. Ontogeny of axillary buds and shoots in roses: Leaf initiation and pith development.

    NARCIS (Netherlands)

    Marcelis-van Acker, C.A.M.

    1994-01-01

    The ontogeny of an axillary bud (in the middle region of a shoot) from initiation up to flowering of the subsequent shoot was studied. The first secondary buds appeared in the axillary bud (primary bud) when the leaf subtending the primary bud unfolded. By that time, the primary bud contained seven

  4. Sentinel Lymph Node Biopsy in Breast Cancer: Predictors of Axillary and Non-Sentinel Lymph Node Involvement

    Directory of Open Access Journals (Sweden)

    Hakan Postacı

    2013-12-01

    Full Text Available Background: Sentinel lymph node biopsy is a standard method for the evaluation of axillary status in patients with T1-2N0M0 breast cancers. Aims: To determine the prognostic significance of primary tumour-related clinico-histopathological factors on axillary and non-sentinel lymph node involvement of patients who underwent sentinel lymph node biopsy. Study design: Retrospective clinical study. Methods: In the present study, 157 sentinel lymph node biopsies were performed in 151 consecutive patients with early stage breast cancer between June 2008 and December 2011. Results: Successful lymphatic mapping was obtained in 157 of 158 procedures (99.4%. The incidence of larger tumour size (2.543±1.21 vs. 1.974±1.04, lymphatic vessel invasion (70.6% vs. 29.4%, blood vessel invasion (84.2% vs. 15.8%, and invasive lobular carcinoma subtype (72.7% vs. 27.3% were statistically significantly higher in patients with positive SLNs. Logistic stepwise regression analysis disclosed tumour size (odds ratio: 1.51, p=0.0021 and lymphatic vessel invasion (odds ratio: 4.68, p=0.001 as significant primary tumour-related prognostic determinants of SLN metastasis. Conclusion: A close relationship was identified between tumour size and lymphatic vessel invasion of the primary tumour and axillary lymph node involvement. However, the positive predictive value of these two independent variables is low and there is no compelling evidence to recommend their use in routine clinical practice.

  5. Ultrasound-guided axillary nerve block for ED incision and drainage of deltoid abscess.

    Science.gov (United States)

    Lyons, Claire; Herring, Andrew A

    2017-07-01

    Deltoid abscesses are common and painful, often a consequence of injection drug use and seen frequently in emergency departments (EDs). The required incision and drainage can be completed successfully with effective pain relief using a peripheral nerve block. The brachial plexus nerve block works well, however it is technically complex with a low, but potentially serious, risk of complications such as phrenic nerve paralysis. Selective blockade of the axillary nerve eliminates the risks associated with a brachial plexus block, while providing more specific anesthesia for the deltoid region. Our initial experience suggests that the axillary nerve block (ANB) is a technically simple, safe, and effective way to manage the pain of deltoid abscesses and the necessary incision and drainage (I&D). The block involves using ultrasound guidance to inject a 20mL bolus of local anesthetic into the quadrangular space surrounding the axillary nerve (inferior to the posterolateral aspect of the acromion, near the overlap of the long head of triceps brachii and teres minor). Once injected the local will anesthetize the axillary nerve resulting in analgesia of the cutaneous area of the lateral shoulder and the deeper tissues including the deltoid muscle. Further research will clarify questions about the volume and concentration of local anesthetic, the role of injected adjuncts, and expected duration of analgesia and anesthesia. Herein we present a description of an axillary nerve block successfully used for deltoid abscess I&D in the ED. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Ultrasound-guided core biopsy: an effective method of detecting axillary nodal metastases.

    LENUS (Irish Health Repository)

    Solon, Jacqueline G

    2012-02-01

    BACKGROUND: Axillary nodal status is an important prognostic predictor in patients with breast cancer. This study evaluated the sensitivity and specificity of ultrasound-guided core biopsy (Ax US-CB) at detecting axillary nodal metastases in patients with primary breast cancer, thereby determining how often sentinel lymph node biopsy could be avoided in node positive patients. STUDY DESIGN: Records of patients presenting to a breast unit between January 2007 and June 2010 were reviewed retrospectively. Patients who underwent axillary ultrasonography with or without preoperative core biopsy were identified. Sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography and percutaneous biopsy were evaluated. RESULTS: Records of 718 patients were reviewed, with 445 fulfilling inclusion criteria. Forty-seven percent (n = 210\\/445) had nodal metastases, with 110 detected by Ax US-CB (sensitivity 52.4%, specificity 100%, positive predictive value 100%, negative predictive value 70.1%). Axillary ultrasonography without biopsy had sensitivity and specificity of 54.3% and 97%, respectively. Lymphovascular invasion was an independent predictor of nodal metastases (sensitivity 60.8%, specificity 80%). Ultrasound-guided core biopsy detected more than half of all nodal metastases, sparing more than one-quarter of all breast cancer patients an unnecessary sentinel lymph node biopsy. CONCLUSIONS: Axillary ultrasonography, when combined with core biopsy, is a valuable component of the management of patients with primary breast cancer. Its ability to definitively identify nodal metastases before surgical intervention can greatly facilitate a patient\\'s preoperative integrated treatment plan. In this regard, we believe our study adds considerably to the increasing data, which indicate the benefit of Ax US-CB in the preoperative detection of nodal metastases.

  7. Sentinel node detection in pre-operative axillary staging.

    Science.gov (United States)

    Trifirò, Giuseppe; Viale, Giuseppe; Gentilini, Oreste; Travaini, Laura Lavinia; Paganelli, Giovanni

    2004-06-01

    The concept of sentinel lymph node biopsy in breast cancer surgery is based on the fact that the tumour drains in a logical way via the lymphatic system, from the first to upper levels. Since axillary node dissection does not improve the prognosis of patients with breast cancer, sentinel lymph node biopsy might replace complete axillary dissection for staging of the axilla in clinically N0 patients. Sentinel lymph node biopsy would represent a significant advantage as a minimally invasive procedure, considering that about 70% of patients are found to be free from metastatic disease, yet axillary node dissection can lead to significant morbidity. Subdermal or peritumoural injection of small aliquots (and very low activity) of radiotracer is preferred to intratumoural administration, and (99m)Tc-labelled colloids with most of the particles in the 100-200 nm size range would be ideal for radioguided sentinel node biopsy in breast cancer. The success rate of radioguidance in localising the sentinel lymph node in breast cancer surgery is about 97% in institutions where a high number of procedures are performed, and the success rate of lymphoscintigraphy in sentinel node detection is about 100%. The sentinel lymph node should be processed for intraoperative frozen section examination in its entirety, based on conventional histopathology and, when necessary, immune staining with anti-cytokeratin antibody. Nowadays, lymphoscintigraphy is a useful procedure in patients with different clinical evidence of breast cancer.

  8. A comparative study of thoracoscopic sympathicotomy versus local surgical treatment for axillary hyperhidrosis

    DEFF Research Database (Denmark)

    Heidemann, Erik; Licht, Peter B

    2013-01-01

    Axillary hyperhidrosis affects approximately 1.4% of the population. Medical management is often frustrating, and the response generally transient. Surgical methods include thoracoscopic sympathectomy or sympathicotomy and local axillary surgery such as suction-curettage or en-bloc skin resection....... Many case series with retrospective follow-up are available in the literature, but no comparative studies between surgical techniques have been published....

  9. Linfonodo sentinela intramamário comprometido e axila livre: esvaziamento axilar ou conduta conservadora? Intramammary lymph node sentinel metastasis without metastasis in axilla: axillary lymph node dissection or conservative surgery?

    Directory of Open Access Journals (Sweden)

    René Aloisio da Costa Vieira

    2012-01-01

    Full Text Available A pesquisa do linfonodo sentinela constitui tratamento padrão para pacientes portadoras de câncer de mama e axila clinicamente negativa. A presença do linfonodo sentinela (LS extra-axilar e intramamário (IM ocorre em até 2,6% dos casos, e na presença do LS IM metastático, a positividade axilar pode alcançar até 81%. Na associação do LS IM metastático ao LS axilar não metastático, não há conduta padronizada, visto um limitado número de casos descritos. Adicionamos dois casos à literatura, observando, em um deles, a presença de doença metastática axilar na linfadenectomia complementar. A utilização de nomograma demonstrou que o risco de doença metastática axilar era inferior a 10%, e a adição destes casos à literatura mostrou que, nesta situação, a taxa de doença metastática axilar é de 6,25%. Discutimos os prós e contras da linfadenectomia axilar complementar nesta situação.The sentinel lymph node biopsy is a standard treatment for patients with breast cancer and clinically negative axilla lymph node. The presence of an extra-axillary and intra-axillary (IM sentinel lymph node (SLN occurs in up to 2.6% of cases. In the presence of a metastatic IM SLN, axillary positivity may occur in up to 81% of cases. Due to the limited number of cases reported, there is no standard treatment for the association of metastatic SLN IM and non-metastatic axillary SLN . We add here two cases to the literature, one of them with metastatic disease in the axilla. The use of a nomogram demonstrated that the risk of axillary metastasis was less than 10% and the addition of these cases to the literature showed that in this situation the rate of axillary metastasis is 6.25%. We discuss the pros and cons of further axillary dissection in this situation.

  10. Nipple adenoma arising from axillary accessory breast: a case report

    Directory of Open Access Journals (Sweden)

    Shioi Yoshihiro

    2012-11-01

    Full Text Available Abstract Nipple adenoma is a relatively rare benign breast neoplasm, and cases of the disease arising from the axillary accessory breast have very seldom been reported in the English literature. We report a case of nipple adenoma arising from axillary accessory breast including clinical and pathological findings. An 82-year-old woman presented with the complaint of a small painful mass in the right axilla. Physical examination confirmed a well-defined eczematous crusted mass that was 8 mm in size. The diagnosis of nipple adenoma was made from an excisional specimen on the basis of characteristic histological findings. Microscopic structural features included a compact proliferation of small tubules lined by epithelial and myoepithelial cells, and the merging of glandular epithelial cells of the adenoma into squamous epithelial cells in the superficial epidermal layer. Because clinically nipple adenoma may resemble Paget’s disease and pathologically can be misinterpreted as tubular carcinoma, the correct identification of nipple adenoma is an important factor in the differential diagnosis for axillary tumor neoplasms. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1186821489769063

  11. [Comparison of body temperatures in children measured using 3 different thermometers: tympanic, skin and digital axillary].

    Science.gov (United States)

    Padilla-Raygoza, Nicolás; Ruiz-Paloalto, M Laura; Díaz-Guerrero, Rosalina; Olvera-Villanueva, Georgina; Maldonado, Angélica; Raygoza-Mendoza, María Del Pilar

    2014-01-01

    To compare body temperature measurements using tympanic, skin and digital axillary thermometers. Hospitalized or outpatient children from the General Hospital Celaya, ISSSTE Hospital Clinic and General Hospital No. 4 IMSS, and the pediatric private service in Celaya, Guanajuato, from 1 day of life until 16 years old, were recruited over a one month period, after their parents signed the consent form. The order of each institution was selected by simple randomization. Body temperatures were measured in triplicate using tympanic, skin and digital axillary thermometers. The sample consisted of 554 children. The Pearson r between the tympanic and digital axillary thermometers was 0.57 to 0.65, with a positive linear relationship (P<.05); between the skin and the digital axillary thermometers, it was between 0.47 and 0.52 with a positive linearrelationship (P<.05). The intra-observer Kappa for the tympanic thermometer was 0.86, and for the inter-observer was 0.77; for the skin thermometer it was 0.82 and 0.67, respectively, and for the digital axillary thermometer it was 0.86 for intra-observer reliability and 0.78 for inter -observer reliability. Tympanic and axillary thermometers showed better precision in measuring the body temperature in children than skin thermometers. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  12. Axillary lymph nodes siliconoma in a woman with intracapsular implant rupture

    International Nuclear Information System (INIS)

    Plachkov, I.; Cvetankov, K.; Hadjidekov, G.

    2013-01-01

    Full text: Introduction: Siliconoma, or silicone granuloma is the migration of silicon particles in the axillary lymph nodes, muscle and other non- ruptured or intact silicone implant. The latter is a relatively rare finding, and usually occurs in patients with extracapsular rupture of silicone prosthesis and has a typical ultrasound image. We present a case of a young woman with bilateral silicone prostheses placed 5 years ago, where in the right axilla are enlarged, structurally altered lymph nodes in the clinical and ultrasonography studies. Subsequent magnetic resonance examination shows intracapsular rupture ipsilateral silicone prosthesis and migration of silicon particles in the axillary lymph nodes. What you will learn: In this case we present twenty-three year old woman who reported pain and ‘swelling’ in the right axilla. The patient is with bilateral silicone prosthesis, she is not febrile and not reported other illness. After physical examination enlarged and tender lymph nodes in the right axilla was found. Several structurally altered and enlarged lymph nodes were visualized by ultrasound. These lymph nodes are hypoechogenic with obliterated fatty hilus. Due to the suspicion of silicone ‘extravasation’ in axillary lymph nodes, a magnetic resonance study of both mammary glands was performed. The images show intracapsular rupture of the right prosthesis without reliable data on silicone gel outside the fibrous capsule. Discussion: Siliconoma is a complication after plastic surgery of the breast and can affect both the axillary lymph nodes, and other lymphatic chains and also muscle and lung. Most frequently it occurs at damage of the extracapsular silicone prostheses. More rarely siliconoma occurs in siliconoma intracapsular damage, as in the presented case or in a silicone gel microbleed. Conclusion: The presence of siliconoma in axillary lymph nodes is relatively rare complication in plastic surgery of the breast. Methods of imaging diagnostic

  13. Axillary fine needle aspiration cytology for pre-operative staging of patients with screen-detected invasive breast carcinoma.

    LENUS (Irish Health Repository)

    Hayes, Brian D

    2012-02-01

    INTRODUCTION: Fine needle aspiration cytology (FNAC) of radiologically abnormal axillary lymph nodes in patients with breast cancer can identify patients suitable for primary axillary clearance (AC) rather than sentinel node biopsy, enabling surgical axillary staging by a single operation. This study assessed the accuracy of FNAC in predicting positive axillary lymph nodes. METHODS: 161 patients with screen-detected invasive carcinoma and who had pre-operative FNAC of a radiologically abnormal axillary lymph node were identified from two screening units, The axillary FNAC reports were correlated with sentinel node biopsy and AC reports, and sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated. RESULTS: FNAC had a moderate sensitivity (66.3%) and NPV (71.8%), and a high specificity (98.7%) and PPV (98.3%). Most patients (86%) had a single axillary operation. The sensitivity was highest in grade 3 (81.8%) and ductal type (77.8%) tumours. The sensitivity was lower in tumours of special type (34.8%), grade 1 tumours (50%) and those without lymphovascular invasion (LVI) (55.9%). The NPV was highest in pT1 (86.7%) and in grade 1 (84.5%) tumours, and lowest (44%) in tumours with LVI. The PPV was 100% in grade 1 and 3 tumours, stage pT2 and pT3 tumours and those without LVI, and was high (>96%) in all other groups. In lymph-node-positive patients, the mean number of lymph nodes involved was higher in the case of a positive (6.4) than negative FNAC (4.4). CONCLUSIONS: FNAC of ultrasonically abnormal axillary lymph nodes achieved surgical staging by a single operation in most patients with screen-detected invasive breast carcinoma, with moderate sensitivity and high specificity.

  14. Development and growth potential of axillary buds in roses as affected by bud age.

    NARCIS (Netherlands)

    Marcelis-van Acker, C.A.M.

    1994-01-01

    The effect of axillary bud age on the development and potential for growth of the bud into a shoot was studied in roses. Age of the buds occupying a similar position on the plant varied from 'subtending leaf just unfolded' up to 1 year later. With increasing age of the axillary bud its dry mass,

  15. Axillary lymph node dissection for breast cancer utilizing Harmonic Focus®

    Directory of Open Access Journals (Sweden)

    Moldrem Amy

    2011-08-01

    Full Text Available Abstract Background For patients with axillary lymph node metastases from breast cancer, performance of a complete axillary lymph node dissection (ALND is the standard approach. Due to the rich lymphatic network in the axilla, it is necessary to carefully dissect and identify all lymphatic channels. Traditionally, these lymphatics are sealed with titanium clips or individually sutured. Recently, the Harmonic Focus®, a hand-held ultrasonic dissector, allows lymphatics to be sealed without the utilization of clips or ties. We hypothesize that ALND performed with the Harmonic Focus® will decrease operative time and reduce post-operative complications. Methods Retrospective review identified all patients who underwent ALND at a teaching hospital between January of 2005 and December of 2009. Patient demographics, presenting pathology, treatment course, operative time, days to drain removal, and surgical complications were recorded. Comparisons were made to a selected control group of patients who underwent similar surgical procedures along with an ALND performed utilizing hemostatic clips and electrocautery. A total of 41 patients were included in this study. Results Operative time was not improved with the use of ultrasonic dissection, however, there was a decrease in the total number of days that closed suction drainage was required, although this was not statistically significant. Complication rates were similar between the two groups. Conclusion In this case-matched retrospective review, there were fewer required days of closed suction drainage when ALND was performed with ultrasonic dissection versus clips and electrocautery.

  16. Diagnostic performance of fluorodeoxyglucose-positron emission tomography/computed tomography of breast cancer in detecting axillary lymph node metastasis. Comparison with ultrasonography and contrast-enhanced CT

    International Nuclear Information System (INIS)

    Monzawa, Shuichi; Adachi, Shuji; Suzuki, Kayo; Hirokaga, Koichi; Takao, Shintaro; Sakuma, Toshiko; Hanioka, Keisuke

    2009-01-01

    The purpose of this retrospective study was to evaluate the diagnostic performance of positron emission tomography/computed tomography (PET/CT) with fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose (FDG) in comparison with that of ultrasonography and contrast-enhanced computed tomography (CT) in detecting axillary lymph node metastasis in patients with breast cancer. Fifty patients with invasive breast cancer were recruited. They had received no neoadjuvant chemotherapy and underwent PET/CT, ultrasonography and contrast-enhanced CT before mastectomy. The clinical stage was I in 34 patients, II in 15 patients, and III in one patient. The images of these modalities were interpreted in usual practice before surgery and the diagnostic reports were reviewed for analysis. Sensitivity, specificity, positive predictive value, and negative predictive value of each modality were obtained taking histopathological results of axillary lymph node dissection or sentinel lymph node biopsy as the reference standard. Axillary lymph node metastasis was confirmed in 15 of 50 patients by histopathological studies. PET/CT identified lymph node metastasis in three of these 15 patients. The overall sensitivity and specificity, positive predictive value, and negative predictive value of PET/CT in the diagnosis of axillary lymph node metastasis were 20, 97, 75, and 74%, and those of ultrasonography were 33, 94, 71, and 77% and those of contrast-enhanced CT were 27, 97, 80, and 76%, respectively. PET/CT showed poor sensitivity and high specificity in the detection of axillary lymph node metastasis of breast cancer. Diagnostic performance of PET/CT was not superior to that of ultrasonography and contrast-enhanced CT. (author)

  17. Multi-detector row CT in the assessment of axillary lymph node metastasis in breast cancer

    International Nuclear Information System (INIS)

    Murakami, Shogo

    2003-01-01

    The purpose of this study is to evaluate the diagnostic capability instead of clinical efficacy of multi-detector row CT (MDCT) in the assessment of axillary lymph node metastasis in breast cancer. MDCT was performed in 63 patients with breast cancer, and multiplanar reformation (MPR) and volume rendering (VR) images were reconstructed for the evaluation of bilateral axillary lymph nodes. Two hundred sixty eight lymph nodes were depicted with MDCT, and correlation with pathological findings was performed. The short axis length of lymph node was measured on MPR image, and the shape of the nodes was analyzed with the pathological results statistically. The diagnostic criteria on size and shape of lymph node metastasis were discussed Dynamic study with contrast media was also performed, and the CT value ratios (CTVR) of the lymph nodes and breast tumors were calculated. No relevance of axillary lymph node metastasis was noted to the pathological types of breast cancer. The average short axis length of the ipsilateral axillary nodes was 8.9 mm±3.8 (SD) while that of the contralateral nodes was 4.9 mm±1.1 (SD) showing significant difference. More than 6.5 mm in short length of the lymph node was thought to be an effective criterion for positive metastasis, and its sensitivity was 96%. Soybean-shape lymph node was statistically common in metastasis, while non-metastatic nodes were commonly demonstrated as letter ''c'' shape or ring-like shape. Statistical relevance was obtained between the CTVR of axillary lymph nodes and that of breast tumors, suggesting clinical usefulness of dynamic study using contrast media in the evaluation of lymph node metastasis. With MPR and VR images using MDCT, more accurate morphological evaluation of axillary lymph nodes was possible. When soybean-shape node with more than 6.5 mm in short axis is depicted in the axillar region on MDCT metastasis should be the consideration. Comparison with the contralateral side as a control in coronal

  18. Sentinel node biopsy before neoadjuvant chemotherapy spares breast cancer patients axillary lymph node dissection.

    Science.gov (United States)

    van Rijk, Maartje C; Nieweg, Omgo E; Rutgers, Emiel J T; Oldenburg, Hester S A; Olmos, Renato Valdés; Hoefnagel, Cornelis A; Kroon, Bin B R

    2006-04-01

    Neoadjuvant chemotherapy in breast cancer patients is a valuable method to determine the efficacy of chemotherapy and potentially downsize the primary tumor, which facilitates breast-conserving therapy. In 18 studies published about sentinel node biopsy after neoadjuvant chemotherapy, the sentinel node was identified in on average 89%, and the false-negative rate was on average 10%. Because of these mediocre results, no author dares to omit axillary clearance just yet. In our institute, sentinel lymph node biopsy is performed before neoadjuvant chemotherapy. The aim of this study was to evaluate our experience with this approach. Sentinel node biopsy was performed before neoadjuvant chemotherapy in 25 T2N0 patients by using lymphoscintigraphy, a gamma ray detection probe, and patent blue dye. Axillary lymph node dissection was performed after chemotherapy if the sentinel node contained metastases. Ten patients had a tumor-positive axillary sentinel node, and one patient had an involved lateral intramammary node. Four patients had additional involved nodes in the completion lymph node dissection specimen. The other 14 patients (56%) had a tumor-negative sentinel node and did not undergo axillary lymph node dissection. No recurrences have been observed after a median follow-up of 18 months. Fourteen (56%) of the 25 patients were spared axillary lymph node dissection when the sentinel node was found to be disease free. Performing sentinel node biopsy before neoadjuvant chemotherapy seems successful and reliable in patients with T2N0 breast cancer.

  19. Predicting axillary lymph node metastasis from kinetic statistics of DCE-MRI breast images

    Science.gov (United States)

    Ashraf, Ahmed B.; Lin, Lilie; Gavenonis, Sara C.; Mies, Carolyn; Xanthopoulos, Eric; Kontos, Despina

    2012-03-01

    The presence of axillary lymph node metastases is the most important prognostic factor in breast cancer and can influence the selection of adjuvant therapy, both chemotherapy and radiotherapy. In this work we present a set of kinetic statistics derived from DCE-MRI for predicting axillary node status. Breast DCE-MRI images from 69 women with known nodal status were analyzed retrospectively under HIPAA and IRB approval. Axillary lymph nodes were positive in 12 patients while 57 patients had no axillary lymph node involvement. Kinetic curves for each pixel were computed and a pixel-wise map of time-to-peak (TTP) was obtained. Pixels were first partitioned according to the similarity of their kinetic behavior, based on TTP values. For every kinetic curve, the following pixel-wise features were computed: peak enhancement (PE), wash-in-slope (WIS), wash-out-slope (WOS). Partition-wise statistics for every feature map were calculated, resulting in a total of 21 kinetic statistic features. ANOVA analysis was done to select features that differ significantly between node positive and node negative women. Using the computed kinetic statistic features a leave-one-out SVM classifier was learned that performs with AUC=0.77 under the ROC curve, outperforming the conventional kinetic measures, including maximum peak enhancement (MPE) and signal enhancement ratio (SER), (AUCs of 0.61 and 0.57 respectively). These findings suggest that our DCE-MRI kinetic statistic features can be used to improve the prediction of axillary node status in breast cancer patients. Such features could ultimately be used as imaging biomarkers to guide personalized treatment choices for women diagnosed with breast cancer.

  20. Secondary node analysis as an indicator for axillary lymphadenectomy in breast cancer patients.

    Science.gov (United States)

    Cremades, Manel; Torres, Mireia; Solà, Montse; Navinés, Jordi; Pascual, Icíar; Mariscal, Antonio; Caballero, Albert; Castellà, Eva; Luna, Miguel Ángel; Julián, Joan Francesc

    2017-11-01

    Currently, there is no agreement regarding if it would be necessary to perform an axillary lymph node dissection (ALND) in patients who have macrometastases in the sentinel lymph node (SLN). We studied the utility of the secondary node analysis (SN), defined as the following node after the SLN in an anatomical and lymphatic pathway, as a sign of malignant axillary involvement. An observational, retrospective and multicentre study was designed to assess the utility of the SN as a sign of axillary involvement. Among 2273 patients with breast cancer, a valid sample of 283 was obtained representing those who had the SN studied. Main endpoints of our study were: the SLN, the SN and the ALND histological pattern. Sensitivity, specificity and precision of the test were also calculated. SN test, in cases with positive SLN, has a sensitivity of 61.1%, a specificity of 78.7%, a positive predictive value of 45.8% and a negative predictive value of 87.3% with a precision of 74.7%. The study of the SN together with the technique of the SLN allows a more precise staging of the axillary involvement, in patients with breast cancer, than just the SLN technique. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Staging of women with breast cancer after introduction of sentinel node guided axillary dissection

    DEFF Research Database (Denmark)

    Tvedskov, Tove Filtenborg

    2012-01-01

    Today, sentinel lymph node dissection (SLND) has replaced axillary lymph node dissection (ALND) as standard procedure for staging of the axilla in the treatment of breast cancer. SLND can accurately stage the axilla by removing on average only two lymph nodes. Only in case of metastatic spread...... was not significantly different in the two periods, whereas the proportion of patients with micrometastases increased significantly from 5.1% to 9.0%. However, the proportion of patients offered adjuvant systemic treatment due to positive nodal status as the only high-risk criterion did only increase from 7.8% to 8...

  2. An estimation of the minimum effective anesthetic volume of 2% lidocaine in ultrasound-guided axillary brachial plexus block.

    LENUS (Irish Health Repository)

    O'Donnell, Brian D

    2009-07-01

    Ultrasound guidance facilitates precise needle and injectate placement, increasing axillary block success rates, reducing onset times, and permitting local anesthetic dose reduction. The minimum effective volume of local anesthetic in ultrasound-guided axillary brachial plexus block is unknown. The authors performed a study to estimate the minimum effective anesthetic volume of 2% lidocaine with 1:200,000 epinephrine (2% LidoEpi) in ultrasound-guided axillary brachial plexus block.

  3. Benefits of ambulatory axillary intra-aortic balloon pump for circulatory support as bridge to heart transplant.

    Science.gov (United States)

    Umakanthan, Ramanan; Hoff, Steven J; Solenkova, Natalia; Wigger, Mark A; Keebler, Mary E; Lenneman, Andrew; Leacche, Marzia; Disalvo, Thomas G; Ooi, Henry; Naftilan, Allen J; Byrne, John G; Ahmad, Rashid M

    2012-05-01

    Axillary intra-aortic balloon pump therapy has been described as a bridge to transplant. Advantages over femoral intra-aortic balloon pump therapy include reduced incidence of infection and enhanced patient mobility. We identified the patients who would benefit most from this therapy while awaiting heart transplantation. We conducted a single-center, retrospective observational study to evaluate outcomes from axillary intra-aortic balloon pump therapy. These included hemodynamic parameters, duration of support, and success in bridging to transplant. We selected patients on the basis of history of sternotomy, elevated panel-reactive antibody, and small body habitus. Patients were made to ambulate aggressively beginning on postoperative day 1. Between September 2007 and September 2010, 18 patients underwent axillary intra-aortic balloon pump therapy. All patients had the devices placed through the left axillary artery with a Hemashield side graft (Boston Scientific, Natick, Mass). Before axillary placement, patients underwent femoral placement to demonstrate hemodynamic benefit. Duration of support ranged from 5 to 63 days (median = 19 days). There was marked improvement in ambulatory potential and hemodynamic parameters, with minimal blood transfusion requirements. There were no device-related infections. Some 72% of the patients (13/18) were successfully bridged to transplantation. Axillary intra-aortic balloon pump therapy provides excellent support for selected patients as a bridge to transplant. The majority of the patients were successfully bridged to transplant and discharged. Although this therapy has been described in previous studies, this is the largest series to incorporate a regimen of aggressive ambulation with daily measurements of distances walked. Copyright © 2012. Published by Mosby, Inc.

  4. Technological evolution of axillary lymph nodes: Radiological visualisation in breast cancer patients

    International Nuclear Information System (INIS)

    Eglitis, J.; Krumins, V.; Stengrevics, A.; Berzins, A.; Vevere, I.; Storozenko, G.

    2004-01-01

    Full text: In patients with breast cancer, detection of axillary lymph node spread has a great prognostic significance. Visualisation of lymphatic glands is attracting attention of radiologists since long. Lymphogram usually shows 4-9 lymph glands as compared to 8 to 50 identified during surgical intervention. Lymphography is a laborious and complicated process requiring specific skills. Likewise, the evaluation and interpretation of results depends upon the experience of the specialist. We evaluated 234 breast cancer patients and found that lymphograms of these patients initially detected 1-2 central axillary lymph nodes followed by others. During surgical intervention, the total number of lymphatic glands removed from these patients was 3,241 of which only 2,693 (83.1%) were seen on lymphography. On further evaluation it was found that the largest groups of lymphatic nodes were seen in the following pattern (i) central axillary (ii) subclavicular (iii) lateral, with central axillary lymph nodes being the biggest (1.5 - 2 cm) and subclavicular the smallest (0.2 - 0.5 cm). Sternal lymph nodes receive lymph from medial quadrants of the breast and / or if the axillary lymph nodes are obstructed by metastases. The results of lymphography and post-operative examination matched in 71.7-75 % of cases. False positivity was seen in 19.2 % and false negative 9.1 % instances. As this method was not sufficiently selective and specific, its relative upsurge receded backwards and was forgotten. The last decade of the twentieth century saw a sentinel node (SN) concept. In advanced countries, the possibility to detect breast cancer of up to 1 cm diameter corresponding to T1A category, when the axillary lymph nodes still are not involved in malignant growth, accounts about 50%. Hence the search of lymphatic spread vis-a-vis sentinel node detection has gained more importance. Earlier, SN detection involved colour contrast methods, which was reasonably sensitive and specific in

  5. Traumatiske laesioner af a. axillaris og a. brachialis

    DEFF Research Database (Denmark)

    Bitsch, M; Hensler, M K; Schroeder, T V

    1994-01-01

    During af six year period 16 patients were treated for an axillary or brachial artery trauma. The vascular injury was caused by fracture in nine cases, contusion in four and penetrating injury in three. Concomitant nerve or tendon lesion occurred in five cases. Five of the 16 events were industri...

  6. Utility of 18F-fluoro-deoxyglucose emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in combination with ultrasonography for axillary staging in primary breast cancer

    International Nuclear Information System (INIS)

    Ueda, Shigeto; Ishida, Jiro; Abe, Yoshiyuki; Mochizuki, Hidetaka; Tsuda, Hitoshi; Asakawa, Hideki; Omata, Jiro; Fukatsu, Kazuhiko; Kondo, Nobuo; Kondo, Tadaharu; Hama, Yukihiro; Tamura, Katsumi

    2008-01-01

    Accurate evaluation of axillary lymph node (ALN) involvement is mandatory before treatment of primary breast cancer. The aim of this study is to compare preoperative diagnostic accuracy between positron emission tomography/computed tomography with 18 F-fluorodeoxyglucose ( 18 F-FDG PET/CT) and axillary ultrasonography (AUS) for detecting ALN metastasis in patients having operable breast cancer, and to assess the clinical management of axillary 18 F-FDG PET/CT for therapeutic indication of sentinel node biopsy (SNB) and preoperative systemic chemotherapy (PSC). One hundred eighty-three patients with primary operable breast cancer were recruited. All patients underwent 18 F-FDG PET/CT and AUS followed by SNB and/or ALN dissection (ALND). Using 18 F-FDG PET/CT, we studied both a visual assessment of 18 F-FDG uptake and standardized uptake value (SUV) for axillary staging. In a visual assessment of 18 F-FDG PET/CT, the diagnostic accuracy of ALN metastasis was 83% with 58% in sensitivity and 95% in specificity, and when cut-off point of SUV was set at 1.8, sensitivity, specificity, and accuracy were 36, 100, and 79%, respectively. On the other hand, the diagnostic accuracy of AUS was 85% with 54% in sensitivity and 99% in specificity. By the combination of 18 F-FDG PET/CT and AUS to the axilla, the sensitivity, specificity, and accuracy were 64, 94, and 85%, respectively. If either 18 F-FDG PET uptake or AUS was positive in allixa, the probability of axillary metastasis was high; 50% (6 of 12) in 18 F-FDG PET uptake only, 80% (4 of 5) in AUS positive only, and 100% (28 of 28) in dual positive. By the combination of AUS and 18 F-FDG PET/CT, candidates of SNB were more appropriately selected. The axillary 18 F-FDG uptake was correlated with the maximum size and nuclear grade of metastatic foci (p = 0.006 and p = 0.03). The diagnostic accuracy of 18 F-FDG PET/CT was shown to be nearly equal to ultrasound, and considering their limited sensitivities, the high radiation

  7. Is axillary sonographic staging less accurate in invasive lobular breast cancer than in ductal breast cancer?

    Science.gov (United States)

    Sankaye, Prashant; Chhatani, Sharmila; Porter, Gareth; Steel, Jim; Doyle, Sarah

    2014-10-01

    The purpose of this study was to determine whether axillary sonography is less accurate in invasive lobular breast cancer than in ductal breast cancer. Patients with invasive breast cancer were retrospectively identified from histologic records from 2010 to 2012. Staging axillary sonograms from 96 patients with primary breast cancer in each of 2 subgroups, invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC), were reviewed. Preoperative sonographically guided 14-gauge core biopsy was performed on morphologically abnormal lymph nodes. Thirty-one of 96 patients (32%) in each subgroup were node positive on final postoperative histopathologic analysis. Axillary staging sensitivity was 17 of 31 patients (54%) in the IDC subgroup and 15 of 31(48%) in the ILC subgroup. Further analysis of the data showed no statistically significant differences between these subgroups. We found that there was no statistically significant difference in the accuracy of axillary sonographic staging between ILC and IDC. © 2014 by the American Institute of Ultrasound in Medicine.

  8. Nomogram for prediction of level 2 axillary lymph node metastasis in proven level 1 node-positive breast cancer patients.

    Science.gov (United States)

    Jiang, Yanlin; Xu, Hong; Zhang, Hao; Ou, Xunyan; Xu, Zhen; Ai, Liping; Sun, Lisha; Liu, Caigang

    2017-09-22

    The current management of the axilla in level 1 node-positive breast cancer patients is axillary lymph node dissection regardless of the status of the level 2 axillary lymph nodes. The goal of this study was to develop a nomogram predicting the probability of level 2 axillary lymph node metastasis (L-2-ALNM) in patients with level 1 axillary node-positive breast cancer. We reviewed the records of 974 patients with pathology-confirmed level 1 node-positive breast cancer between 2010 and 2014 at the Liaoning Cancer Hospital and Institute. The patients were randomized 1:1 and divided into a modeling group and a validation group. Clinical and pathological features of the patients were assessed with uni- and multivariate logistic regression. A nomogram based on independent predictors for the L-2-ALNM identified by multivariate logistic regression was constructed. Independent predictors of L-2-ALNM by the multivariate logistic regression analysis included tumor size, Ki-67 status, histological grade, and number of positive level 1 axillary lymph nodes. The areas under the receiver operating characteristic curve of the modeling set and the validation set were 0.828 and 0.816, respectively. The false-negative rates of the L-2-ALNM nomogram were 1.82% and 7.41% for the predicted probability cut-off points of level 1 axillary lymph node metastasis. Patients with a low probability of L-2-ALNM could be spared level 2 axillary lymph node dissection, thereby reducing postoperative morbidity.

  9. Field theory and the Standard Model

    Energy Technology Data Exchange (ETDEWEB)

    Dudas, E [Orsay, LPT (France)

    2014-07-01

    This brief introduction to Quantum Field Theory and the Standard Model contains the basic building blocks of perturbation theory in quantum field theory, an elementary introduction to gauge theories and the basic classical and quantum features of the electroweak sector of the Standard Model. Some details are given for the theoretical bias concerning the Higgs mass limits, as well as on obscure features of the Standard Model which motivate new physics constructions.

  10. Novel Axillary Approach for Brachial Plexus in Robotic Surgery: A Cadaveric Experiment

    Directory of Open Access Journals (Sweden)

    Cihangir Tetik

    2014-01-01

    Full Text Available Brachial plexus surgery using the da Vinci surgical robot is a new procedure. Although the supraclavicular approach is a well known described and used procedure for robotic surgery, axillary approach was unknown for brachial plexus surgery. A cadaveric study was planned to evaluate the robotic axillary approach for brachial plexus surgery. Our results showed that robotic surgery is a very useful method and should be used routinely for brachial plexus surgery and particularly for thoracic outlet syndrome. However, we emphasize that new instruments should be designed and further studies are needed to evaluate in vivo results.

  11. Studies on topical antiperspirant control of axillary hyperhidrosis.

    Science.gov (United States)

    Shelley, W B; Hurley, H J

    1975-01-01

    Axillary hyperhidrotics is reviewed from the standpoint of anatomical factors, physiological mechanisms and the history of methods of control. Anhydrous aluminum chloride and anhydrous zirconium tetrachloride are shown to be superior topical agents for partial control of axillary sweating when applied as a powder or in anhydrous nonreactive vehicles. Complete anhidrosis as demonstrated by sustained garment armpit dryness could be achieved in hyperhidrotics within 48 hours by the following trinary antiperspirant system: (1) a saturated solution of aluminum chloride hexahydrate or zirconyl chloride in absolute ethanol or isopropyl alcohol, (2) application to the dry axilla at times of sleep or other prolonged non-sweating period, (3) water vapor occlusion of area for 6 to 8 hours by means of Saran wrap. The hypothesis is presented that metallic antiperspirants act by reflux entrance into the terminal intraepidermal eccrine duct, slowly combining with the intraductal keratin, to produce a fibrillar contraction (super contraction) of keratin and hence functional closure, not histologically evident. This altered keratin is shed weeks later, with the consequent return of ductal patency and sweating.

  12. Prospective evaluation of fluorodeoxyglucose positron emission tomography/computed tomography scan (FDG-PET/CT) for axillary staging in breast cancer

    International Nuclear Information System (INIS)

    Yamaguchi, Masahide; Noguchi, Akinori; Tani, Naoki

    2008-01-01

    Seventy-two patients from 2005 October to 2007 February with operative breast cancer underwent fluorodeoxyglucose positron emission tomography/computed tomography scan (FDG-PET/CT) of chest and body, ultrasound scan (US) and enhanced computed tomography scan (CT) followed by sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND). The results of PET/CT were compared with histopathological diagnosis of SLNB and ALND. Sensitivity, specificity and accuracy of PET/CT for detection of axillary lymph node metastases were 61%, 96% and 88%, respectively. Seven false-negative and two false-positive of PET/CT results were found. In patients with false-negative of PET/CT results there are two skin-invasive breast cancer patients and axillary lymph node metastases were detected in three patients with US, in one with CT and in four with SLNB. In clinical method for diagnosis of axillary lymph node metastases SLNB should be recommended because sensitivity of PET/CT for early breast cancer patients were low and positive diagnosis of axillary lymph node metastases with PET needs more than 1 cm size of lesion. PET/CT is useful for not-early breast cancer patients. To decide the operation of axillary lymph node disection needs total diagnosis of US, CT, SLNB and clinical findings. (author)

  13. Deodorant effects of a sage extract stick: Antibacterial activity and sensory evaluation of axillary deodorancy

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Shahtalebi

    2013-01-01

    Full Text Available Background: Deodorant products prevent the growth and activity of the degrading apocrine gland bacteria living in the armpit. Common antibacterial agents in the market like triclosan and aluminum salts, in spite of their suitable antibacterial effects, increase the risk of Alzheimer′s disease, breast and prostate cancers or induce contact dermatitis. Therefore, plant extracts possessing antibacterial effects are of interest. The aim of the present study was to verify the in vitro antimicrobial effects of different sage extracts against two major bacteria responsible for axillary odor, and to evaluate the deodorant effect of a silicon-based stick containing sage extracts in different densities in humans. Materials and Methods: Different fractions of methanolic extract of Salvia officinalis (sage were evaluated on a culture of armpit skin surface of volunteers through agar microdilution antimicrobial assay. Then, randomized, double-blind placebo-controlled clinical trial with the best antibacterial fraction was conducted on 45 female healthy volunteers. Participants were treated with a single dose in four groups, each containing 15 individuals: Group 1 (200 μg/mL, 2 (400 μg/mL, 3 (600 μg/mL of dichloromethane sage extract, and placebo (without extract. A standard sensory evaluation method for the evaluation of deodorant efficacy was used before, and two hours, four hours, and eight hours after single application of a deodorant or placebo (ASTM method E 1207-87 Standard Practice for the Sensory Evaluation of Axillary Deodorancy. Results: The data were analyzed with two factors relating to densities and time. In 45 participants with a mean [± standard deviation (SD] age of 61.5±11.8 years, statistically significant within-group differences were observed before and two, four, and eight hours after deodorant treatment for groups 1, 2, and 3. Groups 1, 2, and 3 had a significantly smaller odor score than placebo after two, four, and eight hours

  14. Role of Tulipa gesneriana TEOSINTE BRANCHED1 (TgTB1) in the control of axillary bud outgrowth in bulbs.

    Science.gov (United States)

    Moreno-Pachon, Natalia M; Mutimawurugo, Marie-Chantal; Heynen, Eveline; Sergeeva, Lidiya; Benders, Anne; Blilou, Ikram; Hilhorst, Henk W M; Immink, Richard G H

    2018-06-01

    Tulip vegetative reproduction. Tulips reproduce asexually by the outgrowth of their axillary meristems located in the axil of each bulb scale. The number of axillary meristems in one bulb is low, and not all of them grow out during the yearly growth cycle of the bulb. Since the degree of axillary bud outgrowth in tulip determines the success of their vegetative propagation, this study aimed at understanding the mechanism controlling the differential axillary bud activity. We used a combined physiological and "bottom-up" molecular approach to shed light on this process and found that first two inner located buds do not seem to experience dormancy during the growth cycle, while mid-located buds enter dormancy by the end of the growing season. Dormancy was assessed by weight increase and TgTB1 expression levels, a conserved TCP transcription factor and well-known master integrator of environmental and endogenous signals influencing axillary meristem outgrowth in plants. We showed that TgTB1 expression in tulip bulbs can be modulated by sucrose, cytokinin and strigolactone, just as it has been reported for other species. However, the limited growth of mid-located buds, even when their TgTB1 expression is downregulated, points at other factors, probably physical, inhibiting their growth. We conclude that the time of axillary bud initiation determines the degree of dormancy and the sink strength of the bud. Thus, development, apical dominance, sink strength, hormonal cross-talk, expression of TgTB1 and other possibly physical but unidentified players, all converge to determine the growth capacity of tulip axillary buds.

  15. Consumption of garlic positively affects hedonic perception of axillary body odour.

    Science.gov (United States)

    Fialová, Jitka; Roberts, S Craig; Havlíček, Jan

    2016-02-01

    Beneficial health properties of garlic, as well as its most common adverse effect - distinctive breath odour - are well-known. In contrast, analogous research on the effect of garlic on axillary odour is currently missing. Here, in three studies varying in the amount and nature of garlic provided (raw garlic in study 1 and 2, garlic capsules in study 3), we tested the effect of garlic consumption on the quality of axillary odour. A balanced within-subject experimental design was used. In total, 42 male odour donors were allocated to either a "garlic" or "non-garlic" condition, after which they wore axillary pads for 12 h to collect body odour. One week later, the conditions were reversed. Odour samples were then judged for their pleasantness, attractiveness, masculinity and intensity by 82 women. We found no significant differences in ratings of any characteristics in study 1. However, the odour of donors after an increased garlic dosage was assessed as significantly more pleasant, attractive and less intense (study 2), and more attractive and less intense in study 3. Our results indicate that garlic consumption may have positive effects on perceived body odour hedonicity, perhaps due to its health effects (e.g., antioxidant properties, antimicrobial activity). Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Clinical utility of routine pre-operative axillary ultrasound and fine needle aspiration cytology in patient selection for sentinel lymph node biopsy.

    Science.gov (United States)

    Rattay, T; Muttalib, M; Khalifa, E; Duncan, A; Parker, S J

    2012-04-01

    In patients with operable breast cancer, pre-operative evaluation of the axilla may be of use in the selection of appropriate axillary surgery. Pre-operative axillary ultrasound (US) and fine needle aspiration cytology (FNAC) assessments have become routine practice in many breast units, although the evidence base is still gathering. This study assessed the clinical utility of US+/-FNAC in patient selection for either axillary node clearance (ANC) or sentinel lymph node biopsy (SLNB) in patients undergoing surgery for operable breast cancer. Over a two-year period, 348 patients with a clinically negative axilla underwent axillary US. 67 patients with suspicious nodes on US also underwent FNAC. The sensitivity and specificity of axillary investigations to determine nodal involvement were 56% (confidence interval: 47-64%) and 90% (84-93%) for US alone, and 76% (61-87%) and 100% (65-100%) for FNAC combined with US, respectively. With a positive US, the post-test probability was 78%. A negative US carried a post-test probability of 25%. When FNAC was positive, the post-test probability was greater than unity. A negative FNAC yielded a post-test probability of 52%. All patients with positive FNAC and most patients with suspicious US were listed for axillary node clearance (ANC) after consideration at the multi-disciplinary team (MDT) meeting. With pre-operative axillary US+/-FNAC, 20% of patients were saved a potential second axillary procedure, facilitating a reduction in the overall re-operation rate to 12%. In this study, a positive pre-operative US+/-FNAC directs patients towards ANC. When the result is negative, other clinico-pathological factors need to be taken into account in the selection of the appropriate axillary procedure. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Partial axillary dissection in early breast cancer | El-Fayoumi ...

    African Journals Online (AJOL)

    ... of later clinical involvement of the axilla and at establishing a sound basis for adjuvant treatment planning axillary dissection is an important operative procedure. ... Methods: Eighteen patients underwent modified radical mastectomy, while the other two patients who were fulfilling the criteria for conservative breast surgery ...

  18. Successful Completion of the Pilot Phase of a Randomized Controlled Trial Comparing Sentinel Lymph Node Biopsy to No Further Axillary Staging in Patients with Clinical T1-T2 N0 Breast Cancer and Normal Axillary Ultrasound.

    Science.gov (United States)

    Cyr, Amy E; Tucker, Natalia; Ademuyiwa, Foluso; Margenthaler, Julie A; Aft, Rebecca L; Eberlein, Timothy J; Appleton, Catherine M; Zoberi, Imran; Thomas, Maria A; Gao, Feng; Gillanders, William E

    2016-08-01

    Axillary surgery is not considered therapeutic in patients with clinical T1-T2 N0 breast cancer. The importance of axillary staging is eroding in an era in which tumor biology, as defined by biomarker and gene expression profile, is increasingly important in medical decision making. We hypothesized that axillary ultrasound (AUS) is a noninvasive alternative to sentinel lymph node biopsy (SLNB), and AUS could replace SLNB without compromising patient care. Patients with clinical T1-T2 N0 breast cancer and normal AUS were eligible for enrollment. Subjects were randomized to no further axillary staging (arm 1) vs SLNB (arm 2). Descriptive statistics were used to describe the results of the pilot phase of the randomized controlled trial. Sixty-eight subjects were enrolled in the pilot phase of the trial (34 subjects in arm 1, no further staging; 32 subjects in arm 2, SLNB; and 2 subjects voluntarily withdrew from the trial). The median age was 61 years (range 40 to 80 years) in arm 1 and 59 years (range 31 to 81 years) in arm 2, and there were no significant clinical or pathologic differences between the arms. Median follow-up was 17 months (range 1 to 32 months). The negative predictive value (NPV) of AUS for identification of clinically significant axillary disease (>2.0 mm) was 96.9%. No axillary recurrences have been observed in either arm. Successful completion of the pilot phase of the randomized controlled trial confirms the feasibility of the study design, and provides prospective evidence supporting the ability of AUS to exclude clinically significant disease in the axilla. The results provide strong support for a phase 2 randomized controlled trial. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Correlation between obesity and fat-infiltrated axillary lymph nodes visualized on mammography.

    Science.gov (United States)

    diFlorio Alexander, Roberta M; Haider, Steffen J; MacKenzie, Todd; Goodrich, Martha E; Weiss, Julie; Onega, Tracy

    2018-01-05

    Using screening mammography, this study investigated the association between obesity and axillary lymph node (LN) size and morphology. We conducted a retrospective review of 188 females who underwent screening mammography at an academic medical centre. Length and width of the LN and hilum were measured in the largest, mammographically visible axillary node. The hilo-cortical ratio (HCR) was calculated as the hilar width divided by the cortical width. Measurements were performed by a board certified breast radiologist and a resident radiology physician. Inter-rater agreement was assessed with Pearson correlation coefficient. We performed multivariable regression analysis for associations of LN measurements with body mass index (BMI), breast density and age. There was a strong association between BMI and LN dimensions, hilum dimensions and HCR (p < 0.001 for all metrics). There was no significant change in cortex width with increasing BMI (p = 0.15). Increases in LN length and width were found with increasing BMI [0.6 mm increase in length per unit BMI, 95% CI (0.4-0.8), p < 0.001 and0.3 mm increase in width per unit BMI, 95% CI(0.2-0.4), p < 0.001, respectively]. Inter-rater reliability for lymph node and hilum measurements was 0.57-0.72. We found a highly significant association between increasing BMI and axillary LN dimensions independent of age and breast density with strong interobserver agreement. The increase in LN size was driven by expansion of the LN hilum secondary to fat infiltration. Advances in knowledge: This preliminary work determined a relationship between fat infiltrated axillary lymph nodes and obesity.

  20. Utility of 18F-fluoro-deoxyglucose emission tomography/computed tomography fusion imaging (18F-FDG PET/CT in combination with ultrasonography for axillary staging in primary breast cancer

    Directory of Open Access Journals (Sweden)

    Tamura Katsumi

    2008-06-01

    Full Text Available Abstract Background Accurate evaluation of axillary lymph node (ALN involvement is mandatory before treatment of primary breast cancer. The aim of this study is to compare preoperative diagnostic accuracy between positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (18F-FDG PET/CT and axillary ultrasonography (AUS for detecting ALN metastasis in patients having operable breast cancer, and to assess the clinical management of axillary 18F-FDG PET/CT for therapeutic indication of sentinel node biopsy (SNB and preoperative systemic chemotherapy (PSC. Methods One hundred eighty-three patients with primary operable breast cancer were recruited. All patients underwent 18F-FDG PET/CT and AUS followed by SNB and/or ALN dissection (ALND. Using 18F-FDG PET/CT, we studied both a visual assessment of 18F-FDG uptake and standardized uptake value (SUV for axillary staging. Results In a visual assessment of 18F-FDG PET/CT, the diagnostic accuracy of ALN metastasis was 83% with 58% in sensitivity and 95% in specificity, and when cut-off point of SUV was set at 1.8, sensitivity, specificity, and accuracy were 36, 100, and 79%, respectively. On the other hand, the diagnostic accuracy of AUS was 85% with 54% in sensitivity and 99% in specificity. By the combination of 18F-FDG PET/CT and AUS to the axilla, the sensitivity, specificity, and accuracy were 64, 94, and 85%, respectively. If either 18F-FDG PET uptake or AUS was positive in allixa, the probability of axillary metastasis was high; 50% (6 of 12 in 18F-FDG PET uptake only, 80% (4 of 5 in AUS positive only, and 100% (28 of 28 in dual positive. By the combination of AUS and 18F-FDG PET/CT, candidates of SNB were more appropriately selected. The axillary 18F-FDG uptake was correlated with the maximum size and nuclear grade of metastatic foci (p = 0.006 and p = 0.03. Conclusion The diagnostic accuracy of 18F-FDG PET/CT was shown to be nearly equal to ultrasound, and considering their

  1. Horizontal right axillary minithoracotomy: aesthetic and effective option for atrial and ventricular septal defect repair in infants and toddlers

    Directory of Open Access Journals (Sweden)

    Luciana da Fonseca da Silva

    2014-04-01

    Full Text Available Introduction: Congenital heart defects treatment shows progressive reduction in morbidity and mortality, however, the scar, resulting from ventricular (VSD and atrial septal defect (ASD repair, may cause discomfort. Right axillary minithoracotomy approach, by avoiding the breast growth region, is an option for correction of these defects that may provide better aesthetic results at low cost. Since October 2011, we have been using this technique for repairing VSD and ASD defects as well as associated defects. Objectives: To evaluate the efficacy of this method in children undergoing correction of VSD and ASD, to compare perioperative clinical outcomes with those repaired by median sternotomy, and to evaluate the aesthetic result. Methods: Perioperative clinical data of 25 patients submitted to axillary thoracotomy were compared with data from a paired group of 25 patients with similar heart defects repaired by median sternotomy, from October 2011 to August 2012. Results: Axillary approach was possible even in infants. There was no mortality and the main perioperative variables were similar in both groups, except for lower use of blood products in the axillary group (6/25 vs. control (13/25, with statistical difference (P =0.04. The VSD size varied from 7 to 15 mm in axillary group. Cannulation of the aorta and vena cavae was performed through the main incision, whose size ranged from 3 to 5 cm in the axillary group, with excellent aesthetic results. Conclusion: The axillary thoracotomy was effective, allowing for a heart defect repair similar to the median sternotomy, with more satisfactory aesthetic results and reduced blood transfusion, and it can be safely used in infants.

  2. presence of axillary bud and application of plant growth hormones

    African Journals Online (AJOL)

    D. alata)- were grown in pots in the greenhouse. Half the cuttings bore axillary buds and half had none. The cuttings were sprayed with a factorial combination of indole acetic acid (IAA), benzyladenine (BA) and giberellic acid (GA3). Cuttings ...

  3. Staging primary breast cancer. Are there tumour pathological features that correlate with a false-negative axillary ultrasound?

    International Nuclear Information System (INIS)

    Johnson, S.; Brown, S.; Porter, G.; Steel, J.; Paisley, K.; Watkins, R.; Holgate, C.

    2011-01-01

    Aim: To investigate whether the histopathological characteristics of primary breast cancer tumours could predict the likelihood of false-negative axillary ultrasound. Materials and methods: Screening and symptomatic patients were identified from pathology records and imaging and pathology records reviewed. True and false-negative axillary staging ultrasound groups were compared statistically in terms of tumour size, pathological type and grade, lymphovascular invasion, and oestrogen receptor (ER) status. Results: Of 155 women with normal ultrasounds, 45 (29%) were node positive at axillary surgery. Breast tumour size was significantly different with the average size smaller in the true-negative group: 21 versus 30 mm (p < 0.02). The histological type varied significantly between the groups, with more lobular carcinomas in the false-negative group [6/110 (5%) versus 6/45 (13%), p < 0.001]. The false-negative group was also more likely to show lymphovascular invasion in the breast [6/110 (5%) versus 14/45 (31%), p < 0.001]. There was no significant difference in tumour grade or ER status. Conclusion: The present study has found significant differences in tumour characteristics between women with true-negative and false-negative axillary staging ultrasound in terms of size, primary tumour histological type and presence of lymphovascular invasion. In particular, axillary ultrasound in primary lobular carcinoma may be less accurate and a negative result is more likely to be spurious than with primary ductal carcinomas.

  4. Merkel cell carcinoma with axillary metastasis; a case report of a rare disease

    Directory of Open Access Journals (Sweden)

    Serdar Culcu

    2018-04-01

    Full Text Available Merkel cell carcinoma is a rare primer neuroendocrine carcinoma of the skin. It is an extremely aggressive tumor. This rare carcinoma is seen with high local and regional recurrence ratios and distant metastasis. We report that a 64 years old female patient who had undergo an excision in another center because of a mass on 4 cm proximal of her right elbow had been diagnosed with Merkel cell carcinoma with positive surgical margins. She was treated with wide re-excision and axillary dissection at our clinic. Keywords: Merkel cell carcinoma, Skin, Axillary metastasis

  5. Harmonic focus versus electrocautery in axillary lymph node dissection for breast cancer: a randomized clinical study.

    Science.gov (United States)

    He, Qingqing; Zhuang, Dayong; Zheng, Luming; Fan, Ziyi; Zhou, Peng; Zhu, Jian; Lv, Zhen; Chai, Jixin; Cao, Lei

    2012-12-01

    Electrocautery has been proven to be associated with prolonged serous drainage that might result in several complications in patients requiring axillary lymph node dissection for breast cancer. We proposed that the Harmonic Focus might outperform electrocautery in axillary lymph node dissection, resulting in shorter operative times and reduced postoperative complications. One hundred twenty-eight women with confirmed T1-3 N1-2 breast cancer were randomly assigned to undergo mastectomy or breast-conserving surgery with axillary dissection by using Harmonic Focus or electrocautery. Sixty-four has surgery with Harmonic Focus (group A) and 64 with electrocautery (group B) by the same surgical team. Operative time, blood loss, total drainage volume and days, incidence of seroma, hematoma, pain score, and flap necrosis were recorded. Using Harmonic Focus significantly diminished operative time, blood loss, total drainage volume, days of stay, and visual analogue scale as compared with traditional electrocautery. There was no statistical difference between the 2 groups regarding seroma, hematoma, and flap necrosis. Axillary lymph node dissection using Harmonic Focus is feasible, safe, and a more comfortable design for the surgeon. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. [Isolated traumatic injuries of the axillary nerve. Radial nerve transfer in four cases and literatura review].

    Science.gov (United States)

    Domínguez-Páez, Miguel; Socolovsky, Mariano; Di Masi, Gilda; Arráez-Sánchez, Miguel Ángel

    2012-11-01

    To analyze the results of an initial series of four cases of traumatic injuries of the axillary nerve, treated by a nerve transfer from the triceps long branch of the radial nerve. An extensive analysis of the literature has also been made. Four patients aged between 21 and 42 years old presenting an isolated traumatic palsy of the axillary nerve were operated between January 2007 and June 2010. All cases were treated by nerve transfer six to eight months after the trauma. The results of these cases are analyzed, the same as the axillary nerve injuries series presented in the literature from 1982. One year after the surgery, all patients improved their abduction a mean of 70° (range 30 to 120°), showing a M4 in the British Medical Council Scale. No patient complained of triceps weakness after the procedure. These results are similar to those published employing primary grafting for the axillary nerve. Isolated injuries of the axillary nerve should be treated with surgery when spontaneous recovery is not verified 6 months after the trauma. Primary repair with grafts is the most popular surgical technique, with a rate of success of approximately 90%. The preliminary results of a nerve transfer employing the long triceps branch are similar, and a definite comparison of both techniques with a bigger number of cases should be done in the future. Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  7. Evaluation of axillary dose coverage following whole breast radiotherapy: Variation with the breast volume and shape

    International Nuclear Information System (INIS)

    Aguiar, Artur; Gomes Pereira, Helena; Azevedo, Isabel; Gomes, Luciano

    2015-01-01

    Objective: To evaluate the axillary dose coverage in patients treated with tridimensional whole breast radiotherapy (3D-WBRT), according to the breast volume and shape in treatment position. Background: Several studies have demonstrated an insufficient dose contribution to the axillary levels, using 3D-WBRT, remaining unclear whether the breast volume and shape can influence it. Materials and methods: We retrospectively delineated the axillary levels on planning CT-images of 100 patients, treated with 3D-WBRT along 2012 in our institution. To estimate the shape we established an anatomic CT-based interval, defined as the Thoracic Extent (TE). The breast volume matched its CTV. Mean dose levels and V95 (volume receiving at least 95% of the prescribed dose) were evaluated. Results: Mean axillary level I (A1), II (A2) and III (A3) volume was 56.1 cc, 16.5 cc and 18.9 cc, respectively, and mean doses were 43.9 Gy, 38.6 Gy and 19.5 Gy. For breast volumes of <800 cc, 800–999 cc, 1000–1199 cc and >1200 cc, mean A1 V95 was 38%, 51%, 61.2% and 57.2% whereas median A2 V95 was 8.3%, 13.4%, 19.4% and 28% respectively. Regarding shape, where the breast relative position to the TE was categorized in intervals between 31% and 40%, 41% and 50%, 51% and 60%, and 61% and 70%, mean A1 V95 was 38.7%, 43.1%, 51.1% and 77.3% whereas mean A2 V95 was 6.1%, 11.2%, 17.1% and 37% respectively. Conclusions: We observed inadequate dose coverage to all axillary levels, even after applying a sub-analysis accounting for different breast volumes and shapes. Although higher doses were associated with the more voluminous and pendulous breasts, axillary coverage with 3D-WBRT seems to be inefficient, regardless of the breast morphology

  8. Use of ropivacain and lidocaine for axillary plexus blockade ...

    African Journals Online (AJOL)

    Use of ropivacain and lidocaine for axillary plexus blockade. ... of the juvenile anatomy, psychological barriers, time constraints on block ... children in the age group of 2 to 10 years and undergoing short upper limb surgery. ... Browse By Category · Browse Alphabetically · Browse By Country · List All Titles · Free To Read ...

  9. Feasibility study of axillary reverse mapping lymphoscintigraphy in carcinoma breast: A concept toward preventing lymphedema

    International Nuclear Information System (INIS)

    Gandhi, Sunny J.; Satish, C.; Sundaram, Palaniswamy Shanmuga; Subramanyam, Padma; Vijaykumar, D. K.

    2016-01-01

    In the surgery of breast cancer, axillary reverse mapping (ARM) is the identification and preservation of arm draining lymph node (ARM node) during an axillary dissection. The assumption is that the ARM node is different from node draining breast and is unlikely to be involved even in the patients with axillary nodal metastases. If we can identify and preserve ARM node using lymphoscintigraphy; morbidity of lymphedema, as seen with axillary dissection, may be avoided. Pathologically proven 50 breast cancer patients undergoing initial surgery (cTx-4, cN0-2, and Mx-0) were included in this study. Less than 37 MBq, 0.5 ml in equally divided doses of filtered 99mTc sulfur colloid was injected intradermally into the second and third web spaces. ARM nodes in the axilla were identified with the help of Gamma Probe intraoperatively; however, their location was noted with the reference to specific anatomical landmarks and sent for histopathological examination after excision. The ARM node was successfully identified in 47/50 cases (sensitivity - 94%). In 40 out of 47 cases (85%), the location of the ARM node was found to lateral to the subscapular pedicle, above the second intercostobrachial nerve and just below the axillary vein. Of the 47 patients in whom ARM node/s were identified, metastasis was noted in 5 of them (10%). Four out of these 5 patients had the pN3 disease. ARM node exists, and it is feasible to identify ARM node using radio isotope technique with an excellent sensitivity. ARM node seems to have a fairly constant location in more than 80% cases. It is involved with metastasis (10% cases) only when there are multiple lymph nodal metastases in the axilla

  10. Contemporary management of subclavian and axillary artery injuries-A Western Trauma Association multicenter review.

    Science.gov (United States)

    Waller, Christine J; Cogbill, Thomas H; Kallies, Kara J; Ramirez, Luis D; Cardenas, Justin M; Todd, S Rob; Chapman, Kayla J; Beckman, Marshall A; Sperry, Jason L; Anto, Vincent P; Eriksson, Evert A; Leon, Stuart M; Anand, Rahul J; Pearlstein, Maura; Capano-Wehrle, Lisa; Cothren Burlew, Clay; Fox, Charles J; Cullinane, Daniel C; Roberts, Jennifer C; Harrison, Paul B; Berg, Gina M; Haan, James M; Lightwine, Kelly

    2017-12-01

    Subclavian and axillary artery injuries are uncommon. In addition to many open vascular repairs, endovascular techniques are used for definitive repair or vascular control of these anatomically challenging injuries. The aim of this study was to determine the relative roles of endovascular and open techniques in the management of subclavian and axillary artery injuries comparing hospital outcomes, and long-term limb viability. A multicenter, retrospective review of patients with subclavian or axillary artery injuries from January 1, 2004, to December 31, 2014, was completed at 11 participating Western Trauma Association institutions. Statistical analysis included χ, t-tests, and Cochran-Armitage trend tests. A p value less than 0.05 was significant. Two hundred twenty-three patients were included; mean age was 36 years, 84% were men. An increase in computed tomography angiography and decrease in conventional angiography was observed over time (p = 0.018). There were 120 subclavian and 119 axillary artery injuries. Procedure type was associated with injury grade (p < 0.001). Open operations were performed in 135 (61%) patients, including 93% of greater than 50% circumference lacerations and 83% of vessel transections. Endovascular repairs were performed in 38 (17%) patients; most frequently for pseudoaneurysms. Fourteen (6%) patients underwent a hybrid procedure. Use of endovascular versus open procedures did not increase over the duration of the study (p = 0.248). In-hospital mortality rate was 10%. Graft or stent thrombosis occurred in 7% and graft or stent infection occurred in 3% of patients. Mean follow-up was 1.6 ± 2.4 years (n = 150). Limb salvage was achieved in 216 (97%) patients. The management of subclavian and axillary artery injuries still requires a wide variety of open exposures and procedures, especially for the control of active hemorrhage from more than 50% vessel lacerations and transections. Endovascular repairs were used most often for

  11. [Ultrasound-assisted approach to blocking the intercostal nerves in the mid-axillary line for non-reconstructive breast and axilla surgery].

    Science.gov (United States)

    Diéguez García, P; Fajardo Pérez, M; López Álvarez, S; Alfaro de la Torre, P; Pensado Castiñeiras, A P

    2013-01-01

    Several nerve blocks have recently been used for pain treatment in breast surgery. The main objective of our study was to determine the efficacy and safety of ultrasound-assisted blocking of the anterior and lateral cutaneous branches of the intercostal nerves in the mid-axillary line for non-reconstructive breast and axilla surgery. A prospective observational study was conducted on 30 patients scheduled for non-reconstructive breast and axilla surgery. An intercostal branches block was performed in the mid-axillary line with 0,5% levobupivacaine (3ml in each intercostal space). Clinical efficacy was assessed by standard intraoperative hemodynamic response to surgical stimulus and the need for opioids, and in the postoperative period, by assessing pain intensity as a verbal numerical scale and the need for rescue treatment. We also evaluated the quality of sleep the first night after surgery, any adverse events that occurred, and the satisfaction of patients and surgeons with the anesthetic technique. The intercostal branches block in the mid-axillary line was effective in most cases, with only 2 patients requiring intraoperative opioids, and in one case analgesic rescue was necessary in the postoperative period. The duration of postoperative analgesia was 19±4h. There were no notable adverse events or complications. The satisfaction with the chosen technique was assessed as "very good" in all patients, and by 97% of the surgeons. Intercostal branches block in the mid-axillary line provides adequate intraoperative and postoperative analgesia for non-reconstructive breast and axilla surgery. It is a simple, reproducible technique in most patients of this study, with an easy to understand ultrasound anatomy, in which adequate analgesia could be provided through a single puncture, and may be an alternative to neuroaxial blocks. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights

  12. Axillary artery to left anterior descending coronary artery bypass with an externally stented graft: a technical report

    Directory of Open Access Journals (Sweden)

    Salvador Loris

    2008-02-01

    Full Text Available Abstract With the proliferation of minimally invasive cardiac surgery a number of alternative inflow sites for coronary artery bypass grafting have been utilized, especially in higher risk patients. The use of axillary-coronary artery bypass is a safe and effective alternative especially in the case of patients requiring redo coronary revascularization. However, the length and convoluted course of the axillary-coronary vein graft makes is susceptible to twisting, trauma and neointimal hyperplasia. We therefore report a case of an axillary-coronary artery bypass in a high risk patient in which a Dacron conduit was used to externally support and protect the vein graft to the left anterior descending artery. Surgical technique and considerations are presented and discussed.

  13. Quantifying the number of lymph nodes identified in one-stage versus two-stage axillary dissection in breast cancer

    DEFF Research Database (Denmark)

    Damgaard, Olaf E; Jensen, Maj-Britt; Kroman, Niels

    2013-01-01

    To establish whether a different number of lymph nodes is identified in a delayed versus an immediate axillary lymph node dissection (ALND) in breast cancer patients.......To establish whether a different number of lymph nodes is identified in a delayed versus an immediate axillary lymph node dissection (ALND) in breast cancer patients....

  14. Sentinel Node Biopsy Alone versus Completion Axillary Node Dissection in Node Positive Breast Cancer: Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Rachna Ram

    2014-01-01

    Full Text Available Introduction. There has been recent interest in validity of completion axillary node dissection after a positive sentinel node. This systematic review aims to ascertain if sentinel lymph node dissection alone was noninferior to axillary lymph node dissection for breast cancer patients who have a positive sentinel node. Method. A systematic review of the electronic databases Embase, MEDLINE, and Cochrane Register of Controlled Trials was carried out. Only randomised trials that had patients with positive sentinel node as the study sample were included in the meta-analysis using the reported hazard ratios with a fixed effect model. Results. Three randomised controlled trials and five retrospective studies were identified. The pooled effect for overall survival was HR 0.94, 95% CI [0.79, 1.19], and for disease free survival was HR 0.83, 95% CI [0.60, 1.14]. The reported rates for locoregional recurrence were similar in both groups. The surgical morbidity was found to be significantly more in patients who had underwent axillary dissection. Conclusion. Amongst patients with micrometastasis in the sentinel node, no further axillary dissection is necessary. For patients with macrometastasis in the sentinel node, it is reasonable to consider omitting axillary dissection to avoid the morbidity of the procedure.

  15. The surgical importance of an axillary arch in sentinel node biopsy.

    LENUS (Irish Health Repository)

    Ridgway, P F

    2011-03-01

    When Carl Langer described the aberrant axillary arch in 1846 its relevance in sentinel node biopsy (SNB) surgery could not have been contemplated. The authors define an incidence and elucidate relevance of the arch in SNB of the axilla.

  16. A case of recurrent metastasis in the supraclavicular and axillary lymph nodes and vertebrae following irradiation and paclitaxel plus bevacizumab administration

    International Nuclear Information System (INIS)

    Nishiyama, Yasuyuki; Nishimura, Reiki; Ohsako, Tomofumi; Tashima, Rumiko; Nakano, Masahiro; Fujisue, Mamiko

    2013-01-01

    A 48-year-old woman with invasive ductal carcinoma of the left breast underwent breast-conserving surgery and axillary dissection; 19 months after surgery, she developed local recurrence. Subsequently, she underwent mastectomy and received endocrine therapy and chemotherapy. At 47 years of age, she developed pleural metastasis, which directly invaded the vertebrae as well as the right supraclavicular and right axillary lymph nodes. In addition, liver metastasis was observed. To avoid acute transverse myelopathy, the patient received radiation therapy to the vertebrae and the right supraclavicular and right axillary lymph nodes followed by paclitaxel plus bevacizumab administration. After 2 courses of paclitaxel plus bevacizumab, we observed a remarkable shrinkage of the vertebral tumor, and skin necrosis was observed in the right supraclavicular and right axillary region; in contrast, the liver metastasis had increased in size. After discontinuation of the combination therapy, the patient died of blood loss from the axillary skin defect. This wound healing complication might have arisen because of the synergistic effects of paclitaxel plus bevacizumab and irradiation. (author)

  17. The sensitivity of pre-operative axillary staging in breast cancer: comparison of invasive lobular and ductal carcinoma.

    Science.gov (United States)

    Topps, A; Clay, V; Absar, M; Howe, M; Lim, Y; Johnson, R; Bundred, N

    2014-07-01

    Axillary ultrasound (AUS) with fine-needle aspiration (FNA) biopsy of abnormal lymph nodes is important for pre-operative staging and planning the surgical management of the axilla. Invasive lobular carcinoma (ILC) metastases are thought to be difficult to detect because the cells are small and on cytology resemble lymphocytes. To investigate this we directly compared the sensitivity of pre-operative axillary staging between ILC and invasive ductal carcinoma (IDC). Consecutive patients that presented in a single breast unit with pure IDC between April 2005 and December 2006 and pure ILC between January 2008 and December 2012 were retrospectively identified from pathology records. Pre-operative axillary ultrasound and FNA biopsy results were compared with post-operative histopathology from the sentinel node biopsy (SNB) or axillary lymph node dissection (ALND). A total of 275 and 142 axillae were identified in the IDC and ILC groups respectively. In the node positive patients there was no significant difference in the sensitivity of AUS (IDC vs. ILC; 58.7% vs. 52.8%). However, there was a significant difference in the sensitivity of ultrasound-guided FNA biopsy of abnormal nodes (IDC vs. ILC; 98.4% vs. 53.6%; p < 0.001). AUS has comparative sensitivities between IDC and ILC populations. In contrast, FNA biopsy of abnormal axillary nodes is clearly less sensitive in the ILC group. In these patients, who have abnormal AUS, we suggest that a core biopsy is required to improve the pre-operative staging and prevent unnecessary surgical procedures. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Impact of axillary nodal metastases on lymphatic mapping and sentinel lymph node identification rate in patients with early stage breast cancer

    International Nuclear Information System (INIS)

    Pelosi, Ettore; Ala, Ada; Bussone, Riccardo; Bello, Marilena; Douroukas, Anastasios; Varetto, Teresio; Migliaretti, Giuseppe; Berardengo, Ester; Bisi, Gianni

    2005-01-01

    The aim of this study was to define the impact of the presence of axillary nodal metastases on lymphatic mapping and sentinel lymph node (SLN) identification rate in patients with early breast cancer. Two hundred and forty-six lymphatic mapping procedures were performed with both labelled nanocolloid and blue dye, followed by SLN biopsy and/or complete axillary dissection. The following parameters were recorded: patient's age, tumour laterality and location, tumour size, tumour histology, tumour stage, tumour grade, lymphovascular invasion, radiotracer injection site (subdermal-peritumoural/peri-areolar), SLN visualisation at lymphoscintigraphy, SLN metastases (presence/absence, size) and other axillary metastases (presence/absence, number). Discriminant analysis was used to analyse the data. SLNs were identified by labelled nanocolloid alone in 94.7% of tumours, by blue dye alone in 93.5% and by the combined technique in 99.2%. Discriminant analysis showed the gamma probe SLN identification rate to be significantly limited by the presence of axillary nodal metastases. In particular, the size of SLN metastases and the number of other axillary metastases were the most important variables in reducing the gamma probe SLN identification rate (p=0.004 and p=0.002, respectively). On the other hand, high tumour grade was the only parameter limiting the blue dye SLN identification rate. The accuracy of lymphatic mapping with labelled nanocolloid is limited by the presence of axillary nodal metastases, and particularly by the degree of SLN tumoural invasion and the presence and number of other axillary nodal metastases. Neither of these elements seems to interfere with the blue dye identification rate. The combination of the two tracers maximises the SLN identification rate. (orig.)

  19. Impact of axillary nodal metastases on lymphatic mapping and sentinel lymph node identification rate in patients with early stage breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pelosi, Ettore [Ospedale S. Giovanni Battista, S.C.D.U. Medicina Nucleare 2, Turin (Italy); Universita Torino, Dottorato di Ricerca Radioimmunolocalizzazione dei Tumori Umani, Turin (Italy); Ala, Ada; Bussone, Riccardo [Ospedale S. Giovanni Battista, Reparto di Chirurgia Oncologica 10, Turin (Italy); Bello, Marilena; Douroukas, Anastasios; Varetto, Teresio [Ospedale S. Giovanni Battista, S.C.D.U. Medicina Nucleare 2, Turin (Italy); Migliaretti, Giuseppe [Universita di Torino, Dipartimento di Sanita Pubblica e Microbiologia, Turin (Italy); Berardengo, Ester [Ospedale S. Giovanni Battista, Servizio di Anatomia Patologica 4, Turin (Italy); Bisi, Gianni [Ospedale S. Giovanni Battista, S.C.D.U. Medicina Nucleare 2, Turin (Italy); Universita di Torino, Dipartimento di Medicina Interna, SCDU Medicina Nucleare 2, Turin (Italy)

    2005-08-01

    The aim of this study was to define the impact of the presence of axillary nodal metastases on lymphatic mapping and sentinel lymph node (SLN) identification rate in patients with early breast cancer. Two hundred and forty-six lymphatic mapping procedures were performed with both labelled nanocolloid and blue dye, followed by SLN biopsy and/or complete axillary dissection. The following parameters were recorded: patient's age, tumour laterality and location, tumour size, tumour histology, tumour stage, tumour grade, lymphovascular invasion, radiotracer injection site (subdermal-peritumoural/peri-areolar), SLN visualisation at lymphoscintigraphy, SLN metastases (presence/absence, size) and other axillary metastases (presence/absence, number). Discriminant analysis was used to analyse the data. SLNs were identified by labelled nanocolloid alone in 94.7% of tumours, by blue dye alone in 93.5% and by the combined technique in 99.2%. Discriminant analysis showed the gamma probe SLN identification rate to be significantly limited by the presence of axillary nodal metastases. In particular, the size of SLN metastases and the number of other axillary metastases were the most important variables in reducing the gamma probe SLN identification rate (p=0.004 and p=0.002, respectively). On the other hand, high tumour grade was the only parameter limiting the blue dye SLN identification rate. The accuracy of lymphatic mapping with labelled nanocolloid is limited by the presence of axillary nodal metastases, and particularly by the degree of SLN tumoural invasion and the presence and number of other axillary nodal metastases. Neither of these elements seems to interfere with the blue dye identification rate. The combination of the two tracers maximises the SLN identification rate. (orig.)

  20. Breast-axillary complex in HIV/AIDS patients | Eni | Nigerian Journal ...

    African Journals Online (AJOL)

    This is a report of three cases seen and managed by the authors. : Three adult female patients presented with progressively increasing axillary and ipsilateral breast swellings. They also had associated fevers and weight loss. Their main concern had been development of breast cancer. One of the patients was a known ...

  1. Ultrasound-Guided Single-Injection Infraclavicular Block Versus Ultrasound-Guided Double-Injection Axillary Block: A Noninferiority Randomized Controlled Trial.

    Science.gov (United States)

    Boivin, Ariane; Nadeau, Marie-Josée; Dion, Nicolas; Lévesque, Simon; Nicole, Pierre C; Turgeon, Alexis F

    2016-01-01

    Single-injection ultrasound-guided infraclavicular block is a simple, reliable, and effective technique. A simplified double-injection ultrasound-guided axillary block technique with a high success rate recently has been described. It has the advantage of being performed in a superficial and compressible location, with a potentially improved safety profile. However, its effectiveness in comparison with single-injection infraclavicular block has not been established. We hypothesized that the double-injection ultrasound-guided axillary block would show rates of complete sensory block at 30 minutes noninferior to the single-injection ultrasound-guided infraclavicular block. After approval by our research ethics committee and written informed consent, adults undergoing distal upper arm surgery were randomized to either group I, ultrasound-guided single-injection infraclavicular block, or group A, ultrasound-guided double-injection axillary block. In group I, 30 mL of 1.5% mepivacaine was injected posterior to the axillary artery. In group A, 25 mL of 1.5% mepivacaine was injected posteromedial to the axillary artery, after which 5 mL was injected around the musculocutaneous nerve. Primary outcome was the rate of complete sensory block at 30 minutes. Secondary outcomes were the onset of sensory and motor blocks, surgical success rates, performance times, and incidence of complications. All outcomes were assessed by a blinded investigator. The noninferiority of the double-injection ultrasound-guided axillary block was considered if the limits of the 90% confidence intervals (CIs) were within a 10% margin of the rate of complete sensory block of the infraclavicular block. At 30 minutes, the rate of complete sensory block was 79% in group A (90% CI, 71%-85%) compared with 91% in group I (90% CI, 85%-95%); the upper limit of CI of group A is thus included in the established noninferiority margin of 10%. The rate of complete sensory block was lower in group A (proportion

  2. Breast and Axillary Lymph Nodes Metastasis five years after Radical ...

    African Journals Online (AJOL)

    Breast is an uncommon and rare site for metastasis. Primary and secondary tumors of the breast need to be differentiated as management is different. We present a 67 year old female patient with two breast lumps and an axillary lymph node, 5 years after nephrectomy for Renal Cell Carcinoma (RCC). Mammogram report ...

  3. [Selective biopsy of the sentinel lymph node in breast cancer: without axillary recurrences after a mean follow-up of 4.5 years].

    Science.gov (United States)

    Bañuelos Andrío, Luis; Rodríguez Caravaca, Gil; Argüelles Pintos, Miguel; Mitjavilla Casanova, Mercedes

    2014-01-01

    To analyze the rate of axillary recurrences (AR) in patients with early breast cancer who had not undergone an axillary node dissection (ALND) because of a negative sentinel lymph node biopsy (SLNB). The study includes 173 patients operated on for breast cancer and selective node biopsy. In 32 patients the SLNB was positive and undergone subsequent ALND. We followed up 141 patients with negative SLNB without LDN, with a median follow up of 55 months (range 74-36). The detection rate of SLN was of 99.42%. After a median follow-up of 4.5 years, there were no axillary recurrences. Two patients developed local recurrence, other two patients developed distant metastases and four patients developed a metachronous tumor. Four patients died, none of them because of breast cancer. The results obtained support the SLNB as an accurate technique in the axillary stratification of patients with breast cancer, offering in the cases of negative SLNB a safe axillary control after 4.5 year follow-up. Copyright © 2013 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  4. Comparison of peripheral nerve stimulator versus ultrasonography guided axillary block using multiple injection technique.

    Science.gov (United States)

    Kumar, Alok; Sharma, Dk; Sibi, Maj E; Datta, Barun; Gogoi, Biraj

    2014-01-01

    The established methods of nerve location were based on either proper motor response on nerve stimulation (NS) or ultrasound guidance. In this prospective, randomised, observer-blinded study, we compared ultrasound guidance with NS for axillary brachial plexus block using 0.5% bupivacaine with the multiple injection techniques. A total of 120 patients receiving axillary brachial plexus block with 0.5% bupivacaine, using a multiple injection technique, were randomly allocated to receive either NS (group NS, n = 60), or ultrasound guidance (group US, n = 60) for nerve location. A blinded observer recorded the onset of sensory and motor blocks, skin punctures, needle redirections, procedure-related pain and patient satisfaction. The median (range) number of skin punctures were 2 (2-4) in group US and 3 (2-5) in group NS (P =0.27). Insufficient block was observed in three patient (5%) of group US and four patients (6.67%) of group NS (P > =0.35). Patient acceptance was similarly good in the two groups. Multiple injection axillary blocks with ultrasound guidance provided similar success rates and comparable incidence of complications as compared with NS guidance with 20 ml 0.5% bupivacaine.

  5. Comparison of peripheral nerve stimulator versus ultrasonography guided axillary block using multiple injection technique

    Directory of Open Access Journals (Sweden)

    Alok Kumar

    2014-01-01

    Full Text Available Background: The established methods of nerve location were based on either proper motor response on nerve stimulation (NS or ultrasound guidance. In this prospective, randomised, observer-blinded study, we compared ultrasound guidance with NS for axillary brachial plexus block using 0.5% bupivacaine with the multiple injection techniques. Methods : A total of 120 patients receiving axillary brachial plexus block with 0.5% bupivacaine, using a multiple injection technique, were randomly allocated to receive either NS (group NS, n = 60, or ultrasound guidance (group US, n = 60 for nerve location. A blinded observer recorded the onset of sensory and motor blocks, skin punctures, needle redirections, procedure-related pain and patient satisfaction. Results: The median (range number of skin punctures were 2 (2-4 in group US and 3 (2-5 in group NS (P =0.27. Insufficient block was observed in three patient (5% of group US and four patients (6.67% of group NS (P > =0.35. Patient acceptance was similarly good in the two groups. Conclusion: Multiple injection axillary blocks with ultrasound guidance provided similar success rates and comparable incidence of complications as compared with NS guidance with 20 ml 0.5% bupivacaine.

  6. Hydrogen Field Test Standard: Laboratory and Field Performance

    Science.gov (United States)

    Pope, Jodie G.; Wright, John D.

    2015-01-01

    The National Institute of Standards and Technology (NIST) developed a prototype field test standard (FTS) that incorporates three test methods that could be used by state weights and measures inspectors to periodically verify the accuracy of retail hydrogen dispensers, much as gasoline dispensers are tested today. The three field test methods are: 1) gravimetric, 2) Pressure, Volume, Temperature (PVT), and 3) master meter. The FTS was tested in NIST's Transient Flow Facility with helium gas and in the field at a hydrogen dispenser location. All three methods agree within 0.57 % and 1.53 % for all test drafts of helium gas in the laboratory setting and of hydrogen gas in the field, respectively. The time required to perform six test drafts is similar for all three methods, ranging from 6 h for the gravimetric and master meter methods to 8 h for the PVT method. The laboratory tests show that 1) it is critical to wait for thermal equilibrium to achieve density measurements in the FTS that meet the desired uncertainty requirements for the PVT and master meter methods; in general, we found a wait time of 20 minutes introduces errors methods, respectively and 2) buoyancy corrections are important for the lowest uncertainty gravimetric measurements. The field tests show that sensor drift can become a largest component of uncertainty that is not present in the laboratory setting. The scale was calibrated after it was set up at the field location. Checks of the calibration throughout testing showed drift of 0.031 %. Calibration of the master meter and the pressure sensors prior to travel to the field location and upon return showed significant drifts in their calibrations; 0.14 % and up to 1.7 %, respectively. This highlights the need for better sensor selection and/or more robust sensor testing prior to putting into field service. All three test methods are capable of being successfully performed in the field and give equivalent answers if proper sensors without drift are

  7. False-positive axillary lymph node on F-18 FDG PET/CT due to moxibustion therapy

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Shin Young; Lee, Sang Woo; Ahn, Byeong Cheol; Lee, Jae Tae [Kyungpook National University Hospital, Daegu (Korea, Republic of); Seo, Ji Hyoung [Inje University Haeundae Paik Hospital, Busan (Korea, Republic of)

    2010-12-15

    A 30-year-old female was diagnosed with papillary thyroid cancer and underwent total thyroidectomy and high-dose radioiodine ablation. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for recurrence detection of thyroid carcinoma was performed at 3 years after total thyroidectomy. Moxibustion is a traditional Chinese medicine therapy using moxa or the mugwort herb. Moxibustion is the burning of a small, thimble-sized, smoldering plug of dried leaves such as moxa or mugwort on the skin at an acupuncture point. Acupuncture and moxibustion induce hyperemia and a local inflammatory reaction. Complications associated with moxibustion such as skin bums or infection of the site have been reported previously. False-positive FDG uptake in PET may result from inflammation, infection, and variations in physiological uptake. In the present case, the hypermetabolic axillary lymph node disappeared without any treatment. Well-known of false-positive FDG uptake in axillary lymph noes such as arthritis of the upper extremity, extravasation of injected FDG, and vaccination were not found. Thus, left axillary lymph node uptake was

  8. False-positive axillary lymph node on F-18 FDG PET/CT due to moxibustion therapy

    International Nuclear Information System (INIS)

    Jeong, Shin Young; Lee, Sang Woo; Ahn, Byeong Cheol; Lee, Jae Tae; Seo, Ji Hyoung

    2010-01-01

    A 30-year-old female was diagnosed with papillary thyroid cancer and underwent total thyroidectomy and high-dose radioiodine ablation. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for recurrence detection of thyroid carcinoma was performed at 3 years after total thyroidectomy. Moxibustion is a traditional Chinese medicine therapy using moxa or the mugwort herb. Moxibustion is the burning of a small, thimble-sized, smoldering plug of dried leaves such as moxa or mugwort on the skin at an acupuncture point. Acupuncture and moxibustion induce hyperemia and a local inflammatory reaction. Complications associated with moxibustion such as skin bums or infection of the site have been reported previously. False-positive FDG uptake in PET may result from inflammation, infection, and variations in physiological uptake. In the present case, the hypermetabolic axillary lymph node disappeared without any treatment. Well-known of false-positive FDG uptake in axillary lymph noes such as arthritis of the upper extremity, extravasation of injected FDG, and vaccination were not found. Thus, left axillary lymph node uptake was

  9. A case study of an axillary artery pseudoaneurysm following anterior dislocation of the glenohumeral joint: A rare presentation on plain film radiographs

    International Nuclear Information System (INIS)

    Whittam, Katie; Hardy, Maryann

    2007-01-01

    Axillary pseudoaneurysm is a rare but important complication of anterior glenohumeral joint dislocation. Diagnosis of axillary pseudoaneurysm is predominantly undertaken following clinical examination but where diagnosis is uncertain, Doppler ultrasound is the imaging examination of choice to confirm diagnosis. In this case study, the initial clinical signs of axillary pseudoaneurysm were masked by the presenting trauma and, although findings indicative of pseudoaneurysm were present on late plain film images, they were not immediately recognised. Misdiagnosis or delayed diagnosis of axillary pseudoaneurysm may result in upper limb morbidity or patient mortality. Consequently, the prompt and accurate identification of an axillary pseudoaneurysm on plain film radiographs, although rare, is essential. Yet for inexperienced film readers, correctly identifying an axillary pseudoaneurysm can be difficult due to its apparent similarity to other pathologies. This article will highlight the differences in radiological appearances between a pseudoaneurysm and a gleno-humeral joint effusion to raise radiographer awareness of the risks and clinical signs of an axillary pseudoaneurysm post gleno-humeral joint dislocation and discuss the difficulties encountered in its diagnosis. Finally, this review will evaluate current diagnostic practices in comparison with best practice, as identified in the literature [Fitzgerald JF, Keates J. False aneurysm as a late complication of anterior shoulder dislocation. Ann Surg 1975;6:785-6; Drury JK, Scullion JE. Vascular complications of anterior dislocation of the shoulder. Br J Surg 1980;67(8):579-81. Waxman DL, France MP, Douglas T, Harryman I. Late lateral displacement of the humeral head after closed reduction of dislocation: a sign of vascular injury. J Bone Joint Surg 1996;78(6):907-10

  10. Permanent pace maker implantation through axillary vein approach

    International Nuclear Information System (INIS)

    Shah, B.; Hussain, C.; Awan, Z.A.

    2017-01-01

    Device implantation is an integral part of interventional cardiology particularly electrophysiology. In this study, we are going to share our experience of device implantation technique at electrophysiology department Hayatabad Medical Complex, Peshawar. Methods: the study was conducted from June 2011 to December 2015. Axillary vein was used to implant the devices but in some cases when this rout was not convenient due to any reason then subclavian vein was entered through the Seldinger technique. Fluoroscopy time was less than 10 minutes and total procedure time was not more than 45 minutes. Electric cautery was used only in two cases. Pressure dressing was used in a few cases. Results: Total numbers of permanent pacemakers (PPM) remain 800 during the study period. There were 450 single chamber pacemakers and 350 dual chambers pacemakers. No case of any major bleeding was documented and in very few cases there was mild ooze from the procedure site after the operation which was tackled with pressure dressing. Four cases of pneumothorax were noted during the study period and in three cases chest intubation were done and one patient was kept on conservative management. Patient were followed after one month of discharge from the hospital and then yearly. Eight cases of lead dislodgment were documented during the study period. Conclusion: Axillary vein approach for implantation of permanent pacemakers is a safe and less time-consuming technique. (author)

  11. Diversification in the South American Pampas: the genetic and morphological variation of the widespread Petunia axillaris complex (Solanaceae).

    Science.gov (United States)

    Turchetto, Caroline; Fagundes, Nelson J R; Segatto, Ana L A; Kuhlemeier, Cris; Solís Neffa, Viviana G; Speranza, Pablo R; Bonatto, Sandro L; Freitas, Loreta B

    2014-02-01

    Understanding the spatiotemporal distribution of genetic variation and the ways in which this distribution is connected to the ecological context of natural populations is fundamental for understanding the nature and mode of intraspecific and, ultimately, interspecific differentiation. The Petunia axillaris complex is endemic to the grasslands of southern South America and includes three subspecies: P. a. axillaris, P. a. parodii and P. a. subandina. These subspecies are traditionally delimited based on both geography and floral morphology, although the latter is highly variable. Here, we determined the patterns of genetic (nuclear and cpDNA), morphological and ecological (bioclimatic) variation of a large number of P. axillaris populations and found that they are mostly coincident with subspecies delimitation. The nuclear data suggest that the subspecies are likely independent evolutionary units, and their morphological differences may be associated with local adaptations to diverse climatic and/or edaphic conditions and population isolation. The demographic dynamics over time estimated by skyline plot analyses showed different patterns for each subspecies in the last 100 000 years, which is compatible with a divergence time between 35 000 and 107 000 years ago between P. a. axillaris and P. a. parodii, as estimated with the IMa program. Coalescent simulation tests using Approximate Bayesian Computation do not support previous suggestions of extensive gene flow between P. a. axillaris and P. a. parodii in their contact zone. © 2013 John Wiley & Sons Ltd.

  12. A rare case of breast carcinoma co-existing with axillary mantle cell lymphoma

    Directory of Open Access Journals (Sweden)

    Scally John

    2003-12-01

    Full Text Available Abstract Background Mantle cell lymphoma (MCL is a rare variety of non-Hodgkin's lymphoma which originates from CD5+ B-cell population in the mantle zones of lymphoid follicles. Coexistence of such tumours in the axillary lymph nodes with invasive breast cancers without prior history of adjuvant chemotherapy or radiotherapy has not been previously reported in literature. Case report We report a rare case of breast cancer co-existing with stage I mantle cell lymphoma of the ipsilateral axillary lymph node detected fortuitously by population screening. Conclusion Though some studies have tried to prove breast carcinomas and lymphomas to share a common molecular or viral link, more research needs to be done to establish whether such a link truly exists.

  13. The Effect of Ketamine and Dexamethasone in Combination with Lidocaine on the Onset and Duration of Axillary Block in Hand and Forearm Soft Tissue Surgery.

    Science.gov (United States)

    Zaman, Behrooz; Hojjati Ashrafi, Siavash; Seyed Siamdoust, Seyedalireza; Hassani, Valiollah; Mohamad Taheri, Siavash; Noorizad, Samad

    2017-10-01

    Using peripheral nerve block compared to general anesthesia has gained more popularity due to reduced postoperative pain, less need for post-surgery analgesic drugs, reduced incidence of nausea, shortness of PACU time, and increased patient satisfaction. The aim of this study was to compare the effect of ketamine and dexamethasone as additives to lidocaine on duration and onset of axillary block action. In this clinical trial, all patients who referred to Hazrat-e-Fatemeh hospital for forearm and hand soft tissue surgery with informed consent were randomly divided into three groups in order to examine the onset and duration of axillary block: lidocaine + ketamine, lidocaine + dexamethasone in axillary block, and lidocaine alone (control). Then, the onset and duration of sensory and motor blocks were measured and recorded every three minutes and after the surgery. Quantitative and qualitative variables were analyzed using ANOVA or Kruskal-Wallis test and Chi-square or Fisher exact test in SPSS v.22. Duration of sensory and motor block axillary was significantly higher in lidocaine + dexamethasone group than in lidocaine + ketamine group (P block axillary between the three groups (P > 0.05). According to the results of our study, we can conclude that adding dexamethasone or ketamine to lidocaine could improve duration of sensory and motor axillary block in patients undergoing forearm and hand soft tissue surgery. However, dexamethasone had the highest effect on duration of block axillary. We proved that dexamethasone or ketamine added to lidocaine had no effect on the onset of block axillary.

  14. Readiness for surgery after axillary block

    DEFF Research Database (Denmark)

    Koscielniak-Nielsen, Z J; Stens-Pedersen, H L; Lippert, F K

    1997-01-01

    required less time for block performance (mean 5.5 min) than multiple injections (mean 9.5 min), P requirement for supplemental nerve blocks was greater, after single injections (33 min and 57%) than after multiple injections (15.5 min and 7......We have assessed prospectively the time to readiness for surgery following axillary block (sum of block performance and latency times) in 80 patients. The brachial plexus was identified using a nerve stimulator, and anaesthetized with 45 mL of mepivacaine 1% with adrenaline 5 micrograms mL-1......%, respectively), P effectiveness was 100% in group 1 and 98% in group 2 (NS). The frequency of adverse effects (vessel puncture or paraesthesia) was similar...

  15. Repair of Multiple Subclavian and Axillary Artery Aneurysms in a 58-Year-Old Man with Marfan Syndrome

    OpenAIRE

    Dolapoglu, Ahmet; de la Cruz, Kim I.; Preventza, Ourania; Coselli, Joseph S.

    2016-01-01

    Dilation of the ascending aorta and aortic dissections are often seen in Marfan syndrome; however, true aneurysms of the subclavian and axillary arteries rarely seem to develop in patients who have this disease. We present the case of a 58-year-old man with Marfan syndrome who had undergone a Bentall procedure and thoracoabdominal aortic repair for an aortic dissection and who later developed multiple aneurysmal dilations of his right subclavian and axillary arteries. The aneurysms were succe...

  16. In vitro Proliferation Ability of Axillary Buds in Musa spp | Youmbi ...

    African Journals Online (AJOL)

    from : Pisang Mas (AA), Grande Naine (AAA), Batard and French Clair (AAB), CRBP 39 (AAAB) and Pelipita (ABB) varieties were used as explants. The proliferation rate of Axillary and apical buds and other growth parameters were measured. Results showed that no significant differences were observed between the two ...

  17. The role of sonography in patients with breast cancer presenting as an axillary mass

    International Nuclear Information System (INIS)

    Park, Sun Young; Kim, Eun Kyung; Oh, Ki Keun; Lee, Kyong Sik; Park, Byeong Woo

    2002-01-01

    To compare sonography and mammography in terms of their diagnostic value in breast cancer cases which initially presented as an axillary mass without a palpable mass or other clinical symptoms. Seven patients with enlarged axillary lymph nodes who first presented with no evidence of palpable breast lesions and who underwent both mammography and sonography were enrolled in this study. In six of the seven, the presence of metastatic adenocarcinoma was confirmed preoperatively by axillary needle aspiration biopsy; in four, subsequent sonographically guided breast core biopsy performed after careful examination of the primary site indicated that primary breast cancer was present. In each case, the radiologic findings were evaluated by both breast sonography and mammography. Breast lesions were detected mammographically in four of seven cases (57%); in three of the four, the lesion presented as a mass, and in one as microcalcification. In three of these four detected cases, fatty or scattered fibroglandular breast parenchyma was present; in one, the parenchyma was dense. In the three cases in which lesions were not detected, mammography revealed the presence of heterogeneously dense parenchyma. Breast sonography showed that lesions were present in six of seven cases (86%); in the remaining patient, malignant microcalcification was detected at mammography. Final pathologic examination indicated that all breast lesions except one, which was a ductal carcinoma in situ, with microinvasion, were infiltrating ductal carcinomas whose size ranged from microscopic to greater than 3 cm. At the time of this study, all seven patients were alive and well, having been disease free for up to 61 months after surgery. In women with a palpable axillary mass confirmed as metastatic adenocarcinoma, breast sonography may be a valuable adjunct to mammography

  18. Technetium-99m-tetrofosmin in diagnosis of breast cancer and axillary lymph node involvement

    International Nuclear Information System (INIS)

    Jaukovic, Dj.; Ajdinovic, B.Z.; Jankovic, Z. D.; Strbac, M.

    2006-01-01

    The aim of this study was to evaluate the accuracy of breast cancer seeking agent Tc-99m-Tetrofosmin in the detection of breast malignancy and axillary lymph node metastases. Twenty-eight female patients (mean age 52.4) with 30 breast lesions suspected of malignancy were enrolled in the study. All the patients underwent clinical investigation, Tc-99m Tetrofosmin scintimammography (SMM), mammography (MM) and biopsy/surgery for final histopathologic diagnosis. Patients were injected intravenously with 555 MBq of Tc-99m Tetrofosmin, cubitally, in the contralateral arm to the side of suspicious lesion. Seven minute static scans or at least 2.0 million counts were obtained using single head gamma camera (Orbiter 75, Siemens). Planar images were acquired in left and right prone lateral view as well as in the supine position for an anterior view of chest and axillary region. SMM scans of 30 breast lesions were compared to the definitive histopathology findings (HP) using decision matrix. In the group of 23 patients with positive SMM scans 19 had breast malignancy: 15 infiltrating ductal cancer, three patients with one infiltrating lobular, one papillary, one colloidal cancer and one patient with cystosarcoma phyllodes-malignant type. SMM detected primary breast malignancy with 95% sensitivity, 60% specificity and 83% accuracy. Axillary dissection was performed in 19/20 with malignant disease. The number of lymph nodes extracted and HP evaluated varied from 4 to 23 per patient. Metastatic involvement was confirmed by HP in 9 out of 20 patients. SMM detected axillary metastases with 55% sensitivity and 80% accuracy. Our results showed that SMM might be useful as a complementary test to improve the sensitivity and specificity of conventional imaging modalities, although SMM in the staging of breast carcinoma was less reliable. Further studies to evaluate the role of SMM in metastatic node involvement are necessary. (author)

  19. 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.

  20. Extranodal extension of axillary metastasis of invasive breast carcinoma as a possible predictor for the total number of positive lymph nodes

    NARCIS (Netherlands)

    Palamba, H. W.; Rombouts, M. C.; Ruers, T. J.; Klinkenbijl, J. H.; Wobbes, T.

    2001-01-01

    By the implementation of the sentinel node procedure in the treatment of breast carcinoma routine axillary lymph node, dissection can be abandoned in patients with a tumour-negative sentinel node. When the sentinel node is positive there are two options; an axillary dissection or radiotherapy of the

  1. A clinical assessment tool for ultrasound-guided axillary brachial plexus block.

    LENUS (Irish Health Repository)

    Sultan, S F

    2012-05-01

    Competency in anesthesia traditionally has been determined subjectively in practice. Optimal training in procedural skills requires valid and reliable forms of assessment. The objective was to examine a procedure-specific clinical assessment tool for ultrasound-guided axillary brachial plexus block for inter-rater reliability and construct validity in a clinical setting.

  2. The value of completion axillary treatment in sentinel node positive breast cancer patients undergoing a mastectomy: a Dutch randomized controlled multicentre trial (BOOG 2013-07)

    International Nuclear Information System (INIS)

    Roozendaal, L. M. van; Wilt, J. HW de; Dalen, T. van; Hage, J. A. van der; Strobbe, L. JA; Boersma, L. J.; Linn, S. C.; Lobbes, M. BI; Poortmans, P. MP; Tjan-Heijnen, V. CG; Van de Vijver, K. KBT; Vries, J. de; Westenberg, A. H.; Kessels, A. GH; Smidt, M. L.

    2015-01-01

    Trials failed to demonstrate additional value of completion axillary lymph node dissection in case of limited sentinel lymph node metastases in breast cancer patients undergoing breast conserving therapy. It has been suggested that the low regional recurrence rates in these trials might partially be ascribed to accidental irradiation of part of the axilla by whole breast radiation therapy, which precludes extrapolation of results to mastectomy patients. The aim of the randomized controlled BOOG 2013–07 trial is therefore to investigate whether completion axillary treatment can be safely omitted in sentinel lymph node positive breast cancer patients treated with mastectomy. This study is designed as a non-inferiority randomized controlled multicentre trial. Women aged 18 years or older diagnosed with unilateral invasive clinically T1-2 N0 breast cancer who are treated with mastectomy, and who have a maximum of three axillary sentinel lymph nodes containing micro- and/or macrometastases, will be randomized for completion axillary treatment versus no completion axillary treatment. Completion axillary treatment can consist of completion axillary lymph node dissection or axillary radiation therapy. Primary endpoint is regional recurrence rate at 5 years. Based on a 5-year regional recurrence free survival rate of 98 % among controls and 96 % for study subjects, the sample size amounts 439 per arm (including 10 % lost to follow-up), to be able to reject the null hypothesis that the rate for study and control subjects is inferior by at least 5 % with a probability of 0.8. Results will be reported after 5 and 10 years of follow-up. We hypothesize that completion axillary treatment can be safely omitted in sentinel node positive breast cancer patients undergoing mastectomy. If confirmed, this study will significantly decrease the number of breast cancer patients receiving extensive treatment of the axilla, thereby diminishing the risk of morbidity and improving quality of

  3. Negative pressure wound therapy, staged excision and definitive closure with split-thickness skin graft for axillary hidradenitis suppurativa: a retrospective study.

    Science.gov (United States)

    Pearce, F B; Richardson, K A

    2017-01-02

    Bilateral axillary hidradenitis is a chronic, suppurative, and scarring disease that is most effectively treated by complete excision of all hair-bearing tissues. We assessed our staged procedure for excision and placement of a split-thickness skin graft for bilateral axillary hidradenitis in terms of costs, outcomes, and timing of excision. An IRB approved retrospective case analysis was performed on patients that underwent bilateral axillary hidradenitis skin excision with eventual placement of split-thickness skin grafting using the current LSUHSC/University Health hidradenitis surgical treatment protocol. Using ICD-9 codes (705.83) and CPT codes (11041, 11042, 11451, 11600, 11601, 11602, 11603, 11604) we reviewed cases performed at our institution from 1 January 2008 to 24 Febuary 2014 and we selected patients based on bilateral axillary involvement (alone) and >1 year history of active disease. Patients were excluded if resection of tissue encompassed regions outside of the immediately adjacent axillary. A total of seven patients matching criteria for bilateral axillary hidradenitis were selected for analysis. Clinical course, cost and surgical techniques were assessed. Of the seven patients, six required admission throughout their treatment due to lack of funding making use of negative pressure wound therapy at home not possible. These patients stayed an average of 10 days with a mean hospital charge of $35,178 and a mean hospital provider charge of $10,019. No recurrence was demonstrated. All patients attained full range of motion, post grafting. No patient required a further operation due to graft failure. Split-thickness skin grafting without use of bilayer dermal regenerative templates yielded definitive results with acceptable cosmesis and functionality, without the added cost of treatments such as a bilayer dermal regenerative template.

  4. Intramedullary fixation of proximal humerus fractures: do locking bolts endanger the axillary nerve or the ascending branch of the anterior circumflex artery? A cadaveric study

    Directory of Open Access Journals (Sweden)

    Sermon An

    2008-12-01

    Full Text Available Abstract Background Proximal humerus fractures are one of the most common fractures. Intramedullary locked nailing is becoming a popular alternative treatment, especially for easier fracture patterns. Although axillary nerve injury has been reported, no study has compared the safety of the proximal locking options relative to the axillary nerve and the ascending branch of the anterior circumflex artery. Method Six different commercially available proximal humeral nails were implanted in 30 shoulders of 18 cadavers. After fluoroscopically guided implantation the shoulders were carefully dissected and the distance between the locking screws, the axillary nerve and the ascending branch of the anterior circumflex artery was measured. Results The course of the axillary nerve varies. A mean distance of 55.8 mm (SD = 5.3 between the lateral edge of the acromions and the axillary nerve at the middle of the humerus in a neutrally rotated position was observed. The minimum distance was 43.4 mm, the maximum 63.9 mm. Bent nails with oblique head interlocking bolts appeared to be the most dangerous in relation to the axillary nerve. The two designs featuring such a bend and oblique bolt showed a mean distance of the locking screw to the axillary nerve of 1 mm and 2.7 mm respectively Sirus (Zimmer® and (Stryker® T2 PHN (Proximal Humeral Nail. Regarding the ascending branch of the anterior circumflex artery, there was no difference between the nails which have an anteroposterior locking option. Conclusion It is of great importance for surgeons treating proximal humerus fractures to understand the relative risk of any procedure they perform. Since the designs of different nailing systems risk damaging the axillary nerve and ascending branch, blunt dissection, the use of protection sleeves during drilling and screw insertion, and individual risk evaluation prior to the use of a proximal humeral nail are advocated.

  5. Expression of LRP and MDR1 in locally advanced breast cancer predicts axillary node invasion at the time of rescue mastectomy after induction chemotherapy

    International Nuclear Information System (INIS)

    Schneider, José; Gonzalez-Roces, Severino; Pollán, Marina; Lucas, Raul; Tejerina, Armando; Martin, Miguel; Alba, Alfonso

    2001-01-01

    Axillary node status after induction chemotherapy for locally advanced breast cancer has been shown on multivariate analysis to be an independent predictor of relapse. However, it has been postulated that responders to induction chemotherapy with a clinically negative axilla could be spared the burden of lymphadenectomy, because most of them will not show histological nodal invasion. P-glycoprotein expression in the rescue mastectomy specimen has finally been identified as a significant predictor of patient survival. We studied the expression of the genes encoding multidrug resistance associated protein (MDR1) and lung cancer associated resistance protein (LRP) in formalin-fixed, paraffin-embedded tumor samples from 52 patients treated for locally advanced breast cancer by means of induction chemotherapy followed by rescue mastectomy. P-glycoprotein expression was assessed by means of immunohistochemistry before treatment in 23 cases, and by means of reverse-transcriptase-mediated polymerase chain reaction (RT-PCR) after treatment in 46 (6 failed). LRP expression was detected by means of immunohistochemistry, with the LRP-56 monoclonal antibody, in 31 cases before treatment. Immunohistochemistry for detecting the expression of c-erb-B2, p53, Ki67, estrogen receptor and progesterone receptor are routinely performed in our laboratory in every case, and the results obtained were included in the study. All patients had received between two and six cycles of standard 5-fluorouracil, doxorubicin and cyclophosphamide (FAC) chemotherapy, with two exceptions [one patient received four cycles of a docetaxel-adriamycin combination, and the other four cycles of standard cyclophosphamide-methotrexate-5-fluorouracil (CMF) polychemotherapy]. Response was assessed in accordance with the Response Evaluation Criteria In Solid Tumors (RECIST). By these, 2 patients achieved a complete clinical response, 37 a partial response, and the remaining 13 showed stable disease. This makes a

  6. A unique branching pattern of the axillary artery: a case report.

    Science.gov (United States)

    Bagoji, Ishwar B; Hadimani, Gavishiddappa A; Bannur, Balappa M; Patil, B G; Bharatha, Ambadasu

    2013-12-01

    During routine dissection classes for under graduate students, we found a unique and unusual case regarding the anomalous branching in the third part of the axillary artery was terminated into subscapular arterial trunk, superficial brachial artery and deep brachial artery. The subscapular arterial trunk was origin of several important arteries as the circumflex scapular, thoracodorsal, posterior circumflex humeral, thoraco-acromial and lateral thoracic arteries. The deep brachial artery in the arm gave anterior circumflex humeral artery at the surgical neck of humerus, which terminated in the cubital fossa by dividing into radial and ulnar arteries. The superficial brachial artery gave two profunda brachii arteries, both of which passed through spiral groove, along with radial nerve and three muscular branches, to brachialis muscle. This variation is very rare. As per our knowledge, we did not find any literature which explained variations which were similar to this. The normal and abnormal anatomy of the axillary region has practical importance among vascular radiologists and surgeons and it should be known for making an accurate diagnostic interpretation.

  7. CLINICOPATHOLOGICAL FACTORS ASSOCIATED WITH POSITIVE PREOPERATIVE AXILLARY ULTRASOUND SCANNING IN BREAST CANCER PATIENTS

    Directory of Open Access Journals (Sweden)

    Lona Jalini

    2016-01-01

    Full Text Available Background: Axillary lymph node status is the most important breast cancer prognostic factor. Preoperative axillary ultrasound examination (PAUS is used to triage patients for sentinel lymph node biopsy (SLNB or axillary lymph node dissection (ALND. We assessed the detection rate of lymph node metastases by PAUS in a screening unit and evaluated associations between clinicopathological factors and PAUS positivity. Patients and Methods: This was a single-centre retrospective analysis of data extracted from a hospital breast cancer database and clinical records. Clinical, radiological, and pathological and prognostic indices were compared between PAUS-positive and PAUS-negative patients subsequently found to have lymph node metastases on histopathological analysis. Results: Two hundred and two patients were eligible for analysis. 50.5% of lymph node-positive patients were correctly identified as PAUS positive. Patients with PAUS-positive lymph nodes had less favorable disease characteristics, namely clinically palpable lymph nodes, higher Nottingham prognostic (NPI index, high lymph node burden according to the European Society of Medical Oncology (ESMO group classification, and larger, grade 3 tumors with lymphovascular invasion and extranodal spread. Moreover, PAUS-positive patients had more macrometastases and lymph node involvement than PAUS-negative patients. Conclusion: PAUS-positive patients and PAUS-negative (SLNB-positive patients have different clinicopathological characteristics. The presence of LVI, extranodal spread, grade 3 histology, or large tumors with poor prognostic indices in PAUS-negative patients should be regarded with caution and perhaps prompt second-look ultrasound examination.

  8. On standardization of low symmetry crystal fields

    Science.gov (United States)

    Gajek, Zbigniew

    2015-07-01

    Standardization methods of low symmetry - orthorhombic, monoclinic and triclinic - crystal fields are formulated and discussed. Two alternative approaches are presented, the conventional one, based on the second-rank parameters and the standardization based on the fourth-rank parameters. Mainly f-electron systems are considered but some guidelines for d-electron systems and the spin Hamiltonian describing the zero-field splitting are given. The discussion focuses on premises for choosing the most suitable method, in particular on inadequacy of the conventional one. Few examples from the literature illustrate this situation.

  9. Ultrasound Guidance Versus Peripheral Neurostimulation for Brachial Plexus Block Anesthesia with Axillary Approach and Multiple Injection Technique

    Directory of Open Access Journals (Sweden)

    Lazar Alexandra

    2017-09-01

    Full Text Available Introduction: There are several approaches for brachial plexus anesthesia: supraclavicular, infraclavicular, interscalenic and axillary. Out of these, the axillary approach is considered to be the safest because of the low risk of lesioning the adjacent structures, low risk of phrenic nerve blockade or of producing an iatrogenic pneumothorax. The block can be performed by one single injection at the site, by two injections or by several injection, among each nerve of the plexus. Ultrasound was introduced in regional anesthesia since 1978, being used initially as an auxiliary method to peripheral neurostimulator.

  10. International standardization in the field of environment

    International Nuclear Information System (INIS)

    Lehmann, K.

    1991-01-01

    The ISO (International Organization for Standardization) is an international federation of national standards bodies. Its activities increasingly take health and environmental effects into account; in the future, standardization will also focus on identification systems that could facilitate recycling and proper disposal. Three technical committees in particular are concerned with standardization as it relates to air, water and soil quality. Other ISO work concerns product-oriented standardization, e.g. in the fields of fire protection equipment, refrigeration, thermal insulation, fibre-reinforced cement, and material and equipment used in the petroleum and natural gas industries. (author)

  11. Standardization of Safety Checklists for Sport Fields in Schools

    OpenAIRE

    S. Arghami; G. Zahirian; T. Allahverdi

    2015-01-01

    Introduction: Nowadays in all human societies, sport is considered as a human-training matter, which often occurs in sport fields. Many people, including students in schools, occasionally deal with these fields. Therefore, a standard tool is required to frequently inspection of sport fields. The aim of this study was to standardize checklists for sport fields in schools. .Material and Method: This study is a kind of tool and technique evaluation was done in Zanjan in 2013. The studied populat...

  12. Ultrasound-guided approach for axillary brachial plexus, femoral nerve, and sciatic nerve blocks in dogs.

    Science.gov (United States)

    Campoy, Luis; Bezuidenhout, Abraham J; Gleed, Robin D; Martin-Flores, Manuel; Raw, Robert M; Santare, Carrie L; Jay, Ariane R; Wang, Annie L

    2010-03-01

    To describe an ultrasound-guided technique and the anatomical basis for three clinically useful nerve blocks in dogs. Prospective experimental trial. Four hound-cross dogs aged 2 +/- 0 years (mean +/- SD) weighing 30 +/- 5 kg and four Beagles aged 2 +/- 0 years and weighing 8.5 +/- 0.5 kg. Axillary brachial plexus, femoral, and sciatic combined ultrasound/electrolocation-guided nerve blocks were performed sequentially and bilaterally using a lidocaine solution mixed with methylene blue. Sciatic nerve blocks were not performed in the hounds. After the blocks, the dogs were euthanatized and each relevant site dissected. Axillary brachial plexus block Landmark blood vessels and the roots of the brachial plexus were identified by ultrasound in all eight dogs. Anatomical examination confirmed the relationship between the four ventral nerve roots (C6, C7, C8, and T1) and the axillary vessels. Three roots (C7, C8, and T1) were adequately stained bilaterally in all dogs. Femoral nerve block Landmark blood vessels (femoral artery and femoral vein), the femoral and saphenous nerves and the medial portion of the rectus femoris muscle were identified by ultrasound in all dogs. Anatomical examination confirmed the relationship between the femoral vessels, femoral nerve, and the rectus femoris muscle. The femoral nerves were adequately stained bilaterally in all dogs. Sciatic nerve block. Ultrasound landmarks (semimembranosus muscle, the fascia of the biceps femoris muscle and the sciatic nerve) could be identified in all of the dogs. In the four Beagles, anatomical examination confirmed the relationship between the biceps femoris muscle, the semimembranosus muscle, and the sciatic nerve. In the Beagles, all but one of the sciatic nerves were stained adequately. Ultrasound-guided needle insertion is an accurate method for depositing local anesthetic for axillary brachial plexus, femoral, and sciatic nerve blocks.

  13. Axillary node metastasis from differentiated thyroid carcinoma with hürthle and signet ring cell differentiation. A case of disseminated thyroid cancer with peculiar histologic findings

    International Nuclear Information System (INIS)

    Chiofalo, Maria Grazia; Losito, Nunzia Simona; Fulciniti, Franco; Setola, Sergio Venanzio; Tommaselli, Antonio; Marone, Ugo; Di Cecilia, Maria Luisa; Pezzullo, Luciano

    2012-01-01

    Differentiated thyroid cancer is usually associated with an excellent prognosis and indolent course. Distant metastases are rare events at the onset of thyroid cancer. Among these presentations, metastasis to the axillary lymph nodes is even more unusual: only few cases were previously reported in the literature; there has been no report of axillary lymph node metastasis from follicular thyroid carcinoma. Axillary lymph node metastasis generally arises in the context of disseminated disease and carries an ominous prognosis. Here we present a case of axillary lymph node metastasis in the context of disseminated differentiated thyroid cancer. The patient underwent near total thyroidectomy and neck and axillary lymph node dissection. A histopathological diagnosis of poorly differentiated follicular carcinoma with 'signet ring cells' and Hürthle cell features was established. The patient received radioactive iodine therapy and TSH suppression therapy. Subsequently his serum thyroglobulin level decreased to 44.000 ng/ml from over 100.000 ng/ml. Currently there are only few reported cases of axillary node metastases from thyroid cancer, and to our knowledge, this is the first report on axillary lymph node metastasis from follicular thyroid carcinoma. 'Signet ring cell' is a morphologic feature shared by both benign and, more rarely, malignant follicular thyroid neoplasm, and it generally correlates with an arrest in folliculogenesis. Our case is one of the rare 'signet ring cells' carcinomas so far described

  14. Standardization of Safety Checklists for Sport Fields in Schools

    Directory of Open Access Journals (Sweden)

    S. Arghami

    2015-01-01

    Full Text Available Introduction: Nowadays in all human societies, sport is considered as a human-training matter, which often occurs in sport fields. Many people, including students in schools, occasionally deal with these fields. Therefore, a standard tool is required to frequently inspection of sport fields. The aim of this study was to standardize checklists for sport fields in schools. .Material and Method: This study is a kind of tool and technique evaluation was done in Zanjan in 2013. The studied population included indoor and outdoor sport fields in governmental boys’ high schools in Zanjan city. The checklists’ items selected based on existing regulations, standards and relevant studies. Standardization of all tools was done applying the face and content validity and reliability tests. .Result: The primary checklist for outdoor sport fields in high schools, which considered by the expert panel, consisted of 75 items. Based on CVI (2 to 3.9 and CVR (.5 to .78, modifications were done and 6 more items were added. And the same process for the primary checklist for outdoor sports fields (85 items was repeated. Based on CVI (2 to 3.9 and CVR (.5 to .78, items increased to 92.  .Conclusion: The safety checklist for sport fields in schools are matched with the properties of them. The safety checklist developed in this study has an acceptable reliability and validity for useful applying in sport field inspections.

  15. The Use of Ultrasound to Improve Axillary Vein Access and Minimize Complications during Pacemaker Implantation.

    Science.gov (United States)

    Esmaiel, Abdullah; Hassan, Jeremy; Blenkhorn, Fay; Mardigyan, Vartan

    2016-05-01

    The Agency for Healthcare Research and Quality in the United States recommends the use of ultrasound (US) for central venous access to improve patient outcomes. However, in a recent publication, US is still underutilized for axillary vein access during pacemaker implantation. We sought to describe a technique for US-guided axillary vein access during pacemaker implantation and to report complication rates and success rate. Retrospective data collection included success rate and complications on all pacemaker implants by one operator since implementing the systematic use of US at our institution, from November 2012 to January 2015. For the last 59 cases, data were collected prospectively to include time of venous access and number of attempts. A total of 403 consecutive patients were included in the analysis. Two leads were implanted in 255 cases and one lead was implanted in 148 cases. The rate of successful US-guided access was 99.25%. There were no access-related complications. The average number of venipuncture attempts was 1.18 per patient. The average time to obtain venous access was 2.24 minutes including the time to apply the sterile US sleeve. The described technique has the potential to improve the success rate of axillary vein access and minimize complications during pacemaker implantation. ©2016 Wiley Periodicals, Inc.

  16. Prognostic significance of pathological response of primary tumor and metastatic axillary lymph nodes after neoadjuvant chemotherapy for locally advanced breast carcinoma.

    Science.gov (United States)

    Machiavelli, M R; Romero, A O; Pérez, J E; Lacava, J A; Domínguez, M E; Rodríguez, R; Barbieri, M R; Romero Acuña, L A; Romero Acuña, J M; Langhi, M J; Amato, S; Ortiz, E H; Vallejo, C T; Leone, B A

    1998-01-01

    The prognostic significance of pathological response of primary tumor and metastatic axillary lymph nodes after neoadjuvant chemotherapy was assessed in patients with noninflammatory locally advanced breast carcinoma. Between January 1989 and April 1995, 148 consecutive patients with locally advanced breast carcinoma participated in the study. Of these, 140 fully evaluable patients (67, stage IIIA; 73, stage IIIB) were treated with three courses of 5-fluorouracil, doxorubicin, and cyclophosphamide (FAC), followed by modified radical mastectomy when technically feasible or definitive radiation therapy. The median age was 53 years (range, 26 to 75 years); 55% of patients were postmenopausal. Objective response was recorded in 99 of 140 patients (71%; 95% confidence interval, 63% to 79%). Complete response occurred in 11 patients (8%), and partial response occurred in 88 patients (63%). No change was recorded in 37 patients (26%), and progressive disease occurred in 4 patients (3%). One hundred and thirty-six patients underwent the planned surgery. Maximal pathological response of the primary tumor (in situ carcinoma or minimal microscopic residual tumor) was observed in 24 (18%); 112 patients (82%) presented minimal pathological response of the primary tumor (gross residual tumor). The number of metastatic axillary nodes after neoadjuvant chemotherapy was as follows: N0, 39 patients (29%); N1-N3, 35 patients (26%); > N3, 62 patients (45%). Considering the initial TNM status, 75% of the patients had decreases in tumor compartment after neoadjuvant chemotherapy. Also, 31% and 23% of patients with clinical N1 and N2, respectively, showed uninvolved axillary lymph nodes. A significant correlation was noted between pathological response of primary tumor and the number of metastatic axillary lymph nodes. Median disease-free survival was 34 months, whereas median overall survival was 66 months. Pathological responses of both primary tumor and metastatic axillary lymph nodes

  17. Successful ablation of a right atrium-axillary ventricular accessory pathway associated with Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Yuan, Yuan; Long, Deyong; Dong, Jianzeng; Tao, Ling; Ma, Changsheng

    2017-12-01

    We report a case of a patient with right axillary ventricular. Similar congenital anomaly of the right atrium was reported as "right appendage diverticulum or right atrial diverticulum." However, this independent chamber has its own annulus, synchronizes with the right ventricular, and generates large ventricular potential. Under the guidance of the CARTO mapping system (Biosense Webster, Diamond Bar, CA, USA), a right atrioventricular accessory pathway associated with type B Wolff-Parkinson-White syndrome was ablated successfully. This pathway was close to the annulus of the axillary ventricular. The patient remained free of arrhythmia at 1-year follow-up. © 2017 Wiley Periodicals, Inc.

  18. Axillary lymph node metastases in patients with breast carcinomas: assessment with nonenhanced versus uspio-enhanced MR imaging.

    Science.gov (United States)

    Memarsadeghi, Mazda; Riedl, Christopher C; Kaneider, Andreas; Galid, Arik; Rudas, Margaretha; Matzek, Wolfgang; Helbich, Thomas H

    2006-11-01

    To prospectively assess the accuracy of nonenhanced versus ultrasmall superparamagnetic iron oxide (USPIO)-enhanced magnetic resonance (MR) imaging for depiction of axillary lymph node metastases in patients with breast carcinoma, with histopathologic findings as reference standard. The study was approved by the university ethics committee; written informed consent was obtained. Twenty-two women (mean age, 60 years; range, 40-79 years) with breast carcinomas underwent nonenhanced and USPIO-enhanced (2.6 mg of iron per kilogram of body weight intravenously administered) transverse T1-weighted and transverse and sagittal T2-weighted and T2*-weighted MR imaging in adducted and elevated arm positions. Two experienced radiologists, blinded to the histopathologic findings, analyzed images of axillary lymph nodes with regard to size, morphologic features, and USPIO uptake. A third independent radiologist served as a tiebreaker if consensus between two readers could not be reached. Visual and quantitative analyses of MR images were performed. Sensitivity, specificity, and accuracy values were calculated. To assess the effect of USPIO after administration, signal-to-noise ratio (SNR) changes were statistically analyzed with repeated-measurements analysis of variance (mixed model) for MR sequences. At nonenhanced MR imaging, of 133 lymph nodes, six were rated as true-positive, 99 as true-negative, 23 as false-positive, and five as false-negative. At USPIO-enhanced MR imaging, 11 lymph nodes were rated as true-positive, 120 as true-negative, two as false-positive, and none as false-negative. In two metastatic lymph nodes in two patients with more than one metastatic lymph node, a consensus was not reached. USPIO-enhanced MR imaging revealed a node-by-node sensitivity, specificity, and accuracy of 100%, 98%, and 98%, respectively. At USPIO-enhanced MR imaging, no metastatic lymph nodes were missed on a patient-by-patient basis. Significant interactions indicating differences

  19. Concurrent Rotator Cuff Tear and Axillary Nerve Palsy Associated with Anterior Dislocation of the Shoulder and Large Glenoid Rim Fracture: A “Terrible Tetrad”

    Directory of Open Access Journals (Sweden)

    Fumiaki Takase

    2014-01-01

    Full Text Available We present a case of concurrent rotator cuff tear and axillary nerve palsy resulting from anterior dislocation of the shoulder and a large glenoid rim fracture—a “terrible tetrad.” A 61-year-old woman fell on her right shoulder. Radiographs showed anterior dislocation of the shoulder with a glenoid rim fracture, and an MRI two months after injury revealed a rotator cuff tear. Upon referral to our hospital, physical and electrophysiological examinations revealed axillary nerve palsy. The axillary nerve palsy was incomplete and recovering, and displacement of the glenoid rim fracture was minimal and already united; therefore, we surgically repaired only the rotator cuff tear three months after injury. The patient recovered satisfactorily following the operation. In patients whose axillary nerve palsy is recovering, surgeons should consider operating on rotator cuff tears in an attempt to prevent rotator cuff degeneration.

  20. An astrometric standard field in omega Cen

    Science.gov (United States)

    Wyse, Rosemary

    2003-07-01

    We propose to obtain a high-precision astrometric standard in a two-step procedure. First, we will create a ground-based astrometric standard field around omega Cen down to V=22 with a 3 mas accuracy in positions and better than 0.5 mas/yr in proper motions. This standard will be used to obtain precise absolute plate solutions for selected WFPC2 CCD frames and refine the self-calibrated mean distortion solution for the WFPC2 CCD chips. This will eliminate systematic errors inherent in the self-calibration techniques down to the rms=0.3 mas level, thus opening new opportunities to perform precision astrometry with WFPC2 alone or in combination with the other HST imaging instruments. We will also address the issue of the distortion's variation which has a paramount significance for space astrometry such as spearheaded by the HST or being under development {SIM, GAIA}. Second, all reduced WFPC2 CCD frames will be combined into the two field catalogs {astrometric flat fields} of positions in omega Cen of unprecedented precision {s.e.=0.1 mas} down to V=22 and will be available to the GO community and readily applicable to calibrating the ACS.

  1. Impact of axillary ultrasound and core needle biopsy on the utility of intraoperative frozen section analysis and treatment decision making in women with invasive breast cancer.

    Science.gov (United States)

    Caretta-Weyer, Holly; Sisney, Gale A; Beckman, Catherine; Burnside, Elizabeth S; Salkowsi, Lonie R; Strigel, Roberta M; Wilke, Lee G; Neuman, Heather B

    2012-09-01

    Our objective was to evaluate the impact of preoperative axillary ultrasound and core needle biopsy (CNB) on breast cancer treatment decision making. A secondary aim was to evaluate the impact on the utility of intraoperative sentinel lymph node (SLN) frozen section. A review of 84 patients with clinically negative axilla who underwent axillary ultrasound was performed. Sensitivity, specificity, and positive/negative predictive value for axillary ultrasound with CNB was calculated. Thirty-one (37%) had suspicious nodes. Of 27 amenable to CNB, 12 (14%) were malignant, changing treatment plans. The sensitivity of ultrasound and CNB was 54% and specificity 100%; the positive and negative predictive values were 100% and 80%, respectively. In 41 patients with normal ultrasounds who underwent SLN frozen section, 10 (24%) were positive. Preoperative axillary ultrasound impacts treatment decision making in 14%. With a sensitivity of 54%, it is a useful adjunct to, but not replacement for, SLN biopsy. Frozen section remains of utility even after a negative axillary ultrasound. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. Automatic detection of axillary lymphadenopathy on CT scans of untreated chronic lymphocytic leukemia patients

    Science.gov (United States)

    Liu, Jiamin; Hua, Jeremy; Chellappa, Vivek; Petrick, Nicholas; Sahiner, Berkman; Farooqui, Mohammed; Marti, Gerald; Wiestner, Adrian; Summers, Ronald M.

    2012-03-01

    Patients with chronic lymphocytic leukemia (CLL) have an increased frequency of axillary lymphadenopathy. Pretreatment CT scans can be used to upstage patients at the time of presentation and post-treatment CT scans can reduce the number of complete responses. In the current clinical workflow, the detection and diagnosis of lymph nodes is usually performed manually by examining all slices of CT images, which can be time consuming and highly dependent on the observer's experience. A system for automatic lymph node detection and measurement is desired. We propose a computer aided detection (CAD) system for axillary lymph nodes on CT scans in CLL patients. The lung is first automatically segmented and the patient's body in lung region is extracted to set the search region for lymph nodes. Multi-scale Hessian based blob detection is then applied to detect potential lymph nodes within the search region. Next, the detected potential candidates are segmented by fast level set method. Finally, features are calculated from the segmented candidates and support vector machine (SVM) classification is utilized for false positive reduction. Two blobness features, Frangi's and Li's, are tested and their free-response receiver operating characteristic (FROC) curves are generated to assess system performance. We applied our detection system to 12 patients with 168 axillary lymph nodes measuring greater than 10 mm. All lymph nodes are manually labeled as ground truth. The system achieved sensitivities of 81% and 85% at 2 false positives per patient for Frangi's and Li's blobness, respectively.

  3. Intraductal papilloma in an axillary lymph node of a patient with human immunodeficiency virus: a case report and review of the literature.

    Science.gov (United States)

    Cottom, Hannah; Rengabashyam, Bhavani; Turton, Philip E; Shaaban, Abeer M

    2014-05-23

    Inclusions of ectopic breast tissue in axillary lymph nodes are reported very infrequently and typically are only identified microscopically as an incidental finding. Furthermore the development of a benign proliferative lesion in the form of an intraductal papilloma from intranodal ectopic breast tissue is an extremely rare phenomenon with only three previous cases reported. This report describes an unusual and rare case of an intraductal papilloma arising in an axillary lymph node of a patient known to have the human immunodeficiency virus. A 40-year-old Black African woman underwent excision of an enlarged palpable axillary lymph node. In the preceding 7 years she had received at least six separate surgical excisions to her ipsilateral breast for papillomatosis. The last surgical intervention was performed 1 year prior to presentation with an enlarged axillary lymph node. Histological examination of her axillary lymph node revealed a papillomatous proliferative epithelial lesion within an apparent encompassing duct, resembling a mammary intraductal papilloma. In the surrounding lymphoid tissue small groups of duct-like structures were additionally noted. Immunostaining with a panel of myoepithelial markers in conjunction with oestrogen receptor produced a mixed heterogeneous staining pattern in both the papillomatous lesion and the peripheral duct-like structures. This confirmed the diagnosis of a benign intraductal papilloma within an axillary lymph node, considered to have arisen from ectopic breast tissue. This case demonstrates that intranodal ectopic breast tissue has the potential to undergo benign proliferative change albeit extremely rarely. Therefore this possibility must be considered to ensure the correct diagnosis is made. In addition, to the best of our knowledge, this is the first case report which has described recurrent intraductal papillomas and the subsequent development of an intraductal papilloma within an ipsilateral axillary lymph node, in

  4. Frequency and associated factors of axillary web syndrome in women who had undergone breast cancer surgery: a transversal and retrospective study.

    Science.gov (United States)

    Fukushima, Kassandra Ferreira Pessoa; Carmo, Luana Aroucha; Borinelli, Adriana Carvalho; Ferreira, Caroline Wanderley Souto

    2015-01-01

    Breast cancer is the most common malignancy among women. Surgical treatment is an essential part of therapy, which still includes chemotherapy, radiotherapy and hormone therapy. The increase in early cancer detection and less aggressive treatment has made longer survival rates possible for women with this neoplasia. Morbidities after treatment have subsequently aroused particular interest in the scientific community in order to minimize their effects and provide increased quality-of-life for these patients. The present study aimed at investigating one of these morbidities: axillary web syndrome, which occurs after axillary surgical management. From December 2011 to September 2012, according to the inclusion and exclusion criteria, 97 patients, who had been surgically treated for breast cancer, were enrolled, interviewed, and submitted to a specific physical exam. An investigation of the axillary cords, characteristic of this syndrome, was performed in all patients. The axillary web syndrome was diagnosed in 28.86% of the women. Higher risk of triggering the syndrome has been associated with younger age (21.7%), longer time between first treatment and data collection (29.3%), greater number of resected lymph nodes (149.7%) and surgical management medical teams (113.2%). One can conclude that axillary web syndrome was associated with younger age, greater time elapsed since surgery, surgical management of medical staff and number of resected lymph nodes. Further studies are needed to review prior-to-surgery and post-operative follow-up, to properly assess the effects of surgery in the axilla on homeostatic balance, not only in the ipsilateral upper limb, but also assess their compensatory consequences throughout the body.

  5. Sclerotic fibroma (storiform collagenoma)-like stroma in a fibroadenoma of axillary accessory breast tissue.

    Science.gov (United States)

    Val-Bernal, José Fernando; González-Vela, María Carmen; De Grado, Mauricio; Garijo, María Francisca

    2012-08-01

    Accessory breast tissue is a subcutaneous remnant persisting after normal embryological development of the breast. It occurs most frequently in the axilla. Fibroadenomas in axillary breast tissue are rare. We report the case of a 29-year-old female patient who presented a fibroadenoma arising in the accessory breast tissue of the right axillary fossa. The neoplasm showed foci of sclerotic fibroma-like stroma. The patient had no signs of Cowden's syndrome. To the best of our knowledge, a lesion of this kind has not been previously reported. This stromal change suggests an uncommon involutional phase of the fibroadenoma with production of sclerotic and hypocellular collagen. The lesion should be differentiated from extraneural perineuroma, from the changes in fibroadenomas in Cowden's syndrome, from sclerosing lobular hyperplasia (fibroadenomatoid mastopathy) and from pseudoangiomatous stromal hyperplasia. Copyright © 2012 John Wiley & Sons A/S.

  6. International multicenter tool to predict the risk of four or more tumor-positive axillary lymph nodes in breast cancer patients with sentinel node macrometastases

    DEFF Research Database (Denmark)

    Meretoja, Tuomo J; Audisio, R A; Heikkilä, P S

    2013-01-01

    Recently, many centers have omitted routine axillary lymph node dissection (ALND) after metastatic sentinel node biopsy in breast cancer due to a growing body of literature. However, existing guidelines of adjuvant treatment planning are strongly based on axillary nodal stage. In this study, we aim...

  7. Axillary local anesthetic spread after the thoracic interfacial ultrasound block – a cadaveric and radiological evaluation

    Directory of Open Access Journals (Sweden)

    Patricia Alfaro de la Torre

    2017-11-01

    Full Text Available Background: Oral opioid analgesics have been used for management of peri- and postoperative analgesia in patients undergoing axillary dissection. The axillary region is a difficult zone to block and does not have a specific regional anesthesia technique published that offers its adequate blockade. Methods: After institutional review board approval, anatomic and radiological studies were conducted to determine the deposition and spread of methylene blue and local anesthetic injected respectively into the axilla via the thoracic inter-fascial plane. Magnetic Resonance Imaging studies were then conducted in 15 of 34 patients scheduled for unilateral breast surgery that entailed any of the following: axillary clearance, sentinel node biopsy, axillary node biopsy, or supernumerary breasts, to ascertain the deposition and time course of spread of solution within the thoracic interfascial plane in vivo. Results: Radiological and cadaveric studies showed that the injection of local anesthetic and methylene blue via the thoracic inter-fascial plane, using ultrasound guide technique, results in reliable deposition into the axilla. In patients, the injection of the local anesthetic produced a reliable axillary sensory block. This finding was supported by Magnetic Resonance Imaging studies that showed hyper-intense signals in the axillary region. Conclusions: These findings define the anatomic characteristics of the thoracic interfascial plane nerve block in the axillary region, and underline the clinical potential of this novel nerve block. Resumo: Justificativa: Os analgésicos orais à base de opioides têm sido usados para o manejo da analgesia nos períodos peri e pós-operatório de pacientes submetidos à linfadenectomia axilar. A região axilar é uma zona difícil de bloquear e não há registro de uma técnica de anestesia regional específica que ofereça o seu bloqueio adequado. Métodos: Após a aprovação do Conselho de Ética institucional

  8. Real-time three-dimensional ultrasound-assisted axillary plexus block defines soft tissue planes.

    Science.gov (United States)

    Clendenen, Steven R; Riutort, Kevin; Ladlie, Beth L; Robards, Christopher; Franco, Carlo D; Greengrass, Roy A

    2009-04-01

    Two-dimensional (2D) ultrasound is commonly used for regional block of the axillary brachial plexus. In this technical case report, we described a real-time three-dimensional (3D) ultrasound-guided axillary block. The difference between 2D and 3D ultrasound is similar to the difference between plain radiograph and computer tomography. Unlike 2D ultrasound that captures a planar image, 3D ultrasound technology acquires a 3D volume of information that enables multiple planes of view by manipulating the image without movement of the ultrasound probe. Observation of the brachial plexus in cross-section demonstrated distinct linear hyperechoic tissue structures (loose connective tissue) that initially inhibited the flow of the local anesthesia. After completion of the injection, we were able to visualize the influence of arterial pulsation on the spread of the local anesthesia. Possible advantages of this novel technology over current 2D methods are wider image volume and the capability to manipulate the planes of the image without moving the probe.

  9. Gastric Metastasis of Ectopic Breast Cancer Mimicking Axillary Metastasis of Primary Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Selami Ilgaz Kayılıoğlu

    2014-01-01

    Full Text Available Ectopic breast tissue has the ability to undergo all the pathological changes of the normal breast, including breast cancer. Gastrointestinal metastasis of breast cancer is rarely observed and it is very difficult to differentiate gastric metastases from primary gastric cancer. We present a case of 52-year-old female, who suffered from abdominal pain. Physical examination showed a palpable mass in the left anterior axilla and computerized tomography revealed gastric wall thickening with linitis plastica. When gastroscopic biopsy showed no signs of malignancy, excisional biopsy was performed in the left axilla. Histological examination revealed invasive lobular carcinoma of the breast, consistent with ectopic breast cancer. Further gastroscopic submucosal biopsies and immunohistochemical studies revealed gastric metastases of invasive lobular carcinoma. Axillary ectopic breast tissue carcinomas can mimic axillary lymphadenopathies. Additionally, gastric metastasis of breast cancer is an uncommon but possible condition. To the best of our knowledge, this is the first report of ectopic breast cancer with gastric metastasis.

  10. Arm morbidity following sentinel lymph node biopsy or axillary lymph node dissection: a study from the Danish Breast Cancer Cooperative Group

    DEFF Research Database (Denmark)

    Husted, Madsen A.; Haugaard, K.; Soerensen, J.

    2008-01-01

    BACKGROUND: Sentinel lymph node biopsy was implemented in the treatment of early breast cancer with the aim of reducing shoulder and arm morbidity. Relatively few prospective studies have been published where the morbidity was assessed by clinical examination. Very few studies have examined...... lymph node biopsy with node negative patients having a lymph node dissection of levels I and II of the axilla, we found significant increase in arm volume among the patients who had an axillary dissection. Only minor, but significant, differences in shoulder mobility were observed comparing the two...... groups of node negative patients. Highly significant difference was found comparing sensibility. Comparing the morbidity in node positive patients who had a one-step axillary dissection with patients having a two-step procedure (sentinel lymph node biopsy followed by delayed axillary dissection) revealed...

  11. Rupture of an expander prosthesis mimics axillary cancer recurrence.

    LENUS (Irish Health Repository)

    Ismael, T

    2005-10-01

    Regional silicone gel migration from a ruptured breast implant has been reported at different locations including the upper extremity, chest wall muscles, axilla and back. We report a patient who presented with an axillary mass that mimicked a regional recurrence 5 years after breast cancer reconstruction with a latissimus dorsi musculocutaneous flap and silicon gel expander-prosthesis. Surgical exploration revealed that the mass contained silicone gel around the port of the breast expander that had ruptured. The mass was confluent with an intracapsular silicone leak through a tract along the tube of the expander port.

  12. Multidetector-row computed tomography for the preoperative evaluation of axillary nodal status in patients with breast cancer

    International Nuclear Information System (INIS)

    Ogasawara, Yutaka; Doihara, Hiroyoshi; Shiraiwa, Misaki; Ishihara, Setsuko

    2008-01-01

    We evaluated the effectiveness of multidetector-row computed tomography (MD-CT) for detecting axillary lymph nodal status (ALNS) in patients with breast cancer. We reviewed 42 patients with breast cancer. A metastatic lymph node on MD-CT was defined as oval or round, with more than 5 mm on the short axis. We evaluated ALNS preoperatively by both palpation and MD-CT findings and performed sentinel lymph node biopsy (SLNB) and complete axillary lymph node dissection (ALND). For establishing the ALNS, MD-CT showed a sensitivity of 76.9%, a specificity of 96.6%, and an accuracy of 90.5%. On the basis of the MD-CT findings, misdiagnosis was made in 4 of the 42 patients, only one of which was false positive. On the other hand, one patient with a histologically negative sentinel lymph node (SLN) result had metastasis only in a non-SLN. Preoperative MD-CT showed a positive node in this patient. Multidetector-row computed tomography assists in identifying women who require ALND without SLNB, with sufficient positive predictive value. False-negative detection by SLNB could be avoided with careful interpretation of the axillary lymph nodes shown by MD-CT. (author)

  13. Localization studies of metastatic axillary lymph node by radioimmunoimmaging with monoclonal antibody C50 in breast cancer

    International Nuclear Information System (INIS)

    Feng Jue; Gao Yougong

    1993-01-01

    Eleven patients with breast cancer and 2 normal controls (26 axillary lymph-nodes) were studied by the radio immunoimaging with 131 I labelled anti-CEA monoclonal antibody C 50 . Among them, the imaging was positive in 8 patients and negative in 3 patients. 7 of the 8 positive patients were proven by the pathological examination of postoperative lymph nodes. Other one had proved with the presence of CEA-antigen and antigen-antibody immuno complexes in the lymphoid sinus by immuno histochemistry. Cancer cell was not found by pathology in the axillary lymph node of 3 negative imaging patients. 2 normal controls was also negative

  14. Preoperative axillary lymph node staging by ultrasound-guided cytology using a four-level sonographic score

    International Nuclear Information System (INIS)

    De Coninck, Caroline; Noël, Jean-Christophe; Boutemy, Rachel; Simon, Philippe

    2016-01-01

    The staging of axillary lymph nodes is critical to the management and prognosis of breast cancer, the most frequent cancer in females. Neoadjuvant therapy and lymph node dissection are recommended when malignant cells invade the lymph nodes. Therefore the pre-operative examination of these lymph nodes is crucial to treatment. In this study, we examined the effectiveness of cytology through ultrasound-guided fine needle aspiration (USG-FNA) and ultrasound (US) imaging using an established classification system in correctly identifying lymph node status compared to the final histological results after surgery. Cytology by USG-FNA and US classification were found to be promising methods of axillary lymph node staging. US and CB offer minimally invasive techniques to pre-operatively examine these lymph nodes in patients with primary breast cancer

  15. Para-axillary subcutaneous endoscopic approach in torticollis: tips and tricks in the surgical technique.

    Science.gov (United States)

    Tokar, Baran; Karacay, Safak; Arda, Surhan; Alici, Umut

    2015-04-01

    An obvious scar on the neck may appear following the open surgery for congenital muscular torticollis (CMT). The cosmetic result may displease the patient and the family. In this study, we describe a minimally invasive technique, para-axillary subcutaneous endoscopic approach (PASEA) in CMT. A total of 11 children (seven girls and four boys with the age range between 1 and 15 years) were operated for torticollis by PASEA. All patients had facial asymmetry and head and neck postural abnormality. Following an incision at the ipsilateral para-axillary region, a subcutaneous cavernous working space is formed toward sternocleidomastoid (SCM) muscle. The muscle and fascia are cut by cautery under endoscopic vision. The patients had postoperative 2nd-week and 3rd-month visits. The incision scar, inspection, and palpation findings of the region, head posture, and shoulder position of the affected side were considered in evaluation of the cosmetic outcome. Preoperative and postoperative range of motion of the head and neck were compared for functional outcome. We preferred single incision surgery in our last two patients; the rest had double para-axillary incision for port insertion. Incomplete transection of the muscle was not observed. There was no serious complication. Postoperatively, head posture and shoulder elevation were corrected significantly. Range of motion of the head was improved. Postoperatively, all the patients had rotation capacity with more than 30 degrees. The range of postoperative flexion and extension movements was between 45 and 60 degrees. The open surgery techniques of CMT causes visible lifelong incision scar on the neck. PASEA leaves a cosmetically hidden scar in the axillary region. A single incision surgery is also possible. A well-formed cavernous working space is needed. External manual palpation, delicate dissection, and cutting of SCM muscle with cautery are the important components of the procedure. Surgeons having experience in pediatric

  16. Least squares analysis of fission neutron standard fields

    International Nuclear Information System (INIS)

    Griffin, P.J.; Williams, J.G.

    1997-01-01

    A least squares analysis of fission neutron standard fields has been performed using the latest dosimetry cross sections. Discrepant nuclear data are identified and adjusted spectra for 252 Cf spontaneous fission and 235 U thermal fission fields are presented

  17. Proactive error analysis of ultrasound-guided axillary brachial plexus block performance.

    LENUS (Irish Health Repository)

    O'Sullivan, Owen

    2012-07-13

    Detailed description of the tasks anesthetists undertake during the performance of a complex procedure, such as ultrasound-guided peripheral nerve blockade, allows elements that are vulnerable to human error to be identified. We have applied 3 task analysis tools to one such procedure, namely, ultrasound-guided axillary brachial plexus blockade, with the intention that the results may form a basis to enhance training and performance of the procedure.

  18. A Unique Branching Pattern of the Axillary Artery: A Case Report

    OpenAIRE

    Bagoji, Ishwar B.; Hadimani, Gavishiddappa A.; Bannur, Balappa M.; Patil, B.G.; Bharatha, Ambadasu

    2013-01-01

    During routine dissection classes for under graduate students, we found a unique and unusual case regarding the anomalous branching in the third part of the axillary artery was terminated into subscapular arterial trunk, superficial brachial artery and deep brachial artery. The subscapular arterial trunk was origin of several important arteries as the circumflex scapular, thoracodorsal, posterior circumflex humeral, thoraco-acromial and lateral thoracic arteries. The deep brachial artery in t...

  19. Topical niacinamide 4% and desonide 0.05% for treatment of axillary hyperpigmentation: a randomized, double-blind, placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Castanedo-Cazares JP

    2013-01-01

    Full Text Available Juan Pablo Castanedo-Cazares,1 Gabryela Lárraga-Piñones,1 Adriana Ehnis-Pérez,1 Cornelia Fuentes-Ahumada,1 Cuauhtemoc Oros-Ovalle,2 Bruce R Smoller,3 Bertha Torres-Álvarez11Department of Dermatology, 2Department of Pathology, Hospital Central Dr Ignacio Morones Prieto, Universidad Autónoma de San Luis Potosí, México; 3Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AK, USABackground: Axillary hyperpigmentation is a frequent cause of cosmetic consultations in dark-skinned women from tropical areas, including Latin America. Currently, there is no widely accepted treatment for the disorder, but it is usually treated with bleaching agents because it is considered a variant of inflammatory hyperpigmentation. The purpose of this study was to assess the efficacy of niacinamide 4% and desonide 0.05% emulsions compared with placebo in the treatment of axillary hyperpigmentation.Methods: Twenty-four women aged 19–27 years with hyperpigmented axillae (phototype III–V were randomly assigned to receive the study treatments in the axillary region. Improvement was assessed at baseline, then clinically and by colorimetry 9 weeks later. Quantitative evaluation including melanin, inflammatory infiltrates, NKI/Beteb, CD1a, CD68, and collagen type IV content was performed by histochemistry and immunohistochemistry, assisted by computerized morphometric analysis.Results: Both niacinamide and desonide induced significant colorimetric improvement compared with placebo; however, desonide showed a better depigmenting effect than niacinamide. A good to excellent response was achieved in 24% of cases for niacinamide, 30% for desonide, and 6% for placebo. We observed a marked disruption of the basal membrane in axillary hyperpigmentation and an inflammatory infiltrate that improved after treatment. Decreased pigmentation in the desonide-treated axillae was associated with recovery of disruption at the basal membrane

  20. Role of axillary lymph node ultra-sound and large core biopsy in the preoperative assessment of patients selected for sentinel node biopsy

    International Nuclear Information System (INIS)

    Nori, Jacopo; Boeri, Cecilia; Vanzi, Ermanno; Nori Bufalini, Filippo; Masi, Andrea; Bazzocchi, Massimo; Londero, Viviana; Mangialavori, Giuseppe; Distante, Vito; Simoncini, Roberta

    2005-01-01

    Purpose: To aim of this study was to evaluate the diagnostic accuracy of axillary lymph node sonography, if necessary in collaboration with US-guided large core biopsy, in the preoperative evaluation of breast cancer patients scheduled for quadrantectomy and sentinel lymph node excision. Materials and methods: From July 2001 to December 2002, we evaluated 117 breast cancer patients with ultrasound and, where indicated, FNAB. Breast lesions has diameters between 4 and 26 mm (mean diameter 11 mm). Fifteen (13%) of the 117 patients were excluded from the series as they did not found fulfil the criteria for preliminary sonography of the axilla: in 9 patients fewer than 4 nodes were detected and in 6 patients the breast lesions were intraoperatively found to be benign. Eleven patients (10.7%) with sonographically suspicious axillary nodes were sampled by US-guided core biopsy using a 14 or 16 Gauge Tru-Cut needle. Results: The ultrasound study aims to evaluate the dimensions and morphology of the breast lesion as well as detect and assess at least 4 axillary nodes. These were evaluated for hilar and cortical thickening and radio between the sinus diameter and the total longitudinal diameter. Lymph nodes with hilar diameters equal to or greater than 50% of the longitudinal diameter were considered normal. Of the 102 patients evaluated, 77 (75.7%) had normal axillary nodes according to the US criteria adopted. Negativity was confirmed by histology in 56 cases (72.7%, true negative); 21 (27.3%, false negative) were found to be positive, in contrast with the sonographic appearance. The false negative cases were due to lymph node micrometastasis which probably did not cause morphologic alterations perceptible at ultrasound. The remaining 25 patients (24.5%) had axillary lymph nodes classified as suspicious. In 13 cases of (52%, true positive) there was agreement with histology, whereas in 12 cases (48%, false positive) the US suspicion was not confirmed at surgery. The most

  1. Characterization of Trichome-Expressed BAHD Acyltransferases in Petunia axillaris Reveals Distinct Acylsugar Assembly Mechanisms within the Solanaceae.

    Science.gov (United States)

    Nadakuduti, Satya Swathi; Uebler, Joseph B; Liu, Xiaoxiao; Jones, A Daniel; Barry, Cornelius S

    2017-09-01

    Acylsugars are synthesized in the glandular trichomes of the Solanaceae family and are implicated in protection against abiotic and biotic stress. Acylsugars are composed of either sucrose or glucose esterified with varying numbers of acyl chains of differing length. In tomato ( Solanum lycopersicum ), acylsugar assembly requires four acylsugar acyltransferases (ASATs) of the BAHD superfamily. Tomato ASATs catalyze the sequential esterification of acyl-coenzyme A thioesters to the R4, R3, R3', and R2 positions of sucrose, yielding a tetra-acylsucrose. Petunia spp. synthesize acylsugars that are structurally distinct from those of tomato. To explore the mechanisms underlying this chemical diversity, a Petunia axillaris transcriptome was mined for trichome preferentially expressed BAHDs. A combination of phylogenetic analyses, gene silencing, and biochemical analyses coupled with structural elucidation of metabolites revealed that acylsugar assembly is not conserved between tomato and petunia. In P. axillaris , tetra-acylsucrose assembly occurs through the action of four ASATs, which catalyze sequential addition of acyl groups to the R2, R4, R3, and R6 positions. Notably, in P. axillaris , PaxASAT1 and PaxASAT4 catalyze the acylation of the R2 and R6 positions of sucrose, respectively, and no clear orthologs exist in tomato. Similarly, petunia acylsugars lack an acyl group at the R3' position, and congruently, an ortholog of SlASAT3, which catalyzes acylation at the R3' position in tomato, is absent in P. axillaris Furthermore, where putative orthologous relationships of ASATs are predicted between tomato and petunia, these are not supported by biochemical assays. Overall, these data demonstrate the considerable evolutionary plasticity of acylsugar biosynthesis. © 2017 American Society of Plant Biologists. All Rights Reserved.

  2. Axillary staging for breast cancer during pregnancy

    DEFF Research Database (Denmark)

    Han, S N; Amant, F; Cardonick, E H

    2018-01-01

    BACKGROUND: Safety of sentinel lymph node (SLN) biopsy for breast cancer during pregnancy is insufficiently explored. We investigated efficacy and local recurrence rate in a large series of pregnant patients. PATIENTS AND METHODS: Women diagnosed with breast cancer who underwent SLN biopsy during...... pregnancy were identified from the International Network on Cancer, Infertility and Pregnancy, the German Breast Group, and the Cancer and Pregnancy Registry. Chart review was performed to record technique and outcome of SLN biopsy, locoregional and distant recurrence, and survival. RESULTS: We identified...... were alive and free of disease. Eleven patients experienced a locoregional relapse, including 1 isolated ipsilateral axillary recurrence (0.7%). Eleven (7.6%) patients developed distant metastases, of whom 9 (6.2%) died of breast cancer. No neonatal adverse events related to SLN procedure during...

  3. Detection of axillary lymph node involvement of breast cancer by Tc-99m MIBI scintimammography

    International Nuclear Information System (INIS)

    Pusuwan, P.; Chakrappe-sirisuk, S.; Amornpichetkul, K.; Padhy, A.K.; Dondi, M.; Watanabe, N.

    2006-01-01

    Breast cancer is the most common malignancy among women, leading to hundreds of thousands of deaths annually around the world. Lymph node status is the most important prognostic indicator in newly diagnosed breast cancer. The presence of axillary lymph node metastases has major prognostic implications in breast cancer patients, and it is an important criterion in determining the need for adjuvant chemotherapy. There is not an accurate anatomical test for detecting axillary lymph node metastasis and clinical examination has inappropriate diagnostic values. Routine lymph node dissection is the only accepted method for therapeutic decisions but it is invasive and produces significant morbidity such as lymphedema and infections. On the other hand, an important proportion of breast cancer patients are nodenegative. Ultrasonography has also been reported to be helpful, especially in conjunction with fine needle aspiration biopsy

  4. Population based study on sentinel node biopsy before or after neoadjuvant chemotherapy in clinically node negative breast cancer patients : Identification rate and influence on axillary treatment

    NARCIS (Netherlands)

    van der Heiden-van der Loo, M.; de Munck, L.; Sonke, G. S.; van Dalen, T.; van Diest, P. J.; van den Bongard, H. J. G. D.; Peeters, P. H. M.; Rutgers, E. J. T.

    The timing of the sentinel lymph node biopsy (SNB) is controversial in clinically node negative patients receiving neoadjuvant chemotherapy (NAC). We studied variation in the timing of axillary staging in breast cancer patients who received NAC and the subsequent axillary treatment in The

  5. Repair of Multiple Subclavian and Axillary Artery Aneurysms in a 58-Year-Old Man with Marfan Syndrome.

    Science.gov (United States)

    Dolapoglu, Ahmet; de la Cruz, Kim I; Preventza, Ourania; Coselli, Joseph S

    2016-10-01

    Dilation of the ascending aorta and aortic dissections are often seen in Marfan syndrome; however, true aneurysms of the subclavian and axillary arteries rarely seem to develop in patients who have this disease. We present the case of a 58-year-old man with Marfan syndrome who had undergone a Bentall procedure and thoracoabdominal aortic repair for an aortic dissection and who later developed multiple aneurysmal dilations of his right subclavian and axillary arteries. The aneurysms were successfully repaired by means of a surgical bypass technique in which a Dacron graft was placed between the carotid and brachial arteries. We also discuss our strategy for determining the optimal surgical approach in these patients.

  6. Supine MRI for regional breast radiotherapy: imaging axillary lymph nodes before and after sentinel-node biopsy

    Science.gov (United States)

    van Heijst, Tristan C. F.; Eschbach-Zandbergen, Debora; Hoekstra, Nienke; van Asselen, Bram; Lagendijk, Jan J. W.; Verkooijen, Helena M.; Pijnappel, Ruud M.; de Waard, Stephanie N.; Witkamp, Arjen J.; van Dalen, Thijs; Desirée van den Bongard, H. J. G.; Philippens, Marielle E. P.

    2017-08-01

    Regional radiotherapy (RT) is increasingly used in breast cancer treatment. Conventionally, computed tomography (CT) is performed for RT planning. Lymph node (LN) target levels are delineated according to anatomical boundaries. Magnetic resonance imaging (MRI) could enable individual LN delineation. The purpose was to evaluate the applicability of MRI for LN detection in supine treatment position, before and after sentinel-node biopsy (SNB). Twenty-three female breast cancer patients (cTis-3N0M0) underwent 1.5 T MRI, before and after SNB, in addition to CT. Endurance for MRI was monitored. Axillary levels were delineated. LNs were identified and delineated on MRI from before and after SNB, and on CT, and compared by Wilcoxon signed-rank tests. LN locations and LN-based volumes were related to axillary delineations and associated volumes. Although postoperative effects were visible, LN numbers on postoperative MRI (median 26 LNs) were highly reproducible compared to preoperative MRI when adding excised sentinel nodes, and higher than on CT (median 11, p  <  0.001). LN-based volumes were considerably smaller than respective axillary levels. Supine MRI of LNs is feasible and reproducible before and after SNB. This may lead to more accurate RT target definition compared to CT, with potentially lower toxicity. With the MRI techniques described here, initiation of novel MRI-guided RT strategies aiming at individual LNs could be possible.

  7. Validation of sentinel lymph node biopsy in breast cancer women N1-N2 with complete axillary response after neoadjuvant chemotherapy. Multicentre study in Tarragona.

    Science.gov (United States)

    Carrera, D; de la Flor, M; Galera, J; Amillano, K; Gomez, M; Izquierdo, V; Aguilar, E; López, S; Martínez, M; Martínez, S; Serra, J M; Pérez, M; Martin, L

    2016-01-01

    The aim of our study was to evaluate sentinel lymph node biopsy as a diagnostic test for assessing the presence of residual metastatic axillary lymph nodes after neoadjuvant chemotherapy, replacing the need for a lymphadenectomy in negative selective lymph node biopsy patients. A multicentre, diagnostic validation study was conducted in the province of Tarragona, on women with T1-T3, N1-N2 breast cancer, who presented with a complete axillary response after neoadjuvant chemotherapy. Study procedures consisted of performing an selective lymph node biopsy followed by lymphadenectomy. A total of 53 women were included in the study. Surgical detection rate was 90.5% (no sentinel node found in 5 patients). Histopathological analysis of the lymphadenectomy showed complete disease regression of axillary nodes in 35.4% (17/48) of the patients, and residual axillary node involvement in 64.6% (31/48) of them. In lymphadenectomy positive patients, 28 had a positive selective lymph node biopsy (true positive), while 3 had a negative selective lymph node biopsy (false negative). Of the 28 true selective lymph node biopsy positives, the sentinel node was the only positive node in 10 cases. All lymphadenectomy negative cases were selective lymph node biopsy negative. These data yield a sensitivity of 93.5%, a false negative rate of 9.7%, and a global test efficiency of 93.7%. Selective lymph node biopsy after chemotherapy in patients with a complete axillary response provides valid and reliable information regarding axillary status after neoadjuvant treatment, and might prevent lymphadenectomy in cases with negative selective lymph node biopsy. Copyright © 2016 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  8. The value of level III clearance in patients with axillary and sentinel node positive breast cancer.

    LENUS (Irish Health Repository)

    Dillon, Mary F

    2012-02-01

    BACKGROUND: The value of level III axillary clearance is contentious, with great variance worldwide in the extent and levels of clearance performed. OBJECTIVE: To determine rates of level III positivity in patients undergoing level I-III axillary clearance, and identify which patients are at highest risk of involved level III nodes. METHODS: From a database of 2850 patients derived from symptomatic and population-based screening service, 1179 patients who underwent level I-III clearance between the years 1999-2007 were identified. The pathology, surgical details, and prior sentinel nodes biopsies of patients were recorded. RESULTS: Eleven hundred seventy nine patients had level I-III axillary clearance. Of the patients, 63% (n = 747) were node positive. Of patients with node positive disease, 23% (n = 168) were level II positive and 19% (n = 141) were level III positive. Two hundred fifty patients had positive sentinel node biopsies prior to axillary clearance. Of these, 12% (n = 30) and 9% (n = 22) were level II and level III positive, respectively. On multivariate analysis, factors predictive of level III involvement in patients with node positive disease were tumor size (P < 0.001, OR = 1.36; 95% CI: 1.2-1.5), invasive lobular disease (P < 0.001, OR = 3.6; 95% CI: 1.9-6.95), extranodal extension (P < 0.001, OR = 0.27; 95% CI: 0.18-0.4), and lymphovascular invasion (P = 0.04, OR = 0.58; 95% CI: 0.35-1). Lobular invasive disease (P = 0.049, OR = 4.1; 95% CI: 1-16.8), extranodal spread (P = 0.003, OR = 0.18; 95% CI: 0.06-0.57), and having more than one positive sentinel node (P = 0.009, OR = 4.9; 95% CI: 1.5-16.1) were predictive of level III involvement in patients with sentinel node positive disease. CONCLUSION: Level III clearance has a selective but definite role to play in patients who have node positive breast carcinoma. Pathological characteristics of the primary tumor are of particular use in identifying those who are at various risk of level III nodal

  9. Axillary brachial plexus block duration with mepivacaine in patients with chronic renal failure. Case-control study.

    Science.gov (United States)

    Mojica, V; Nieuwveld, D; Herrera, A E; Mestres, G; López, A M; Sala-Blanch, X

    2017-04-01

    Regional anaesthesia is commonly preferred for arteriovenous fistula (AVF) creation. Previous studies suggest a shorter block duration in patients with chronic renal failure, maybe because of the changes in regional blood flow. The aim of our study was to evaluate the duration of the axillary block with 1.5% mepivacaine in patients with chronic renal failure scheduled for AVF compared with healthy controls. Patients scheduled for AVF creation for the first time (GIRC) were included. They were compared with patients without renal failure (GC), with similar anthropometric characteristics. Ultrasound-guided axillary blocks with 20mL of 1.5% mepivacaine were performed on all patients. We evaluated onset time, humeral artery diameter and blood flow before and after the block, as well as the block duration. Twenty-three patients (GIRC: 12 and GC: 11) were included. No differences between groups were observed in block duration (GIRC: 227±43min vs GC: 229±27min; P=.781), or in onset time (GIRC: 13±5min vs GC: 12.2±3min; P=.477). The humeral blood flow before and after block was significantly lower in the GIRC (pre-block: GIRC: 52±21ml/min GC: 100±62ml/min; P=.034 and p ost block: GIRC: 130±57ml/min and GC: 274±182ml/min; P=.010). There was no significant correlation between the duration of the block and the preblock humeral blood flow (Spearman Rho: 0.106; P=.657) or the postblock humeral blood flow (Spearman Rho: 0.267; P=.254). The duration of the axillary block with 1.5% mepivacaine in patients with chronic renal failure was similar to that of the control patients. The duration of axillary brachial plexus block seems not to be related to changes in regional blood flow. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Predictors of axillary lymph node metastases in women with early breast cancer in Singapore.

    Science.gov (United States)

    Tan, L G L; Tan, Y Y; Heng, D; Chan, M Y

    2005-12-01

    The presence of axillary lymph node metastases is an important prognostic factor in breast cancer. Sentinel lymph node biopsy (SLNB) is an emerging method for the staging of the axilla. It is hoped that with SLNB, the morbidity from axillary lymph node dissection (ALND) can be avoided without compromising the staging and management of early breast cancer. However, only patients found to be SLNB negative benefit from this procedure, as those with positive SLNB may still require ALND. Our objective is to study the various clinico-pathological factors to find predictive factors for axillary lymph node involvement in early breast cancer. It is hoped that with these factors, we will be better able to identify groups of patients most likely to benefit from SLNB. A retrospective study of 380 early breast cancer cases (stage T1 and T2, N0, N1, M0) in women treated in the Department of General Surgery, Tan Tock Seng Hospital, between January 1999 and August 2002, was conducted. Incidence of nodal metastases was correlated with clinico-pathological factors, and analysed by univariate and multivariate analyses. Approximately 35 percent of the 380 cases of early breast cancer had nodal metastases. Multivariate analyses revealed four independent predictors of node positivity: tumour size (p-value equals 0.0001), presence of lymphovascular invasion (p-value is less than 0.0001), tumours with histology other than invasive ductal or lobular carcinoma (p-value equals 0.04), and presence of progesterone receptors (p-value equals 0.05). We have found independent preoperative predictive factors in our local population for the presence of nodal metastases. This information can aid patient selection for SLNB and improve patient counselling.

  11. In elective arch surgery with circulatory arrest, does the arterial cannulation site really matter? A propensity score analysis of right axillary and innominate artery cannulation.

    Science.gov (United States)

    Preventza, Ourania; Price, Matt D; Spiliotopoulos, Konstantinos; Amarasekara, Hiruni S; Cornwell, Lorraine D; Omer, Shuab; de la Cruz, Kim I; Zhang, Qianzi; Green, Susan Y; LeMaire, Scott A; Rosengart, Todd K; Coselli, Joseph S

    2018-05-01

    The preferred arterial cannulation site for elective proximal aortic procedures requiring circulatory arrest varies, and different sites have been tried. We evaluated the relationships between arterial cannulation site and adverse outcomes, including stroke, in patients undergoing elective aortic arch surgery. We reviewed the records of 938 patients who underwent elective hemiarch or total arch surgery with circulatory arrest between 2006 and 2016. Five cannulation sites were used: the right axillary (n = 515; 54.9%), innominate (n = 376; 40.1%), and right common carotid arteries (n = 15; 1.6%), each with a side graft; the ascending aorta (n = 19; 2.0%); and the femoral artery (n = 13; 1.4%). Multivariable logistic regression analysis was used to model the effects of cannulation site on adverse outcomes for the entire cohort and for a subcohort of 891 patients who underwent innominate or axillary artery cannulation. Propensity-matching yielded 564 patients (282 pairs) from the right axillary and innominate artery groups. For the entire cohort, mortality, stroke, and composite adverse outcome (operative death or persistent stroke or renal failure at hospital discharge) rates were 7.0%, 4.1%, and 9.8%. In the multivariable analysis of the axillary/innominate subcohort, cannulation site did not independently predict operative mortality, persistent stroke, or composite adverse event. These results were confirmed with the propensity-matched analysis, where both axillary and innominate artery cannulation provided equivalent composite adverse event rates, operative death rates, and overall stroke rates. During elective arch surgery, right axillary artery cannulation and innominate artery cannulation (both via a side graft) produce excellent results and can be used interchangeably. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  12. Bilateral axillary skin fold flaps used for dorsal thoracic skin wound closure in a dog : clinical communication

    Directory of Open Access Journals (Sweden)

    B. G. Nevill

    2010-05-01

    Full Text Available A 10-year-old greyhound-cross dog was presented with a large, chronic skin wound extending over the interscapular region. The substantial skin defect was closed by making use of bilateral axillary skin fold flaps. It was possible to elevate the 2 skin flaps sufficiently to allow them to meet at the dorsal midline and thus facilitate complete closure of a large and awkwardly positioned wound. Small dorsal areas of the skin flaps underwent necrosis, but the resulting defects were closed without difficulty in a subsequent procedure. To the author's knowledge, this is the 1st clinical report of the use of bilateral axillary skin fold flaps in this fashion and describes an additional use of a versatile skin flap procedure.

  13. Development of human exposure standards for radio frequency fields

    International Nuclear Information System (INIS)

    Lin, James C.

    2000-01-01

    Historical aspects of the problem of developing human exposure standards for radio frequency (RF) electromagnetic fields are discussed. It is shown that biological effects and health implications of radiofrequency (RF) electromagnetic fields have been a subject of scientific investigation for more than 50 years. It has become a focus of attention because of the expanded use of RF radiation in the frequency range between 300 MHz and 6 GHz for wireless communication over the past decade. Another cause for the attention is the uncertainty of some observed responses and lack of understanding of the mechanism of interaction of RF electromagnetic fields with biological systems. At present, considerable efforts are devoted to developing and revising RF exposure standards. Each of these efforts should aim to make explicit the philosophy and process by which they reason and decide guidelines for deeming exposure as safe. Furthermore, the reconciliation of philosophies of protection will definitely be an asset, in practice, to those interested in international harmonization of RF exposure standards [ru

  14. Characterization of Trichome-Expressed BAHD Acyltransferases in Petunia axillaris Reveals Distinct Acylsugar Assembly Mechanisms within the Solanaceae1[OPEN

    Science.gov (United States)

    Uebler, Joseph B.; Liu, Xiaoxiao

    2017-01-01

    Acylsugars are synthesized in the glandular trichomes of the Solanaceae family and are implicated in protection against abiotic and biotic stress. Acylsugars are composed of either sucrose or glucose esterified with varying numbers of acyl chains of differing length. In tomato (Solanum lycopersicum), acylsugar assembly requires four acylsugar acyltransferases (ASATs) of the BAHD superfamily. Tomato ASATs catalyze the sequential esterification of acyl-coenzyme A thioesters to the R4, R3, R3ʹ, and R2 positions of sucrose, yielding a tetra-acylsucrose. Petunia spp. synthesize acylsugars that are structurally distinct from those of tomato. To explore the mechanisms underlying this chemical diversity, a Petunia axillaris transcriptome was mined for trichome preferentially expressed BAHDs. A combination of phylogenetic analyses, gene silencing, and biochemical analyses coupled with structural elucidation of metabolites revealed that acylsugar assembly is not conserved between tomato and petunia. In P. axillaris, tetra-acylsucrose assembly occurs through the action of four ASATs, which catalyze sequential addition of acyl groups to the R2, R4, R3, and R6 positions. Notably, in P. axillaris, PaxASAT1 and PaxASAT4 catalyze the acylation of the R2 and R6 positions of sucrose, respectively, and no clear orthologs exist in tomato. Similarly, petunia acylsugars lack an acyl group at the R3ʹ position, and congruently, an ortholog of SlASAT3, which catalyzes acylation at the R3ʹ position in tomato, is absent in P. axillaris. Furthermore, where putative orthologous relationships of ASATs are predicted between tomato and petunia, these are not supported by biochemical assays. Overall, these data demonstrate the considerable evolutionary plasticity of acylsugar biosynthesis. PMID:28701351

  15. [Efficacy and safety of ultrasound-guided or neurostimulator-guided bilateral axillary brachial plexus block].

    Science.gov (United States)

    Xu, C S; Zhao, X L; Zhou, H B; Qu, Z J; Yang, Q G; Wang, H J; Wang, G

    2017-10-17

    Objective: To explore the efficacy and safety of bilateral axillary brachial plexus block under the guidance of ultrasound or neurostimulator. Methods: From February 2012 to April 2014, 120 patients undergoing bilateral hand/forearm surgery in Beijing Jishuitan Hospital were enrolled and anaesthetized with bilateral axillary brachial plexus block. All patients were divided into two groups randomly using random number table: the ultrasound-guided group (group U, n =60) and the neurostimulator-guidedgroup (group N, n =60). The block was performed with 0.5% ropivacaine. Patients' age, sex and operation duration were recorded. Moreover, success rate, performance time, onset of sensor and motor block, performance pain, patient satisfaction degree and the incidence of related complications were also documented. Venous samples were collected at selected time points and the total and the plasma concentrations of ropivacaine were analyzed with HPLC. Results: The performance time, the onset of sensor block and the onset of motor block of group U were (8.2±1.5), (14.2± 2.2)and (24.0±3.5)min respectively, which were markedly shorter than those in group N( (14.6±3.9), (19.9±3.8), (28.8±4.2)min, respectively), and the differences were statistically significant( t =11.74, 10.09, 6.73, respectively, all P 0.05). No analgesic was superadded and no other anesthesia methods were applied. No complications were detected perioperatively. Conclusions: The bilateral axillary brachial plexus block under the guidance of ultrasound or neurostimulator are both effective and safe for bilateral hand/forearm surgery. However, the ultrasound-guided block may be more clinically beneficial because of its shorter performance time, rapid onset and higher patient satisfaction degree.

  16. [Axillary ectopic breast tissue fibroadenoma: report of three cases and review of the literature].

    Science.gov (United States)

    Ortiz-Mendoza, Carlos Manuel

    2012-02-01

    Ninety-five percent of women have mammary tissue at the axilla. However, the fibroadenoma seldom occur in this area and there are only isolated case reports of this tumor. This paper presents a series of three cases of this rare entity. Three women came to our hospital by axillary lumps. The patients had a median age of 36 +/- 9-years-old with an average time of evolution of 34 +/- 53 months. One patient had the history of a breast phyllodes tumor previously excised, and two were nulliparous. In two cases, neither ultrasound nor mammogram gave useful information for its diagnosis. Mammary glands of all cases were normal. The tumors were firm and movable, similar to a lymphadenopathy, and one was evident. The mean tumor size was 28 +/- 18 mm; all were oval and with white appearance. Histological diagnosis for all cases was fibroadenoma. Our findings match with literature reports. The axillary fibroadenomas may occur in women aged 30 to 50-years-old, mimicking a lymphadenopathy. Finally, the ultrasound and the mammography are not useful tools for its diagnosis.

  17. Persistent pain, sensory disturbances and functional impairment after immediate or delayed axillary lymph node dissection

    DEFF Research Database (Denmark)

    Geving Andersen, Kenneth; Jensen, Maj-Britt Raaby; Tvedskov, Tove Filtenborg

    2013-01-01

    BACKGROUND: Patients treated with 2-step axillary lymph node dissection (ALND) may be at increased risk of nerve damage due to more challenging surgery than an ALND immediately after a sentinel lymph node biopsy (SLNB), and thus more at risk for persistent pain after breast cancer treatment (PPBCT...

  18. In vitro mass propagation of Salvia canariensis by axillary shoots

    Directory of Open Access Journals (Sweden)

    Sebastiana Mederos Molina

    2014-01-01

    Full Text Available During the establishment of shoots of Salvia canariensis L., five environmental factor treatments were applied. For each axillary node two shoots grew well when explants were incubated at continued ligth for 15 days followed by 16 hrs photoperiod by 30 days. Shoots multiplication was improved on a modified Murashige and Skoog (MS (1962 medium - MS + 825 mg/l NH4NO3 - supplemented with 10-7 M BA and 10-7 M NAA. The shoots produced well developed root systems within three weeks after transfer to the same culture medium supplemented with 5x 10-7 M NAA.

  19. A moat around castle walls. The role of axillary and facial hair in lymph node protection from mutagenic factors.

    Science.gov (United States)

    Komarova, Svetlana V

    2006-01-01

    Axillary hair is a highly conserved phenotypical feature in humans, and as such deserves at least consideration of its functional significance. Protection from environmental factors is one of the main functions attributed to hair in furred vertebrates, but is believed to be inapplicable to humans. I considered the hypothesis that the phenotypic preservation of axillary hair is due to its unrecognized role in the organism protection. Two immediate questions arise--what exactly is being protected and what it is protected from. A large group of axillary lymph nodes represents a major difference between underarms and the adjacent areas of the trunk. The consideration of potential factors from which hair can offer protection identifies sunlight as the most likely candidate. Intense sweat production underarms may represent an independent defense mechanism, specifically protecting lymph nodes from overheating. Moreover, the pattern of facial hair growth in males strikingly overlaps with the distribution of superficial lymph nodes, suggesting potential role for facial hair in protection of lymph nodes, and possibly thymus and thyroid. The idea of lymph node protection from environmental mutagenic factors, such as UV radiation and heat, appears particularly important in light of wide association of lymph nodes with cancers. The position of contemporary fashion towards body hair is aggressively negative, including the social pressure for removal of axillary and bikini line hair for women, facial hair for men in many professional occupations, and even body hair for men. If this hypothesis is proven to be true, the implications will be significant for immunology (by providing new insights in lymph node physiology), health sciences (depilation is painful and therefore easily modifiable habit if proven to increase disease risk), as well as art, social fashion and economy.

  20. Mapping axillary microbiota responsible for body odours using a culture-independent approach.

    Science.gov (United States)

    Troccaz, Myriam; Gaïa, Nadia; Beccucci, Sabine; Schrenzel, Jacques; Cayeux, Isabelle; Starkenmann, Christian; Lazarevic, Vladimir

    2015-01-01

    Human axillary odour is commonly attributed to the bacterial degradation of precursors in sweat secretions. To assess the role of bacterial communities in the formation of body odours, we used a culture-independent approach to study axillary skin microbiota and correlated these data with olfactory analysis. Twenty-four Caucasian male and female volunteers and four assessors showed that the underarms of non-antiperspirant (non-AP) users have significantly higher global sweat odour intensities and harboured on average about 50 times more bacteria than those of AP users. Global sweat odour and odour descriptors sulfury-cat urine and acid-spicy generally increased from the morning to the afternoon sessions. Among non-AP users, male underarm odours were judged higher in intensity with higher fatty and acid-spicy odours and higher bacterial loads. Although the content of odour precursors in underarm secretions varied widely among individuals, males had a higher acid: sulfur precursor ratio than females did. No direct correlations were found between measured precursor concentration and sweat odours. High-throughput sequencing targeting the 16S rRNA genes of underarm bacteria collected from 11 non-AP users (six females and five males) confirmed the strong dominance of the phyla Firmicutes and Actinobacteria, with 96% of sequences assigned to the genera Staphylococcus, Corynebacterium and Propionibacterium. The proportion of several bacterial taxa showed significant variation between males and females. The genera Anaerococcus and Peptoniphilus and the operational taxonomic units (OTUs) from Staphylococcus haemolyticus and the genus Corynebacterium were more represented in males than in females. The genera Corynebacterium and Propionibacterium were correlated and anti-correlated, respectively, with body odours. Within the genus Staphylococcus, different OTUs were either positively or negatively correlated with axillary odour. The relative abundance of five OTUs (three

  1. Ultrasound-guided diffuse optical tomography (DOT) of invasive breast carcinoma: Does tumour total haemoglobin concentration contribute to the prediction of axillary lymph node status?

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Qingli, E-mail: qinglizhu@gmail.com [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); Xiao, Mengsu, E-mail: xiaomengsu_2000@sina.com [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); You, Shanshan, E-mail: shanshan_0531@sina.com [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); Zhang, Jing, E-mail: zhang.jing1029@163.com [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); Jiang, Yuxin, E-mail: yuxinjiangxh@yahoo.com.cn [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); Lai, Xingjian, E-mail: lxjpumch@yahoo.com.cn [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China); Dai, Qing, E-mail: qingdai_2000@yahoo.com [Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1, Dongcheng District, Beijing 100730 (China)

    2012-11-15

    Objectives: To prospectively study the ultrasound-guided near-infrared diffuse optical tomography (DOT) findings of the total haemoglobin concentration (THC) detected in invasive breast carcinomas and its contribution to the prediction of axillary lymph node (LN) status. Methods: A total of 195 invasive breast carcinomas were prospectively studied with DOT before surgery. Lumpectomy or mastectomy with full axillary nodal dissection was performed. Tumour size and THC level were correlated with LN status by a logistic regression analysis. Results: One hundred twenty-four patients (63.59%) was LN(-) and 71 (36.41%) was LN(+). The average THC was significantly higher in the LN(+) group than in the LN(-) group (252.94 {+-} 69.19 {mu}mol/L versus 203.86 {+-} 83.13 {mu}mol/L, P = 0.01). A multivariate analysis showed an independent relationship between the probability of axillary metastasis, elevated THC level (P = 0.01), and tumour size (P = 0.001). The odds ratio with THC {>=} 140 {mu}mol/L was 13.651 (1.781-104.560), whereas that of tumour size with a 1 cm increment was only 1.777 (1.283-2.246). Conclusions: The THC level and the tumour size are independent and preoperative predictors of axillary nodal status; these variables may improve the diagnosis of patients with lymph node metastasis.

  2. Comparative analysis of multi-slice spiral CT and positron emission tomography-CT in evaluation of axillary lymph nodes in breast cancer patients

    International Nuclear Information System (INIS)

    Sun Xianchang; Zhang Ruyi; Liu Qingwei; Zhao Suhong; Zu Degui; Li Xin

    2008-01-01

    Objective: To evaluate and compare spiral CT and positron emission tomography-CT (PET-CT) in characterization of of axillary lymph nodes in breast cancer patients. Methods: Forty patients with pathologically proven breast cancer underwent contrast-enhanced spiral CT of the breast and axilla, 13 of them also underwent PET-CT examination. One hundred and fifty-eight axillary lymph nodes were found in the 40 patients through contrast enhanced spiral CT, while 57 lymph nodes were found in the 13 patients through PET-CT. Three radiologists rated the lymph nodes found in CT images on a five-point scale. If the score was equal to or greater than 3, it was defined as positive (metastatic), otherwise negative. Visual observation and semiquantitative analysis were used to classify lymph nodes in PET-CT images. The results of spiral CT observation and PET-CT observation of lymph nodes were compared with pathological results. The relative value of CT and PET-CT was analyzed. Exact probability statistics were employed. Results: One hundred and fifty eight lymph nodes of 40 patients were detected by spiral CT, 91 of them were diagnosed as positive and 67 as negative Among the lymph nodes found in spiral CT, 99 were positive and 59 were negative pathologicall. A total of 57 lymph nodes were found by PET-CT. Thirty-nine of them were defined as positive and 18 as negative. Among the lymph nodes found in PET-CT, 39 were positive and 18 were negative pathologically. The sensitivity, specificity, accuracy, positive and negative predictive values in CT prediction in axillary lymph nodes metastases were 88.89%, 94.91%, 91.14%, 96.70%, and 83.58%, respectively. The sensitivity, specificity, accuracy, positive and negative predictive values in PET-CT prediction in axillary lymph nodes metastases were 97.44%, 94.44%, 96.49%, 97.44%, and 94.44%, respectively. PET-CT had no significant difference with spiral CT in sensitivity, accuracy, positive and negative predictive values for detection

  3. Low-Volume Brachial Plexus Block Providing Surgical Anesthesia for Distal Arm Surgery Comparing Supraclavicular, Infraclavicular, and Axillary Approach: A Randomized Observer Blind Trial

    Directory of Open Access Journals (Sweden)

    Mojgan Vazin

    2016-01-01

    Full Text Available Background. Distal arm surgery is widely performed under regional anesthesia with brachial plexus block. The preponderance of evidence for the efficacy relies upon injection of local anesthetic in excess of 30 mL. We aimed to compare three different ultrasound-guided brachial plexus block techniques restricting the total volume to 20 mL. Methods. 120 patients were prospectively randomized to ultrasound-guided brachial plexus block with 20 mL ropivacaine 0.75% at either the supraclavicular, infraclavicular, or axillary level. Multiinjection technique was performed with all three approaches. Primary outcome measure was performance time. Results. Performance time and procedural pain were similar between groups. Needle passes and injection numbers were significantly reduced in the infraclavicular group (P<0.01. Nerve visibility was significantly reduced in the axillary group (P=0.01. Success-rate was significantly increased in the supraclavicular versus the axillary group (P<0.025. Total anesthesia-related time was significantly reduced in the supraclavicular compared to the infraclavicular group (P<0.01. Block duration was significantly increased in the infraclavicular group (P<0.05. No early adverse effects occurred. Conclusion. Supraclavicular and infraclavicular blocks exhibited favorable characteristics compared to the axillary block. Supraclavicular brachial plexus block with the multiinjection intracluster technique exhibited significantly reduced total anesthesia-related time and higher success rate without any early adverse events.

  4. Data Friction Meets Social Friction: Challenges for standardization in emerging fields of geoscience

    Science.gov (United States)

    Darch, P. T.

    2017-12-01

    Many interdisciplinary endeavors in the geosciences occur in emergent scientific fields. These fields are often characterized by heterogeneity of methods for production and collection of data, and by data scarcity. This paper presents findings about processes of methods standardization from a long-term case study of an emergent, data-scarce field, the deep subseafloor biosphere. Researchers come from many physical and life science backgrounds to study interactions between microbial life in the seafloor and the physical environment they inhabit. Standardization of methods for collecting data promises multiple benefits to this field, including: Addressing data scarcity through enabling greater data reuse and promoting better interoperability with large scale infrastructures; Fostering stronger collaborative links between researchers distributed across institutions and backgrounds. Ongoing standardization efforts in the field do not only involve scientific judgments about which among a range of methods is most efficient, least biased, or most reliable. Instead, these efforts also encounter multiple difficult social challenges, including: Lack of agreed upon criteria about how to judge competing methods: should efficiency, bias, or reliability take priority?; Lack of resources to carry out the work necessary to determine standards, particularly acute in emergent fields; Concerns that standardization is premature in such a new field, foreclosing the possibility of better methods being developed in the future; Concerns that standardization could prematurely shut down important scientific debates; Concerns among some researchers that their own work may become obsolete should the methods chosen as standard be different from their own. The success of these standardization efforts will depend on addressing both scientific and social dimensions, to ensure widespread acceptance among researchers in the field.

  5. Harmonized technical standards in the nuclear field

    International Nuclear Information System (INIS)

    Carbone, Ferdinando

    1976-01-01

    The need was felt of harmonizing and gradually standardizing technical norms, from the well-known Anglo-Saxon type codes of practice to the equally well-known recommendations of the International Commission on Radiological Protection (ICRP). The latter provide the basis for the Euratom Directives (basic standards), which, following their adoption, were embodied in the national laws of community Member countries. ISO (International Standardization Organization) is active in the nuclear technical regulations field, in particular through its Committee ISO/TC 85 ''Nuclear Energy'' at international level and, in Italy, through the National Italian Unification Agency (UNI) and its Nuclear Unification Commission (UNICEN). At its XI plenary meeting this body, on the proposal of the Secretary-General, set up a Study Group to promote revision of the regulation in force and coordination between legislation and development of UNICEN standards, considered as a set of integrative industrial technical standards. CISDEN, the Italian Nuclear Energy Forum (FIEN) and other interested organizations have been invited to collaborate in this work. (N.E.A.)

  6. Axillary artery injury after an anterior shoulder fracture dislocation and “periosteal sleeve avulsion of the rotator cuff” (SARC. Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Ash Chehata

    2017-04-01

    Full Text Available We present the rare complication of an axillary artery injury associated with an anterior dislocation of the humerus and what we believe to be the first reported periosteal sleeve avulsion of the entire rotator cuff (SARC. We review the literature and discuss the cause of this unusual injury pattern. Keywords: Axillary artery, Shoulder fracture dislocation, Periosteal sleeve avulsion, SARC

  7. Role of fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography in the evaluation of axillary lymph node involvement in operable breast cancer in comparison with sentinel lymph node biopsy

    International Nuclear Information System (INIS)

    Challa, Vasu Reddy; Srivastava, Anurag; Dhar, Anita; Parshad, Rajinder; Bal, Chandrasekhar; Gona, Rama Mohan Reddy; Kumar, Rakesh; Sharma, Punit; Gupta, Siddhartha Datta

    2013-01-01

    Role of (18(F)fluorine-18-labeled 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography-computed tomography (PET-CT) in the evaluation of axillary lymph node involvement in T1T2N0 breast cancer and compare results with sentinel lymph node biopsy (SLNB). SLN was identified in 32 of 37 patients with an identification rate of 86.48% (32/37). With combined technique SLN identification rate was 100% (6/6) while with blue dye alone; it was 83.8% (26/31). Among 37 patients, 16 had axillary metastases of which 12 had macrometastases and four had micrometastases detected by immunohistochemistry (IHC). Of 12 patients with axillary macrometastases, skip metastases were present in two patients in whom SLN was negative and in two patients SLN was not identified, but axillary dissection showed metastases. PET-CT had shown sensitivity, specificity, negative predictive value and positive predictive value of 56%, 90%, 73%, and 81.8%, respectively. IHC of SLN detected four patients with micrometastases upstaging the disease by 11% (4/37). Because FDG PET-CT has a high specificity in the evaluation of axillary lymph node involvement in T1T2N0 breast cancer patients according to the results of this study if FDG PET-CT is positive in axillary lymph nodes, axillary lymph node dissection may be considered instead of SLNB

  8. Dexmedetomidine as an adjuvant to 0.5% ropivacaine in ultrasound-guided axillary brachial plexus block.

    Science.gov (United States)

    Koraki, E; Stachtari, C; Kapsokalyvas, I; Stergiouda, Z; Katsanevaki, A; Trikoupi, A

    2018-06-01

    The aim of this study was to elucidate the effect of dexmedetomidine added to ropivacaine on the onset and duration of sensory and motor block and duration of analgesia of ultrasound-guided axillary brachial plexus block. Thirty-seven ASA physical status I-II patients with elective forearm and hand surgery under ultrasound-guided axillary brachial plexus block were randomly divided into 2 groups. Patients in ropivacaine-dexmedetomidine group (group RD, n = 19) received 15 mL of 0.5% ropivacaine with 100 μg (1 mL) dexmedetomidine, and patients in ropivacaine group (group R, n = 18) received 15 mL of 0.5% ropivacaine with 1 mL of normal saline. Onset time and duration of sensory and motor block and duration of analgesia were assessed. Duration of sensory block (U-value = 35, P block (P = .001) and duration of analgesia (P block in group RD was significantly faster than in group R (U-value = 65.5, P = .001). Onset time of motor block showed no significant difference between the 2 groups (U-value = 116.5, P = .096). Adverse reactions were reported only in group RD (bradycardia in 2 and hypotension in 3 patients). Our study indicated that dexmedetomidine 100 μg as adjuvant on ultrasound-guided axillary plexus block significantly prolonged the duration of sensory block and analgesia, as well as accelerated the time to onset of sensory block. These results should be weighed against the increased risks of motor block prolongation, transient bradycardia and hypotension and allow for attentive optimism, only if prolonged clinical trials provide a definitive answer. © 2017 John Wiley & Sons Ltd.

  9. Loop Corrections to Standard Model fields in inflation

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Xingang [Institute for Theory and Computation, Harvard-Smithsonian Center for Astrophysics,60 Garden Street, Cambridge, MA 02138 (United States); Department of Physics, The University of Texas at Dallas,800 W Campbell Rd, Richardson, TX 75080 (United States); Wang, Yi [Department of Physics, The Hong Kong University of Science and Technology,Clear Water Bay, Kowloon, Hong Kong (China); Xianyu, Zhong-Zhi [Center of Mathematical Sciences and Applications, Harvard University,20 Garden Street, Cambridge, MA 02138 (United States)

    2016-08-08

    We calculate 1-loop corrections to the Schwinger-Keldysh propagators of Standard-Model-like fields of spin-0, 1/2, and 1, with all renormalizable interactions during inflation. We pay special attention to the late-time divergences of loop corrections, and show that the divergences can be resummed into finite results in the late-time limit using dynamical renormalization group method. This is our first step toward studying both the Standard Model and new physics in the primordial universe.

  10. Abscisic acid signaling is controlled by a BRANCHED1/HD-ZIP i cascade in Arabidopsis axillary buds

    NARCIS (Netherlands)

    Gonzalez-Grandio, Eduardo; Pajoro, Alice; Franco-Zorrilla, Jose M.; Tarancon, Carlos; Immink, Richard G.H.; Cubas, Pilar

    2017-01-01

    Shoot-branching patterns determine key aspects of plant life and are important targets for crop breeding. However, we are still largely ignorant of the genetic networks controlling locally themost important decision during branch development: whether the axillary bud, or branch primordium, grows out

  11. Nerve Stimulator Guided Axillary Block in Painless Reduction of Distal Radius Fractures; a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Hossein Alimohammadi

    2013-12-01

    Full Text Available Introduction: Given the high prevalence of upper extremity fractures and increasing need to perform painless reduction in the emergency departments, the use of analgesic methods with fewer complications and more satisfaction appears to be essential. The aim of this study is comparison the nerve stimulator guided axillary block (NSAB with intravenous sedation in induction of analgesia for painless reduction of distal radius fractures. Methods: In the present randomized clinical trial, 60 patients (18-70 years of age suffered from distal radius fractures, were divided into two equal groups. One group received axillary nerve block by nerve stimulator guidance and the other procedural sedation and analgesia (PSA using midazolam/fentanyl. Onset of analgesia, duration of analgesic effect, total procedure time and pain scores were recorded using visual analogue scale (VAS and the outcomes were compared. Chi-squared and student t test were performed to evaluate differences between two groups. Results: Sixty patients were randomly divided into two groups (83.3% male. The mean age of patients was 31 ±0.7 years. While the onset of analgesia was significantly longer in the NSAB group, the mean total time of procedure was shorter than PSA (p<0.001. The NSAB group needed a shorter post-operative observation time (P<0.001. Both groups experienced equal pain relief before, during and after procedure (p>0.05. Conclusion: It seems that shorter post-operative monitoring time and consequently lesser total time of procedure, make nerve stimulator guided axillary block as an appropriate alternative for procedural sedation and analgesia in painless reduction of distal radius fractures in emergency department. 

  12. Overview on the standardization in the field of electromagnetic compatibility

    Science.gov (United States)

    Goldberg, Georges

    1989-04-01

    Standardization in the domain of electromagnetic compatibility (EMC) is discussed, with specific reference to the standards of the International Electrotechnical Commission, the Comite International Special des Perturbations Radioelectriques, and the Comite Europeen de Normalisation Electrotechnique. EMC fields considered include radiocommunications, telecommunications, biological effects, and data transmission. Standards are presented for such electromagnetic disturbances as low-frequency, high-frequency, conduction, and radiation phenomena.

  13. Standardized UXO Technology Demonstration Site, Open Field Scoring Record Number 426

    National Research Council Canada - National Science Library

    Overbay, Larry, Jr; Boutin, Matthew; Archiable, Robert; Fling, Rick; McClung, Christina; Robitaille, George

    2005-01-01

    ...) utilizing the YPG Standardized UXO Technology Demonstration Site Open Field. Scoring Records have been coordinated by Larry Overbay and the Standardized UXO Technology Demonstration Site Scoring Committee...

  14. Standardized UXO Technology Demonstration Site, Open Field Scoring Record Number 657

    National Research Council Canada - National Science Library

    Overbay, Larry; Robitaille, George

    2005-01-01

    ...) utilizing the APG Standardized UXO Technology Demonstration Site Open Field. Scoring Records have been coordinated by Larry Overbay and the Standardized UXO Technology Demonstration Site Scoring Committee...

  15. Standardized UXO Technology Demonstration Site, Open Field Scoring Record No. 897

    National Research Council Canada - National Science Library

    Burch, William; Fling, Rick; McClung, Christina

    2008-01-01

    ...) utilizing the APG Standardized UXO Technology Demonstration Site Open Field. This Scoring Record was coordinated by William Burch and the Standardized UXO Technology Demonstration Site Scoring Committee...

  16. Standardized UXO Technology Demonstration Site Open Field Scoring Record No. 442

    National Research Council Canada - National Science Library

    Overbay, Larry, Jr; Boutin, Matthew; Archiable, Robert; Fling, Rick; McClung, Christina; Robitaille, George

    2005-01-01

    ...) unitizing the YPG Standardized UXO Technology Demonstration Site Open Field. The scoring record was coordinated by Larry Overbay and the Standardized UXO Technology Demonstration Site Scoring Committee...

  17. Standardized UXO Technology Demonstration Site, Open Field Scoring Record Number 638

    National Research Council Canada - National Science Library

    Overbay, Larry, Jr; Robitaille, George; Boutin, Matthew; Archiable, Robert; McClung, Christina

    2005-01-01

    ...) utilizing the YPG Standardized UXO Technology Demonstration Site Open Field. The scoring record was coordinated by Larry Overbay and the Standardized UXO Technology Demonstration Site Scoring Committee...

  18. Standardized UXO Technology Demonstration Site Open Field Scoring Record No. 857

    National Research Council Canada - National Science Library

    Fling, Rick; McClung, Christina; Banta, Matthew; Burch, William; McDonnell, Patrick

    2007-01-01

    ...) utilizing the APG Standardized UXO Technology Demonstration Site Open Field. This Scoring Record was coordinated by Dennis Teefy and the Standardized UXO Technology Demonstration Site Scoring Committee...

  19. Axillary basal cell carcinoma in patients with Goltz-Gorlin syndrome: report of basal cell carcinoma in both axilla of a woman with basal cell nevus syndrome and literature review.

    Science.gov (United States)

    Cohen, Philip R

    2014-08-17

    Basal cell carcinoma of the axilla, an area that is not usually exposed to the sun, is rare. Individuals with basal cell nevus syndrome, a disorder associated with a mutation in the patch 1 (PTCH1) gene, develop numerous basal cell carcinomas. To describe a woman with basal cell nevus syndrome who developed a pigmented basal cell carcinoma in each of her axilla and to review the features of axillary basal cell carcinoma patients with Goltz-Gorlin syndrome. Pubmed was used to search the following terms: axillary basal cell carcinoma and basal cell nevus syndrome. The papers and their citations were evaluated. Basal cell nevus syndrome patients with basal cell carcinoma of the axilla were observed in two women; this represents 2.5% (2 of 79) of the patients with axillary basal cell carcinoma. Both women had pigmented tumors that were histologically nonaggressive. The cancers did not recur after curettage or excision. Basal cell carcinoma of the axilla has only been described in 79 individuals; two of the patients were women with pigmented tumors who had basal cell nevus syndrome. Similar to other patients with axillary basal cell carcinoma, the tumors were histologically nonaggressive and did not recur following treatment. Whether PTCH1 gene mutation predisposes basal cell nevus patients to develop axillary basal cell carcinomas remains to be determined.

  20. Micropropagation of Helleborus through axillary budding.

    Science.gov (United States)

    Beruto, Margherita; Viglione, Serena; Bisignano, Alessandro

    2013-01-01

    Helleborus genus, belonging to the Ranunculaceae family, has 20 species of herbaceous perennial flowering plants. The commercial exploitation of this plant is dependent on the selection and propagation of appropriate lines. High propagation rate could be accomplished by using a suitable tissue culture method enabling the rapid introduction of valuable selections in the market. However, in vitro cultivation of Helleborus is still very difficult. Thereby the development of reliable in vitro propagation procedures is crucial for future production systems. Axillary buds cultured on agar-solidified Murashige and Skoog medium supplemented with 1 mg/L benzyladenine, 0.1 mg/L β-naphthoxyacetic acid, and 2 mg/L isopentenyl adenine develop shoots after 16 weeks of culture under 16 h light regime, 50-60 μmol/s/m(2), and 19 ± 1°C. The multiplication rate ranges from 1.4 to 2.1. However, the genotype and the number of subcultures affect the efficiency of the micropropagation process. The rooting of shoots is about 80% in solidified MS medium containing 1 mg/L 1-naphthaleneacetic acid and 3 mg/L indole-3-butyric acid. The described protocol provides information which can contribute to the commercial production of Helleborus plants.

  1. Quantum field theory and the standard model

    CERN Document Server

    Schwartz, Matthew D

    2014-01-01

    Providing a comprehensive introduction to quantum field theory, this textbook covers the development of particle physics from its foundations to the discovery of the Higgs boson. Its combination of clear physical explanations, with direct connections to experimental data, and mathematical rigor make the subject accessible to students with a wide variety of backgrounds and interests. Assuming only an undergraduate-level understanding of quantum mechanics, the book steadily develops the Standard Model and state-of-the-art calculation techniques. It includes multiple derivations of many important results, with modern methods such as effective field theory and the renormalization group playing a prominent role. Numerous worked examples and end-of-chapter problems enable students to reproduce classic results and to master quantum field theory as it is used today. Based on a course taught by the author over many years, this book is ideal for an introductory to advanced quantum field theory sequence or for independe...

  2. Standardized UXO Technology Demonstration Site. Open Field Scoring Record Number 154

    National Research Council Canada - National Science Library

    Overbay, Larry

    2004-01-01

    ...) utilizing the APG Standardized UXO Technology Demonstration Site Open Field. The scoring record was coordinated by Larry Overbay and by the Standardized UXO Technology Demonstration Site Scoring Committee...

  3. Standardized UXO Technology Demonstration Site, Open Field Scoring Record Number 379

    National Research Council Canada - National Science Library

    Overbay, Larry; Robitaille, George

    2005-01-01

    ... (UXO) utilizing the APG Standardized UXO Technology Demonstration Site Open Field. Scoring Records have been coordinated by Larry Overbay and the Standardized UXO Technology Demonstration Site Scoring Committee...

  4. Standardized UXO Technology Demonstration Site Open Field Scoring Record Number 354

    National Research Council Canada - National Science Library

    Overbay, Larry, Jr; Archiable, Robert; McClung, Christina

    2005-01-01

    ...) utilizing the YPG Standardized UXO Technology Demonstration Site Open Field. The scoring record was coordinated by Larry Overbay and by the Standardized UXO Technology Demonstration Site Scoring Committee...

  5. Standardized UXO Technology Demonstration Site Open Field Scoring Record No. 311

    National Research Council Canada - National Science Library

    Overbay, Larry, Jr; Boutin, Matthew; Fling, Rick; McClung, Christina; Robitaille, George

    2005-01-01

    ...) utilizing the APG Standardized UXO Technology Demonstration Site Open Field. The scoring record was coordinated by Larry Overbay and by the Standardized UXO Technology Demonstration Site Scoring Committee...

  6. Standardized UXO Technology Demonstration Site Open Field Scoring Record Number 129

    National Research Council Canada - National Science Library

    Overbay, Larry

    2004-01-01

    ...) utilizing the APO Standardized UXO Technology Demonstration Site Open Field. The scoring record was coordinated by Larry Overbay and by the Standardized UXO Technology Demonstration Site Scoring Committee...

  7. Standardized UXO Technology Demonstration Site, Open Field Scoring Record Number 229

    National Research Council Canada - National Science Library

    Overbay, Larry, Jr; Boutin, Matthew; Fling, Rick; McClung, Christina; Robitaille, George

    2005-01-01

    ...) utilizing the APG Standardized UXO Technology Demonstration Site Open Field. The scoring record was coordinated by Larry Overbay and by the Standardized UXO Technology Demonstration Site Scoring Committee...

  8. Standardized UXO Technology Demonstration Site, Open Field Scoring Record Number 411

    National Research Council Canada - National Science Library

    Overbay, Larry; Robitaille, George

    2005-01-01

    ...) utilizing the APG Standardized UXO Technology Demonstration Site Open Field. The scoring record was coordinated by Larry Overbay and by the Standardized UXO Technology Demonstration Site Scoring Committee...

  9. Standardized UXO Technology Demonstration Site Open Field Scoring Record Number 169

    National Research Council Canada - National Science Library

    Overbay, Larry; Archiable, Robert; McClung, Christina; Robitaille, George

    2005-01-01

    ...) utilizing the YPG Standardized UXO Technology Demonstration Site Open Field. The scoring record was coordinated by Larry Overbay and by the Standardized UXO Technology Demonstration Site Scoring Committee...

  10. Standardized UXO Technology Demonstration Site Open Field Scoring Record Number 201

    National Research Council Canada - National Science Library

    Overbay, Larry, Jr; Fling, Rick; Robitaille, George

    2004-01-01

    ...) utilizing the APG Standardized UXO Technology Demonstration Site Open Field. The scoring record was coordinated by Larry Overbay and by the Standardized UXO Technology Demonstration Site Scoring Committee...

  11. Standardized UXO Technology Demonstration Site Open Field Scoring Record Number 165

    National Research Council Canada - National Science Library

    Overbay, Larry

    2004-01-01

    ...) utilizing the APO Standardized UXO Technology Demonstration Site Open Field. The scoring record was coordinated by Larry Overbay and by the Standardized UXO Technology Demonstration Site Scoring Committee...

  12. 47 CFR 52.36 - Standard data fields for simple port order processing.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Standard data fields for simple port order processing. 52.36 Section 52.36 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) NUMBERING Number Portability § 52.36 Standard data fields for simple port order processing. (a) A telecommunications...

  13. Potential Bud Bank Responses to Apical Meristem Damage and Environmental Variables: Matching or Complementing Axillary Meristems?

    Czech Academy of Sciences Publication Activity Database

    Klimešová, Jitka; Malíková, Lenka; Rosenthal, J.; Šmilauer, P.

    2014-01-01

    Roč. 9, č. 2 (2014), e88093 E-ISSN 1932-6203 R&D Projects: GA ČR GPP504/12/P540; GA ČR GA526/09/0963 Institutional support: RVO:67985939 Keywords : bud bank * axillary meristem * disturbance Subject RIV: EH - Ecology, Behaviour Impact factor: 3.234, year: 2014

  14. Standardized UXO Technology Demonstration Site Open Field Scoring Record Number 245

    National Research Council Canada - National Science Library

    Overbay, Larry

    2005-01-01

    ... (UXO) utilizing the YPG Standardized UXO Technology Demonstration Site Open Field. The scoring record was coordinated by Larry Overbay and by the Standardized UXO Technology Demonstration Site Scoring Committee...

  15. Standardized UXO Technology Demonstration Site Open Field Scoring Record Number 675

    National Research Council Canada - National Science Library

    Overbay, Larry; Robitaille, George

    2005-01-01

    ... (UXO) utilizing the APG Standardized UXO Technology Demonstration Site Open Field. The scoring record was coordinated by Larry Overbay and by the Standardized UXO Technology Demonstration Site Scoring Committee...

  16. Male occult breast cancer with axillary lymph node metastasis as the first manifestation: A case report and literature review.

    Science.gov (United States)

    Xu, Ruixin; Li, Jianbin; Zhang, Yingjie; Jing, Hongbiao; Zhu, Youzhe

    2017-12-01

    Occult breast cancer (OBC) is extremely rare in males with neither symptoms in the breast nor abnormalities upon imaging examination. This current case report presents a young male patient who was diagnosed with male OBC first manifesting as axillary lymph node metastasis. The physical and imaging examination showed no primary lesions in either breasts or in other organs. The pathological results revealed infiltrating ductal carcinoma in the axillary lymph nodes. Immunohistochemical (IHC) staining was negative for estrogen receptor (ER), progesterone receptor (PR), cytokeratin (CK)20 and thyroid transcription factor-1 (TTF-1), positive for CK7, gross cystic disease fluid protein-15 (GCDFP-15), epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA), and suspicious positive for human epidermal receptor-2 (Her-2). On basis of IHC markers, particularly such as CK7, CK20 and GCDFP-15, and eliminating other malignancies, male OBC was identified in spite of negativity for hormone receptors. The patient underwent left axillary lymph node dissection (ALND) but not mastectomy. After the surgery, the patient subsequently underwent chemotherapy and radiotherapy. The patient is currently being followed up without any signs of recurrence. Carefully imaging examination and pathological analysis were particularly essential in the diagnosis of male OBC. The guidelines for managing male OBC default to those of female OBC and male breast cancer. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  17. Revealing impaired pathways in the an11 mutant by high-throughput characterization of Petunia axillaris and Petunia inflata transcriptomes.

    Science.gov (United States)

    Zenoni, Sara; D'Agostino, Nunzio; Tornielli, Giovanni B; Quattrocchio, Francesca; Chiusano, Maria L; Koes, Ronald; Zethof, Jan; Guzzo, Flavia; Delledonne, Massimo; Frusciante, Luigi; Gerats, Tom; Pezzotti, Mario

    2011-10-01

    Petunia is an excellent model system, especially for genetic, physiological and molecular studies. Thus far, however, genome-wide expression analysis has been applied rarely because of the lack of sequence information. We applied next-generation sequencing to generate, through de novo read assembly, a large catalogue of transcripts for Petunia axillaris and Petunia inflata. On the basis of both transcriptomes, comprehensive microarray chips for gene expression analysis were established and used for the analysis of global- and organ-specific gene expression in Petunia axillaris and Petunia inflata and to explore the molecular basis of the seed coat defects in a Petunia hybrida mutant, anthocyanin 11 (an11), lacking a WD40-repeat (WDR) transcription regulator. Among the transcripts differentially expressed in an11 seeds compared with wild type, many expected targets of AN11 were found but also several interesting new candidates that might play a role in morphogenesis of the seed coat. Our results validate the combination of next-generation sequencing with microarray analyses strategies to identify the transcriptome of two petunia species without previous knowledge of their genome, and to develop comprehensive chips as useful tools for the analysis of gene expression in P. axillaris, P. inflata and P. hybrida. © 2011 The Authors. The Plant Journal © 2011 Blackwell Publishing Ltd.

  18. Chemical composition of axillary odorants reflects social and individual attributes in rhesus macaques.

    Science.gov (United States)

    Weiß, Brigitte M; Kücklich, Marlen; Thomsen, Ruth; Henkel, Stefanie; Jänig, Susann; Kulik, Lars; Birkemeyer, Claudia; Widdig, Anja

    2018-01-01

    Scents play an important role in the life of most terrestrial mammals and may transmit valuable information about conspecifics. Olfaction was long considered of low importance in Old World monkeys due to their relative reduction of olfactory structures and low incidence of scent-marking behavior but has been increasingly recognized for mediating social relationships in recent years. Yet, studies investigating the composition of their chemical cues remain scarce. In the present study, we analyzed the potential information content of chemicals present on the skin of rhesus macaques ( Macaca mulatta ). We collected axillary secretions from 60 animals of the semifree-ranging population on Cayo Santiago (Puerto Rico, USA) with precleaned cotton swabs from which the secretions were subsequently extracted and analyzed by gas chromatography-mass spectrometry. Rhesus macaque axillary odorants varied in their overall similarity and composition. This variation was attributable to differences in sex, group membership, and kinship and further appeared to reflect age and rank in parts of our sample. The compounds most strongly associated with this variation primarily comprised larger molecular weight aldehydes and steroids. Such compounds are considered to be perceivable by the primate olfactory system through close-range interactions or through breakdown into smaller molecules by bacterial fermentation. Overall, our results provide additional evidence that odors of Old World monkeys reflect a wealth of potential information about their carrier, which provides the basis for chemical communication via body odors; however, its use by conspecifics needs to be confirmed in bioassays. One prerequisite for olfactory communication is the presence of systematic variation in animal odors that is related to attributes such as age, sex, or kinship. The composition of odors has been examined in numerous mammals but, with the exception of humans, remains poorly understood in Old World

  19. Rare Case of Male Breast Cancer and Axillary Lymphoma in the Same Patient: An Unique Case Report

    Directory of Open Access Journals (Sweden)

    Emiliano Sordi

    2011-01-01

    Full Text Available Breast cancer in men is uncommon, and even more rare is the simultaneous presentation of two different malignancies. A 39-year-old man was diagnosed with both breast cancer and axillary lymphoma. Familiar history revealed that his mother died because of breast cancer. The patient underwent fine needle aspiration leading to the diagnosis of malignant lesion. Modified radical mastectomy was performed. Histology revealed an infiltrating ductal carcinoma 2.8 cm wide, grade 2, with vascular and lymphatic invasion. Surprisingly, one of the second level nodes was confirmed as a high-grade large B cell non-Hodgkin's lymphoma. No family inheritance or gene mutations (BRCA 1 and 2 were found. The patient underwent local radiotherapy, followed by 6 chemotherapy courses (RCHOP and treatment with tamoxifen 20 mg/daily. To our knowledge, this is the first case reported in literature of male breast cancer and axillary lymphoma simultaneously confirmed in the same patient.

  20. Pre-operative and intra-operative detection of axillary lymph node metastases in 108 patients with invasive lobular breast cancer undergoing mastectomy.

    Science.gov (United States)

    Novak, Jerica; Besic, Nikola; Dzodic, Radan; Gazic, Barbara; Vogrin, Andrej

    2018-02-05

    Despite the recent changes in the treatment of the axilla in selected breast cancer patient, positive sentinel lymph node (SLN) in patients undergoing mastectomy still necessitates axillary lymph node dissection (ALND). In invasive lobular carcinoma (ILC), pre-operative detection of the lymph node metastasis may be demanding due to its unique morphology. The aim of this study was to examine the benefit of preoperative axillary ultrasound (AUS), ultrasound-guided fine-needle aspiration biopsy (US-FNAB), and intra-operative imprint cytology (IIC), in order to avoid two-stage axillary surgery in patients with ILC undergoing mastectomy. The object of this study were 102 patients (median age 52, range 34-73 years) with clinically non-suspicious axilla in whom 108 mastectomies were performed after a pre-operative AUS investigation. Whenever a metastasis was detected in a sentinel lymph node, ALND was done. Reports of the pre-operative AUS investigation, US-FNAB, and IIC were compared with definitive histopathological reports of surgical specimens. In 46 cases lymph node metastases were diagnosed. AUS suspicious lymph nodes were found in 29/108 cases and histopathology confirmed metastases in 22/30 cases. US-FNAB was performed in 29 cases with AUS suspicious lymph nodes. Cytology proved metastases in 11/29 cases. Histopathology confirmed metastases in 10/11 cases with only isolated tumor cells found in one case. IIC investigation was performed in 63 cases and in 10/27 cases metastases were confirmed by histopathology. Pre-operative AUS, US-FNAB, and/or IIC investigation enabled ALND during a single surgical procedure in 20/46 patients with metastases in lymph nodes. Pre-operative AUS, US-FNAB, and/or IIC are/is beneficial in patients with ILC planned for mastectomy in order to decrease the number of two stage axillary procedures.

  1. Prognostic significance of axillary dissection in breast cancer patients with micrometastases or isolated tumor cells in sentinel nodes

    DEFF Research Database (Denmark)

    Tvedskov, Tove Filtenborg; Jensen, Maj-Britt; Ejlertsen, Bent

    2015-01-01

    We estimated the impact of axillary lymph node dissection (ALND) on the risk of axillary recurrence (AR) and overall survival (OS) in breast cancer patients with micrometastases or isolated tumor cells (ITC) in sentinel nodes. We used the Danish Breast Cancer Cooperative Group (DBCG) database...... to identify patients with micrometastases or ITC in sentinel nodes following surgery for primary breast cancer between 2002 and 2008. A Cox proportional hazard regression model was developed to assess the hazard ratios (HR) for AR and OS between patients with and without ALND. We identified 2074 patients...... and 2.21 (95 % CI 0.54-8.95, P = 0.27), in patients with ITC after a median follow-up of 6 years and 3 months. There was no significant difference in overall survival between patients with and without ALND, when adjusting for age, co-morbidity, tumor size, histology type, malignancy grade...

  2. Changes In Men’s Salivary Testosterone And Cortisol Levels, And In Sexual Desire After Smelling Female Axillary And Vulvar Scents

    Directory of Open Access Journals (Sweden)

    Ricardo eMondragón-Ceballos

    2013-10-01

    Full Text Available Several studies have shown that a woman’s vaginal or axillary odors convey information on her attractivity. Yet, whether such scents induce psychoneuroendocrinological changes in perceivers is still controversial. We studied if smelling axillary and vulvar odors collected in the periovulatory and late luteal phases of young women modify salivary testosterone and cortisol levels, as well as sexual desire in men. Forty-five women and 115 men, all of them college students and unacquainted with each other, participated in the study. Female odors were collected on pads affixed to the axilla and on panty protectors both worn the entire night before experiments. Men provided five saliva samples, a basal one before the smelling procedure, and four more 15, 30, 60 and 75 min after exposure to odors. Immediately after smelling the odor source, men answered a questionnaire rating hedonic qualities of scents, and after providing the last saliva sample they answered questionnaire on sexual desire. We found that periovulatory axillary and vulvar odors increased testosterone and cortisol levels, with vulvar scents producing a more prolonged effect. Luteal axilla odors decreased testosterone and cortisol levels, while luteal vulva odors increased cortisol. Periovulatory axilla and vulva scents accounted for a general increase of interest in sex. These odors were also rated as more pleasant and familiar, while luteal vulvar odors were perceived as intense and unpleasant.

  3. How Standards Enable the Emergence of Sustainable Construction as a New Organizational Field

    DEFF Research Database (Denmark)

    Boxenbaum, Eva; Georg, Susse; Reijonen, Satu

    This paper examines the role of standards in the emergence of new fields. We analyzed the current formation of sustainable construction as a new field within the Danish construction sector. Data were derived from four qualitative studies on mandatory and voluntary standards pertaining to sustaina...

  4. High field MRI of axillary lymph nodes and breast cancer

    NARCIS (Netherlands)

    Korteweg, M.A.

    2011-01-01

    In this thesis nodal characteristics have been assessed with high field Magnetic Resonance Imaging (MRI) using a clinical scanner in order to discriminate non-metastatic from metastatic nodes of breast cancer patients. The final goal is to non-invasively determine nodal and tumor stage of breast

  5. Fibrin glue instillation under skin flaps to prevent seroma-related morbidity following breast and axillary surgery.

    Science.gov (United States)

    Sajid, Muhammad S; Hutson, Kristian H; Rapisarda, Ignazio F; Bonomi, Riccardo

    2013-05-31

    Fibrin glue (FG) combines fibrinogen and thrombin, under the presence of factor XIII and calcium chloride, and produces a 'fibrin clot' as would occur through the natural clotting cascade. FG is thought to close over any small vessels including lymphatics that are too small for conventional surgical closure, thereby reducing seroma formation, seroma incidence and related comorbidities. To assess the evidence on the effectiveness of FG in people undergoing breast and axillary surgery and to establish whether FG is an efficient modality to prevent postoperative seroma and seroma-related outcomes. We searched the Cochrane Breast Cancer Group's (CBCG) Specialised Register (9 December 2011), the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 1 2012), MEDLINE (9 December 2011), EMBASE (9 December 2011), LILACS (22 October 2012), SCI-E (22 October 2012), the World Health Organization's International Clinical Trial Registry (9 December 2011) and ClinicalTrials.gov (22 October 2012). Randomised controlled trials (RCTs) comparing the effectiveness of FG in terms of reducing the postoperative seroma incidence and related comorbidities in people undergoing breast and axillary surgery. At least two review authors independently scrutinised search results, selected eligible studies and extracted the data. The pooled analysis of the extracted data was achieved by the statistical analysis on Review Manager software. The quality of studies was assessed using The Cochrane Collaboration's 'Risk of bias' tool. The search of four standard electronic databases yielded 119 potentially relevant studies but only 18 RCTs involving 1252 people were found suitable for statistical analysis. There was significant heterogeneity among trials and the majority of trials were of poor quality. The use of FG under skin flaps following breast and axillary surgery failed to reduce the incidence of postoperative seroma (risk ratio (RR) 1.02; 95% Confidence Interval (CI) 0.90 to 1.16, P

  6. A comparative study on accuracy of liquid crystal forehead, digital electronic axillary, infrared tympanic with glass-mercury rectal thermometer in infants and young children.

    Science.gov (United States)

    Kongpanichkul, A; Bunjongpak, S

    2000-09-01

    This study was carried out to assess the accuracy of three devices namely, liquid crystal forehead, digital electronic axillary and infrared tympanic thermometer, using a glass-mercury rectal thermometer as the control. The subjects were two hundred children aged 0-48 months. The mean rectal temperature was 38.0 +/- 0.91 degrees C; forehead, 37.83 +/- 0.94 degrees C; tympanic, 37.77 +/- 0.95 degrees C, and axillary, 37.71 +/- 0.86 degrees C. Compared to the rectal temperature, all values were significantly lower (p < 0.05). Forehead, tympanic and axillary temperature differed from rectal temperature by at least 0.5 degrees C in 33.33 per cent, 23.5 per cent and 31.5 per cent of subjects, and at least 1 degrees C in 22 per cent, 1 per cent and 6 per cent of subjects respectively. Accuracy in detection of fever was 79 per cent for forehead, 85.5 per cent for tympanic and 84 per cent for axillary thermometry. Sensitivity of the three devices was 67-83 per cent in detection of fever and 64-77 per cent in detection of high fever. Tympanic thermometry had the best performance while forehead thermometry had the poorest. After using revised diagnostic threshold temperature by ROC curves, sensitivity of each device improved but accuracy was nearly the same. It is concluded that the three devices are not suitable as a substitute for a glass-mercury rectal thermometer in assessment of fever in infants and young children.

  7. A Longitudinal Comparison of Arm Morbidity in Stage I-II Breast Cancer Patients Treated with Sentinel Lymph Node Biopsy, Sentinel Lymph Node Biopsy Followed by Completion Lymph Node Dissection, or Axillary Lymph Node Dissection

    NARCIS (Netherlands)

    Kootstra, Jan J.; Hoekstra-Weebers, Josette E. H. M.; Rietman, Johan S.; de Vries, Jakob; Baas, Peter C.; Geertzen, Jan H. B.; Hoekstra, Harald J.

    Background. Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared outcomes after SLNB, SLNB + CLND, and

  8. A longitudinal comparison of arm morbidity in stage I-II breast cancer patients treated with sentinel lymph node biopsy, sentinel lymph node biopsy followed by completion lymph node dissection, or axillary lymph node dissection

    NARCIS (Netherlands)

    Kootstra, Jan J.; Hoekstra-Weebers, Josette E.; Rietman, Johan Swanik; de Vries, Jakob; Baas, Peter C.; Geertzen, Jan H.B.; Hoekstra, Harald J.

    2010-01-01

    Background: Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared outcomes after SLNB, SLNB + CLND, and

  9. Ultrasound elastography as an adjuvant to conventional ultrasound in the preoperative assessment of axillary lymph nodes in suspected breast cancer: A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, K., E-mail: kathryn.taylor@addenbrookes.nhs.uk [Department of Radiology, Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom); O' Keeffe, S.; Britton, P.D.; Wallis, M.G. [Department of Radiology, Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom); Treece, G.M.; Housden, J. [Department of Engineering, University of Cambridge, Cambridge (United Kingdom); Parashar, D.; Bond, S. [Cambridge Cancer Trials Centre, Department of Oncology, University of Cambridge, Addenbrookes Hospital, Cambridge (United Kingdom); Cambridge Hub in Trials Methodology Research, MRC Biostatics Unit, University Forvie Site, Cambridge (United Kingdom); Sinnatamby, R. [Department of Radiology, Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom)

    2011-11-15

    Aims: To compare the performance of ultrasound elastography with conventional ultrasound in the assessment of axillary lymph nodes in suspected breast cancer and whether ultrasound elastography as an adjunct to conventional ultrasound can increase the sensitivity of conventional ultrasound used alone. Materials and methods: Fifty symptomatic women with a sonographic suspicion for breast cancer underwent ultrasound elastography of the ipsilateral axilla concurrent with conventional ultrasound being performed as part of triple assessment. Elastograms were visually scored, strain measurements calculated and node area and perimeter measurements taken. Theoretical biopsy cut points were selected. The sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) were calculated and receiver operating characteristic (ROC) analysis was performed and compared for elastograms and conventional ultrasound images with surgical histology as the reference standard. Results: The mean age of the women was 57 years. Twenty-nine out of 50 of the nodes were histologically negative on surgical histology and 21 were positive. The sensitivity, specificity, PPV, and NPV for conventional ultrasound were 76, 78, 70, and 81%, respectively; 90, 86, 83, and 93%, respectively, for visual ultrasound elastography; and for strain scoring, 100, 48, 58 and 100%, respectively. There was no significant difference between any of the node measurements Conclusions: Initial experience with ultrasound elastography of axillary lymph nodes, showed that it is more sensitive than conventional ultrasound in detecting abnormal nodes in the axilla in cases of suspected breast cancer. The specificity remained acceptable and ultrasound elastography used as an adjunct to conventional ultrasound has the potential to improve the performance of conventional ultrasound alone.

  10. Cytological and Pathological Correlation of FNAC in Assessing Breast Lumps and Axillary Lymph Node Swellings in a Public Sector Hospital in India

    Directory of Open Access Journals (Sweden)

    Vasu Reddy Challa

    2013-01-01

    Full Text Available Background. Breast lumps have varied pathology, and there are different techniques to prove the diagnosis. The aim of the present study is to analyze the role of fine needle aspiration cytology (FNAC of the breast lesions at our center. Methods. We had retrospectively analysed 854 patients who underwent FNAC for primary breast lumps and 190 patients who underwent FNAC for an axillary lymph node in the year 2010. Results. Of 854 patients, histological correlation was available in 723 patients. The analysis was done for 812 patients as medical records were not available for 42 patients. FNAC was false negative in seven cases; 2 cases of phyllodes were reported as fibroadenoma, and 5 cases of carcinoma were diagnosed as atypical hyperplasia. The sensitivity, specificity, and false negative value of FNAC in diagnosing breast lumps were 99% (715/723, 100%, and 1%, respectively. Of 190 patients for whom FNAC was performed for axilla, 170 had proven to have axillary lymph node metastases, and the rest had reactive hyperplasia or inflammatory cells. Conclusions. FNAC is rapid, accurate, outpatient based, and less complicated procedure and helps in diagnosis of breast cancer, benign diseases, and axillary involvement in experienced hands with less chance of false results.

  11. Impact on regional recurrence and survival of axillary surgery in women with node-negative primary breast cancer

    DEFF Research Database (Denmark)

    Axelsson, C K; Düring, M; Christiansen, P M

    2009-01-01

    -negative primary breast cancer treated solely by surgery. Median follow-up was 9 years. RESULTS: The number of lymph nodes removed correlated with a reduction in the rate of subsequent axillary recurrence (from 2.1 to 0.4 per cent; P = 0.037), local recurrence (from 7.4 to 3.8 per cent; P

  12. Ultrasonographic measurement of the axillary recess thickness in an asymptomatic shoulder

    Directory of Open Access Journals (Sweden)

    Gi-Young Park

    2017-04-01

    Full Text Available Purpose The purpose of this study was to measure the axillary recess (AR thickness in an asymptomatic shoulder by using ultrasonography (US and to analyze the factors affecting it. Methods We recruited 141 patients (52 males; 89 females; age, 57.7±9.9 years with unilateral shoulder pain and performed US on the unaffected shoulder. Two physiatrists measured the AR thickness of the unaffected shoulder independently. All patients were examined in an upright sitting position with 90° shoulder abduction. The ultrasonographic transducer was placed longitudinally on the mid-axillary line and along the long axis of the humeral shaft. The factors affecting the AR thickness values were analyzed, and intra-class correlation coefficients were used for assessing the reproducibility of each measurement. Results The intrarater reliability values for the two physiatrists were 0.98 and 0.96, respectively. The inter-rater reliability of the mean AR thickness measurements was 0.91. The mean AR thickness in all subjects, males, and females was 2.8±0.6 mm, 3.1±0.6 mm, and 2.6±0.5 mm (P<0.01, respectively. No difference between the left and the right sides (males, P=0.086; females, P=0.535 or between the dominant and the non-dominant sides (males, P=0.173; female, P=0.244 was found. The AR thickness correlated positively with the height (r=0.313, P<0.01 and the weight (r=0.319, P<0.01. However, it did not correlate with the body mass index (r=0.152, P=0.077 or the age (r=-0.056, P=0.515. Conclusion US measurements of the AR thickness in asymptomatic shoulders demonstrated excellent intrarater and inter-rater reliabilities. The AR thickness showed anatomical variation with sex, height, and weight.

  13. Ultrasonographic measurement of the axillary recess thickness in an asymptomatic shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Park, Gi Young; Lee, Jin Hoon; Kwon, Dae Gil [Dept. of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu (Korea, Republic of)

    2017-04-15

    The purpose of this study was to measure the axillary recess (AR) thickness in an asymptomatic shoulder by using ultrasonography (US) and to analyze the factors affecting it. We recruited 141 patients (52 males; 89 females; age, 57.7±9.9 years) with unilateral shoulder pain and performed US on the unaffected shoulder. Two physiatrists measured the AR thickness of the unaffected shoulder independently. All patients were examined in an upright sitting position with 90° shoulder abduction. The ultrasonographic transducer was placed longitudinally on the mid-axillary line and along the long axis of the humeral shaft. The factors affecting the AR thickness values were analyzed, and intra-class correlation coefficients were used for assessing the reproducibility of each measurement. The intrarater reliability values for the two physiatrists were 0.98 and 0.96, respectively. The inter-rater reliability of the mean AR thickness measurements was 0.91. The mean AR thickness in all subjects, males, and females was 2.8±0.6 mm, 3.1±0.6 mm, and 2.6±0.5 mm (P<0.01), respectively. No difference between the left and the right sides (males, P=0.086; females, P=0.535) or between the dominant and the non-dominant sides (males, P=0.173; female, P=0.244) was found. The AR thickness correlated positively with the height (r=0.313, P<0.01) and the weight (r=0.319, P<0.01). However, it did not correlate with the body mass index (r=0.152, P=0.077) or the age (r=-0.056, P=0.515). US measurements of the AR thickness in asymptomatic shoulders demonstrated excellent intrarater and inter-rater reliabilities. The AR thickness showed anatomical variation with sex, height, and weight.

  14. Strain elastography of abnormal axillary nodes in breast cancer patients does not improve diagnostic accuracy compared with conventional ultrasound alone.

    Science.gov (United States)

    Park, Young Mi; Fornage, Bruno D; Benveniste, Ana Paula; Fox, Patricia S; Bassett, Roland L; Yang, Wei Tse

    2014-12-01

    The purpose of this study was to determine the diagnostic value of strain elastography (SE) alone and in combination with gray-scale ultrasound in the diagnosis of benign versus metastatic disease for abnormal axillary lymph nodes in breast cancer patients. Patients with breast cancer and axillary lymph nodes suspicious for metastatic disease on conventional ultrasound who underwent SE of the suspicious node before ultrasound-guided fine-needle aspiration biopsy (FNAB) were included in this study. On conventional ultrasound, the long- and short-axis diameters, long-axis-to-short-axis ratio, cortical echogenicity, thickness, and evenness were documented. The nodal vascularity was assessed on power Doppler imaging. Elastograms were evaluated for the percentage of black (hard) areas in the lymph node, and the SE-ultrasound size ratio was calculated. Two readers assessed the images independently and then in consensus in cases of disagreement. ROC AUCs were calculated for conventional ultrasound, SE, and both methods combined. Interreader reliability was assessed using kappa statistics. A total of 101 patients with 104 nodes were examined; 35 nodes were benign, and 69 had metastases. SE alone showed a significantly lower AUC (62%) than did conventional ultrasound (92%) (pultrasound and the AUC of the combination of conventional ultrasound and SE (93%) (p=0.16). Interreader reliability was moderate for all variables (κ≥0.60) except the SE-ultrasound size ratio (κ=0.35). Added SE does not improve the diagnostic ability of conventional ultrasound when evaluating abnormal axillary lymph nodes.

  15. Using quantitative image analysis to classify axillary lymph nodes on breast MRI: A new application for the Z 0011 Era

    Energy Technology Data Exchange (ETDEWEB)

    Schacht, David V., E-mail: dschacht@radiology.bsd.uchicago.edu; Drukker, Karen, E-mail: kdrukker@uchicago.edu; Pak, Iris, E-mail: irisgpak@gmail.com; Abe, Hiroyuki, E-mail: habe@radiology.bsd.uchicago.edu; Giger, Maryellen L., E-mail: m-giger@uchicago.edu

    2015-03-15

    Highlights: •Quantitative image analysis showed promise in evaluating axillary lymph nodes. •13 of 28 features performed better than guessing at metastatic status. •When all features were used in together, a considerably higher AUC was obtained. -- Abstract: Purpose: To assess the performance of computer extracted feature analysis of dynamic contrast enhanced (DCE) magnetic resonance images (MRI) of axillary lymph nodes. To determine which quantitative features best predict nodal metastasis. Methods: This institutional board-approved HIPAA compliant study, in which informed patient consent was waived, collected enhanced T1 images of the axilla from patients with breast cancer. Lesion segmentation and feature analysis were performed on 192 nodes using a laboratory-developed quantitative image analysis (QIA) workstation. The importance of 28 features were assessed. Classification used the features as input to a neural net classifier in a leave-one-case-out cross-validation and evaluated with receiver operating characteristic (ROC) analysis. Results: The area under the ROC curve (AUC) values for features in the task of distinguishing between positive and negative nodes ranged from just over 0.50 to 0.70. Five features yielded AUCs greater than 0.65: two morphological and three textural features. In cross-validation, the neural net classifier obtained an AUC of 0.88 (SE 0.03) for the task of distinguishing between positive and negative nodes. Conclusion: QIA of DCE MRI demonstrated promising performance in discriminating between positive and negative axillary nodes.

  16. Minimal Subdermal Shaving by Means of Sclerotherapy Using Absolute Ethanol: A New Method for the Treatment of Axillary Osmidrosis

    Directory of Open Access Journals (Sweden)

    Hyung-Sup Shim

    2013-07-01

    Full Text Available BackgroundAxillary osmidrosis is characterized by unpleasant odors originating from the axillary apocrine glands, resulting in psychosocial stress. The main treatment modality is apocrine gland removal. Until now, of the various surgical techniques have sometimes caused serious complications. We describe herein the favorable outcomes of a new method for ablating apocrine glands by minimal subdermal shaving using sclerotherapy with absolute ethanol.MethodsA total of 12 patients underwent the procedure. The severity of osmidrosis was evaluated before surgery. Conventional subdermal shaving was performed on one side (control group and ablation by means of minimal subdermal shaving and absolute ethanol on the other side (study group. Postoperative outcomes were compared between the study and control groups.ResultsThe length of time to removal of the drain was 1 day shorter in the study group than in the control group. There were no serious complications, such as hematoma or seroma, in either group, but flap margin necrosis and flap desquamation occurred in the control group, and were successfully managed with conservative treatment. Six months after surgery, we and our patients were satisfied with the outcomes.ConclusionsSclerotherapy using absolute ethanol combined with minimal subdermal shaving may be useful for the treatment of axillary osmidrosis. It can reduce the incidence of seroma and hematoma and allow the skin flap to adhere to its recipient site. It can degrade and ablate the remaining apocrine glands and eliminate causative organisms. Furthermore, since this technique is relatively simple, it takes less time than the conventional method.

  17. Minimal Subdermal Shaving by Means of Sclerotherapy Using Absolute Ethanol: A New Method for the Treatment of Axillary Osmidrosis

    Directory of Open Access Journals (Sweden)

    Hyung­Sup Shim

    2013-07-01

    Full Text Available Background Axillary osmidrosis is characterized by unpleasant odors originating from the axillary apocrine glands, resulting in psychosocial stress. The main treatment modality is apocrine gland removal. Until now, of the various surgical techniques have sometimes caused serious complications. We describe herein the favorable outcomes of a new method for ablating apocrine glands by minimal subdermal shaving using sclerotherapy with absolute ethanol.Methods A total of 12 patients underwent the procedure. The severity of osmidrosis was evaluated before surgery. Conventional subdermal shaving was performed on one side (control group and ablation by means of minimal subdermal shaving and absolute ethanol on the other side (study group. Postoperative outcomes were compared between the study and control groups.Results The length of time to removal of the drain was 1 day shorter in the study group than in the control group. There were no serious complications, such as hematoma or seroma, in either group, but flap margin necrosis and flap desquamation occurred in the control group, and were successfully managed with conservative treatment. Six months after surgery, we and our patients were satisfied with the outcomes.Conclusions Sclerotherapy using absolute ethanol combined with minimal subdermal shaving may be useful for the treatment of axillary osmidrosis. It can reduce the incidence of seroma and hematoma and allow the skin flap to adhere to its recipient site. It can degrade and ablate the remaining apocrine glands and eliminate causative organisms. Furthermore, since this technique is relatively simple, it takes less time than the conventional method.

  18. THE PROGNOSIS SIGNIFICANCE OF CATHEPSIN-D EXPRESSION IN THE DIFFERENT LOCATIONS IN AXILLARY NODES NEGATIVE CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: The aim of this study was to investigate Cathepsin-D (Cath-D) expression in different location and its relationship with prognosis in the axillary lymph nodes negative (ANN) breast cancer patients. Methods: Cath-D expression in 192 cases of breast carcinoma were examined by immunohistochemistry. Depending on different parts of expression, three evaluating methods were used, compared and analysed. Results: The positive rate of Cath-D expression in ANN breast cancer with poor prognosis group and axillary nodes positive (ANP) group were significantly higher than that in ANN breast cancer with good prognosis group (x2=23.20, P0.05). Cath-D expression in stromal cells had no statistical difference among the three groups (x2=1.56, P>0.05). When the Cath-D expression in cancer and stromal cells were counted into the positive rate, it was near the same (u1=0.47, u2=1.41, P>0.05). Conclusion: These results suggest that Cath-D expression is one of the powerful prognostic markers in ANN breast cancer. It's a reliable, practical, and convenient method to observe and evaluate Cath-D expression in cancer cells.

  19. Usefulness of dynamic MR mammography for diagnosis of axillary lymph node status in breast cancer patient

    International Nuclear Information System (INIS)

    Enya, Mayumi; Goto, Hiroo; Nandate, Yuka; Kiryu, Takuji; Kanematsu, Masayuki; Hoshi, Hiroaki

    2000-01-01

    A retrospective study was performed to evaluate whether dynamic MR imaging is useful for the diagnosis of axillary lymph node metastases from breast cancer. Thirty-five patients with breast cancer were scanned and 147 lymph nodes were detected and compared with pathological nodal status. The parameters were the long axis dimension, the short axis dimension, the long-to-short axis (L/S) ratio, the shape, the contrast enhancement ratio (CER), the CER of lymph node-to-primary tumor (L/P) ratio. All parameters had significant differences between metastatic and normal nodes and there was a positive correlation between the CER of primary breast tumors and metastatic nodes. Multivariate analysis identified three parameters: the shape, the CER (1st phase), the L/P ratio (1st phase). ROC analysis revealed the shape and CER are superior in diagnostic performance to L/P ratio. If the shape and CER (1st phase) 60% and above are employed as criteria, the sensitivity, the specificity, the accuracy and the positive and negative predictive value were 86.0%, 78.4%, 81.0%, 67.2% and 91.6%, respectively. This method gives us useful information about the evaluation of axillary lymph node status preoperatively. (author)

  20. ER, HER2, and TOP2A expression in primary tumor, synchronous axillary nodes, and asynchronous metastases in breast cancer

    DEFF Research Database (Denmark)

    Jensen, Jeanette Dupont; Knoop, Ann; Ewertz, Marianne

    2011-01-01

    with the primary tumors with respect to ER, HER2, and TOP2A. In the prospective tissue-collection study, 81 patients had biopsy from a suspected relapse. Additional archived paired material was included, leaving a total of 119 patients with paired primary tumor, synchronous axillary nodes (available in 52 patients......At recurrence of breast cancer, the therapeutic target is the metastases. However, it is current practice to base the choice of systemic treatment on the biomarker profile of the primary tumor. In the present study, confirmatory biopsies were obtained from suspected metastatic lesions and compared......) and asyncronous metastases available for analysis. ER, HER2, and TOP2A expression of primary tumors, axillary nodes and metastases were re-analysed and determined centrally by immunohistochemistry, chromogenic in situ hybridization, and fluorescence in situ hybridization. Of the 81 patients with a biopsy from...

  1. Biomonitorization of cadmium, chromium, manganese, nickel and lead in whole blood, urine, axillary hair and saliva in an occupationally exposed population

    Energy Technology Data Exchange (ETDEWEB)

    Gil Fernando, E-mail: fgil@ugr.es [Department of Legal Medicine and Toxicology, University of Granada, School of Medicine (Spain); Hernandez, Antonio F. [Department of Legal Medicine and Toxicology, University of Granada, School of Medicine (Spain); Marquez, Claudia [Internal Resident in Occupational Medicine, School of Occupational Medicine of University of Granada (Spain); Femia, Pedro [Department of Statistics, University of Granada, School of Medicine (Spain); Olmedo, Pablo; Lopez-Guarnido, Olga; Pla, Antonio [Department of Legal Medicine and Toxicology, University of Granada, School of Medicine (Spain)

    2011-02-15

    Heavy metal contamination from occupational origin is a cause for concern because of its potential accumulation in the environment and in living organisms leading to long term toxic effects. This study was aimed to assess Cd, Cr, Mn, Ni and Pb levels in whole blood, urine, axillary hair and saliva from 178 individuals with occupational exposure to heavy metals. Levels of metal compounds were determined by atomic absorption spectrometry. We collected information on occupation, lifestyle habits and food intake by questionnaire. Multiple linear regression analyses for metal ion concentration in whole blood, urine, axillary hair and saliva were adjusted for age, gender, smoking and alcohol consumption, lifetime workplace exposure, residence area and food habits. Overall, blood and urine median concentrations found for the five metals analyzed do not exceed biological exposure indexes, so that they are very similar to a non-occupationally exposed population. Toxicokinetic differences may account for the lack of correlations found for metal levels in hair and saliva with those in blood or urine. For those heavy metals showing higher median levels in blood with respect to hair (Cd, Mn and Pb) indicating lesser hair incorporation from blood, the lifetime working experience was inversely correlated with their hair levels. The longer the lifetime working experience in industrial environments, the higher the Mn and Ni concentration in saliva. Axillary hair and saliva may be used as additional and/or alternative samples to blood or urine for biomonitoring hair Mn, and saliva Ni in subjects with occupational exposure. - Research Highlights: {yields} Metal levels in workers were similar to an occupationally non-exposed population. {yields} Metal levels in blood and urine were below recommended reference values. {yields} A lack of correlation was observed between metal levels in blood and saliva. {yields} Toxicokinetic differences may account for the lack of correlations observed

  2. Complexity in quantum field theory and physics beyond the standard model

    International Nuclear Information System (INIS)

    Goldfain, Ervin

    2006-01-01

    Complex quantum field theory (abbreviated c-QFT) is introduced in this paper as an alternative framework for the description of physics beyond the energy range of the standard model. The mathematics of c-QFT is based on fractal differential operators that generalize the momentum operators of conventional quantum field theory (QFT). The underlying premise of our approach is that c-QFT contains the right analytical tools for dealing with the asymptotic regime of QFT. Canonical quantization of c-QFT leads to the following findings: (i) the Fock space of c-QFT includes fractional numbers of particles and antiparticles per state (ii) c-QFT represents a generalization of topological field theory and (iii) classical limit of c-QFT is equivalent to field theory in curved space-time. The first finding provides a field-theoretic motivation for the transfinite discretization approach of El-Naschie's ε (∞) theory. The second and third findings suggest the dynamic unification of boson and fermion fields as particles with fractional spin, as well as the close connection between spin and space-time topology beyond the conventional physics of the standard model

  3. Complexity in quantum field theory and physics beyond the standard model

    Energy Technology Data Exchange (ETDEWEB)

    Goldfain, Ervin [OptiSolve Consulting, 4422 Cleveland Road, Syracuse, NY 13215 (United States)

    2006-05-15

    Complex quantum field theory (abbreviated c-QFT) is introduced in this paper as an alternative framework for the description of physics beyond the energy range of the standard model. The mathematics of c-QFT is based on fractal differential operators that generalize the momentum operators of conventional quantum field theory (QFT). The underlying premise of our approach is that c-QFT contains the right analytical tools for dealing with the asymptotic regime of QFT. Canonical quantization of c-QFT leads to the following findings: (i) the Fock space of c-QFT includes fractional numbers of particles and antiparticles per state (ii) c-QFT represents a generalization of topological field theory and (iii) classical limit of c-QFT is equivalent to field theory in curved space-time. The first finding provides a field-theoretic motivation for the transfinite discretization approach of El-Naschie's {epsilon} {sup ({infinity}}{sup )} theory. The second and third findings suggest the dynamic unification of boson and fermion fields as particles with fractional spin, as well as the close connection between spin and space-time topology beyond the conventional physics of the standard model.

  4. Axillary sentinel node identification in breast cancer patients: degree of radioactivity present at biopsy is critical

    DEFF Research Database (Denmark)

    Nielsen, Kristina R; Oturai, Peter S; Friis, Esbern

    2011-01-01

    The radioactivity present in the patient (Act(rem) ) at sentinel node (SN) biopsy will depend on injected activity amount as well as on the time interval from tracer injection to biopsy, which both show great variations in the literature. The purpose of this study was to analyse the influence...... of varying Act(rem) levels on the outcome of axillary SN biopsy in patients with breast cancer (BC)....

  5. Side effects, complications and outcome of thoracoscopic sympathectomy for palmar and axillary hyperhidrosis in 406 patients.

    Science.gov (United States)

    Rodríguez, Pedro M; Freixinet, Jorge L; Hussein, Mohamed; Valencia, Jose M; Gil, Rita M; Herrero, Jorge; Caballero-Hidalgo, Araceli

    2008-09-01

    Thoracic sympathectomy (TS) is the treatment of choice for severe primary hyperhidrosis. However, complications, side effects and satisfaction have not been well defined. To analyze the complications, side effects, satisfaction degree and quality of life of patients after TS for primary upper limb hyperhidrosis. One-year follow-up after 406 consecutive TS for primary upper limb hyperhidrosis. Bilateral TS was completed in all patients. Complications arose in 23 cases (5.6%), with pneumothorax being the most frequent. The success rate after discharge, 6 and 12 months was respectively, 100%, 98.1% and 96.5% for palmo-axillary hyperhidrosis; 100%, 99.3% and 97.8% for isolated palmar hyperhidrosis and 100%, 85.7% and 71.4% for isolated axillary hyperhidrosis. No persistence of hyperhidrosis was observed. Global recurrence was 3.7% (28.5% axillary hyperhidrosis group). Compensatory sweating (CS) appeared in 55% and was not related to the extension of the TS. Being female was a predisposing factor of CS (p<0.004). Excessive dryness appeared at 9% and was associated with extensive TS (P<0.001). Plantar hyperhidrosis improved at 33.6%, worsened at 10% and remained stable during the follow-up. Satisfaction degree decreased with the passage of time and was associated with recurrence. Quality of life was excellent at discharge, 6 and 12 month in 100%, 100% and 97%, respectively. Pneumothorax is the most frequent complication of TS. CS is the main and undesirable side effect, appears with the passage of time, and is not related to the extension of TS. Being female is the only predictor factor of suffering CS. Plantar hyperhidrosis improves initially, although tends to reappear. Excessive dryness appears in extensive TS and does not improve over time. Postoperative satisfaction degree is high but decreases over time owing to the appearance of recurrence. Effectiveness and the absence of CS determine an excellent quality of life. Six percent of the patients regret the surgery

  6. Characterization of MORE AXILLARY GROWTH genes in Populus.

    Directory of Open Access Journals (Sweden)

    Olaf Czarnecki

    Full Text Available Strigolactones are a new class of plant hormones that play a key role in regulating shoot branching. Studies of branching mutants in Arabidopsis, pea, rice and petunia have identified several key genes involved in strigolactone biosynthesis or signaling pathway. In the model plant Arabidopsis, MORE AXILLARY GROWTH1 (MAX1, MAX2, MAX3 and MAX4 are four founding members of strigolactone pathway genes. However, little is known about the strigolactone pathway genes in the woody perennial plants.Here we report the identification of MAX homologues in the woody model plant Populus trichocarpa. We identified the sequence homologues for each MAX protein in P. trichocarpa. Gene expression analysis revealed that Populus MAX paralogous genes are differentially expressed across various tissues and organs. Furthermore, we showed that Populus MAX genes could complement or partially complement the shoot branching phenotypes of the corresponding Arabidopsis max mutants.This study provides genetic evidence that strigolactone pathway genes are likely conserved in the woody perennial plants and lays a foundation for further characterization of strigolactone pathway and its functions in the woody perennial plants.

  7. Electromagnetic field standards in Central and Eastern European countries: current state and stipulations for international harmonization.

    Science.gov (United States)

    Gajsek, P; Pakhomov, A G; Klauenberg, B J

    2002-04-01

    Electromagnetic field standards in the West are based on well-established acute biological effects that could be considered as signaling a potentially adverse health effect. The specific absorption rate, which is proportional to the tissue heating (thermal effects), represents the basic restriction of exposure to Radio-Frequency (RF) fields. On the other hand, Eastern European standards are designed to protect from potential non-thermal effects that might be caused by chronic exposure to very low intensities, where a so-called "power load" (a product of field intensity and duration of exposure) represents the basic limitation. Thus, electromagnetic field standards in Eastern European countries differ considerably from those which are proposed by the International Commission of Non-ionizing Radiation Protection and the Standards Coordinating Committee 28 of the Institute of Electrical and Electronics Engineers, Inc. In the present paper, the strategies for development of exposure limit values in electromagnetic fields standards currently in force in Eastern and Central European countries are discussed. Some differences as well as similarities of the national health and safety standards and the main obstacles to harmonization of these standards with those being established by Western national and international organizations and agencies are presented.

  8. Is there a requirement for axillary lymph node dissection following identification of micro-metastasis or isolated tumour cells at sentinel node biopsy for breast cancer?

    LENUS (Irish Health Repository)

    Joyce, D P

    2012-02-29

    INTRODUCTION: Recent decades have seen a significant shift towards conservative management of the axilla. Increasingly, immunohistochemical analysis of sentinel nodes leads to the detection of small tumour deposits, the significance of which remains uncertain. The aims of this study are to examine patients whose sentinel lymph nodes are positive for macro-metastasis, micro-metastasis or isolated tumour cells (ITCs) and to determine the rate of further nodal disease after axillary lymph node dissection (ALND). METHODS: A retrospective analysis of all patients undergoing a sentinel lymph node biopsy (SLNB) between January 2007 and December 2010 in a tertiary referral breast unit was performed. Patients who underwent an axillary lymph node dissection for macro-metastasis, micro-metastasis or ITCs were identified. Demographics, histological data and the rate of further axillary disease were examined. RESULTS: In total, 664 breast cancer patients attended the symptomatic breast unit during the study period, 360 of whom underwent a SLNB. Seventy patients had a SLNB positive for macro-metastasis. All of these patients underwent ALND. A positive SLNB with either micro-metastasis or ITCs was identified in 58 patients. Only 41 of the 58 patients went on to have an ALND, due primarily to variations in surgeons\\' preferences. Nineteen patients with micro-metastasis underwent an ALND. Four patients had further axillary disease (21%). Twenty-two patients had ITCs identified, of whom only one had further disease (4.5%). No statistically significant difference was found between the two groups in terms of tumour size, grade, lymphovascular invasion or oestrogen receptor status. CONCLUSION: ALND should be considered in patients with micro-metastasis at SLNB. It should rarely be employed in the setting of SLNB positive for ITCs.

  9. An efficient regeneration and rapid micropropagation protocol for Almond using dormant axillary buds as explants.

    Science.gov (United States)

    Choudhary, Ravish; Chaudhury, Rekha; Malik, Surendra Kumar; Sharma, Kailash Chandra

    2015-07-01

    An efficient in vitro protocol was standardized for Almond (Prunus dulcis) propagation using dormant axillary buds as explants. Explants were cultured on Murashige and Skoog (MS) and woody plant medium (WPM) supplemented with different concentration/combination(s) of phytohormones. MS basal medium showed lowest shoot induction and took longest duration for shoot initiation. Multiple shoots were induced in MS medium supplemented with the combination of BAP (0.5 mgL(-1)). Cultures showed poor response for rooting in all combinations of plant growth regulators (PGRs) and took 90 days for initiation. Rooting was higher in half strength of MS than in full-strength. The highest root induction (33.33%) was recorded in half MS medium supplemented with 0.1 mgL(-1) IBA (indole-3-butyric acid) followed by full strength of MS medium (20%) supplemented with IBA (0.1 mgL(-1)). α-Naphthalene acetic acid (NAA) was less effective for rooting than IBA. The highest root induction (25%) was found in half strength of MS medium supplemented with 0.1 mgL(-1) NAA followed by full strength of MS medium (20%). The protocol developed would be of use in mass propagation of almond and also support in vitro conservation.

  10. New progress in wastewater treatment technology for standard-reaching discharge in sour gas fields

    Directory of Open Access Journals (Sweden)

    Jie Yang

    2018-02-01

    Full Text Available Gas field water is generally characterized by complex contaminant components and high salinity. Its proper treatment has always been the great concern in the field of environmental protection of oil & gas fields. In this paper, the wastewater from a gas field in the Sichuan Basin with high salinity and more contaminants (e.g. sulfides was treated as a case study for the standard-reaching discharge. Lab experiments were carried out to analyze the adaptability and effectiveness of coagulation–desulfurization composite treatment technology, chemical oxidation based ammonia nitrogen removal technology and cryogenic multi-efficacy distillation technology in the treatment of wastewater in this field. The results show that the removal rate of sulfides and oils is over 90% if polymeric ferric sulfate (PFS is taken as the coagulant combined with TS-1 desulfurization agent. Besides, the removal rate of ammonia nitrogen is over 96% if CA-1 is taken as the oxidant. Finally, after the gas field water is treated by means of cryogenic three-efficacy distillation technology, chloride concentration of distilled water is below 150 mg/L and CODcr concentration is less than 60 mg/L. It is concluded that after the whole process treatment, the main contaminant indicators of wastewater in this case study can satisfy the grade one standard specified in the Integrated Wastewater Discharge Standard (GB 8978–1996 and the chloride concentration can meet the requirement of the Standards for Irrigation Water Quality (GB 5084–2005. To sum up, the above mentioned composite technologies are efficient to the wastewater treatment in sour gas fields. Keywords: Sulfide-bearing gas field water, Coagulation, Desulfurization, Chemical oxidation, Standard discharge, Ammonia nitrogen, Chloride, Cryogenic multi-efficacy distillation, Sichuan Basin

  11. Evaluating the Effects of Aluminum-Containing and Non-Aluminum Containing Deodorants on Axillary Skin Toxicity During Radiation Therapy for Breast Cancer: A 3-Armed Randomized Controlled Trial

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, Lucy, E-mail: Lucy.lewis@curtin.edu.au [Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, Western Australia (Australia); School of Nursing and Midwifery Curtin University, Perth (Australia); Carson, Sharron [Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia (Australia); Bydder, Sean [Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia (Australia); School of Surgery, The University of Western Australia, Crawley, Western Australia (Australia); Athifa, Mariyam [School of Nursing and Midwifery Curtin University, Perth (Australia); Williams, Anne M. [School of Nursing and Midwifery Curtin University, Perth (Australia); School of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia (Australia); Bremner, Alexandra [School of Population Health, The University of Western Australia, Crawley, Western Australia (Australia)

    2014-11-15

    Purpose: Deodorant use during radiation therapy for breast cancer has been controversial as there are concerns deodorant use may exacerbate axillary skin toxicity. The present study prospectively determined the use of both aluminum-containing and non aluminum containing deodorants on axillary skin toxicity during conventionally fractionated postoperative radiation therapy for breast cancer. Methods and Materials: This 3-arm randomized controlled study was conducted at a single center, tertiary cancer hospital between March 2011 and April 2013. Participants were randomized to 1 of 2 experimental groups (aluminum-containing deodorant and soap or non–aluminum containing deodorant and soap) or a control group (soap). A total of 333 participants were randomized. Generalized estimating equations were used to estimate and compare the odds of experiencing high levels of sweating and skin toxicity in each of the deodorant groups to the odds in the control group. The study evaluated a range of endpoints including objective measurements of axilla sweating, skin toxicity, pain, itch and burning. Quality of life was assessed with a validated questionnaire. Results: Radiation characteristics were similar across all groups. Patients in the deodorant groups did not report significantly different ratings for axillary pain, itch, or burning compared with the control group. Patients in the aluminum-containing deodorant group experienced significantly less sweating than the control; the odds of their sweating being barely tolerable and frequently or always interfering with their daily activities was decreased by 85% (odds ratio, 0.15; 95% confidence interval, 0.03-0.91). Conclusions: We found no evidence that the use of either aluminum-containing or non–aluminum containing deodorant adversely effects axillary skin reaction during conventionally fractionated radiation therapy for breast cancer. Our analysis also suggests patients in the aluminum-containing deodorant arm had

  12. Evaluating the Effects of Aluminum-Containing and Non-Aluminum Containing Deodorants on Axillary Skin Toxicity During Radiation Therapy for Breast Cancer: A 3-Armed Randomized Controlled Trial

    International Nuclear Information System (INIS)

    Lewis, Lucy; Carson, Sharron; Bydder, Sean; Athifa, Mariyam; Williams, Anne M.; Bremner, Alexandra

    2014-01-01

    Purpose: Deodorant use during radiation therapy for breast cancer has been controversial as there are concerns deodorant use may exacerbate axillary skin toxicity. The present study prospectively determined the use of both aluminum-containing and non aluminum containing deodorants on axillary skin toxicity during conventionally fractionated postoperative radiation therapy for breast cancer. Methods and Materials: This 3-arm randomized controlled study was conducted at a single center, tertiary cancer hospital between March 2011 and April 2013. Participants were randomized to 1 of 2 experimental groups (aluminum-containing deodorant and soap or non–aluminum containing deodorant and soap) or a control group (soap). A total of 333 participants were randomized. Generalized estimating equations were used to estimate and compare the odds of experiencing high levels of sweating and skin toxicity in each of the deodorant groups to the odds in the control group. The study evaluated a range of endpoints including objective measurements of axilla sweating, skin toxicity, pain, itch and burning. Quality of life was assessed with a validated questionnaire. Results: Radiation characteristics were similar across all groups. Patients in the deodorant groups did not report significantly different ratings for axillary pain, itch, or burning compared with the control group. Patients in the aluminum-containing deodorant group experienced significantly less sweating than the control; the odds of their sweating being barely tolerable and frequently or always interfering with their daily activities was decreased by 85% (odds ratio, 0.15; 95% confidence interval, 0.03-0.91). Conclusions: We found no evidence that the use of either aluminum-containing or non–aluminum containing deodorant adversely effects axillary skin reaction during conventionally fractionated radiation therapy for breast cancer. Our analysis also suggests patients in the aluminum-containing deodorant arm had

  13. Towards an Interoperable Field Spectroscopy Metadata Standard with Extended Support for Marine Specific Applications

    Directory of Open Access Journals (Sweden)

    Barbara A. Rasaiah

    2015-11-01

    Full Text Available This paper presents an approach to developing robust metadata standards for specific applications that serves to ensure a high level of reliability and interoperability for a spectroscopy dataset. The challenges of designing a metadata standard that meets the unique requirements of specific user communities are examined, including in situ measurement of reflectance underwater, using coral as a case in point. Metadata schema mappings from seven existing metadata standards demonstrate that they consistently fail to meet the needs of field spectroscopy scientists for general and specific applications (μ = 22%, σ = 32% conformance with the core metadata requirements and μ = 19%, σ = 18% for the special case of a benthic (e.g., coral reflectance metadataset. Issues such as field measurement methods, instrument calibration, and data representativeness for marine field spectroscopy campaigns are investigated within the context of submerged benthic measurements. The implication of semantics and syntax for a robust and flexible metadata standard are also considered. A hybrid standard that serves as a “best of breed” incorporating useful modules and parameters within the standards is proposed. This paper is Part 3 in a series of papers in this journal, examining the issues central to a metadata standard for field spectroscopy datasets. The results presented in this paper are an important step towards field spectroscopy metadata standards that address the specific needs of field spectroscopy data stakeholders while facilitating dataset documentation, quality assurance, discoverability and data exchange within large-scale information sharing platforms.

  14. Does the Addition of Tramadol and Ketamine to Ropivacaine Prolong the Axillary Brachial Plexus Block?

    Directory of Open Access Journals (Sweden)

    Ahmet Can Senel

    2014-01-01

    Full Text Available Background and Objectives. A prospective, randomized, controlled, double-blind clinical trial to assess the effect of tramadol and ketamine, 50 mg, added to ropivacaine in brachial plexus anesthesia. Methods. Thirty-six ASA physical statuses I and II patients, between 18 and 60 years of age, scheduled for forearm and hand surgery under axillary brachial plexus block, were allocated to 3 groups. Group R received 0.375% ropivacaine in 40 mL, group RT received 0.375% ropivacaine in 40 mL with 50 mg tramadol, and group RK received 0.375% ropivacaine in 40 mL with 50 mg ketamine for axillary brachial plexus block. The onset times and the duration of sensory and motor blocks, duration of analgesia, hemodynamic parameters, and adverse events (nausea, vomiting, and feeling uncomfortable were recorded. Results. The onset time of sensorial block was the fastest in ropivacaine + tramadol group. Duration of sensorial and motor block was the shortest in the ropivacaine + tramadol group. Duration of analgesia was significantly longer in ropivacaine + tramadol group. Conclusion. We conclude that when added to brachial plexus analgesia at a dose of 50 mg, tramadol extends the onset and duration time of the block and improves the quality of postoperative analgesia without any side effects.

  15. Axillary silicone lymphadenopathy presenting with a lump and altered sensation in the breast: a case report

    Directory of Open Access Journals (Sweden)

    Adams Simon T

    2009-03-01

    Full Text Available Abstract Introduction Silicone lymphadenopathy is a rare but recognised complication of procedures involving the use of silicone. It has a poorly understood mechanism but is thought to occur following the transportation of silicone particles from silicone-containing prostheses to lymph nodes by macrophages. Case presentation We report of a case involving a 35-year-old woman who presented to the breast clinic with a breast lump and altered sensation below her left nipple 5 years after bilateral cosmetic breast augmentations. A small lump was detected inferior to the nipple but clinical examination and initial ultrasound investigation showed both implants to be intact. However, mammography and magnetic resonance imaging of both breasts revealed both intracapsular and extracapsular rupture of the left breast prosthesis. The patient went on to develop a flu-like illness and tender lumps in the left axilla and right mastoid regions. An excision biopsy of the left axillary lesion and replacement of the ruptured implant was performed. Subsequent histological analysis showed that the axillary lump was a lymph node containing large amounts of silicone. Conclusion The exclusion of malignancy remains the priority when dealing with lumps in the breast or axilla. Silicone lymphadenopathy should however be considered as a differential diagnosis in patients in whom silicone prostheses are present.

  16. Axillary lymph node core biopsy for breast cancer metastases — How many needle passes are enough?

    International Nuclear Information System (INIS)

    Macaskill, E.J.; Purdie, C.A.; Jordan, L.B.; Mclean, D.; Whelehan, P.; Brown, D.C.; Evans, A.

    2012-01-01

    Aim: To determine the diagnostic yield of each of three core passes when sampling abnormal lymph nodes in patients presenting with breast cancer. Materials and methods: All patients suspected of having breast cancer had axillary ultrasound as part of initial assessment. Radiologically abnormal nodes (cortical thickness >2.3 mm or round shape) were biopsied with three passes of a 22 mm throw 14 G core biopsy needle and sent for histopathology in separate numbered pots. Data were collected prospectively, and analysis performed on the data of 55 consecutive patients who had positive nodes on at least one core biopsy needle pass. Results: Of 55 patients with a positive node on core biopsy, tumour was noted in all three cores taken in 39 (70.9%). Lymph node metastasis was detected in 45 (81.8%) first core biopsies. With the first two cores taken, positive results were detected in 53 of 55 cases (96.4%). In both cases where tumour was only found on a third core biopsy pass, no lymph node tissue was present in the first two biopsy passes. Conclusion: Two well-directed 14 G core biopsy samples from an abnormal axillary node are adequate for diagnosis of breast cancer metastasis.

  17. FDG uptake in axillary lymph nodes after vaccination against pandemic (H1N1)

    International Nuclear Information System (INIS)

    Panagiotidis, Emmanouil; Exarhos, Demetrios; Housianakou, Irene; Bournazos, Apostolos; Datseris, Ioannis

    2010-01-01

    To alert the imaging community to potential false positive findings related to current immunization programmes against H1N1 influenza virus. We reviewed 10 patients referred for positron emission tomography/computed tomography (PET/CT) who had undergone recent vaccination. All studies showed 18 F-fluorodeoxyglucose (FDG) uptake in the draining axillary lymph nodes close to the vaccination site, while low-dose CT revealed lymph nodes ranged between 0.5 cm and 1.2 cm at the same site. This potential pitfall in PET/CT should be borne in mind during current vaccination programmes. (orig.)

  18. European standards in the field of combating cyber crime

    Directory of Open Access Journals (Sweden)

    Matijašević-Obradović Jelena

    2014-01-01

    Full Text Available Cyber crime is a phenomenon which is often written and spoken about, ever since its inception, in theory, judicial and legislative practice of developed countries and international institutions. It had rapidly developed in the last decade of the 20th century, and in the 21st century its evolution has become even more evident. Countries have responded by introducing new measures in their criminal legislation, in an effort to reconcile traditional criminal law with the demands for perception, investigation and demonstration of new criminal acts. This paper presents and analyzes the most significant European standards adopted in order to create more effective national legislation in the field of combating cyber crime. Standards given in the Convention of the Council of Europe but also the European Union Directives have to a large extent been a guide for national legislations in order to regulate the new situations regarding the misuse of information and communication technologies in the most adequate manner. Among other things, this paper pays special attention to the most important Convention in the field of combating cyber crime, which is the Council of Europe Convention on cyber crime, whose objectives include: harmonization of national legislations with regard to substantive provisions in the field of cyber crime, introduction of adequate instruments in national legislations with regard to process provisions in order to create the necessary basis for investigation and prosecution of offenders in this field and establishment of quick and efficient institutions and procedures for international cooperation.

  19. Quality of life in patients with primary axillary hyperhidrosis before and after treatment with fractionated microneedle radiofrequency

    Directory of Open Access Journals (Sweden)

    Bahareh Abtahi-Naeini

    2015-01-01

    Full Text Available Background: Primary axillary hyperhidrosis (PAH is a common condition with a great impact on the patient′s quality of life (QOL. It is associated with serious social, emotional, and occupational distress. The aim of this study was to investigate the QOL in patients with PAH before and after treatment with fractionated microneedle radiofrequency (FMR. Materials and Methods: We evaluated 25 patients with severe PAH. Each patient had three sessions of FMR treatment using a novel applicator at 3-week intervals. The study was based on Dermatology Life Quality Index (DLQI Questionnaires. Patients were evaluated at baseline and 3 months after the last session. Results: Our patients included 32% males and 68% females. The mean ± standard deviation (SD age of subjects was 30.2 ± 6.27 years. The mean ± SD of the DLQI before and after treatment was 12.96 ± 5.93, and 4.29 ± 2.21, respectively. There was a statistically significant difference between the before and after intervention (P < 0.001. No major, permanent adverse effects were shown. Conclusion: Treatment with FMR can improve the DLQI of patients with PAH.

  20. Dimensional reduction of the Standard Model coupled to a new singlet scalar field

    Energy Technology Data Exchange (ETDEWEB)

    Brauner, Tomáš [Faculty of Science and Technology, University of Stavanger,N-4036 Stavanger (Norway); Tenkanen, Tuomas V.I. [Department of Physics and Helsinki Institute of Physics,P.O. Box 64, FI-00014 University of Helsinki (Finland); Tranberg, Anders [Faculty of Science and Technology, University of Stavanger,N-4036 Stavanger (Norway); Vuorinen, Aleksi [Department of Physics and Helsinki Institute of Physics,P.O. Box 64, FI-00014 University of Helsinki (Finland); Weir, David J. [Faculty of Science and Technology, University of Stavanger,N-4036 Stavanger (Norway); Department of Physics and Helsinki Institute of Physics,P.O. Box 64, FI-00014 University of Helsinki (Finland)

    2017-03-01

    We derive an effective dimensionally reduced theory for the Standard Model augmented by a real singlet scalar. We treat the singlet as a superheavy field and integrate it out, leaving an effective theory involving only the Higgs and SU(2){sub L}×U(1){sub Y} gauge fields, identical to the one studied previously for the Standard Model. This opens up the possibility of efficiently computing the order and strength of the electroweak phase transition, numerically and nonperturbatively, in this extension of the Standard Model. Understanding the phase diagram is crucial for models of electroweak baryogenesis and for studying the production of gravitational waves at thermal phase transitions.

  1. Standardized UXO Technology Demonstration Site Open Field Scoring Record Number 740

    National Research Council Canada - National Science Library

    Overbay, Jr., Larry; Fling, Rick; McClug, Christina; Watts, Kimberly; Banta, Matthew

    2006-01-01

    The objective in the Standardized UXO Technology Demonstration Site Program is to evaluate the detection and discrimination capabilities of a given technology under various field and soil conditions...

  2. The relationship between morbidity after axillary surgery and long-term quality of life in breast cancer patients: the role of anxiety

    NARCIS (Netherlands)

    Aerts, P. D. M.; de Vries, J.; van der Steeg, A. F. W.; Roukema, J. A.

    2011-01-01

    Although arm/shoulder morbidity after sentinel lymph node biopsy (SLNB) and/or axillary lymph node dissection (ALND) has been studied before, information is lacking concerning self-imposed restrictions in activities and long-term consequences of both surgical procedures in relationship to quality of

  3. Principles and foundation: national standards on quantities and units in nuclear science field

    International Nuclear Information System (INIS)

    Chen Lishu

    1993-11-01

    The main contents of National Standards on Quantities and units of atomic and nuclear physics (GB 3102.9) and Quantities and Units of nuclear reactions and ionizing radiations (GB 310.10) are presented in which most important quantities with their symbols and definitions in the nuclear scientific field are given. The principles and foundation, including the International System of Units (SI) and its application to the nuclear scientific field, in the setting of the National Standards are explained

  4. A coincidental variation of the axillary artery: the brachioradial artery and the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle

    Directory of Open Access Journals (Sweden)

    Marek Konarik

    2014-09-01

    Full Text Available A case of anomalous terminal branching of the axillary artery was encountered and described in a left upper limb of a male cadaver. A series of 214 upper limbs of Caucasian race was dissected. A variant artery, stemming from the very end of the axillary artery followed a superficial course distally. It passed the cubital fossa, ran on the lateral side of the forearm as usual radial artery, crossed ventrally to the palm and terminated in the deep palmar arch. This vessel is a case of the brachioradial artery (incorrectly termed as the “radial artery with high origin”. Moreover, it was associated with another variation, concerning the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle. The anatomical knowledge of the axillary region is essential for radiodiagnostic, surgical and traumatologic procedures. The superficially located artery brings an elevated danger of heavy bleeding in all unexpected situations, its variant branching can cause problems in radial catheterization procedures and the anomalously coursing other arterial variant poses an elevated danger in surgical procedures concerning the surgical neck of humerus.

  5. Proposed Robust Entanglement-Based Magnetic Field Sensor Beyond the Standard Quantum Limit.

    Science.gov (United States)

    Tanaka, Tohru; Knott, Paul; Matsuzaki, Yuichiro; Dooley, Shane; Yamaguchi, Hiroshi; Munro, William J; Saito, Shiro

    2015-10-23

    Recently, there have been significant developments in entanglement-based quantum metrology. However, entanglement is fragile against experimental imperfections, and quantum sensing to beat the standard quantum limit in scaling has not yet been achieved in realistic systems. Here, we show that it is possible to overcome such restrictions so that one can sense a magnetic field with an accuracy beyond the standard quantum limit even under the effect of decoherence, by using a realistic entangled state that can be easily created even with current technology. Our scheme could pave the way for the realizations of practical entanglement-based magnetic field sensors.

  6. Reduced risk of axillary lymphatic spread in triple-negative breast cancer

    DEFF Research Database (Denmark)

    Holm-Rasmussen, Emil Villiam; Jensen, Maj-Britt; Balslev, Eva

    2015-01-01

    We examined the association between the hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status of women with primary breast cancer and the risk of axillary lymph node (ALN) involvement at the time of diagnosis. Information on 20,009 women diagnosed with primary breast...... cancer between 2008 and 2012 was retrieved from the Danish Breast Cancer Cooperative Group database. The associations between clinical and pathological variables and ALN involvement at the time of diagnosis were evaluated in univariate and multivariate regression analyses, as well as the significance......-negative breast cancer (TNBC) patients showed a significantly reduced risk of ALN involvement at the time of diagnosis compared to patients with HR-positive/HER2-negative tumors (OR 0.55; 95 % CI 0.49-0.62; P

  7. Non standard analysis, polymer models, quantum fields

    International Nuclear Information System (INIS)

    Albeverio, S.

    1984-01-01

    We give an elementary introduction to non standard analysis and its applications to the theory of stochastic processes. This is based on a joint book with J.E. Fenstad, R. Hoeegh-Krohn and T. Lindstroeem. In particular we give a discussion of an hyperfinite theory of Dirichlet forms with applications to the study of the Hamiltonian for a quantum mechanical particle in the potential created by a polymer. We also discuss new results on the existence of attractive polymer measures in dimension d 1 2 phi 2 2 )sub(d)-model of interacting quantum fields. (orig.)

  8. Standardized UXO Technology Demonstration Site Open Field Scoring Record Number 673 (Naval Research Laboratories)

    National Research Council Canada - National Science Library

    Overbay, Larry; Robitaille, George

    2005-01-01

    ...) utilizing the APG standardized UXO Technology Demonstration Site Open Field. Scoring Records have been coordinate by Larry Overbay and the Standardized UXO Technology Demonstration Site Scoring Committee...

  9. Standardized UXO Technology Demonstration Site Open Field Scoring Record Number 492 (Shaw Environmental, Inc.)

    National Research Council Canada - National Science Library

    Overbay, Larry; Robitaille, George

    2005-01-01

    ...) utilizing the APG Standardized UXO Technology Demonstration Site Open Field. Scoring Records have been coordinated by Larry Overbay and the Standardized UXO Technology Demonstration Site Scoring Committee...

  10. Standardized UXO Technology Demonstration Site Open Field Scoring Record Number 668 (NAEVA Geophysics, Inc.)

    National Research Council Canada - National Science Library

    Overbay, Larry; Robitaille, George

    2005-01-01

    ...) utilizing they PG Standardized UXO Technology Demonstration Site Open Field. Scoring Records have been coordinate by Larry Overbay and the Standardized UXO Technology Demonstration Site Scoring Committee...

  11. Standardized UXO Technology Demonstration Site Open Field Scoring Record No. 901 (Sky Research, Inc.)

    National Research Council Canada - National Science Library

    McClung, J. S; Fling, Rick; McClung, Christina; Burch, William; Lombardo, Leonardo; McDonnell, Patrick

    2008-01-01

    ...) utilizing the APG Standardized UXO Technology Demonstration Site Open Field. This Scoring Record was coordinated by Stephen McClung and the Standardized UXO Technology Demonstration Site Scoring Committee...

  12. Isolation barriers between petunia axillaris and Petunia integrifolia (Solanaceae).

    Science.gov (United States)

    Dell'olivo, Alexandre; Hoballah, Maria Elena; Gübitz, Thomas; Kuhlemeier, Cris

    2011-07-01

    The isolation barriers restricting gene flow between populations or species are of crucial interest for understanding how biological species arise and how they are maintained. Few studies have examined the entire range of possible isolation barriers from geographic isolation to next generation hybrid viability. Here, we present a detailed analysis of isolation barriers between two flowering plant species of the genus Petunia (Solanaceae). Petunia integrifolia and P. axillaris feature divergent pollination syndromes but can produce fertile hybrids when crossed in the laboratory. Both Petunia species are primarily isolated in space but appear not to hybridize in sympatry. Our experiments demonstrate that pollinator isolation is very high but not strong enough to explain the absence of hybrids in nature. However, pollinator isolation in conjunction with male gametic isolation (i.e., pollen-pistil interaction) can explain the lack of natural hybridization, while postzygotic isolation barriers are low or nonexistent. Our study supports the notion that reproductive isolation in flowering plants is mainly caused by pre- rather than postzygotic isolation mechanisms. © 2011 The Author(s). Evolution© 2011 The Society for the Study of Evolution.

  13. 2001 updated standard options and recommendations for radiotherapy in non metastatic breast cancer patients

    International Nuclear Information System (INIS)

    Fourquet, A.; Sigal-Zafrani, B.; Cutuli, B.; Luporsi, E.; Lesur, A.

    2002-01-01

    Context. - The 'Standards, Options an Recommendations' (SOR) project, started in 1993, is a collaboration between the Federation of french cancer centers (FNCLCC), the 20 french cancer centers, and specialists from french public universities, general hospitals and private clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients. The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. Objectives. -To develop clinical practice guidelines for non metastatic breast cancer patients according to the definitions of the Standards, Options and Recommendations project. Methods. -Data were identified by searching Medline, web sites, and using the personal reference lists of members of the expert groups. Once the guidelines were defined, the document was submitted for review to 148 independent reviewers. Results. - This article presents the chapter radiotherapy resulting from the 2001 update of the version first published in 1996. The modified 2001 version of the standards, options and recommendations takes into account new information published. The main recommendations are (1) Breast irradiation after conservative surgery significatively decrease the risk of local recurrence (level of evidence A) and the decrease in the risk of local recidivation after chest wall irradiation is greater as the number of risk factors for local recurrence increases (level of evidence A). (2) After conservative surgery, a whole breast irradiation should be performed at a minimum dose of 50 Gy in 25 fractions (standard, level of evidence A). (3) A boost in the tumour bed should be performed in women under 50 years, even if the surgical margins are free (standard, level of evidence B). (4) Internal mammary chain irradiation is indicated for internal or central tumours in the absence of axillary

  14. Prognostic Impact of Adjuvant Radiotherapy in Breast Cancer Patients with One to Three Positive Axillary Lymph Nodes

    OpenAIRE

    Mansour Ansari; Behnam Kadkhodaei; Mehdi Shariat; Abdolrasoul Talei; Majid Akrami; Vahid Zangouri; Niloofar Ahmadloo; Mohammad Mohammadianpanah; Sayed Hasan Hamedi; Hamid Nasrolahi; Shapour Omidvari; Ahmad Mosalaei

    2018-01-01

    Background: Radiotherapy, as an adjuvant treatment, plays a well-known role in prevention of locoregional recurrence in breast cancer patients. This study aims to investigate the impact of radiotherapy in patients with N1 disease. Methods: In this retrospective study, we reviewed the characteristics and treatment outcomes of 316 patients with a biopsy proven diagnosis of breast carcinoma and 1-3 positive axillary lymph nodes. The patients received treatment between 1995 and 201...

  15. In vitro clonal propagation of bael (Aegle marmelos Corr.) CV. CISH-B1 through enhanced axillary branching.

    Science.gov (United States)

    Pati, Rajesh; Chandra, Ramesh; Chauhan, Ugam Kumari; Mishra, Maneesh; Srivastava, Navin

    2008-10-01

    Rapid clonal micropropagation protocol of Aegle marmelos (L.) Corr. cv. CISH-B1 was achieved by nodal stem segment of mature bearing tree. Three centimeter long shoots having one axillary bud excised from 10-15th nodal region of shoots during September gave quick in vitro bud burst (5.33 days) when cultured on MS medium supplemented with BAP, 8.84 μM + IAA 5.7 μM. The maximum number of proliferated shoots (9.0/explant) were obtained on same medium supplemented with BAP 8.84 μM + IAA 5.7 μM. The micro shoots were rooted (100 %) on + IAA 5.7 μM. In vitro rooted plants were acclimatized on autoclaved coconut husk containing plant salt mixture and under shade net house (50 % shade 70-80 % RH). The plants were established in the field after acclimatization. The micropropagated plants were tested for its genetic fidelity using 13 RAPD, 3 ISSR and 2 DAMD primers. Profile obtained by all the three Single Primer Amplification Reaction (SPAR) technique from mother tree and micropropagated plants revealed genetic integrity of micropropagated plants with that of mother tree.

  16. Emergency splenectomy for trauma in the setting of splenomegaly, axillary lymphadenopathy, and incidental B-cell chronic lymphocytic leukemia: A case report

    Directory of Open Access Journals (Sweden)

    Rodolfo J. Oviedo, MD, FACS

    2017-01-01

    Conclusion: An emergency splenectomy is an appropriate operative intervention for a grade V splenic laceration with hemoperitoneum, splenomegaly, and axillary lymphadenopathy regardless of the potential for a neoplastic process such as B-cell CLL. Post-splenectomy vaccinations and oncologic follow-up for systemic chemotherapy should be facilitated after recovery.

  17. Linfadenectomia Axilar Conservadora no Câncer de Mama Estádio Clínico I Conservative Axillary Dissection in Stage I Breast Cancer

    Directory of Open Access Journals (Sweden)

    Luiz Antonio Guimarães Brondi

    2000-01-01

    Full Text Available Objetivo: determinar a eficácia da linfadenectomia axilar conservadora (esvaziamento dos níveis I e II no tratamento cirúrgico do câncer da mama estádio I. Métodos: foram avaliados os resultados de 142 cirurgias realizadas em pacientes portadoras de câncer mamário estádio I (T1NO entre janeiro/93 e dezembro/98. Removidos os linfonodos axilares presentes nos níveis I e II com preservação dos músculos peitorais, os mesmos foram dissecados pelo próprio autor (LAGB, sendo posteriormente examinados histopatologicamente com a realização de apenas 1 corte por linfonodo. A quadrantectomia foi realizada em 138 casos e a mastectomia modificada segundo Patey em 4 casos. Houve predomínio dos casos T1c (130 casos. Resultados: foram removidos 3.282 linfonodos (2.456 presentes no nível I e 826 no nível II com um número médio de 23,1 linfonodos por axila. Desse total, apenas 68 estavam comprometidos (2,1%. Skip metastasis estava presente em apenas um caso (0,7%. Foram observados 35 casos de falso-negativos clínicos (24,6%, estando o nível I comprometido em 34 casos (97,1% e o nível II em apenas 2 casos (5,7%. A axila estava negativa nos 107 casos restantes (75,4%. Conclusão: a dissecção axilar dos níveis I e II é suficiente para tratar a axila no estádio I do câncer de mama. Se linfonodos suspeitos são identificados durante a cirurgia, os gânglios do nível III e o grupo interpeitoral de Rotter deverão ser retirados.Purpose: to evaluate the efficacy of conservative axillary dissection (levels I and II in the surgical treatment of stage I breast cancer. Methods: the results of 142 mastectomies performed from January/93 to December/98 in patients with clinical stage I breast cancer (T1NO were evaluated. Removing the axillary lymph nodes present at levels I and II, with the preservation of the pectoralis muscles, the axillary lymph nodes were dissected by the author (LAGB, and subsequently one section of each lymph node was

  18. [Bilateral axillary nodes. 30-year-old patient, housewife].

    Science.gov (United States)

    Rodak, R; Ramseier, E

    2007-11-14

    A 20-year old patient who had been adequately treated for lymph node tuberculosis 14 years ago presented 1 week after giving birth to a healthy daughter. She complained about painful lumps in both axillae. During pregnancy the patient suffered from hyperemesis gravidarum, lost 6 kg of weight, and had night sweats. During the last three months of her pregnancy she had a deep vein thrombosis in her right lower leg. The clinical examination showed soft axillary lumps up to 3 cm. The lab showed the following pathological findings: blood sedimentation rate 51 mm/h, CRP 44.8 mg/l, LDH 221 U/l and INR 1.3 (indicating insufficient anticoagulation with phenprocoumon). The chest x-ray showed no infiltrate or indications of a past tuberculosis. A fine needle aspiration cytology was performed on an accessible node. Gram stain, Ziehl Neelsen stain, as well as the bacteriological cultures were all negative. An ultrasound examination of the axilla showed a thickened subcutis without a mass. Cytology showed lobular epithelium, consistent wih ductal mamma epithelium without atypical cells. The diagnosis of an accessory mamma tissue in both axillae was made. During the course of the following weeks the glands decreased in size and the patient was free of symptoms.

  19. Evaluation of measurement reproducibility using the standard-sites data, 1994 Fernald field characterization demonstration project

    International Nuclear Information System (INIS)

    Rautman, C.A.

    1996-02-01

    The US Department of Energy conducted the 1994 Fernald (Ohio) field characterization demonstration project to evaluate the performance of a group of both industry-standard and proposed alternative technologies in describing the nature and extent of uranium contamination in surficial soils. Detector stability and measurement reproducibility under actual operating conditions encountered in the field is critical to establishing the credibility of the proposed alternative characterization methods. Comparability of measured uranium activities to those reported by conventional, US Environmental Protection Agency (EPA)-certified laboratory methods is also required. The eleven (11) technologies demonstrated included (1) EPA-standard soil sampling and laboratory mass-spectroscopy analyses, and currently-accepted field-screening techniques using (2) sodium-iodide scintillometers, (3) FIDLER low-energy scintillometers, and (4) a field-portable x-ray fluorescence spectrometer. Proposed advanced characterization techniques included (5) alpha-track detectors, (6) a high-energy beta scintillometer, (7) electret ionization chambers, (8) and (9) a high-resolution gamma-ray spectrometer in two different configurations, (10) a field-adapted laser ablation-inductively coupled plasma-atomic emission spectroscopy (ICP-AES) technique, and (11) a long-range alpha detector. Measurement reproducibility and the accuracy of each method were tested by acquiring numerous replicate measurements of total uranium activity at each of two ''standard sites'' located within the main field demonstration area. Meteorological variables including temperature, relative humidity. and 24-hour rainfall quantities were also recorded in conjunction with the standard-sites measurements

  20. Computed tomography image of the mediastinal and axillary lymph nodes in clinically sound Rottweilers Imagem por tomografia computadorizada dos linfonodos axilares e mediastinais de cães rottweilers clinicamente saudáveis

    Directory of Open Access Journals (Sweden)

    Ana Carolina B. Fonseca Pinto

    2013-03-01

    Full Text Available Trough computed tomography (CT, it is possible to evaluate lymph nodes in detail and to detect changes in these structures earlier than with radiographs and ultrasound. Lack of information in the veterinary literature directed the focus of this report to normal aspects of the axillary and mediastinal lymph nodes of adult dogs on CT imaging. A CT scan of 15 normal adult male and female Rottweilers was done. To define them as clinically sound, anamnesis, physical examination, complete blood count, renal and hepatic biochemistry, ECG, and thoracic radiographs were performed. After the intravenous injection of hydrosoluble ionic iodine contrast medium contiguous 10mm in thickness thoracic transverse images were obtained with an axial scanner. In the obtained images mediastinal and axillary lymph nodes were sought and when found measured in their smallest diameter and their attenuation was compared to musculature. Mean and standard deviation of: age, weight, body length and the smallest diameter of the axillary and mediastinal lymph nodes were determined. Mean and standard deviation of parameters: age 3.87±2.03 years, weight 41.13±5.12, and body length 89.61±2.63cm. Axillary lymph nodes were seen in 60% of the animals, mean of the smallest diameter was 3.58mm with a standard deviation of 2.02 and a minimum value of 1mm and a maximum value of 7mm. From 13 observed lymph nodes 61.53% were hypopodense when compared with musculature, and 30.77% were isodense. Mediastinal lymph nodes were identified in 73.33% of the dogs; mean measure of the smallest diameter was 4.71mm with a standard deviation of 2.61mm and a minimum value of 1mm, and a maximum value of 8mm. From 14 observed lymph nodes 85.71% were isodense when compared with musculature and 14.28% were hypodense. The results show that it is possible to visualize axillary and mediastinal lymph nodes in adult clinically sound Rottweilers with CT using a slice thickness and interval of 10mm. The

  1. Standardized UXO Technology Demonstration Site Open Field Scoring Recording Number 231 (Human Factors Applications, Inc.)

    National Research Council Canada - National Science Library

    Overbay, Larry; Robitaille, George

    2005-01-01

    ...) utilizing the APG Standardized UXO Technology Demonstration Site Open Field. The scoring record was coordinated by Larry Overbuy and by the Standardized UXO Technology Demonstration Site Scoring Committee...

  2. Accumulation of FDG in axillary sweat glands in hyperhidrosis: a pitfall in whole-body PET examination

    International Nuclear Information System (INIS)

    Jacobsson, H.; Celsing, F.; Ingvar, M.; Stone-Elander, S.; Larsson, S.A.

    1998-01-01

    A diabetic male with severe autonomic neuropathy and recently discovered Hodgkin's disease demonstrated bilateral uptake of [2- 18 F]-2-fluoro-2-deoxy-d-glucose (FDG) in the axillary sweat glands during profuse sweating caused by hypoglycaemia at positron emission tomography examination. It is not yet clear whether the sweating interfered with the distribution of the radiopharmaceutical. Regardless of the cause or mechanism for the uptake, the finding is clinically relevant. A bilateral symmetrical accumulation of FDG in the axillae of a tumour patient does not necessarily indicate malignant involvement of the lymph nodes. (orig.)

  3. Directional atherectomy of a heavy calcified axillary artery stenosis inducing critical hand ischemia.

    Science.gov (United States)

    Anzuini, Angelo; Palloshi, Altin; Aprigliano, Gianfranco; Ielasi, Alfonso

    2013-07-01

    The presence of a severe calcified peripheral artery lesion is responsible for a poor response to balloon dilation, due to significant acute vessel recoil and frequent flow-limiting dissections requiring stent implantation. This possibility could be associated with very high compression and/or fracture rates particularly in cases of lesion located at the mobile joints. In this setting directional atherectomy offers the theoretical advantages of eliminating stretch injury on arterial walls and reducing the restenosis rate by direct plaque excision. In this report, we present a case of critical hand ischemia due to a heavily calcified axillary artery lesion managed by directional atherectomy and balloon angioplasty followed by immediate angiographic success and sustained clinical benefit up to 3 years of follow-up.

  4. Detection of lymphovascular invasion in early breast cancer by D2-40 (podoplanin): a clinically useful predictor for axillary lymph node metastases.

    NARCIS (Netherlands)

    Braun, M.; Flucke, U.E.; Debald, M.; Walgenbach-Bruenagel, G.; Walgenbach, K.J.; Holler, T.; Polcher, M.; Wolfgarten, M.; Sauerwald, A.; Keyver-Paik, M.; Kuhr, M.; Buttner, R.; Kuhn, W.

    2008-01-01

    PURPOSE: The aim of this study was to investigate the use of D2-40 for the detection of lymphovascular invasion (LVI) in node positive and negative early breast cancer. LVI is associated with axillary lymph node metastases (ALNM) and a long-term prognostic factor. A precise identification of LVI

  5. Acute Truncal Lymphedema Secondary to Axillary Metastatic Melanoma Presenting Like Cellulitis

    Directory of Open Access Journals (Sweden)

    Shelley J. E. Hwang

    2017-01-01

    Full Text Available There are reported cases of diphencyprone used in treating cutaneous metastases of melanoma. Here, we report a patient with previous primary melanoma on his left back treated with surgical excision and lymphadenectomy, followed by radiotherapy for the recurrent tumor on the primary site. Despite radiotherapy and treatment with dabrafenib and trametinib, in-transit metastases have developed and topical diphencyprone was applied to these metastases. Six weeks later, the patient developed fever and a spreading erythematous tender indurated plaque covering the left side of the body including axillae, back, and flank, clinically suggestive of cellulitis. Systemic antibiotic therapy did not improve the condition and a biopsy showed sparse lymphocytic infiltrate. With the diagnosis of possible acute lymphedema, a CT scan was requested that showed significant axillary lymph node metastasis. The fever was considered secondary to dabrafenib and trametinib therapy. This case highlights that, in patients with lymphadenectomy, atypical forms of lymphedema on the body may appear. Truncal lymphedema is an infrequent event.

  6. Consistent constraints on the Standard Model Effective Field Theory

    International Nuclear Information System (INIS)

    Berthier, Laure; Trott, Michael

    2016-01-01

    We develop the global constraint picture in the (linear) effective field theory generalisation of the Standard Model, incorporating data from detectors that operated at PEP, PETRA, TRISTAN, SpS, Tevatron, SLAC, LEPI and LEP II, as well as low energy precision data. We fit one hundred and three observables. We develop a theory error metric for this effective field theory, which is required when constraints on parameters at leading order in the power counting are to be pushed to the percent level, or beyond, unless the cut off scale is assumed to be large, Λ≳ 3 TeV. We more consistently incorporate theoretical errors in this work, avoiding this assumption, and as a direct consequence bounds on some leading parameters are relaxed. We show how an S,T analysis is modified by the theory errors we include as an illustrative example.

  7. Locoregional Recurrence After Sentinel Lymph Node Dissection With or Without Axillary Dissection in Patients With Sentinel Lymph Node Metastases: Long-term Follow-up From the American College of Surgeons Oncology Group (Alliance) ACOSOG Z0011 Randomized Trial.

    Science.gov (United States)

    Giuliano, Armando E; Ballman, Karla; McCall, Linda; Beitsch, Peter; Whitworth, Pat W; Blumencranz, Peter; Leitch, A Marilyn; Saha, Sukamal; Morrow, Monica; Hunt, Kelly K

    2016-09-01

    The early results of the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial demonstrated no difference in locoregional recurrence for patients with positive sentinel lymph nodes (SLNs) randomized either to axillary lymph node dissection (ALND) or sentinel lymph node dissection (SLND) alone. We now report long-term locoregional recurrence results. ACOSOG Z0011 prospectively examined overall survival of patients with SLN metastases undergoing breast-conserving therapy randomized to undergo ALND after SLND or no further axillary specific treatment. Locoregional recurrence was prospectively evaluated and compared between the groups. Four hundred forty-six patients were randomized to SLND alone and 445 to SLND and ALND. Both groups were similar with respect to age, Bloom-Richardson score, Estrogen Receptor status, adjuvant systemic therapy, histology, and tumor size. Patients randomized to ALND had a median of 17 axillary nodes removed compared with a median of only 2 SLNs removed with SLND alone (P alone arm (P = 0.28). Ten-year cumulative locoregional recurrence was 6.2% with ALND and 5.3% with SLND alone (P = 0.36). Despite the potential for residual axillary disease after SLND, SLND without ALND offers excellent regional control for selected patients with early metastatic breast cancer treated with breast-conserving therapy and adjuvant systemic therapy.

  8. The role of ultrasound and lymphoscintigraphy in the assessment of axillary lymph nodes in patients with breast cancer

    Directory of Open Access Journals (Sweden)

    Michał Nieciecki

    2016-03-01

    Full Text Available Breast cancer is the most common malignancy and the leading cause of death due to cancer in European women. Mammography screening programs aimed to increase the detection of early cancer stages were implemented in numerous European countries. Recent data show a decrease in mortality due to breast cancer in many countries, particularly among young women. At the same time, the number of sentinel node biopsy procedures and breast-conserving surgeries has increased. Intraoperative sentinel lymph node biopsy preceded by lymphoscintigraphy is used in breast cancer patients with no clinical signs of lymph node metastasis. Due to the limited sensitivity and specificity of physical examination in detecting metastatic lesions, developing an appropriate diagnostic algorithm for the preoperative assessment of axillary lymph nodes seems to be a challenge. The importance of ultrasound in patient qualification for sentinel lymph-node biopsy has been discussed in a number of works. Furthermore, different lymphoscintigraphy protocols have been compared in the literature. The usefulness of novel radiopharmaceuticals as well as the methods of image acquisition in sentinel lymph node diagnostics have also been assessed. The aim of this article is to present, basing on current guidelines, literature data as well as our own experience, the diagnostic possibilities of axillary lymph node ultrasound in patient qualification for an appropriate treatment as well as the role of lymphoscintigraphy in sentinel lymph node biopsy.

  9. Fibroadenoma in Axillary Supernumerary Breast in a 17-Year-Old Girl: Case Report.

    Science.gov (United States)

    Surd, Adrian; Mironescu, Aurel; Gocan, Horatiu

    2016-10-01

    Supernumerary breast or polymastia is a well documented anomaly of the breast, and commonly presents along the embryonic milk line extending between the axilla and groin. However, cases of polymastia have been recorded in the face, vulva, and perineum. The clinical significance of these anomalies include their susceptibility to inflammatory and malignant changes, and their association with other congenital anomalies of the urinary and cardiovascular systems. In this article we report a case of fibroadenoma that developed in the supernumerary breast of the right axilla in a 17-year-old girl. It is uncommon to find such palpable masses in young patients. Clinical and sonographic examination of both breasts revealed no abnormalities and no lymph nodes were detected in the axillae or the neck. No associated urologic or cardiovascular abnormalities were found, and the histopathological examination of the excisional biopsy samples showed a well-defined, capsulated intracanalicular type of fibroadenoma similar to that of eutopic mammary tissue. In this report, we describe a rare case of fibroadenoma in an accessory breast in a young woman. There are a fewer than 40 reports in the world about this subject, of which differential diagnoses include: cancer in axillary supernumerary breast, hidradenitis, axillary lymphadenomegaly, lipomas, anexial cutaneous neoplasia, cysts, and phylloides tumor. The combination of clinical examination, ultrasound, and cytology leads to adequate treatment, especially surgical. The diagnosis could be confused because of findings from cytology. In this case, because of the clinical and sonographic findings and multiple differential diagnosis, only the histopathological study was used to confirm the diagnosis. Despite its high sensitivity, cytology has low specificity and could create false positive results. However, atypical lesions can be seen in fibroadenomas, especially in younger patients, pregnant patients, and in patients who use hormonal

  10. Standardized UXO Technology Demonstration Site, Open Field Scoring Record No. 770. Magnetometer FEREX DLG GPS/Sling

    National Research Council Canada - National Science Library

    Karwatka, Mike; Packer, Bonnie

    2006-01-01

    ...) utilizing the YPG Standardized UXO Technology Demonstration Site open field. Scoring Records have been coordinated by Mike Karwatka and the Standardized UXO Technology Demonstration Site Scoring Committee...

  11. Do field position and playing standard influence athlete performance in wheelchair basketball?

    NARCIS (Netherlands)

    de Witte, A.M.H.; Hoozemans, M.J.M.; Berger, M.A.; van der Woude, L.H.V.; Veeger, H.E.J.

    2016-01-01

    Improved understanding of mobility performance in wheelchair basketball is required to increase game performance. The aim of this study was to quantify the wheelchair-athlete activities of players in different field positions and of different playing standard during wheelchair basketball matches.

  12. Quantum dots in axillary lymph node mapping: Biodistribution study in healthy mice

    Directory of Open Access Journals (Sweden)

    Guillemin François

    2008-04-01

    Full Text Available Abstract Background Breast cancer is the first cause of cancer death among women and its incidence doubled in the last two decades. Several approaches for the treatment of these cancers have been developed. The axillary lymph node dissection (ALND leads to numerous morbidity complications and is now advantageously replaced by the dissection and the biopsy of the sentinel lymph node. Although this approach has strong advantages, it has its own limitations which are manipulation of radioactive products and possible anaphylactic reactions to the dye. As recently proposed, these limitations could in principle be by-passed if semiconductor nanoparticles (quantum dots or QDs were used as fluorescent contrast agents for the in vivo imaging of SLN. QDs are fluorescent nanoparticles with unique optical properties like strong resistance to photobleaching, size dependent emission wavelength, large molar extinction coefficient, and good quantum yield. Methods CdSe/ZnS core/shell QDs emitting around 655 nm were used in our studies. 20 μL of 1 μM (20 pmol QDs solution were injected subcutaneously in the anterior paw of healthy nude mice and the axillary lymph node (ALN was identified visually after injection of a blue dye. In vivo fluorescence spectroscopy was performed on ALN before the mice were sacrificed at 5, 15, 30, 60 min and 24 h after QDs injection. ALN and all other organs were removed, cryosectioned and observed in fluorescence microscopy. The organs were then chemically made soluble to extract QDs. Plasmatic, urinary and fecal fluorescence levels were measured. Results QDs were detected in ALN as soon as 5 min and up to 24 h after the injection. The maximum amount of QDs in the ALN was detected 60 min after the injection and corresponds to 2.42% of the injected dose. Most of the injected QDs remained at the injection site. No QDs were detected in other tissues, plasma, urine and feces. Conclusion Effective and rapid (few minutes detection of

  13. Quantum dots in axillary lymph node mapping: Biodistribution study in healthy mice

    International Nuclear Information System (INIS)

    Robe, Anne; Pic, Emilie; Lassalle, Henri-Pierre; Bezdetnaya, Lina; Guillemin, François; Marchal, Frédéric

    2008-01-01

    Breast cancer is the first cause of cancer death among women and its incidence doubled in the last two decades. Several approaches for the treatment of these cancers have been developed. The axillary lymph node dissection (ALND) leads to numerous morbidity complications and is now advantageously replaced by the dissection and the biopsy of the sentinel lymph node. Although this approach has strong advantages, it has its own limitations which are manipulation of radioactive products and possible anaphylactic reactions to the dye. As recently proposed, these limitations could in principle be by-passed if semiconductor nanoparticles (quantum dots or QDs) were used as fluorescent contrast agents for the in vivo imaging of SLN. QDs are fluorescent nanoparticles with unique optical properties like strong resistance to photobleaching, size dependent emission wavelength, large molar extinction coefficient, and good quantum yield. CdSe/ZnS core/shell QDs emitting around 655 nm were used in our studies. 20 μL of 1 μM (20 pmol) QDs solution were injected subcutaneously in the anterior paw of healthy nude mice and the axillary lymph node (ALN) was identified visually after injection of a blue dye. In vivo fluorescence spectroscopy was performed on ALN before the mice were sacrificed at 5, 15, 30, 60 min and 24 h after QDs injection. ALN and all other organs were removed, cryosectioned and observed in fluorescence microscopy. The organs were then chemically made soluble to extract QDs. Plasmatic, urinary and fecal fluorescence levels were measured. QDs were detected in ALN as soon as 5 min and up to 24 h after the injection. The maximum amount of QDs in the ALN was detected 60 min after the injection and corresponds to 2.42% of the injected dose. Most of the injected QDs remained at the injection site. No QDs were detected in other tissues, plasma, urine and feces. Effective and rapid (few minutes) detection of sentinel lymph node using fluorescent imaging of quantum dots was

  14. Bilateral axillary masses mimicking as accessory breast with multiple fibroadenoma and bilateral gigantomastia in HIV-positive patient.

    Science.gov (United States)

    Singh, Saumya; Mishra, Anand K; Tewari, S; Kumar, Sanjeev

    2013-06-24

    Accessory breast is a rare entity that can present as asymptomatic masses or can cause symptoms like heaviness, pain, restriction of arm movement and limitation in daily pursuits with allied apprehension and anxiety for the patient. We present a case of bilateral axillary masses mimicking as accessory breast with multiple fibroadenoma in a 28 years, nulliparous, Indian woman who is HIV positive, which proves to be a diagnostic dilemma. Excisional biopsy was diagnostic. The rarity of such cases imposes challenges on the management in terms of diagnosis, prognosis and therapeutic options.

  15. Cosmetic results following lumpectomy axillary dissection and radiotherapy for smaal breast cancers

    International Nuclear Information System (INIS)

    Dewar, J.A.; Benhamou, S.; Benhamou, E.; Arriagada, R.; Petit, J.Y.; Fontaine, F.; Sarrazin, D.

    1988-01-01

    Between 1970 and April 1982, 592 women, with T/sub 1/, small T/sub 2/, N/sub 0/, N/sub 1/, M/sub 0/ breast cancer were managed by lumpectomy, axillary dissection and radiotherapy at the Institut Gustave Roussy (IGR). The overall cosmetic result and the degree of assymetry, fibrosis and telangiectasia of the treated breast were assessed by the radiation oncologist at each follow-up visit. The changes in these cosmetic parameters with time are shown. At 5 years the overall cosmetic result was excellent in 58%, good in 38% and fair or poor in 8%. A multivariate analysis was performed of the factors associated with a cosmetic defect. The most significant factors were tumour size, the presence of defect after surgery and the daily applied dose per fraction to the breast. Surgical and radiotherapy technique (especially alternate day fractionation) can significantly affect the cosmetic result obtained

  16. Less gastrointestinal toxicity after adjuvant radiotherapy on a small pelvic field compared to a standard pelvic field in patients with endometrial carcinoma

    NARCIS (Netherlands)

    de Jong, Renske A.; Pras, Elisabeth; Boezen, H. Marike; van der Zee, Ate G. J.; Mourits, Marian J. E.; Arts, Henriette J. G.; Aalders, Jan G.; Slot, Annerie; Timmer, Paul R.; Hollema, Harry; Nijman, Hans W.

    Objective: Radiotherapy is associated with short-term and long-term morbidity. This study compared toxicity rates among patients with endometrial carcinoma (EC) treated with adjuvant external beam radiation therapy (EBRT) on a small pelvic field (SmPF) in comparison with a standard pelvic field

  17. Antimicrobial and toxicological evaluation of the leaves of Baissea axillaries Hua used in the management of HIV/AIDS patients

    Directory of Open Access Journals (Sweden)

    Agoreyo Freddy O

    2006-06-01

    Full Text Available Abstract Background Persistent diarrhea is a common endemic disease with high incidence among the Africans including Nigerians. It also represents a frequent opportunistic disease in people living with HIV. Diarrhea represents one of the most distressful and persistent symptoms of HIV/AIDS, which may or may not be accompanied by an infection. The leaves decoction of Baissea axillaries Hua (Apocynaceae is used by traditional herbalists in Edo state, Nigeria for the management of people living with HIV/AIDS. Determination of its antimicrobial activity and toxicological profile will provide supportive scientific evidence in favour of its continuous usage. Method Chemical and chromatographic tests were employed in phytochemical investigations. Inhibitory activities of aqueous and ethanolic extracts against clinical strains of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus faecalis were compared with Togamycin (Spectinomycin. Our report includes minimum inhibitory concentration (MIC against the test organisms. Toxicological evaluation was determined by administering 250 mg/kg and 500 mg/kg of extracts on male Wister rats for 14 days with normal saline as control. The kidneys, liver, heart and testis tissues were examined. Results Phytochemical studies revealed the presence of alkaloids, tannins, and cyanogenetic glycosides. The extracts inhibited the growth of Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus to varying extents, but only the ethanolic extract inhibited growth in Streptococcus faecalis. The LD50 of the extract in mice was above 5000 mg/kg body weight when administered intraperitoneally. Toxicological evaluation showed mere ballooning degeneration of the liver at 250 mg/kg while at 500 mg/kg there was tissue necrosis. The low and high doses showed ill-defined leydig cells in the testis and no remarkable changes in the heart and kidneys. Conclusion Extracts of Baissea axillaries have

  18. Accounting for human variability and sensitivity in setting standards for electromagnetic fields.

    Science.gov (United States)

    Bailey, William H; Erdreich, Linda S

    2007-06-01

    Biological sensitivity and variability are key issues for risk assessment and standard setting. Variability encompasses general inter-individual variations in population responses, while sensitivity relates to unusual or extreme responses based on genetic, congenital, medical, or environmental conditions. For risk assessment and standard setting, these factors affect estimates of thresholds for effects and dose-response relationships and inform efforts to protect the more sensitive members of the population, not just the typical or average person. While issues of variability and sensitivity can be addressed by experimental and clinical studies of electromagnetic fields, investigators have paid little attention to these important issues. This paper provides examples that illustrate how default assumptions regarding variability can be incorporated into estimates of 60-Hz magnetic field exposures with no risk of cardiac stimulation and how population thresholds and variability of peripheral nerve stimulation responses at 60-Hz can be estimated from studies of pulsed gradient magnetic fields in magnetic resonance imaging studies. In the setting of standards for radiofrequency exposures, the International Commission for Non-Ionizing Radiation Protection uses inter-individual differences in thermal sensitivity as one of the considerations in the development of "safety factors." However, neither the range of sensitivity nor the sufficiency or excess of the 10-fold and the additional 5-fold safety factors have been assessed quantitatively. Data on the range of responses between median and sensitive individuals regarding heat stress and cognitive function should be evaluated to inform a reassessment of these safety factors and to identify data gaps.

  19. States and tendencies of German standards in the field of nuclear filter technology

    International Nuclear Information System (INIS)

    Fichtner, N.; Sinhuber, D.

    1977-01-01

    The current situation in the Federal Republic of Germany with regard to standards and guidelines in the field of filter technology, as they apply to nuclear technology, is first presented. A detailed discussion follows of the results arrived at by the Nuclear Technology Standards Committee in its deliberations on the Standards' project DIN 25 414 'Ventilation equipment in nuclear power stations'. Particular attention is paid to the technical safety requirements for particulate filters, filter casings and filter housings, and methods of testing. The results so far obtained as regards filters in ventilation plant for pressurized water reactors are also dealt with

  20. Standard model effective field theory: Integrating out neutralinos and charginos in the MSSM

    Science.gov (United States)

    Han, Huayong; Huo, Ran; Jiang, Minyuan; Shu, Jing

    2018-05-01

    We apply the covariant derivative expansion method to integrate out the neutralinos and charginos in the minimal supersymmetric Standard Model. The results are presented as set of pure bosonic dimension-six operators in the Standard Model effective field theory. Nontrivial chirality dependence in fermionic covariant derivative expansion is discussed carefully. The results are checked by computing the h γ γ effective coupling and the electroweak oblique parameters using the Standard Model effective field theory with our effective operators and direct loop calculation. In global fitting, the proposed lepton collider constraint projections, special phenomenological emphasis is paid to the gaugino mass unification scenario (M2≃2 M1) and anomaly mediation scenario (M1≃3.3 M2). These results show that the precision measurement experiments in future lepton colliders will provide a very useful complementary job in probing the electroweakino sector, in particular, filling the gap of the soft lepton plus the missing ET channel search left by the traditional collider, where the neutralino as the lightest supersymmetric particle is very degenerated with the next-to-lightest chargino/neutralino.

  1. Quasinormal modes of brane-localized standard model fields. II. Kerr black holes

    International Nuclear Information System (INIS)

    Kanti, P.; Konoplya, R. A.; Zhidenko, A.

    2006-01-01

    This paper presents a comprehensive study of the fundamental quasinormal modes of all standard model fields propagating on a brane embedded in a higher-dimensional rotating black-hole spacetime. The equations of motion for fields with spin s=0, 1/2 and 1 propagating in the induced-on-the-brane background are solved numerically, and the dependence of their QN spectra on the black-hole angular momentum and dimensionality of spacetime is investigated. It is found that the brane-localized field perturbations are longer-lived when the higher-dimensional black hole rotates faster, while an increase in the number of transverse-to-the-brane dimensions reduces their lifetime. Finally, the quality factor Q, that determines the best oscillator among the different field perturbations, is investigated and found to depend on properties of both the particular field studied (spin, multipole numbers) and the gravitational background (dimensionality, black-hole angular momentum parameter)

  2. Standardization of radiation protection measurements in mixed fields of an extended energy range

    International Nuclear Information System (INIS)

    Hoefert, M.; Stevenson, G.R.

    1977-01-01

    The improved ICRU concept of dose equivalent index aims at standardizing both area and personnel dose measurements so that the results on the dosimetry of external irradiations in radiation protection become compatible. It seems that for photon and neutron energies up to 3 and 20 MeV respectively the realization of dose-equivalent index is straightforward, but the inclusion of higher energies and/or other types of radiation will lead both to conceptual and practical difficulties. It will be shown that practical measurements in mixed radiation fields of an extended energy range for protection purposes will overestimate the standardized quantity. While area measurements can be performed to represent a good approximation, greater uncertainties have to be accepted in personnel dosimetry for stray radiation fields around GeV proton accelerators

  3. Validation of IRDFF in 252Cf Standard and IRDF-2002 Reference Neutron Fields

    Directory of Open Access Journals (Sweden)

    Simakov Stanislav

    2016-01-01

    Full Text Available The results of validation of the latest release of International Reactor Dosimetry and Fusion File, IRDFF-1.03, in the standard 252Cf(s.f. and reference 235U(nth,f neutron benchmark fields are presented. The spectrum-averaged cross sections were shown to confirm IRDFF-1.03 in the 252Cf standard spontaneous fission spectrum; that was not the case for the current recommended spectra for 235U(nth,f. IRDFF was also validated in the spectra of the research reactor facilities ISNF, Sigma-Sigma and YAYOI, which are available in the IRDF-2002 collection. The ISNF facility was re-simulated to remove unphysical oscillations in the spectrum. IRDFF-1.03 was shown to reproduce reasonably well the spectrum-averaged data measured in these fields except for the case of YAYOI.

  4. A randomised pilot study comparing 13 G vacuum-assisted biopsy and conventional 14 G core needle biopsy of axillary lymph nodes in women with breast cancer

    International Nuclear Information System (INIS)

    Maxwell, A.J.; Bundred, N.J.; Harvey, J.; Hunt, R.; Morris, J.; Lim, Y.Y.

    2016-01-01

    Aim: To compare the acceptability, safety, and feasibility of vacuum-assisted biopsy (VAB) and core needle biopsy (CNB) of axillary lymph nodes in women with breast cancer. Materials and methods: This parallel, non-blinded, randomised study was approved by the National Research Ethics Service. Following written informed consent, women with abnormal appearing axillary lymph nodes and radiologically malignant breast masses were randomised 1:1 to lymph node sampling under local anaesthetic with either 14 G CNB or 13 G VAB in a single UK centre. Primary outcomes were study uptake rate and patient willingness to undergo a repeat procedure if necessary. Procedure duration, immediate and post-procedure pain scores, diagnostic yield, complications, and surgical histopathology were recorded. Results: Ninety-five women were approached; 81 (85.3%) consented and were randomised. Forty underwent CNB; 40 underwent VAB; one was excluded. Median age was 57 years. The median procedure time was 2 minutes for both techniques. The median number of samples obtained was three for CNB and four for VAB. Median pain scores for the procedure and first 3 days were 1/10 and 1/10 for CNB and 1/10 and 2/10 for VAB (p=0.11 and 0.04). More women were prepared to undergo repeat CNB compared to VAB, but the difference was not significant (38/39 versus 33/39; p=0.11). Two patients developed a haematoma after VAB. One CNB and six VABs failed to yield adequate tissue (p=0.11), but the sensitivity was similar at 79% and 78%. Conclusion: Study uptake was high. Acceptability of the two procedures was similar, but VAB was associated with more post-procedure pain. The sensitivity appears to be similar. - Highlights: • Vacuum biopsy of axillary lymph nodes can be performed rapidly. • Post-procedure pain was slightly higher in women who underwent vacuum biopsy. • The inadequate yield rate of vacuum biopsy may be higher than that for core biopsy. • Sensitivity of 13-gauge vacuum biopsy and 14-gauge

  5. The possibility of access to the kidneys from posterior axillary line in supine position for percutaneous nephrolithotomy

    Directory of Open Access Journals (Sweden)

    Ali Tabibi

    2013-11-01

    Full Text Available Please cite this article as: Tabibi A, Kashi AH, Mirjalili SAM, Mahmoudnejad N, Kashani P, Salavatipour B, Soltani MH. The possibility of access to the kidneys from posterior axillary line in supine position for percutaneous nephrolithotomy. Novel Biomed 2013;1(2:43-47.Objectives: To evaluate the possibility of access to the kidneys from posterior axillary line (PAL in supine position for percutaneous nephrolithotomy.Materials and Methods: 102 consecutive patients who were candidated for abdominal CT scan, enrolled in this study. In cases of impossible access, the point on the posterior surface of body which permitted safe access was determined and the percent of movement toward body midline (relative to PAL was calculated (M.PER.Results: Percutaneous access was simulated from upper and middle calyces of the kidney in 13% and 75% of cases, respectively. Access to the lower region was possible in 90% of right and 79% of left lower calyces, respectively (p=0.03. In cases with impossible access from PAL, the M.PER for a safe access was 46-47% for upper region and 34- 38% for middle and lower calyces of the kidney (P = 0.0001.Conclusions: Access to upper calyces from PAL was limited in some cases regarding to the presence of solid organs. Presence of colon made access impossible in the lower right and left calyces in about 10% and 20% of cases, respectively. In upper region, more deviation toward midline was necessary to establish a safe access compared with middle and lower calyces.

  6. Electromagnetic fields and the public: EMF standards and estimation of risk

    Science.gov (United States)

    Grigoriev, Yury

    2010-04-01

    Mobile communications are a relatively new and additional source of electromagnetic exposure for the population. Standard daily mobile-phone use is known to increase RF-EMF (radiofrequency electromagnetic field) exposure to the brains of users of all ages, whilst mobile-phone base stations, and base station units for cordless phones, can regularly increase the exposures of large numbers of the population to RF-EMF radiation in everyday life. The need to determine appropriate standards stipulating the maximum acceptable short-term and long-term RF-EMF levels encountered by the public, and set such levels as general guidelines, is of great importance in order to help preserve the general public's health and that of the next generation of humanity.

  7. Electromagnetic fields and the public: EMF standards and estimation of risk

    International Nuclear Information System (INIS)

    Grigoriev, Yury

    2010-01-01

    Mobile communications are a relatively new and additional source of electromagnetic exposure for the population. Standard daily mobile-phone use is known to increase RF-EMF (radiofrequency electromagnetic field) exposure to the brains of users of all ages, whilst mobile-phone base stations, and base station units for cordless phones, can regularly increase the exposures of large numbers of the population to RF-EMF radiation in everyday life. The need to determine appropriate standards stipulating the maximum acceptable short-term and long-term RF-EMF levels encountered by the public, and set such levels as general guidelines, is of great importance in order to help preserve the general public's health and that of the next generation of humanity.

  8. Integrating out the standard Higgs field in the path integral

    International Nuclear Information System (INIS)

    Dittmaier, S.

    1996-01-01

    We integrate out the Higgs boson in the electroweak standard model at one loop and construct a low-energy effective Lagrangian assuming that the Higgs mass is much larger than the gauge-boson masses. Instead of applying diagrammatical techniques, we integrate out the Higgs boson directly in the path integral, which turns out to be much simpler. By using the background-field method and the Stueckelberg formalism, we directly find a manifestly gauge-invariant result. The heavy-Higgs effects on fermionic couplings are derived, too. At one loop the log M H terms of the heavy-Higgs limit of the electroweak standard model coincide with the UV-divergent terms in the gauged non-linear σ-model, but vertex functions differ in addition by finite constant terms. Finally, the leading Higgs effects to some physical processes are calculated from the effective Lagrangian. (orig.)

  9. A Comparison of Combined Suprascapular and Axillary Nerve Blocks to Interscalene Nerve Block for Analgesia in Arthroscopic Shoulder Surgery: An Equivalence Study.

    Science.gov (United States)

    Dhir, Shalini; Sondekoppam, Rakesh V; Sharma, Ranjita; Ganapathy, Sugantha; Athwal, George S

    2016-01-01

    The primary objective of this study was to compare the analgesic efficacy of combined suprascapular and axillary nerve block (SSAX) with interscalene block (ISB) after arthroscopic shoulder surgery. Our hypothesis was that ultrasound-guided SSAX would provide postoperative analgesia equivalent to ISB. Sixty adult patients undergoing arthroscopic shoulder surgery received either SSAX or ISB prior to general anesthesia, in a randomized fashion. Pain scores, satisfaction, and adverse effects were recorded in the recovery room, 6 hours, 24 hours, and 7 days after surgery. Combined suprascapular and axillary nerve block provided nonequivalent analgesia when compared with ISB at different time points postoperatively, except on postoperative day 7. Interscalene block had better mean static pain score in the recovery room (ISB 1.80 [95% confidence interval [CI], 1.10-2.50] vs SSAX 5.45 [95% CI, 4.40-6.49; P shoulder surgery. While SSAX provides better quality pain relief at rest and fewer adverse effects at 24 hours, ISB provides better analgesia in the immediate postoperative period. For arthroscopic shoulder surgery, SSAX can be a clinically acceptable analgesic option with different analgesic profile compared with ISB.

  10. Hypofractionated irradiation of infra-supraclavicular lymph nodes after axillary dissection in patients with breast cancer post-conservative surgery: impact on late toxicity

    International Nuclear Information System (INIS)

    Guenzi, Marina; Blandino, Gladys; Vidili, Maria Giuseppina; Aloi, Deborah; Configliacco, Elena; Verzanini, Elisa; Tornari, Elena; Cavagnetto, Francesca; Corvò, Renzo

    2015-01-01

    The aim of the present work was to analyse the impact of mild hypofractionated radiotherapy (RT) of infra-supraclavicular lymph nodes after axillary dissection on late toxicity. From 2007 to 2012, 100 females affected by breast cancer (pT1- T4, pN1-3, pMx) were treated with conservative surgery, Axillary Node Dissection (AND) and loco-regional radiotherapy (whole breast plus infra-supraclavicular fossa). Axillary lymph nodes metastases were confirmed in all women. The median age at diagnosis was 60 years (range 34–83). Tumors were classified according to molecular characteristics: luminal-A 59 pts (59 %), luminal-B 24 pts (24 %), basal-like 10 pts (10 %), Her-2 like 7 pts (7 %). 82 pts (82 %) received hormonal therapy, 9 pts (9 %) neo-adjuvant chemotherapy, 81pts (81 %) adjuvant chemotherapy. All patients received a mild hypofractionated RT: 46 Gy in 20 fractions 4 times a week to whole breast and infra-supraclavicular fossa plus an additional weekly dose of 1,2 Gy to the lumpectomy area. The disease control and treatment related toxicity were analysed in follow-up visits. The extent of lymphedema was analysed by experts in Oncological Rehabilitation. Within a median follow-up of 50 months (range 19–82), 6 (6 %) pts died, 1 pt (1 %) had local progression disease, 2 pts (2 %) developed distant metastasis and 1 subject (1 %) presented both. In all patients the acute toxicity was mainly represented by erythema and patchy moist desquamation. At the end of radiotherapy 27 pts (27 %) presented lymphedema, but only 10 cases (10 %) seemed to be correlated to radiotherapy. None of the patients showed a severe damage to the brachial plexus, and the described cases of paresthesias could not definitely be attributed to RT. We did not observe symptomatic pneumonitis. Irradiation of infra-supraclavicular nodes with a mild hypofractionated schedule can be a safe and effective treatment without evidence of a significant increase of lymphedema appearance radiotherapy related

  11. Cyclosporine-A therapy-induced multiple bilateral breast and accessory axillary breast fibroadenomas: a case report

    Directory of Open Access Journals (Sweden)

    Darwish Ahmed

    2010-08-01

    Full Text Available Abstract Introduction Breast adenoma is common. However, in the setting of post-transplantation immune suppression it may be expressed differently. Case presentation A 35-year-old Sudanese woman, with a history of renal transplantation two and half years prior to presentation, was on a single immune suppression therapy in the form of cyclosporine-A since the transplantation. During a regular follow-up visit, she was noticed to have gingival hypertrophy and bilateral breast and axillary swellings. She underwent successful surgical resection of the bilateral fibroadenomas. Conclusions Cyclosporine-A therapy post renal transplantation is associated with an increased incidence of benign breast changes as fibroadenoma. Regular follow-up and appropriate selection of immunosuppressant therapy are essential in the post transplantation management of these patients.

  12. Current state of standardization in the field of dimensional computed tomography

    International Nuclear Information System (INIS)

    Bartscher, Markus; Härtig, Frank; Neuschaefer-Rube, Ulrich; Sato, Osamu

    2014-01-01

    Industrial x-ray computed tomography (CT) is a well-established non-destructive testing (NDT) technology and has been in use for decades. Moreover, CT has also started to become an important technology for dimensional metrology. But the requirements on dimensional CTs, i.e., on performing coordinate measurements with CT, are different from NDT. For dimensional measurements, the position of interfaces or surfaces is of importance, while this is often less critical in NDT. Standardization plays an important role here as it can create trust in new measurement technologies as is the case for dimensional CT. At the international standardization level, the ISO TC 213 WG 10 is working on specifications for dimensional CT. This paper highlights the demands on international standards in the field of dimensional CT and describes the current developments from the viewpoint of representatives of national and international standardization committees. Key aspects of the discussion are the material influence on the length measurement error E and how E can best be measured. A respective study was performed on hole plates as new reference standards for error testing of length measurements incorporating the material influence. We performed corresponding measurement data analysis and present a further elaborated hole plate design. The authors also comment on different approaches currently pursued and give an outlook on upcoming developments as far as they can be foreseen. (paper)

  13. Patient Age and Tumor Subtype Predict the Extent of Axillary Surgery Among Breast Cancer Patients Eligible for the American College of Surgeons Oncology Group Trial Z0011.

    Science.gov (United States)

    Ong, Cecilia T; Thomas, Samantha M; Blitzblau, Rachel C; Fayanju, Oluwadamilola M; Park, Tristen S; Plichta, Jennifer K; Rosenberger, Laura H; Hyslop, Terry; Shelley Hwang, E; Greenup, Rachel A

    2017-11-01

    The American College of Surgeons Oncology Group (ACOSOG) Z0011 trial established the safety of omitting axillary lymph node dissection (ALND) for early-stage breast cancer patients with limited nodal disease undergoing lumpectomy. We examined the extent of axillary surgery among women eligible for Z0011 based on patient age and tumor subtype. Patients with cT1-2, cN0 breast cancers and one or two positive nodes diagnosed from 2009 to 2014 and treated with lumpectomy were identified in the National Cancer Data Base. Sentinel lymph node biopsy (SLNB) was defined as the removal of 1-5 nodes and ALND as the removal of 10 nodes or more. Tumor subtype was categorized as luminal, human epidermal growth factor 2-positive (HER2+), or triple-negative. Logistic regression was used to estimate the odds of receiving SLNB alone versus ALND. The inclusion criteria were met by 28,631 patients (21,029 SLNB-alone and 7602 ALND patients). Patients 70 years of age or older were more likely to undergo SLNB alone than ALND (27.0% vs 20.1%; p alone and 89.7% after ALND. In the multivariate analysis, the uptake of Z0011 recommendations increased over time (2014 vs 2009: odds ratio [OR] 13.02; p alone than older patients (age alone than those with luminal subtypes. Among women potentially eligible for ACOSOG Z0011, the use of SLNB alone increased over time in all groups, but the extent of axillary surgery differed by patient age and tumor subtype.

  14. Study of inflationary generalized cosmic Chaplygin gas for standard and tachyon scalar fields

    Energy Technology Data Exchange (ETDEWEB)

    Sharif, M.; Saleem, Rabia [University of the Punjab, Department of Mathematics, Lahore (Pakistan)

    2014-07-15

    We consider an inflationary universe model in the context of the generalized cosmic Chaplygin gas by taking the matter field as standard and tachyon scalar fields. We evaluate the corresponding scalar fields and scalar potentials during the intermediate and logamediate inflationary regimes by modifying the first Friedmann equation. In each case, we evaluate the number of e-folds, scalar as well as tensor power spectra, scalar spectral index, and the important observational parameter, the tensor-scalar ratio in terms of inflation. The graphical behavior of this parameter shows that the model remains incompatible with WMAP7 and Planck observational data in each case. (orig.)

  15. Study of inflationary generalized cosmic Chaplygin gas for standard and tachyon scalar fields

    International Nuclear Information System (INIS)

    Sharif, M.; Saleem, Rabia

    2014-01-01

    We consider an inflationary universe model in the context of the generalized cosmic Chaplygin gas by taking the matter field as standard and tachyon scalar fields. We evaluate the corresponding scalar fields and scalar potentials during the intermediate and logamediate inflationary regimes by modifying the first Friedmann equation. In each case, we evaluate the number of e-folds, scalar as well as tensor power spectra, scalar spectral index, and the important observational parameter, the tensor-scalar ratio in terms of inflation. The graphical behavior of this parameter shows that the model remains incompatible with WMAP7 and Planck observational data in each case. (orig.)

  16. Unitarity constraints in the standard model with a singlet scalar field

    International Nuclear Information System (INIS)

    Kang, Sin Kyu; Park, Jubin

    2015-01-01

    Motivated by the discovery of a new scalar field and amelioration of the electroweak vacuum stability ascribed to a singlet scalar field embedded in the standard model (SM), we examine the implication of the perturbative unitarity in the SM with a singlet scalar field. Taking into account the full contributions to the scattering amplitudes, we derive unitarity conditions on the scattering matrix which can be translated into bounds on the masses of the scalar fields. In the case that the singlet scalar field develops vacuum expectation value (VEV), we get the upper bound on the singlet scalar mass varying with the mixing between the singlet and Higgs scalars. On the other hand, the mass of the Higgs scalar can be constrained by the unitarity condition in the case that the VEV of the singlet scalar is not generated. Applying the upper bound on the Higgs mass to the scenario of the unitarized Higgs inflation, we discuss how the unitarity condition can constrain the Higgs inflation. The singlet scalar mass is not constrained by the unitarity itself when we impose Z 2 in the model because of no mixing with the Higgs scalar. But, regarding the singlet scalar field as a cold dark matter candidate, we derive upper bound on the singlet scalar mass by combining the observed relic abundance with the unitarity condition.

  17. Microwave-Assisted Extraction of Natural Antioxidants from the Exotic Gordonia axillaris Fruit: Optimization and Identification of Phenolic Compounds

    Directory of Open Access Journals (Sweden)

    Ya Li

    2017-09-01

    Full Text Available Our previous study reported that the fruit of Gordonia axillaris, an edible wild fruit, possessed strong antioxidant activity. In this study, a microwave-assisted extraction (MAE method was established to extract antioxidants from the fruit of Gordonia axillaris. The influence of five parameters, including ethanol concentration, solvent/material ratio, extraction time, extraction temperature and microwave power, was investigated by single-factor experiments. Three factors, namely ethanol concentration, solvent/material ratio, extraction time, were found to exert a major influence on extraction efficacy, and were further studied by response surface methodology to investigate their interactions. Ethanol concentration of 36.89%, solvent/material ratio of 29.56 mL/g, extraction time of 71.04 min, temperature of 40 °C, and microwave power of 400 W were found to be the optimal condition. The TEAC value was 198.16 ± 5.47 µmol Trolox/g DW under the optimal conditions, which was in conformity to the predicted value (200.28 µmol Trolox/g DW. In addition, the MAE method was compared with two conventional methods (Soxhlet extraction and maceration extraction. Results showed that the antioxidant capacity of the extract obtained by MAE method was stronger than that obtained by maceration (168.67 ± 3.88 µmol Trolox/g DW or Soxhlet extraction (114.09 ± 2.01 µmol Trolox/g DW. Finally, several phenolic compounds in the extract were identified and quantified by UPLC-MS/MS, which were rutin, gallic acid, protocatechuic acid, epicatechin, epicatechin gallate, 2-hydrocinnamic acid, p-coumaric acid, quercetin, chlorogenic acid and ferulic acid.

  18. Microwave-Assisted Extraction of Natural Antioxidants from the Exotic Gordonia axillaris Fruit: Optimization and Identification of Phenolic Compounds.

    Science.gov (United States)

    Li, Ya; Li, Sha; Lin, Sheng-Jun; Zhang, Jiao-Jiao; Zhao, Cai-Ning; Li, Hua-Bin

    2017-09-06

    Our previous study reported that the fruit of Gordonia axillaris , an edible wild fruit, possessed strong antioxidant activity. In this study, a microwave-assisted extraction (MAE) method was established to extract antioxidants from the fruit of Gordonia axillaris . The influence of five parameters, including ethanol concentration, solvent/material ratio, extraction time, extraction temperature and microwave power, was investigated by single-factor experiments. Three factors, namely ethanol concentration, solvent/material ratio, extraction time, were found to exert a major influence on extraction efficacy, and were further studied by response surface methodology to investigate their interactions. Ethanol concentration of 36.89%, solvent/material ratio of 29.56 mL/g, extraction time of 71.04 min, temperature of 40 °C, and microwave power of 400 W were found to be the optimal condition. The TEAC value was 198.16 ± 5.47 µmol Trolox/g DW under the optimal conditions, which was in conformity to the predicted value (200.28 µmol Trolox/g DW). In addition, the MAE method was compared with two conventional methods (Soxhlet extraction and maceration extraction). Results showed that the antioxidant capacity of the extract obtained by MAE method was stronger than that obtained by maceration (168.67 ± 3.88 µmol Trolox/g DW) or Soxhlet extraction (114.09 ± 2.01 µmol Trolox/g DW). Finally, several phenolic compounds in the extract were identified and quantified by UPLC-MS/MS, which were rutin, gallic acid, protocatechuic acid, epicatechin, epicatechin gallate, 2-hydrocinnamic acid, p -coumaric acid, quercetin, chlorogenic acid and ferulic acid.

  19. A Comparison between Standard and Functional Clustering Methodologies: Application to Agricultural Fields for Yield Pattern Assessment

    Directory of Open Access Journals (Sweden)

    Simone Pascucci

    2018-04-01

    Full Text Available The recognition of spatial patterns within agricultural fields, presenting similar yield potential areas, stable through time, is very important for optimizing agricultural practices. This study proposes the evaluation of different clustering methodologies applied to multispectral satellite time series for retrieving temporally stable (constant patterns in agricultural fields, related to within-field yield spatial distribution. The ability of different clustering procedures for the recognition and mapping of constant patterns in fields of cereal crops was assessed. Crop vigor patterns, considered to be related to soils characteristics, and possibly indicative of yield potential, were derived by applying the different clustering algorithms to time series of Landsat images acquired on 94 agricultural fields near Rome (Italy. Two different approaches were applied and validated using Landsat 7 and 8 archived imagery. The first approach automatically extracts and calculates for each field of interest (FOI the Normalized Difference Vegetation Index (NDVI, then exploits the standard K-means clustering algorithm to derive constant patterns at the field level. The second approach applies novel clustering procedures directly to spectral reflectance time series, in particular: (1 standard K-means; (2 functional K-means; (3 multivariate functional principal components clustering analysis; (4 hierarchical clustering. The different approaches were validated through cluster accuracy estimates on a reference set of FOIs for which yield maps were available for some years. Results show that multivariate functional principal components clustering, with an a priori determination of the optimal number of classes for each FOI, provides a better accuracy than those of standard clustering algorithms. The proposed novel functional clustering methodologies are effective and efficient for constant pattern retrieval and can be used for a sustainable management of

  20. The value of preoperative ultrasound guided fine-needle aspiration cytology of radiologically suspicious axillary lymph nodes in breast cancer

    Directory of Open Access Journals (Sweden)

    Torill Sauer

    2014-01-01

    Full Text Available Background: Preoperative ultrasound (US and eventually US-guided fine-needle aspiration cytology (FNAC of suspicious axillary lymph nodes (ALN is a standard procedure in the work-up of suspicious breast lesions. Preoperative US FNAC may prevent sentinel node biopsy (SNB procedure in 24-30% of patients with early stage breast carcinoma. The aim of this study was to evaluate the institutional results of this preoperative diagnostic procedure. Materials and Methods: A total of 182 cases of preoperative FNAC of suspicious ALN where retrieved from the pathology files. The results were compared with the final histology and staging. False negative (FN FNAC cases were reviewed and possibly missed metastatic cases (2 were immunostained with the epithelial marker AE1/AE3. Results: There were no false positives, whereas 16 cases were FN. In all but one case the FN′s represented sampling error. Half of the 16 FN cases in this series were macrometastases. Discussion: About 83% of the preoperatively aspirated cases were N+, indicating that a radiologically suspicious ALN has a very high risk of being metastatic. Preoperative US guided FNAC from radiologically suspicious ALN is highly efficient in detecting metastases. Depending on national guidelines, a preoperative, positive ALN FNAC might help to stratify the patients as to SNB and/or ALN dissection.

  1. DsixTools: the standard model effective field theory toolkit

    Energy Technology Data Exchange (ETDEWEB)

    Celis, Alejandro [Ludwig-Maximilians-Universitaet Muenchen, Fakultaet fuer Physik, Arnold Sommerfeld Center for Theoretical Physics, Munich (Germany); Fuentes-Martin, Javier; Vicente, Avelino [Universitat de Valencia-CSIC, Instituto de Fisica Corpuscular, Valencia (Spain); Virto, Javier [University of Bern, Albert Einstein Center for Fundamental Physics, Institute for Theoretical Physics, Bern (Switzerland)

    2017-06-15

    We present DsixTools, a Mathematica package for the handling of the dimension-six standard model effective field theory. Among other features, DsixTools allows the user to perform the full one-loop renormalization group evolution of the Wilson coefficients in the Warsaw basis. This is achieved thanks to the SMEFTrunner module, which implements the full one-loop anomalous dimension matrix previously derived in the literature. In addition, DsixTools also contains modules devoted to the matching to the ΔB = ΔS = 1, 2 and ΔB = ΔC = 1 operators of the Weak Effective Theory at the electroweak scale, and their QCD and QED Renormalization group evolution below the electroweak scale. (orig.)

  2. Magnetic resonance imaging in the evaluation of standard radiotherapy field borders in patients with uterine cervix cancer

    International Nuclear Information System (INIS)

    Freire, Geison Moreira; Dias, Rodrigo Souza; Giordani, Adelmo Jose; Segreto, Helena Regina Comodo; Segreto, Roberto Araujo; Ribalta, Julisa Chamorro Lascasas

    2010-01-01

    Objective: to evaluate, by means of magnetic resonance imaging, the standardized field borders in radiotherapy for malignant neoplasm of uterine cervix, and to determine the role of this method in the reduction of possible planning errors related to the conventional technique. Materials and methods: magnetic resonance imaging studies for planning of treatment of 51 patients with uterine cervix cancer were retrospectively analyzed. The parameters assessed were the anterior and posterior field borders on sagittal section. Results: The anterior field border was inappropriate in 20 (39.2%) patients and geographic miss was observed in 37.3% of cases in the posterior border. The inappropriateness of both field borders did not correlate with clinical parameters such as patients' age, tumor staging, histological type and degree. Conclusion: the evaluation of standardized field borders with the use of magnetic resonance imaging has demonstrated high indices of inappropriateness of the lateral field borders, as well as the relevant role of magnetic resonance imaging in the radiotherapy planning for patients with uterine cervix cancer with a view to reduce the occurrence of geographic miss of the target volume. (author)

  3. Single, double or multiple-injection techniques for non-ultrasound guided axillary brachial plexus block in adults undergoing surgery of the lower arm.

    Science.gov (United States)

    Chin, Ki Jinn; Alakkad, Husni; Cubillos, Javier E

    2013-08-08

    Regional anaesthesia comprising axillary block of the brachial plexus is a common anaesthetic technique for distal upper limb surgery. This is an update of a review first published in 2006 and updated in 2011. To compare the relative effects (benefits and harms) of three injection techniques (single, double and multiple) of axillary block of the brachial plexus for distal upper extremity surgery. We considered these effects primarily in terms of anaesthetic effectiveness; the complication rate (neurological and vascular); and pain and discomfort caused by performance of the block. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE and reference lists of trials. We contacted trial authors. The date of the last search was March 2013 (updated from March 2011). We included randomized controlled trials that compared double with single-injection techniques, multiple with single-injection techniques, or multiple with double-injection techniques for axillary block in adults undergoing surgery of the distal upper limb. We excluded trials using ultrasound-guided techniques. Independent study selection, risk of bias assessment and data extraction were performed by at least two investigators. We undertook meta-analysis. The 21 included trials involved a total of 2148 participants who received regional anaesthesia for hand, wrist, forearm or elbow surgery. Risk of bias assessment indicated that trial design and conduct were generally adequate; the most common areas of weakness were in blinding and allocation concealment.Eight trials comparing double versus single injections showed a statistically significant decrease in primary anaesthesia failure (risk ratio (RR 0.51), 95% confidence interval (CI) 0.30 to 0.85). Subgroup analysis by method of nerve location showed that the effect size was greater when neurostimulation was used rather than the transarterial technique.Eight trials comparing multiple with single

  4. [The effect of mammographic screening on tumor size, axillary node status and the degree of histologic anaplasia].

    Science.gov (United States)

    Garami, Zoltán; Benkó, Klára; Kósa, Csaba; Fülöp, Balázs; Lukács, Géza

    2006-10-01

    Breast cancer is the most frequent malignant tumor in women in Hungary. Significant reduction of mortality has been brought about not only by the increasing efficiency of complex therapy but also by regular mammographic screening. Of the histopathological data of 633 patients operated with primary breast tumor at the 1st Surgical Clinic of the Debrecen Medical University between January 1st 2000 and December 31st 2004, the authors analyzed tumor diameter, axillary node status and the degree of histologic anaplasia and compared them with the data of mammographic screening. Of the "screened"patients, 70.7% were diagnosed with T1 size tumors, 28.5% with T2 size, and 0.8% with tumors bigger than that. In the "unscreened" patients, our findings were 44.3%, 45.9% and 9.8% respectively. Within T1 tumors, Tla tumors were found in 11%, TIb in 37.6% and T1c in 51.4% in the "screened" group of patients, while the "unscreened" group's results were 2.3%, 12.6% and 85% respectively. 72.7% of the "screened" patients and 56.2% of the "unscreened" patients were found to be axillary node-negative. A study of the degree of histologic anaplasia showed G-I tumors in 15.6%, G-IIs in 62.1% and G-IIIs in 22.3% of the "screened" patients. The corresponding values for the "unscreened" patients were 6.1%, 53.8% and 40.1%, respectively. The differences were highly significant (p < 0.001) in all the parameters investigated. The authors have found a significant increase in the proportion of node-negative patients and patients with smaller tumors even after the first round of mammographic screening and at less than 50% participation. It is to be hoped that a 20% reduction in mortality can be achieved by further increasing the rate of participation.

  5. Comparison of Arthroscopically Guided Suprascapular Nerve Block and Blinded Axillary Nerve Block vs. Blinded Suprascapular Nerve Block in Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial.

    Science.gov (United States)

    Ko, Sang Hun; Cho, Sung Do; Lee, Chae Chil; Choi, Jang Kyu; Kim, Han Wook; Park, Seon Jae; Bae, Mun Hee; Cha, Jae Ryong

    2017-09-01

    The purpose of this study was to compare the results of arthroscopically guided suprascapular nerve block (SSNB) and blinded axillary nerve block with those of blinded SSNB in terms of postoperative pain and satisfaction within the first 48 hours after arthroscopic rotator cuff repair. Forty patients who underwent arthroscopic rotator cuff repair for medium-sized full thickness rotator cuff tears were included in this study. Among them, 20 patients were randomly assigned to group 1 and preemptively underwent blinded SSNB and axillary nerve block of 10 mL 0.25% ropivacaine and received arthroscopically guided SSNB with 10 mL of 0.25% ropivacaine. The other 20 patients were assigned to group 2 and received blinded SSNB with 10 mL of 0.25% ropivacaine. Visual analog scale (VAS) score for pain and patient satisfaction score were assessed 4, 8, 12, 24, 36, and 48 hours postoperatively. The mean VAS score for pain was significantly lower 4, 8, 12, 24, 36, and 48 hours postoperatively in group 1 (group 1 vs. group 2; 5.2 vs. 7.4, 4.1 vs. 6.1, 3.0 vs. 5.1, 2.1 vs. 4.2, 0.9 vs. 3.9, and 1.3 vs. 3.3, respectively). The mean patient satisfaction score was significantly higher at postoperative 4, 8, 12, 24, 36, and 48 hours in group 1 (group 1 vs. group 2; 6.7 vs. 3.9, 7.4 vs. 5.1, 8.8 vs. 5.9, 9.2 vs. 6.7, 9.5 vs. 6.9, and 9.0 vs. 7.2, respectively). Arthroscopically guided SSNB and blinded axillary nerve block in arthroscopic rotator cuff repair for medium-sized rotator cuff tears provided more improvement in VAS for pain and greater patient satisfaction in the first 48 postoperative hours than blinded SSNB.

  6. Monte Carlo calculations for intermediate-energy standard neutron field

    International Nuclear Information System (INIS)

    Joneja, O.P.; Subbukutty, K.; Iyengar, S.B.D.; Navalkar, M.P.

    Intermediate-Energy Standard Neutron Field (ISNF) which produces a well characterised spectrum in the energy range of interest for fast reactors including breeders, has been set up at NBS using thin enriched 235 U fission sources. A proposal has been made for setting up a similar facility at BARC using however, easily available natural U instead of enriched U sources, to start with. In order to simulate the neutronics of such a facility Monte Carlo method of calculations has been adopted and developed. The results of these calculations have been compared with those of NBS and it is found that there may be a maximum difference of 10% in spectrum characteristics for the two cases of using thick and thin fission sources. (K.B.)

  7. Developing Standards-Based Geography Curricular Materials from Overseas Field Experiences for K-12 Teachers

    Science.gov (United States)

    Oberle, Alex; Palacios, Fabian Araya

    2012-01-01

    Overseas experiences provide educators with exceptional opportunities to incorporate field study, firsthand experiences, and tangible artifacts into the classroom. Despite this potential, teachers must consider curricular standards that direct how such international endeavors can be integrated. Furthermore, geography curriculum development is more…

  8. Minimum effective concentration of bupivacaine for axillary brachial plexus block guided by ultrasound

    Directory of Open Access Journals (Sweden)

    Alexandre Takeda

    2015-05-01

    Full Text Available Introduction: The use of ultrasound in regional anesthesia allows reducing the dose of local anesthetic used for peripheral nerve block. The present study was performed to determine the minimum effective concentration (MEC90 of bupivacaine for axillary brachial plexus block. Methods: Patients undergoing hand surgery were recruited. To estimate the MEC90, a sequential up-down biased coin method of allocation was used. The bupivacaine dose was 5 mL for each nerve (radial, ulnar, median, and musculocutaneous. The initial concentration was 0.35%. This concentration was changed by 0.05% depending on the previous block; a blockade failure resulted in increased concentration for the next patient; in case of success, the next patient could receive or reduction (0.1 probability or the same concentration (0.9 probability. Surgical anesthesia was defined as driving force ≤2 according to the modified Bromage scale, lack of thermal sensitivity and response to pinprick. Postoperative analgesia was assessed in the recovery room with numeric pain scale and the amount of drugs used within 4 h after the blockade. Results: MEC90 was 0.241% [R2: 0.978, confidence interval: 0.20–0.34%]. No patient, with successful block, reported pain after 4 h. Conclusion: This study demonstrated that ultrasound guided axillary brachial plexus block can be performed with the use of low concentration of local anesthetics, increasing the safety of the procedure. Further studies should be conducted to assess blockade duration at low concentrations. Resumo: Introdução: O uso do ultrassom na anestesia regional permite a redução da dose de anestésico local utilizada para o bloqueio de nervos periféricos. O presente estudo foi conduzido com o objetivo de determinar a concentração mínima efetiva (CME90 de bupivacaína para o bloqueio do plexo braquial via axilar (BPVA. Métodos: Pacientes submetidos a cirurgias da mão foram recrutados. Foi usado um método de alocação

  9. On the sound field requirements in the hearing protector standard ISO 4869-1

    DEFF Research Database (Denmark)

    Jensen, N. S.; Poulsen, Torben

    1999-01-01

    The sound field requirements in the ISO 4869 1 standard for hearing protector attenuation measurements comprise two parts: 1) a sound level difference requirement for positions around the head of the listener (ie at positions 15 cm from a reference point; up-down, front-back and left-right) and 2......) a directivity requirement for the sound incidence at the reference point, measured with a directional microphone, to ensure an approximate diffuse sound field. The level difference requirement (1) is not difficult to fulfil but the directivity requirement (2) may lead to contradicting results if the measurement...

  10. Standard practice for examination of welds using the alternating current field measurement technique

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2007-01-01

    1.1 This practice describes procedures to be followed during alternating current field measurement examination of welds for baseline and service-induced surface breaking discontinuities. 1.2 This practice is intended for use on welds in any metallic material. 1.3 This practice does not establish weld acceptance criteria. 1.4 The values stated in either inch-pound units or SI units are to be regarded separately as standard. The values stated in each system might not be exact equivalents; therefore, each system shall be used independently of the other. 1.5 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.

  11. Effect of temperature on the floral scent emission and endogenous volatile profile of Petunia axillaris.

    Science.gov (United States)

    Sagae, Masanori; Oyama-Okubo, Naomi; Ando, Toshio; Marchesi, Eduardo; Nakayama, Masayoshi

    2008-01-01

    The floral scent emission and endogenous level of its components in Petunia axillaris under different conditions (20, 25, 30, and 35 degrees C) were investigated under the hypothesis that floral scent emission would be regulated by both metabolic and vaporization processes. The total endogenous amount of scent components decreased as the temperature increased, the total emission showing a peak at 30 degrees C. This decrease in endogenous amount was compensated for by increased vaporization, resulting in an increase of floral scent emission from 20 degrees C to 30 degrees C. The ambient temperature differently and independently influenced the metabolism and vaporization of the scent compounds, and differences in vapor pressure among the scent compounds were reduced as the temperature increased. These characteristics suggest the operation of an unknown regulator to change the vaporization of floral scent.

  12. Low-frequency scaling of the standard and mixed magnetic field and Müller integral equations

    KAUST Repository

    Bogaert, Ignace; Cools, Kristof; Andriulli, Francesco P.; Bagci, Hakan

    2014-01-01

    The standard and mixed discretizations for the magnetic field integral equation (MFIE) and the Müller integral equation (MUIE) are investigated in the context of low-frequency (LF) scattering problems involving simply connected scatterers

  13. Sentinel Lymph Node Biopsy and Isolated Tumor Cells in Invasive Lobular Versus Ductal Breast Cancer

    NARCIS (Netherlands)

    Truin, Wilfred; Roumen, Rudi M.; Siesling, Sabine; van der Heiden-van der Loo, Margriet; Lobbezoo, Dorien J.; Tjan-Heijnen, Vivianne C.G.; Voogd, Adri C.

    2016-01-01

    Background Sentinel lymph node (SLN) biopsy is the standard of care for axillary staging in invasive breast cancer. The introduction of SLN biopsy with an extensive pathology examination, in addition to the introduction of the 2002 TNM classification, led to different axillary classification

  14. Evaluation of the characteristics of a field emission cathode for use in a Mercury ion trap frequency standard

    Science.gov (United States)

    Christman, J. M.

    1988-01-01

    The performance is reported of a field emission array characterized for the purpose of replacing the filament in a trapped ion frequency standard. This dark electron emitter eliminates the need for the interference filter currently used in the trapped ion standard. While reducing the filament's unwanted light, this filter causes a significant reduction in the signal. The magnetic field associated with the filament is also eliminated, thus potentially improving the present stability of the trapped ion standard. The operation of the filament in the present system is described, as well as the associated concerns. The cathode considered for the filament's replacement is then described along with the experimental system. Experimental results, observations, and conclusions are presented.

  15. Electroweak Higgs boson production in the standard model effective field theory beyond leading order in QCD

    Energy Technology Data Exchange (ETDEWEB)

    Degrande, Celine [CERN, Theory Division, Geneva 23 (Switzerland); Fuks, Benjamin [Sorbonne Universites, UPMC Univ. Paris 06, Paris (France); CNRS, Paris (France); Mawatari, Kentarou [Universite Grenoble-Alpes, Laboratoire de Physique Subatomique et de Cosmologie, Grenoble (France); Vrije Universiteit Brussel, Theoretische Natuurkunde and IIHE/ELEM, International Solvay Institutes, Brussels (Belgium); Mimasu, Ken [University of Sussex, Department of Physics and Astronomy, Brighton (United Kingdom); Universite catholique de Louvain, Centre for Cosmology, Particle Physics and Phenomenology (CP3), Louvain-la-Neuve (Belgium); Sanz, Veronica [University of Sussex, Department of Physics and Astronomy, Brighton (United Kingdom)

    2017-04-15

    We study the impact of dimension-six operators of the standard model effective field theory relevant for vector-boson fusion and associated Higgs boson production at the LHC. We present predictions at the next-to-leading order accuracy in QCD that include matching to parton showers and that rely on fully automated simulations. We show the importance of the subsequent reduction of the theoretical uncertainties in improving the possible discrimination between effective field theory and standard model results, and we demonstrate that the range of the Wilson coefficient values allowed by a global fit to LEP and LHC Run I data can be further constrained by LHC Run II future results. (orig.)

  16. On the Power Dependence of Extraneous Microwave Fields in Atomic Frequency Standards

    Science.gov (United States)

    2005-01-01

    uncertainty”, Metrologia 35 (1998) pp. 829-845. [6] K. Dorenwendt and A. Bauch, “Spurious Microwave Fields in Caesium Atomic Beam Standards...Cesium Beam Clocks Induced by Microwave Leakages”, IEEE Trans. UFFC 45 (1998)728-738. [8] M. Abgrall, “Evaluation des Performances de la Fontaine...Proc of the EFTF 2005 – in press. [12] A. DeMarchi, “The Optically Pumped Caesium Fountain: 10-15 Frequency Accuracy?”, Metrologia 18 (1982) pp

  17. Standard and procedures for measuring and evaluating of the field electromagnetic signals

    International Nuclear Information System (INIS)

    Fallas Cordero, Oscar

    2007-01-01

    Rules and procedures are developed for measuring the intensity of electromagnetic field signals produced by public commercial broadcasters. International and national standards applicable to existing broadcasting area were investigated. The Manual para la Comprobacion Tecnica de las Emisiones of the International Radio Consultative Committee of the International Telecommunications Union was used for reference in the procedures. It was worked in coordination with the Control Nacional de Radio and Radio U to obtain information and to study the teams to present a measurement system for laboratory that meets with the standards suggested and which can encompass a wide range of transmission services. Finally agreed with the analysis and research work done, a series of recommendations were made for improvement, which are considered to implement them in medium and long time. (author) [es

  18. Identification and expression analysis of the IPT and CKX gene families during axillary bud outgrowth in apple (Malus domestica Borkh.).

    Science.gov (United States)

    Tan, Ming; Li, Guofang; Qi, Siyan; Liu, Xiaojie; Chen, Xilong; Ma, Juanjuan; Zhang, Dong; Han, Mingyu

    2018-04-20

    Cytokinins (CKs) play a crucial role in promoting axillary bud outgrowth and targeting the control of CK metabolism can be used to enhance branching in plants. CK levels are maintained mainly by CK biosynthesis (isopentenyl transferase, IPT) and degradation (dehydrogenase, CKX) genes in plants. A systematic study of the IPT and CKX gene families in apple, however, has not been conducted. In the present study, 12 MdIPTs and 12 MdCKXs were identified in the apple genome. Systematic phylogenetic, structural, and synteny analyses were performed. Expression analysis of these genes in different tissues was also assessed. MdIPT and MdCKX genes exhibit distinct expression patterns in different tissues. The response of MdIPT, MdCKX, and MdPIN1 genes to various treatments (6-BA, decapitation and Lovastatin, an inhibitor of CKs synthesis) that impact branching were also investigated. Results indicated that most of the MdIPT and MdCKX, and MdPIN1 genes were upregulated by 6-BA and decapitation treatment, but inhibited by Lovastatin, a compound that effectively suppresses axillary bud outgrowth induced by decapitation. These findings suggest that cytokinin biosynthesis is required for the activation of bud break and the export of auxin from buds in apple tree with intact primary shoot apex or decapitated apple tree. MdCKX8 and MdCKX10, however, exhibited little response to decapitation, but were significantly up-regulated by 6-BA and Lovastatin, a finding that warrants further investigation in order to understand their function in bud-outgrowth. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. The value of delayed 18F-FDG PET/CT imaging for differentiating axillary lymph nodes in breast cancer

    International Nuclear Information System (INIS)

    Ji, Young Sik; Son, Ju Cheol; Park, Cheol Woo

    2013-01-01

    Positron emission tomography/computed tomography (PET/CT) imaging with fluorodeoxyglucose (FDG) have been used as a powerful fusion modality in nuclear medicine not only for detecting cancer but also for staging and therapy monitoring. Nevertheless, there are various causes of FDG uptake in normal and/or benign tissues. The purpose of present study was to investigate whether additional delayed imaging can improve the diagnosis to differentiate the rates of FDG uptake at axillary lymph nodes (ALN) between malignant and benign in breast cancer patients. 180 PET/CT images were obtained for 27 patients with ALN uptake. The patients who had radiotherapy and chemotherapy were excluded from the study. 18 F-FDG PET/CT scan at 50 min (early phase) and 90 min (delayed phase) after 18 F-FDG injection were included in this retrospective study. The staging of cancers was confirmed by final clinical according to radiologic follow-up and pathologic findings. The standardized uptake value (SUV) of ALN was measured at the Syngo Acquisition Workplace by Siemens. The 27 patients included 18 malignant and 9 ALN benign groups and the 18 malignant groups were classified into the 3 groups according to number of metastatic ALN in each patient. ALNs were categorized less than or equal 3 as N1, between 4 to 9 as N2 and more than 10 as N3 group. Results are expressed as the mean ± standard deviation (S.D.) and statistically analyzed by SPSS. As a result, Retention index (RI-SUV max) in metastasis was significantly higher than that in non-metastasis about 5 fold increased. On the other hand, RI-SUV max in N group tended to decrease gradually from N1 to N3. However, we could not prove significance statistically in malignant group with ANOVA. As a consequence, RI-SUV max was good indicator for differentiating ALN positive group from node negative group in breast cancer patients. These results show that dual-time-point scan appears to be useful in distinguishing malignant from benign

  20. The role of postmastectomy radiotherapy in different molecular subtypes of breast cancer patients with T1 - T2 and one to three positive axillary nodes

    International Nuclear Information System (INIS)

    Wang Hao; Luo Yangkun; Wang Jie; Peng Ying; Wen Hao; Wang Weidong; Lang Jinyi

    2011-01-01

    Objective: To analyze the role of postmastectomy radiotherapy in different molecular subtypes of breast cancer patients with Stage T 1 -T 2 and one to three positive axillary nodes. Methods: A total of 436 breast cancer patients with T 1 -T 2 and one to three positive axillary lymph nodes treated with mastectomy and axillary dissection were retrospectively analyzed. Patients were grouped as the following four subtypes:Luminal A, Luminal B, Her 2 + and triple-negative. The local recurrence (LR), distant metastasis ( DM ), disease free survival (DFS) and overall survival (OS) rates were compared between patients with or without radiotherapy in univariate analyses. Multivariate analyses for LR were performed. Results: The follow-up rate was 86. 0%. In patients with Luminal A subtype, radiotherapy decreased the 5-year LR rate (4.6% vs 15.8%, χ 2 =5.74, P=0.017) but had no influences on DM, DFS or OS rates (17.2% vs 19.7%, χ 2 =0.17, P=0.682; 77.0% vs 67.1%, χ 2 =1.99, P=0.158 or 87.4% : 85.5%, χ 2 =0.12, P=0.733). In patients with Luminal B subtype, radiotherapy decreased the 5-year LR rate (3.7% vs 12. 1%, χ 2 =4.13, P =0.042), increased DFS and OS (84.0% vs 57.6% (χ 2 =14.61, P =0.000) and 91.4% vs 70. 7% (χ 2 =11.87, P =0.001), but had no influence on DM (12.3% vs 22.2%, χ 2 =2.97, P =0.085). In patients with Her 2 + subtype, radiotherapy decreased the 5-year LR rate (5.6% vs 31.0%, χ 2 =4.31, P=0.035) , increased DFS (61.1% vs 13.8%, χ 2 =11.44, P=0.001) ,but had no influence on DM and OS (27.8% vs 41.4%, χ 2 =0.89, P =0.345 and 66.7% vs 48.3%, χ 2 =1.52, P =0.218). In patients with triple-negative subtype, radiotherapy had no influence in LR, DM, DFS or OS (8.7% vs 26.1%, χ 2 =2.42, P=0.120; 39.1% vs 47.8%, χ 2 =0.35, P=0.552; 52.2% vs 26.1%, χ 2 =3.29, P =0.070 or 65.2% vs 56.5%, χ 2 =0.37, P =0.546). Tumor size and radiotherapy were independent prognostic factors for LR rate in multivariate analyses (χ 2 =4.76, P =0.029 and χ 2 =8.06, P =0

  1. Brief reports: a clinical evaluation of block characteristics using one milliliter 2% lidocaine in ultrasound-guided axillary brachial plexus block.

    LENUS (Irish Health Repository)

    O'Donnell, Brian

    2010-09-01

    We report onset and duration of ultrasound-guided axillary brachial plexus block using 1 mL of 2% lidocaine with 1:200,000 epinephrine per nerve (total local anesthetic volume 4 mL). Block performance time, block onset time, duration of surgery, and block duration were measured. Seventeen consecutive patients were recruited. The mean (SD) block performance and onset times were 271 (67.9) seconds and 9.7 (3.7) minutes, respectively. Block duration was 160.8 (30.7) minutes. All operations were performed using regional anesthesia alone. The duration of anesthesia obtained is sufficient for most ambulatory hand surgery.

  2. A standardized and safe method of sterile field maintenance during intra-operative horizontal plane fluoroscopy

    Directory of Open Access Journals (Sweden)

    Kaska Serge C

    2010-12-01

    Full Text Available Abstract Background Intra-operative fluoroscopy for orthopaedic procedures frequently involves imaging in the horizontal plane, which requires the lower portion of the C-arm (x-ray tube to be rotated from an unsterile zone (beneath the table into the sterile field. To protect the integrity of the sterile field the C-arm must be draped repeatedly throughout the surgical case. The current, un-standardized, practice employs draping procedures which violate the Association of peri-Operative Registered Nurses (AORN Standards and Recommended Practices, waste time and material, and pose an increased risk for surgical site infection. Presentation of the hypothesis Use of a novel sterile C-arm drape (C-armor that maintains the integrity of the sterile field, will improve operating room efficiency and reduce surgical site infection risk factors. This reduction in risk factors may potentially reduce surgical site infections in orthopaedic surgical cases requiring repeated horizontal x-ray imaging. Testing the Hypothesis Savings in time and material and the reduction in surgical site infection risk factors afforded by using C-armor are intuitive to those skilled in the practice of orthopaedic surgery. Testing for a reduction in the number of microorganisms introduced to the surgical site by improved C-arm draping would be challenging due to the multiple confounding factors during a surgical operation. Determination of an absolute reduction in surgical site infections may be possible, but will require accounting for many confounding variables and a large study sample in order to achieve statistical significance. Implications of the Hypothesis Improved intraoperative workflow, healthcare savings and a reduction in surgical site infection risk factors will be achieved by utilizing a standardized and safe method of sterile field maintenance during intra-operative horizontal plane fluoroscopy.

  3. Standardization of reference radiation field of beta for 85Kr using extrapolation chamber

    International Nuclear Information System (INIS)

    Nazaroh; Fendinugroho

    2013-01-01

    Standardization of reference radiation field of beta for 85 Kr in PTKMR-BATAN Laboratory has been performed at the SDD's 30 cm by using extrapolation chamber detector, coupled with Uni dose electrometer. The result was : (8.98±3 %) mGy/h, at 95 % confidence level. The aim of standardization of reference radiation field is to support radiation protection and safety program, provided by the International Atomic Energy Agency to its Member States, included BATAN-Indonesia, especially, PTKMR. The aim of radiation protection program and safety program is to promote an internationally harmonized approach for radiation measurement in protection level, besides for calibration of radiation measuring instrument, which users spread across Indonesia, with the number of about 795 firms in the year of 2012. These benefits can be felt by workers, communities and the environment, because by calibration, measurement survey meter, pocket dosimeter and TLD to be more accurate so that the radiation dose received by radiation workers is accurate and can be ascertained in a specified period, not to exceed a predetermined NBD by BAPETEN. The aim of this calibration is appropriate with the primary objective of calibration on IAEA/TRS16:2000. (author)

  4. An Assessment of the Need for Standard Variable Names for Airborne Field Campaigns

    Science.gov (United States)

    Beach, A. L., III; Chen, G.; Northup, E. A.; Kusterer, J.; Quam, B. M.

    2017-12-01

    The NASA Earth Venture Program has led to a dramatic increase in airborne observations, requiring updated data management practices with clearly defined data standards and protocols for metadata. An airborne field campaign can involve multiple aircraft and a variety of instruments. It is quite common to have different instruments/techniques measure the same parameter on one or more aircraft platforms. This creates a need to allow instrument Principal Investigators (PIs) to name their variables in a way that would distinguish them across various data sets. A lack of standardization of variables names presents a challenge for data search tools in enabling discovery of similar data across airborne studies, aircraft platforms, and instruments. This was also identified by data users as one of the top issues in data use. One effective approach for mitigating this problem is to enforce variable name standardization, which can effectively map the unique PI variable names to fixed standard names. In order to ensure consistency amongst the standard names, it will be necessary to choose them from a controlled list. However, no such list currently exists despite a number of previous efforts to establish a sufficient list of atmospheric variable names. The Atmospheric Composition Variable Standard Name Working Group was established under the auspices of NASA's Earth Science Data Systems Working Group (ESDSWG) to solicit research community feedback to create a list of standard names that are acceptable to data providers and data users This presentation will discuss the challenges and recommendations of standard variable names in an effort to demonstrate how airborne metadata curation/management can be improved to streamline data ingest, improve interoperability, and discoverability to a broader user community.

  5. Standards for Measurements in the Field of High Frequency Electromagnetic Radiation for the Purpose of Protection Against Adverse Health Effects

    International Nuclear Information System (INIS)

    Tanatarec, B.; Nikolic, N.

    2011-01-01

    In this paper standards for measurements in the field of high frequency electromagnetic radiation are described with a view to protection from its hazardous action. Beside the standards which directly deal with high frequency electromagnetic radiation measurements, guidelines which describe hazardous influences of high frequency electromagnetic radiation on human body in the form of specific absorption rate (SAR) are given. Special attention is dedicated to standards and regulations, which are dealing with social responsibility, as well as with social responsibility in the field of high frequency radiation. This area is new and insufficiently known, rarely extended in everyday life. (author)

  6. Partial axillary lymph node dissection inferior to the intercostobrachial nerves complements sentinel node biopsy in patients with clinically node-negative breast cancer.

    Science.gov (United States)

    Li, Jianyi; Jia, Shi; Zhang, Wenhai; Qiu, Fang; Zhang, Yang; Gu, Xi; Xue, Jinqi

    2015-06-30

    The practice of breast cancer diagnosis and treatment in China varies to that in western developed countries. With the unavailability of radioactive tracer technique for sentinel lymph nodes biopsy (SLNB), using blue dye alone has been the only option in China. Also, the diagnosis of breast malignant tumor in most Chinese centres heavily relies on intraoperative instant frozen histology which is normally followed by sentinel lymph nodes mapping, SLNB and the potential breast and axillary operations in one consecutive session. This practice appears to cause a high false negative rate (FNR) for SLNB. The present study aimed to investigate the impact of the current practice in China on the accuracy of SLNB, and whether partial axillary lymph node dissection (PALND), dissection of lymph nodes inferior to the intercostobrachial nerve (ICBN), was a good complementary procedure following SLNB using blue dye. 289 patients with clinically node-negative breast cancer were identified and recruited. Tumorectomy, intraoperative instant frozen histological diagnosis, SLNB using methylene blue dye, and PALND or complete axillary node dissection (ALND) were performed in one consecutive operative session. The choice of SLNB only, SLNB followed by PALND or by ALND was based on the pre-determined protocol and preoperative choice by the patient. Clinical parameters were analyzed and survival analysis was performed. 37% patients with clinically negative nodes were found nodes positive. 59 patients with positive SLN underwent ALND, including 47 patients with up to two positive nodes which were all located inferior to the ICBN. 9 patients had failed SLNB and underwent PALND. Among them, 3 (33.3%) patients were found to have one metastatic node. 149 patients showed negative SLNB but chose PALND. Among them, 30 (20.1%), 14 (9.4) and 1 (0.7%) patients were found to have one, two and three metastatic node(s), respectively. PALND detected 48 (30.4%) patients who had either failed SLNB or

  7. Risk Factors for Regional Nodal Relapse in Breast Cancer Patients With One to Three Positive Axillary Nodes

    Energy Technology Data Exchange (ETDEWEB)

    Yates, Lucy, E-mail: lucy.yates@gstt.nhs.uk [Guy' s, King' s, St Thomas' Cancer Centre, Guy' s Hospital, London (United Kingdom); Kirby, Anna [Guy' s, King' s, St Thomas' Cancer Centre, Guy' s Hospital, London (United Kingdom); Department of Clinical Oncology, Royal Marsden Hospital, Sutton (United Kingdom); Crichton, Siobhan [Department of Statistics, Kings College London (United Kingdom); Gillett, Cheryl [Breast Pathology, Kings College London (United Kingdom); Cane, Paul [Department of Histopathology, Guy' s and St Thomas' Foundation Trust, London (United Kingdom); Fentiman, Ian; Sawyer, Elinor [Guy' s, King' s, St Thomas' Cancer Centre, Guy' s Hospital, London (United Kingdom)

    2012-04-01

    Purpose: In many centers, supraclavicular fossa radiotherapy (SCF RT) is not routinely offered to breast cancer patients with one to three positive lymph nodes. We aimed to identify a subgroup of these patients who are at high risk of supra or infraclavicular fossa relapse (SCFR) such that they can be offered SCFRT at the time of diagnosis to improve long term locoregional control. Methods and Materials: We performed a retrospective analysis of the pathological features of 1,065 cases of invasive breast cancer with one to three positive axillary lymph nodes. Patients underwent radical breast conserving surgery or mastectomy. A total of 45% of patients received adjuvant chest wall/breast RT. No patients received adjuvant SCFRT. The primary outcome was SCFR. Secondary outcomes were chest wall/breast recurrence, distant metastasis, all death, and breast-cancer specific death. Kaplan-Meier estimates were used to calculate actuarial event rates and survival functions compared using log-rank tests. Multivariate analyses (MVA) of factors associated with outcome were conducted using Cox proportional hazards models. Results: Median follow-up was 9.7 years. SCFR rate was 9.2%. Median time from primary diagnosis to SCFR was 3.4 years (range, 0.7-14.4 years). SCFR was associated with significantly lower 10-year survival (18% vs. 65%; p < 0.001). Higher grade and number of positive lymph nodes were the most significant predictors of SCFR on MVA (p < 0.001). 10 year SCFR rates were less than 1% in all patients with Grade 1 cancers compared with 30% in those having Grade 3 cancers with three positive lymph nodes. Additional factors associated with SCFR on univariate analysis but not on MVA included larger nodal deposits (p = 0.002) and proportion of positive nodes (p = 0.003). Conclusions: Breast cancer patients with one to three positive lymph nodes have a heterogenous risk of SCFR. Patients with two to three positive axillary nodes and/or high-grade disease may warrant

  8. Evaluation of serological diagnostic tests for typhoid fever in Papua New Guinea using a composite reference standard.

    Science.gov (United States)

    Siba, Valentine; Horwood, Paul F; Vanuga, Kilagi; Wapling, Johanna; Sehuko, Rebecca; Siba, Peter M; Greenhill, Andrew R

    2012-11-01

    Typhoid fever remains a major global health problem. A major impediment to improving outcomes is the lack of appropriate diagnostic tools, which have not significantly improved in low-income settings for 100 years. We evaluated two commercially available rapid diagnostic tests (Tubex and TyphiDot), a prototype (TyphiRapid TR-02), and the commonly used single-serum Widal test in a previously reported high-burden area of Papua New Guinea. Samples were collected from 530 outpatients with axillary temperatures of ≥37.5°C, and analysis was conducted on all malaria-negative samples (n = 500). A composite reference standard of blood culture and PCR was used, by which 47 participants (9.4%) were considered typhoid fever positive. The sensitivity and specificity of the Tubex (51.1% and 88.3%, respectively) and TyphiDot (70.0% and 80.1%, respectively) tests were not high enough to warrant their ongoing use in this setting; however, the sensitivity and specificity for the TR-02 prototype were promising (89.4% and 85.0%, respectively). An axillary temperature of ≥38.5°C correlated with typhoid fever (P = 0.014). With an appropriate diagnostic test, conducting typhoid fever diagnosis only on patients with high-grade fever could dramatically decrease the costs associated with diagnosis while having no detrimental impact on the ability to accurately diagnose the illness.

  9. The incidence of breast cancer following mantle field radiation therapy as a function of dose and technique

    International Nuclear Information System (INIS)

    Tinger, Alfred; Wasserman, Todd H.; Klein, Eric E.; Miller, Elizabeth A.; Roberts, Tracy; Piephoff, James V.; Kucik, Nancy A.

    1997-01-01

    Purpose: There is an increased incidence of breast cancer following mantle field radiation therapy for Hodgkin's disease (HD). We reviewed the experience at the Mallinckrodt Institute of Radiology (MIR) for radiation factors related to the development of breast cancer after mantle field radiation therapy for HD. Methods: The radiation therapy records of 152 women treated with mantle field irradiation for HD at MIR between 1966-1985 were reviewed for the development of breast cancer and treatment-related factors. All patients had a minimum of 5 years of follow-up. The treatment era (1966-1974 vs. 1975-1985), stage of HD, mediastinal dose, axillary dose, maximum dose from the anterior field (anterior d max dose), the anterior-posterior:posterior-anterior (AP:PA) ratio, age at the time of treatment, length of follow-up, and history of splenectomy were analyzed as possible contributing factors for the development of breast cancer. The observed number of breast cancers was compared to the expected number based on age-adjusted incidences from the Connecticut Tumor Registry. Results: Ten breast cancers occurred in the population. Eight involved an upper outer quadrant. In a multivariate analysis, the development of breast cancer was significantly associated with axillary dose. Patients in the early treatment era were at an increased risk for the development of breast cancer due to high anterior d max and breast doses from weighting the fields anteriorly on a low energy linear accelerator. The use of current radiation therapy techniques was not related to an increased risk of breast cancer with a median follow-up of 13 years. Conclusions: A high dose to the axilla and the anterior d max point is significantly associated with the development of breast cancer after mantle field irradiation for HD. Efforts to protect the breast from high doses will likely lessen the increased risk of breast cancer in women treated with radiation therapy for HD

  10. [Population genetic differentiation of Phrynocephalus axillaris in east of Xinjiang Uygur Autonomous Region based on sequence variation of mitochondrial ND4-tRNALeu gene].

    Science.gov (United States)

    Li, Jun; Guo, Xian-Guang; Wang, Yue-Zhao

    2010-08-01

    A 838 bp fragment of mtDNA ND4-tRNALeu gene was sequenced for 66 individuals from five populations (DB: Dabancheng, TU: Turpan, SS: Shanshan, HL: Liushuquan, HD: East district of Hami) of Phrynocephalus axillaris distributed in east of Xinjiang Uygur Autonomous Region. Seventeen haplotypes were identified from 29 nucleotide polymorphic sites in the aligned 838 bp sequence. Excluding DB, there were relatively high haplotype diversity [(0.600+/-0.113)oscillation since Pleistocene and genetic drift.

  11. Particles, fields, quanta. From quantum mechanics to the Standard Model of particle physics; Teilchen, Felder, Quanten. Von der Quantenmechanik zum Standardmodell der Teilchenphysik

    Energy Technology Data Exchange (ETDEWEB)

    Ecker, Gerhard [Wien Univ. (Austria). Fakultaet fuer Physik

    2017-07-01

    The following topics are dealt with: Physics around 1900, the way to quantum mechanics, quantum field theory with quantum electrodynamics as prototype, the crisis of quantum field theory, from the beta decay to the electroweak gauge theory, quantum chromodynamics as quantum field theory of the strong nuclear force, the standard model of the fundamental interactions, physics beyond the standard model. (HSI)

  12. Novel 755-nm diode laser vs. conventional 755-nm scanned alexandrite laser: Side-by-side comparison pilot study for thorax and axillary hair removal.

    Science.gov (United States)

    Paasch, Uwe; Wagner, Justinus A; Paasch, Hartmut W

    2015-01-01

    Alexandrite (755 nm) and diode lasers (800-810 nm) are commonly used for hair removal. The alexandrite laser technology is somewhat cumbersome whereas new diode lasers are more robust. Recently, alexandrite-like 755 nm wavelength diodes became available. To compare the efficacy, tolerability, and subject satisfaction of a 755 nm diode laser operated in conventional (HR) and non-conventional in-motion (SHR) modes with a conventional scanned alexandrite 755 nm laser for chest and axillary hair removal. A prospective, single-center, proof of principle study was designed to evaluate the safety, efficacy and handling of a 755 nm diode laser system in comparison to a standard alexandrite 755 nm scanning hair removal laser. The new 755 nm diode is suitable to be used in SHR and HR mode and has been tested for its safety, efficacy and handling in a volunteer with success. Overall, both systems showed a high efficacy in hair reduction (88.8% 755 nm diode laser vs. 77.7% 755 nm alexandrite laser). Also, during the study period, no severe adverse effects were reported. The new 755 nm diode laser is as effective and safe as the traditional 755 nm alexandrite laser. Additionally, treatment with the 755 nm diode laser with HR and SHR modes was found to be less painful.

  13. Surgical complications associated with sentinel lymph node dissection (SLND) plus axillary lymph node dissection compared with SLND alone in the American College of Surgeons Oncology Group Trial Z0011.

    Science.gov (United States)

    Lucci, Anthony; McCall, Linda Mackie; Beitsch, Peter D; Whitworth, Patrick W; Reintgen, Douglas S; Blumencranz, Peter W; Leitch, A Marilyn; Saha, Sukumal; Hunt, Kelly K; Giuliano, Armando E

    2007-08-20

    The American College of Surgeons Oncology Group trial Z0011 was a prospective, randomized, multicenter trial comparing overall survival between patients with positive sentinel lymph nodes (SLNs) who did and did not undergo axillary lymph node dissection (ALND). The current study compares complications associated with SLN dissection (SLND) plus ALND, versus SLND alone. From May 1999 to December 2004, 891 patients were randomly assigned to SLND + ALND (n = 445) or SLND alone (n = 446). Information on wound infection, axillary seroma, paresthesia, brachial plexus injury (BPI), and lymphedema was available for 821 patients. Adverse surgical effects were reported in 70% (278 of 399) of patients after SLND + ALND and 25% (103 of 411) after SLND alone (P alone group. At 1 year, lymphedema was reported subjectively by 13% (37 of 288) of patients after SLND + ALND and 2% (six of 268) after SLND alone (P alone. Lymphedema was more common after SLND + ALND but was significantly different only by subjective report. The use of SLND alone resulted in fewer complications.

  14. The value of delayed {sup 18}F-FDG PET/CT imaging for differentiating axillary lymph nodes in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ji, Young Sik; Son, Ju Cheol [Dept. of Nuclear Medicine, Dongnam Institute of Radiological and Medical Sciences Cancer Center, Busan (Korea, Republic of); Park, Cheol Woo [Dept. of Radiological Technology Dong-Eui Institute of Technology, Busan (Korea, Republic of)

    2013-12-15

    Positron emission tomography/computed tomography (PET/CT) imaging with fluorodeoxyglucose (FDG) have been used as a powerful fusion modality in nuclear medicine not only for detecting cancer but also for staging and therapy monitoring. Nevertheless, there are various causes of FDG uptake in normal and/or benign tissues. The purpose of present study was to investigate whether additional delayed imaging can improve the diagnosis to differentiate the rates of FDG uptake at axillary lymph nodes (ALN) between malignant and benign in breast cancer patients. 180 PET/CT images were obtained for 27 patients with ALN uptake. The patients who had radiotherapy and chemotherapy were excluded from the study. {sup 18}F-FDG PET/CT scan at 50 min (early phase) and 90 min (delayed phase) after {sup 18}F-FDG injection were included in this retrospective study. The staging of cancers was confirmed by final clinical according to radiologic follow-up and pathologic findings. The standardized uptake value (SUV) of ALN was measured at the Syngo Acquisition Workplace by Siemens. The 27 patients included 18 malignant and 9 ALN benign groups and the 18 malignant groups were classified into the 3 groups according to number of metastatic ALN in each patient. ALNs were categorized less than or equal 3 as N1, between 4 to 9 as N2 and more than 10 as N3 group. Results are expressed as the mean ± standard deviation (S.D.) and statistically analyzed by SPSS. As a result, Retention index (RI-SUV max) in metastasis was significantly higher than that in non-metastasis about 5 fold increased. On the other hand, RI-SUV max in N group tended to decrease gradually from N1 to N3. However, we could not prove significance statistically in malignant group with ANOVA. As a consequence, RI-SUV max was good indicator for differentiating ALN positive group from node negative group in breast cancer patients. These results show that dual-time-point scan appears to be useful in distinguishing malignant from benign.

  15. Development of the 60Co gamma-ray standard field for therapy-level dosimeter calibration in terms of absorbed dose to water (ND,W)

    International Nuclear Information System (INIS)

    Fukumura, Akifumi; Mizuno, Hideyuki; Fukahori, Mai; Sakata, Suoh

    2013-01-01

    A primary standard for the absorbed dose rate to water in a 60 Co gamma-ray field was established at National Metrology Institute of Japan (NMIJ) in fiscal year 2011. Then, a 60 Co gamma-ray standard field for therapy-level dosimeter calibration in terms of absorbed dose to water was developed at National Institute of Radiological Sciences (NIRS) as a secondary standard dosimetry laboratory (SSDL). The results of an International Atomic Energy Agency (IAEA)/World Health Organization (WHO) TLD SSDL audit demonstrated that there was good agreement between NIRS stated absorbed dose to water and IAEA measurements. The IAEA guide based on the International Organization for Standardization (ISO) standard was used to estimate the relative expanded uncertainty of the calibration factor for a therapy-level Farmer type ionization chamber in terms of absorbed dose to water (N D,W ) with the new field. The uncertainty of N D,W was estimated to be 1.1% (k=2), which corresponds to approximately one third of the value determined in the existing air kerma field. The dissemination of traceability of the calibration factor determined in the new field is expected to diminish the uncertainty of dose delivered to patients significantly. (author)

  16. The application of standard definitions of sound to the fields of underwater acoustics and acoustical oceanography

    Science.gov (United States)

    Carey, William M.

    2004-05-01

    Recent societal concerns have focused attention on the use of sound as a probe to investigate the oceans and its use in naval sonar applications. The concern is the impact the use of sound may have on marine mammals and fishes. The focus has changed the fields of acoustical oceanography (AO) and underwater acoustics (UW) because of the requirement to communicate between disciplines. Multiple National Research Council publications, Dept. of Navy reports, and several monographs have been written on this subject, and each reveals the importance as well as the misapplication of ASA standards. The ANSI-ASA standards are comprehensive, however not widely applied. The clear definition of standards and recommendations of their use is needed for both scientists and government agencies. Traditionally the U.S. Navy has been responsible for UW standards and calibration; the ANSI-ASA standards have been essential. However, recent changes in the Navy and its laboratory structure may necessitate a more formal recognition of ANSI-ASA standards and perhaps incorporation of UW-AO in the Bureau of Standards. A separate standard for acoustical terminology, reference levels, and notation used in the UW-AO is required. Since the problem is global, a standard should be compatible and cross referenced with the International Standard (CEI/IEC 27-3).

  17. Chiral phase transition of three flavor QCD with nonzero magnetic field using standard staggered fermions

    Science.gov (United States)

    Tomiya, Akio; Ding, Heng-Tong; Mukherjee, Swagato; Schmidt, Christian; Wang, Xiao-Dan

    2018-03-01

    Lattice simulations for (2+1)-flavor QCD with external magnetic field demon-strated that the quark mass is one of the important parameters responsible for the (inverse) magnetic catalysis. We discuss the dependences of chiral condensates and susceptibilities, the Polyakov loop on the magnetic field and quark mass in three degenerate flavor QCD. The lattice simulations are performed using standard staggered fermions and the plaquette action with spatial sizes Nσ = 16 and 24 and a fixed temporal size Nτ = 4. The value of the quark masses are chosen such that the system undergoes a first order chiral phase transition and crossover with zero magnetic field. We find that in light mass regime, the quark chiral condensate undergoes magnetic catalysis in the whole temperature region and the phase transition tend to become stronger as the magnetic field increases. In crossover regime, deconfinement transition temperature is shifted by the magnetic field when quark mass ma is less than 0:4. The lattice cutoff effects are also discussed.

  18. Evaluation of the Effects of Pasireotide LAR Administration on Lymphocele Prevention after Axillary Node Dissection for Breast Cancer: Results of a Randomized Non-Comparative Phase 2 Study.

    Directory of Open Access Journals (Sweden)

    Elisabeth Chéreau

    Full Text Available The aim of this study was to assess the efficacy (response rate centered on 80% of a somatostatin analog with high affinity for 4 somatostatin receptors in reducing the postoperative incidence of symptomatic lymphocele formation following total mastectomy with axillary lymph node dissection.This prospective, double-blind, randomised, placebo-controlled, phase 2 trial was conducted in two secondary care centres.All female patients for whom mastectomy and axillary lymph node dissection were indicated were eligible for the study, including patients who had received neo-adjuvant chemotherapy. Main exclusion criteria were related to diabetes, cardiac insufficiency, disorder of cardiac conduction or hepatic failure.Patients were randomised to receive one injection of either prolonged-release pasireotide 60 mg or placebo (physiological serum, which were administered intramuscularly 7 to 10 days before the scheduled surgery. The study was conducted in a double-blind manner.The primary outcome measure was the percentage of patients who did not develop post-operative axillary symptomatic lymphoceles during the 2 postoperative months. Secondary endpoints were the total quantity of lymph drained, duration and daily volume of drainage and aspirated volumes of lymph.Ninety-one patients were randomised. Ninety patients were evaluable: 42 patients received pasireotide, and 48 patients received placebo. The mean estimated response rate were 62.4% (95% Credibility Interval [CrI]: 48.6%-75.3% in the treatment group and 50.2% (95% CrI: 37.6%-62.8% in the placebo group. Overall safety was comparable across groups, and one serious adverse event occurred. In the treatment group, one patient with known insulin-depe*ndent diabetes required hospitalization for hyperglycaemia.With this phase 2 preliminary study, even if our results indicate a trend towards a reduction in symptomatic lymphocele, pre-operative injection of pasireotide failed to achieve a response rate

  19. Axillary node metastatic carcinoma without definitive primary: a case report

    Directory of Open Access Journals (Sweden)

    Spencer R. Anderson

    2016-01-01

    Full Text Available Cancer of unknown primary (CUP is the finding of a metastatic cancerous lesion without an established primary source localized within the body. CUP can be of any cancer cell type, however, adenocarcinoma is most often identified by histology. Up to 5% of all malignant diagnoses are classified as CUP. PET is an imaging modality often utilized to distinguish a primary source in the setting of CUP, yet often a primary is never identified. CUP can be further stratified using specific qualifiers as favorable and unfavorable, indicating the potential therapeutic response to treatment regimens. Treatment approach to CUP relies heavily on the cell type identified by histology, the location of the lesion, and the amount of spread within the body. In the typical setting and presentation, per current literature, CUP arises in the 7th decade of life in patients with multiple comorbidities, and often has a poor prognostic value. This case report identifies an atypical presentation of CUP, a 38-year-old Caucasian female with an axillary mobile mass, and no associated systemic symptoms. Biopsy of the node and immunohistochemical staining showed histology consistent with metastatic carcinoma. Mammography, MRI, and PET scan found no evidence of tumor primary or distant metastasis. Further staining confirmed metastatic carcinoma consistent with breast origin, without an established breast primary. As in this case, CUP may present in an atypical manner, warranting a thorough investigation aiming to identify the tumor primary to aid in identification of a proper treatment regimen and approach.

  20. μ-TPC: a future standard instrument for low energy neutron field characterization

    International Nuclear Information System (INIS)

    Maire, D.; Lebreton, L.; Petit, M.; Billard, J.; Bourrion, O.; Bosson, G.; Guillaudin, O.; Lamblin, J.; Mayet, F.; Medard, J.; Muraz, J.F.; Richer, J.P.; Riffard, Q.; Santos, D.

    2013-06-01

    In order to measure energy of neutron fields, with energy ranging from 8 keV to 1 MeV, a new primary standard is being developed at the IRSN (Institute for Radioprotection and Nuclear Safety). This project, μ-TPC (Micro Time Projection Chamber), carried out in collaboration with the LPSC (Laboratoire de Physique Subatomique et de Cosmologie), is based on the nucleus recoil detector principle. The instrument will be presented with the associated method to measure the neutron energy. This article will emphasize the proton energy calibration procedure and energy measurements of a neutron field produced at 127 keV on the IRSN facility AMANDE. Finally the COMIMAC device, dedicated to the calibration, will be described. This original device, developed at the LPSC, is able to produce proton and electron beams with an accurate energy ranging from 1 keV to 50 keV. (authors)

  1. Molecular Heterogeneity in Primary Breast Carcinomas and Axillary Lymph Node Metastases Assessed by Genomic Fingerprinting Analysis

    Science.gov (United States)

    Ellsworth, Rachel E; Toro, Allyson L; Blackburn, Heather L; Decewicz, Alisha; Deyarmin, Brenda; Mamula, Kimberly A; Costantino, Nicholas S; Hooke, Jeffrey A; Shriver, Craig D; Ellsworth, Darrell L

    2015-01-01

    Molecular heterogeneity within primary breast carcinomas and among axillary lymph node (LN) metastases may impact diagnosis and confound treatment. In this study, we used short tandem repeated sequences to assess genomic heterogeneity and to determine hereditary relationships among primary tumor areas and regional metastases from 30 breast cancer patients. We found that primary carcinomas were genetically heterogeneous and sampling multiple areas was necessary to adequately assess genomic variability. LN metastases appeared to originate at different time periods during disease progression from different sites of the primary tumor and the extent of genomic divergence among regional metastases was associated with a less favorable patient outcome (P = 0.009). In conclusion, metastasis is a complex process influenced by primary tumor heterogeneity and variability in the timing of dissemination. Genomic variation in primary breast tumors and regional metastases may negatively impact clinical diagnostics and contribute to therapeutic resistance. PMID:26279627

  2. Molecular Heterogeneity in Primary Breast Carcinomas and Axillary Lymph Node Metastases Assessed by Genomic Fingerprinting Analysis

    Directory of Open Access Journals (Sweden)

    Rachel E. Ellsworth

    2015-01-01

    Full Text Available Molecular heterogeneity within primary breast carcinomas and among axillary lymph node (LN metastases may impact diagnosis and confound treatment. In this study, we used short tandem repeated sequences to assess genomic heterogeneity and to determine hereditary relationships among primary tumor areas and regional metastases from 30 breast cancer patients. We found that primary carcinomas were genetically heterogeneous and sampling multiple areas was necessary to adequately assess genomic variability. LN metastases appeared to originate at different time periods during disease progression from different sites of the primary tumor and the extent of genomic divergence among regional metastases was associated with a less favorable patient outcome ( P = 0.009. In conclusion, metastasis is a complex process influenced by primary tumor heterogeneity and variability in the timing of dissemination. Genomic variation in primary breast tumors and regional metastases may negatively impact clinical diagnostics and contribute to therapeutic resistance.

  3. Case Report and Dosimetric Analysis of an Axillary Recurrence After Partial Breast Irradiation with Mammosite Catheter

    International Nuclear Information System (INIS)

    Shah, Anand P.; Dickler, Adam; Kirk, Michael C.; Chen, Sea S.; Strauss, Jonathan B.; Coon, Alan B.; Turian, Julius V.; Siziopikou, Kalliopi; Dowlat, Kambiz; Griem, Katherine L.

    2008-01-01

    Partial breast irradiation (PBI) was designed in part to decrease overall treatment times associated with whole breast radiation therapy (WBRT). WBRT treats the entire breast and usually portions of the axilla. The goal of PBI is to treat a smaller volume of breast tissue in less time, focusing the dose around the lumpectomy cavity. The following is a case of a 64-year-old woman with early-stage breast cancer treated with PBI who failed regionally in the ipsilateral axilla. With our dosimetric analysis, we found that the entire area of this axillary failure would have likely received at least 45 Gy if WBRT had been used, enough to sterilize microscopic disease. With PBI, this area received a mean dose of only 2.8 Gy, which raises the possibility that this regional failure may have been prevented had WBRT been used instead of PBI

  4. Low-frequency scaling of the standard and mixed magnetic field and Müller integral equations

    KAUST Repository

    Bogaert, Ignace

    2014-02-01

    The standard and mixed discretizations for the magnetic field integral equation (MFIE) and the Müller integral equation (MUIE) are investigated in the context of low-frequency (LF) scattering problems involving simply connected scatterers. It is proved that, at low frequencies, the frequency scaling of the nonsolenoidal part of the solution current can be incorrect for the standard discretization. In addition, it is proved that the frequency scaling obtained with the mixed discretization is correct. The reason for this problem in the standard discretization scheme is the absence of exact solenoidal currents in the rotated RWG finite element space. The adoption of the mixed discretization scheme eliminates this problem and leads to a well-conditioned system of linear equations that remains accurate at low frequencies. Numerical results confirm these theoretical predictions and also show that, when the frequency is lowered, a finer and finer mesh is required to keep the accuracy constant with the standard discretization. © 1963-2012 IEEE.

  5. Comparison of Arthroscopically Guided Suprascapular Nerve Block and Blinded Axillary Nerve Block vs. Blinded Suprascapular Nerve Block in Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial

    OpenAIRE

    Ko, Sang Hun; Cho, Sung Do; Lee, Chae Chil; Choi, Jang Kyu; Kim, Han Wook; Park, Seon Jae; Bae, Mun Hee; Cha, Jae Ryong

    2017-01-01

    Background The purpose of this study was to compare the results of arthroscopically guided suprascapular nerve block (SSNB) and blinded axillary nerve block with those of blinded SSNB in terms of postoperative pain and satisfaction within the first 48 hours after arthroscopic rotator cuff repair. Methods Forty patients who underwent arthroscopic rotator cuff repair for medium-sized full thickness rotator cuff tears were included in this study. Among them, 20 patients were randomly assigned to...

  6. Lymphedema of the arm and breast in irradiated breast cancer patients: risks in an era of dramatically changing axillary surgery.

    Science.gov (United States)

    Goffman, Thomas E; Laronga, Christine; Wilson, Lori; Elkins, David

    2004-01-01

    The purpose of this study was to assess risk for lymphedema of the breast and arm in radiotherapy patients in an era of less extensive axillary surgery. Breast cancer patients treated for cure were reviewed, with a minimum follow-up of 1.5 years from the end of treatment. Clinical, surgical, and radiation-related variables were tested for statistical association with arm and breast lymphedema using regression analyses, t-tests, and chi-squared analyses. Between January 1998 and June 2001, 240 women received radiation for localized breast cancer in our center. The incidence of lymphedema of the ipsilateral breast, arm, and combined (breast and arm) was 9.6%, 7.6%, and 1.8%, respectively, with a median follow-up of 27 months. For breast edema, t-test and multivariate analysis showed body mass index (BMI) to be significant (p = 0.043, p = 0.0038), as was chi-squared and multivariate testing for site of tumor in the breast (p = 0.0043, p = 0.0035). For arm edema, t-test and multivariate analyses showed the number of nodes removed to be significant (p = 0.0040, p = 0.0458); the size of the tumor was also significant by multivariate analyses (p = 0.0027). Tumor size appeared significant because a number of very large cancers failed locally and caused cancer-related obstructive lymphedema. In our center, even modern, limited level 1-2 axillary dissection and tangential irradiation carries the risk of arm lymphedema that would argue in favor of sentinel node biopsy. For breast edema, disruption of draining lymphatics by surgery and radiation with boost to the upper outer quadrant increased risk, especially for the obese. Fortunately both breast and arm edema benefited from manual lymphatic drainage.

  7. Development of Web tools to predict axillary lymph node metastasis and pathological response to neoadjuvant chemotherapy in breast cancer patients.

    Science.gov (United States)

    Sugimoto, Masahiro; Takada, Masahiro; Toi, Masakazu

    2014-12-09

    Nomograms are a standard computational tool to predict the likelihood of an outcome using multiple available patient features. We have developed a more powerful data mining methodology, to predict axillary lymph node (AxLN) metastasis and response to neoadjuvant chemotherapy (NAC) in primary breast cancer patients. We developed websites to use these tools. The tools calculate the probability of AxLN metastasis (AxLN model) and pathological complete response to NAC (NAC model). As a calculation algorithm, we employed a decision tree-based prediction model known as the alternative decision tree (ADTree), which is an analog development of if-then type decision trees. An ensemble technique was used to combine multiple ADTree predictions, resulting in higher generalization abilities and robustness against missing values. The AxLN model was developed with training datasets (n=148) and test datasets (n=143), and validated using an independent cohort (n=174), yielding an area under the receiver operating characteristic curve (AUC) of 0.768. The NAC model was developed and validated with n=150 and n=173 datasets from a randomized controlled trial, yielding an AUC of 0.787. AxLN and NAC models require users to input up to 17 and 16 variables, respectively. These include pathological features, including human epidermal growth factor receptor 2 (HER2) status and imaging findings. Each input variable has an option of "unknown," to facilitate prediction for cases with missing values. The websites developed facilitate the use of these tools, and serve as a database for accumulating new datasets.

  8. Gravitational Field as a Pressure Force from Logarithmic Lagrangians and Non-Standard Hamiltonians: The Case of Stellar Halo of Milky Way

    Science.gov (United States)

    El-Nabulsi, Rami Ahmad

    2018-03-01

    Recently, the notion of non-standard Lagrangians was discussed widely in literature in an attempt to explore the inverse variational problem of nonlinear differential equations. Different forms of non-standard Lagrangians were introduced in literature and have revealed nice mathematical and physical properties. One interesting form related to the inverse variational problem is the logarithmic Lagrangian, which has a number of motivating features related to the Liénard-type and Emden nonlinear differential equations. Such types of Lagrangians lead to nonlinear dynamics based on non-standard Hamiltonians. In this communication, we show that some new dynamical properties are obtained in stellar dynamics if standard Lagrangians are replaced by Logarithmic Lagrangians and their corresponding non-standard Hamiltonians. One interesting consequence concerns the emergence of an extra pressure term, which is related to the gravitational field suggesting that gravitation may act as a pressure in a strong gravitational field. The case of the stellar halo of the Milky Way is considered.

  9. How to use the Standard Model effective field theory

    Energy Technology Data Exchange (ETDEWEB)

    Henning, Brian; Lu, Xiaochuan [Department of Physics, University of California, Berkeley,Berkeley, California 94720 (United States); Theoretical Physics Group, Lawrence Berkeley National Laboratory,Berkeley, California 94720 (United States); Murayama, Hitoshi [Department of Physics, University of California, Berkeley,Berkeley, California 94720 (United States); Theoretical Physics Group, Lawrence Berkeley National Laboratory,Berkeley, California 94720 (United States); Kavli Institute for the Physics and Mathematics of the Universe (WPI),Todai Institutes for Advanced Study, University of Tokyo,Kashiwa 277-8583 (Japan)

    2016-01-05

    We present a practical three-step procedure of using the Standard Model effective field theory (SM EFT) to connect ultraviolet (UV) models of new physics with weak scale precision observables. With this procedure, one can interpret precision measurements as constraints on a given UV model. We give a detailed explanation for calculating the effective action up to one-loop order in a manifestly gauge covariant fashion. This covariant derivative expansion method dramatically simplifies the process of matching a UV model with the SM EFT, and also makes available a universal formalism that is easy to use for a variety of UV models. A few general aspects of RG running effects and choosing operator bases are discussed. Finally, we provide mapping results between the bosonic sector of the SM EFT and a complete set of precision electroweak and Higgs observables to which present and near future experiments are sensitive. Many results and tools which should prove useful to those wishing to use the SM EFT are detailed in several appendices.

  10. Concordance Between FISH Analysis of Her-2/Neu Gene in Breast Duct Carcinoma and Corresponding Axillary Nodal Metastases: Egyptian National Cancer Institute Experience.

    Science.gov (United States)

    Badawy, Omnia M; Hassan, Hannan; ELBakey, Heba A; Mosaad, Maha

    2018-05-10

    Breast cancer is a major health problem in Egypt. Her-2/Neu gene is routinely assessed for all breast cancer patients primarily by immunohistochemistry. At National Cancer Institute (NCI), Cairo University, Flourescence In Situ hybridization (FISH) analysis of Her-2/Neu gene is carried out for Her-2/Neu score 2 and for some cases of score 3 (particularly those assessed outside NCI). The test is performed essentially on the primary tumor. However, some situations require testing on corresponding lymph node metastases. There is a debate about the concordance between Her-2/Neu status in the primary tumor and synchronous lymph node metastases in various studies. The aim of this study was to test for the concordance between Her-2/Neu status in the primary breast tumor and corresponding axillary nodal metastases. This is a retrospective study in which FISH analysis of Her-2/Neu was carried out simultaneously on archived material of 50 cases previously diagnosed as invasive duct carcinoma and the corresponding nodal metastases from the Pathology Department, NCI. There was complete concordance between Her-2 status in the primary tumor and the corresponding axillary lymph node metastatic deposits in which Her-2 was amplified in 44% of the studied cohort of Egyptian patients. Her-2/Neu gene assessed by FISH analysis on synchronous lymph node metastases is strongly correlated with the primary tumor. Hence, it is justified to carry out the Her-2/Neu test on synchronous lymph nodes to decide on whether to carry out anti-Her-2/Neu target therapy. Further studies on other metastatic sites is recommended.

  11. Micrococcus yunnanensis sp. nov., a novel actinobacterium isolated from surface-sterilized Polyspora axillaris roots.

    Science.gov (United States)

    Zhao, Guo-Zhen; Li, Jie; Qin, Sheng; Zhang, Yu-Qin; Zhu, Wen-Yong; Jiang, Cheng-Lin; Xu, Li-Hua; Li, Wen-Jun

    2009-10-01

    In this study, strain YIM 65004(T), isolated from roots of Polyspora axillaris, was shown to represent a novel species of the genus Micrococcus by means of a polyphasic approach. Chemotaxonomic data gathered for peptidoglycan type, menaquinones, phospholipids and fatty acids strongly supported the classification of this strain within the genus Micrococcus: the cell-wall peptidoglycan contained lysine, glutamic acid, alanine, glycine and aspartic acid, the predominant menaquinones were MK-8(H(2)) (66.97 %) and MK-7(H(2)) (23.26 %), the phospholipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylinositol and an unknown ninhydrin-negative phospholipid, and the major cellular fatty acids were anteiso-C(15 : 0) (61.98 %), iso-C(16 : 0) (14.25 %) and iso-C(15 : 0) (13.04 %). The G+C content of the genomic DNA was 71.7 mol%. A number of physiological features were found that clearly distinguished strain YIM 65004(T) from recognized Micrococcus species. DNA-DNA hybridization studies suggested that the novel strain represents a separate genomic species. Based on the above data, a novel species of the genus Micrococcus, Micrococcus yunnanensis sp. nov., is proposed, with the type strain YIM 65004(T) (=CCTCC AA 208060(T)=DSM 21948(T)).

  12. Treatment of primary axillary hyperhidrosis by fractional microneedle radiofrequency: Is it still effective after long-term follow-up?

    Directory of Open Access Journals (Sweden)

    Bahareh Abtahi-Naeini

    2016-01-01

    Full Text Available Background: Primary axillary hyperhidrosis (PAH is a chronic idiopathic disorder causing major stress in patients. Among the common therapies for PAH, only surgical interventions have proven feasible as a permanent solution. Objective and Aim: The aim of this study was to evaluate the efficacy and safety of fractional microneedle radiofrequency (FMR as an alternative permanent treatment for PAH with long-term follow-up. Materials and Methods: This was a single-blind, sham-controlled comparative study. Twenty-five patients with severe PAH were provided three treatments of FMR at 3-week intervals (the treatment group, and a control group was provided the sham treatment. Clinical efficacy was evaluated using the hyperhidrosis disease severity scale (HDSS at baseline and the end of the study, as well as during the 1 year follow-up phase. Results: HDSS demonstrated significant improvement after treatment in the treatment group compared to the sham control. The mean (±standard deviation of HDSS in the group being treated with radiofrequency was 2.50 (±0.88 after 1 year follow-up, and that of the control group was 3.38 (±0.49; P < 0.001. Follow-up results show that there were 10 patients (41.6% with no relapse and 11 patients (45.9% with relapse after 1 year. There was a significant correlation between HDSS changes in relapse and body mass index (BMI (P = 0.03. Conclusion: Treatment of PAH with FMR is a safe and noninvasive procedure with a positive therapeutic effect on HDSS. It is recommended, however, that sessions of FMR be repeated after 1 year, particularly in overweight patients with high BMIs. Clinical Trial Registration: IRCT2013111915455N1. Level of Evidences: Level II-1.

  13. Fine-needle aspirates CYFRA 21-1 is a useful tumor marker for detecting axillary lymph node metastasis in breast cancer patients.

    Directory of Open Access Journals (Sweden)

    Jung Hyun Yoon

    Full Text Available INTRODUCTION: To assess whether the value of CYFRA21-1 in the aspirates of ultrasonography-guided fine-needle aspiration biopsy (US-FNAB can contribute to improving the performances of US-FNAB in the diagnosis of axillary lymph node (LN metastasis in breast cancer patients. METHODS: US-FNAB was performed in 156 axillary LNs in 152 breast cancer patients (mean age: 51.4 years, range: 17-92 years. Concentrations of CYFRA21-1 were measured from washouts of the syringe used during US-FNAB. Tumor marker concentrations, US-FNAB, intraoperative sentinel node biopsy (SNB, and surgical pathology results were reviewed and analyzed. For comparison, the values of CEA and CA15-3 were also measured from washouts. RESULTS: Among the 156 LNs, 75 (48.1% were benign, and 81 (51.9% were metastases. Mean concentrations of CYFRA21-1 were significantly higher in metastasis compared to benign LNs (P<0.001. US-FNAB combined to CYFRA21-1 showed significantly higher sensitivity, NPV, and accuracy compared to US-FNAB alone (all values P<0.05. All diagnostic indices of US-FNAB combined to CYFRA21-1 were significantly higher compared to US-FNAB combined with CEA or CA15-3 (all P<0.001. Of the 28 metastatic LNs which showed metastasis on SNB, CYFRA21-1 showed higher positive rate of 75.0% (CEA or CA15-3∶60.7%, P = 0.076. CONCLUSION: Measuring CYFRA 21-1 concentrations from US-FNAB aspirates improves sensitivity, NPV, and accuracy of US-FNAB alone, and may contribute to reducing up to 75.0% of unnecessary intraoperative SNB. Compared to CEA or CA15-3, CYFRA21-1 shows significantly higher performances when combined to US-FNAB in the preoperative diagnosis of LN metastasis in breast cancer patients.

  14. The clinical importance of axillary lymphadenopathy detected on screening mammography: revisited

    International Nuclear Information System (INIS)

    Patel, T.; Given-Wilson, R.M.; Thomas, V.

    2005-01-01

    AIM: The aim of this study was to re-evaluate our protocol for the management of isolated axillary lymphadenopathy (ALP) on mammographic screening. METHODS: In a retrospective review of 200,716 women screened at the South West London Breast Screening Service (SWLBSS) over 7 years, 72 women with ALP with an otherwise normal mammogram were identified. Thirteen patients were not recalled, nine of who had a known underlying diagnosis and the remainder had longstanding unchanged mammograms. Fifty-nine patients were recalled for further clinical assessment and investigations, including ultrasound, further mammographic views, fine-needle aspiration cytology (FNAC), blood tests and a chest radiograph. Those with a definite diagnosis were referred for appropriate management and those with benign reactive cytology on FNAC reviewed at 6 weeks with subsequent referral for excision of persisting abnormal nodes. RESULTS: The ultimate diagnosis was benign in 45 cases: 26 benign reactive changes, 11 arthritides, five with dermatological and viral conditions and three with tuberculosis. Malignancy was diagnosed in 13 cases: four with metastatic breast carcinoma and nine with lymphoma/leukaemia. The total number of newly diagnosed malignancies was 20% of women recalled. Another 5% of patients had active tuberculosis. Of the 22 patients with benign reactive cytology, one had significant pathology on excision biopsy: tuberculosis. Over 95% of the results from excision biopsy in these patients did not alter management. CONCLUSION: In the majority of patients, the FNAC results were representative of the final excision pathology. The present study suggests that excision biopsy could be omitted for those patients whose FNAC and culture are negative

  15. Comparison of visual field test results obtained through Humphrey matrix frequency doubling technology perimetry versus standard automated perimetry in healthy children.

    Science.gov (United States)

    Kocabeyoglu, Sibel; Uzun, Salih; Mocan, Mehmet Cem; Bozkurt, Banu; Irkec, Murat; Orhan, Mehmet

    2013-10-01

    The aim of this study was to compare the visual field test results in healthy children obtained via the Humphrey matrix 24-2 threshold program and standard automated perimetry (SAP) using the Swedish interactive threshold algorithm (SITA)-Standard 24-2 test. This prospective study included 55 healthy children without ocular or systemic disorders who underwent both SAP and frequency doubling technology (FDT) perimetry visual field testing. Visual field test reliability indices, test duration, global indices (mean deviation [MD], and pattern standard deviation [PSD]) were compared between the 2 tests using the Wilcoxon signed-rank test and paired t-test. The performance of the Humphrey field analyzer (HFA) 24-2 SITA-standard and frequency-doubling technology Matrix 24-2 tests between genders were compared with Mann-Whitney U-test. Fifty-five healthy children with a mean age of 12.2 ± 1.9 years (range from 8 years to 16 years) were included in this prospective study. The test durations of SAP and FDT were similar (5.2 ± 0.5 and 5.1 ± 0.2 min, respectively, P = 0.651). MD and the PSD values obtained via FDT Matrix were significantly higher than those obtained via SAP (P tests in terms of MD (r = 0.352, P = 0.008) and PSD (r = 0.329, P = 0.014) was observed. Children were able to complete both the visual test algorithms successfully within 6 min. However, SAP testing appears to be associated with less depression of the visual field indices of healthy children. FDT Matrix and SAP should not be used interchangeably in the follow-up of children.

  16. On the applicability of the standard approaches for evaluating a neoclassical radial electric field in a tokamak edge region

    Energy Technology Data Exchange (ETDEWEB)

    Dorf, M. A.; Cohen, R. H.; Joseph, I. [Lawrence Livermore National Laboratory, Livermore, California 94550 (United States); Simakov, A. N. [Los Alamos National Laboratory, Los Alamos, New Mexico 87544 (United States)

    2013-08-15

    The use of the standard approaches for evaluating a neoclassical radial electric field E{sub r}, i.e., the Ampere (or gyro-Poisson) equation, requires accurate calculation of the difference between the gyroaveraged electron and ion particle fluxes (or densities). In the core of a tokamak, the nontrivial difference appears only in high-order corrections to a local Maxwellian distribution due to the intrinsic ambipolarity of particle transport. The evaluation of such high-order corrections may be inconsistent with the accuracy of the standard long wavelength gyrokinetic equation (GKE), thus imposing limitations on the applicability of the standard approaches. However, in the edge of a tokamak, charge-exchange collisions with neutrals and prompt ion orbit losses can drive non-intrinsically ambipolar particle fluxes for which a nontrivial (E{sub r}-dependent) difference between the electron and ion fluxes appears already in a low order and can be accurately predicted by the long wavelength GKE. The parameter regimes, where the radial electric field dynamics in the tokamak edge region is dominated by the non-intrinsically ambipolar processes, thus allowing for the use of the standard approaches, are discussed.

  17. Abscisic acid signaling is controlled by a BRANCHED1/HD-ZIP I cascade in Arabidopsis axillary buds.

    Science.gov (United States)

    González-Grandío, Eduardo; Pajoro, Alice; Franco-Zorrilla, José M; Tarancón, Carlos; Immink, Richard G H; Cubas, Pilar

    2017-01-10

    Shoot-branching patterns determine key aspects of plant life and are important targets for crop breeding. However, we are still largely ignorant of the genetic networks controlling locally the most important decision during branch development: whether the axillary bud, or branch primordium, grows out to give a lateral shoot or remains dormant. Here we show that, inside the buds, the TEOSINTE BRANCHED1, CYCLOIDEA, PCF (TCP) transcription factor BRANCHED1 (BRC1) binds to and positively regulates the transcription of three related Homeodomain leucine zipper protein (HD-ZIP)-encoding genes: HOMEOBOX PROTEIN 21 (HB21), HOMEOBOX PROTEIN 40 (HB40), and HOMEOBOX PROTEIN 53 (HB53). These three genes, together with BRC1, enhance 9-CIS-EPOXICAROTENOID DIOXIGENASE 3 (NCED3) expression, lead to abscisic acid accumulation, and trigger hormone response, thus causing suppression of bud development. This TCP/HD-ZIP genetic module seems to be conserved in dicot and monocotyledonous species to prevent branching under light-limiting conditions.

  18. Comparison of visual field test results obtained through Humphrey matrix frequency doubling technology perimetry versus standard automated perimetry in healthy children

    Directory of Open Access Journals (Sweden)

    Sibel Kocabeyoglu

    2013-01-01

    Full Text Available Aims : The aim of this study was to compare the visual field test results in healthy children obtained via the Humphrey matrix 24-2 threshold program and standard automated perimetry (SAP using the Swedish interactive threshold algorithm (SITA-Standard 24-2 test. Materials and Methods: This prospective study included 55 healthy children without ocular or systemic disorders who underwent both SAP and frequency doubling technology (FDT perimetry visual field testing. Visual field test reliability indices, test duration, global indices (mean deviation [MD], and pattern standard deviation [PSD] were compared between the 2 tests using the Wilcoxon signed-rank test and paired t-test. The performance of the Humphrey field analyzer (HFA 24-2 SITA-standard and frequency-doubling technology Matrix 24-2 tests between genders were compared with Mann-Whitney U-test. Results: Fifty-five healthy children with a mean age of 12.2 ± 1.9 years (range from 8 years to 16 years were included in this prospective study. The test durations of SAP and FDT were similar (5.2 ± 0.5 and 5.1 ± 0.2 min, respectively, P = 0.651. MD and the PSD values obtained via FDT Matrix were significantly higher than those obtained via SAP (P < 0.001, and fixation losses and false negative errors were significantly less with SAP (P < 0.05. A weak positive correlation between the two tests in terms of MD (r = 0.352, P = 0.008 and PSD (r = 0.329, P = 0.014 was observed. Conclusion: Children were able to complete both the visual test algorithms successfully within 6 min. However, SAP testing appears to be associated with less depression of the visual field indices of healthy children. FDT Matrix and SAP should not be used interchangeably in the follow-up of children.

  19. GENERIC QUALITY STANDARDS VS. SPECIFIC QUALITY STANDARDS: THE CASE OF HIGHER EDUCATION

    Directory of Open Access Journals (Sweden)

    Laila El Abbadi

    2011-06-01

    Full Text Available Quality as a new requirement for the field of higher education leads institutions to seek to satisfy generic or specific quality standards imposed directly or indirectly by its customers. The aim of this study is to compare between ISO9001, as a generic quality standard, and the Code of Practice of the Quality Assurance Agency for Higher Education (QAA, as a specific quality standard. A correlation matrix is drawn and correlation rates are calculated to show similarities and differences between them. This paper shows, first, that ISO9001 and QAA Code of Practice are compatible. Second, implementing a quality management system in accordance with ISO9001 requirements can constitute an adequate framework for the application of the QAA Code of Practice requirements. Third, to make the ISO9001 requirements closer to a specific quality standard in the field of higher education, it is recommended to complete these standards by specific requirements to the field of higher education.

  20. Infraclavicular versus axillary nerve catheters: A retrospective comparison of early catheter failure rate.

    Science.gov (United States)

    Quast, Michaela B; Sviggum, Hans P; Hanson, Andrew C; Stoike, David E; Martin, David P; Niesen, Adam D

    2018-05-01

    Continuous brachial plexus catheters are often used to decrease pain following elbow surgery. This investigation aimed to assess the rate of early failure of infraclavicular (IC) and axillary (AX) nerve catheters following elbow surgery. Retrospective study. Postoperative recovery unit and inpatient hospital floor. 328 patients who received IC or AX nerve catheters and underwent elbow surgery were identified by retrospective query of our institution's database. Data collected included unplanned catheter dislodgement, catheter replacement rate, postoperative pain scores, and opioid administration on postoperative day 1. Catheter failure was defined as unplanned dislodging within 24 h of placement or requirement for catheter replacement and evaluated using a covariate adjusted model. 119 IC catheters and 209 AX catheters were evaluated. There were 8 (6.7%) failed IC catheters versus 13 (6.2%) failed AX catheters. After adjusting for age, BMI, and gender there was no difference in catheter failure rate between IC and AX nerve catheters (p = 0.449). These results suggest that IC and AX nerve catheters do not differ in the rate of early catheter failure, despite differences in anatomic location and catheter placement techniques. Both techniques provided effective postoperative analgesia with median pain scores < 3/10 for patients following elbow surgery. Reasons other than rate of early catheter failure should dictate which approach is performed. Copyright © 2018. Published by Elsevier Inc.

  1. The Economics of Standards and Standardization in Information and Communication Technologies

    DEFF Research Database (Denmark)

    Pedersen, Mogens Kuhn; Fomin, Vladislav V.

    2006-01-01

    processes in the field of ICT taking place? How and why do open standards differ from other types of standards? How may open standards influence ICT government policy and the reverse: How will government need to take action in the face of the international trend toward open standards in ICT?...

  2. Dynamic expression reveals a two-step patterning of WUS and CLV3 during axillary shoot meristem formation in Arabidopsis.

    Science.gov (United States)

    Xin, Wei; Wang, Zhicai; Liang, Yan; Wang, Yonghong; Hu, Yuxin

    2017-07-01

    Seed plants have a remarkable capability to produce axillary meristems (AM) in the leaf axils, however, the dynamic establishment of a stem cell niche in AM is largely uncharacterized. We comprehensively examined the dynamic patterning of WUSCHEL (WUS) and CLAVATA3 (CLV3), the two key marker genes defining the shoot stem cell niches, during AM formation in Arabidopsis, and we found that a two-step patterning of WUS and CLV3 occurred during AM stem cell niche establishment. Our further work on the wus and clv3 mutants implicates that such two-step patterning is likely critical for the maintenance of AM progenitor cells and the specification of AM stem cell niche. These data provide a cytological frame for how a stem cell niche is established during AM formation. Copyright © 2017 Elsevier GmbH. All rights reserved.

  3. Experience with botulinum toxin therapy for axillary hyperhidrosis and comparison to modelled data for endoscopic thoracic sympathectomy - A quality of life and cost effectiveness analysis.

    Science.gov (United States)

    Gibbons, John P; Nugent, Emmeline; O'Donohoe, Nollaig; Maher, Barry; Egan, Bridget; Feeley, Martin; Tierney, Sean

    2016-10-01

    To estimate cost-effectiveness of botulinum toxin therapy for axillary hyperhidrosis compared to the standard surgical intervention of endoscopic thoracic sympathectomy (ETS). The validated dermatology life quality index questionnaire was given to patients attending for treatment over a 4 month period, to assess their quality of life (QoL) over the preceding week (n = 44). Follow-up was performed 4-6 weeks later by telephone using the same questionnaire to validate the effectiveness of the treatment. The duration of effect of the botulinum toxin treatment was also recorded and this data was used as the basis for cost effectiveness analysis. Using HIPE data, the baseline cost for single intervention using botulinum toxin and ETS was retrieved. Using figures provided by HIPE and expert opinion of the costs of complications, a stochastic model for 10,000 patients was used to evaluate the total costs for ETS including the complications. The results from the QoL analysis show that botulinum toxin therapy is a successful therapy for improvement of symptoms. It was revealed that the mean interval before recurrence of original symptoms after botulinum toxin therapy was 5.6 months. The baseline cost for both treatments are €389 for botulinum toxin and €9389 for uncomplicated ETS. The stochastic model yields a mean cost of €11,390 for ETS including complications. Treatments reached cost equivalence after 13.3 years. However, given the efficacy of the botulinum toxin therapy and the low risk we propose that botulinum toxin therapy for hyperhidrosis should be considered the gold standard. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  4. Standard practice for in situ examination of ferromagnetic Heat-Exchanger tubes using remote field testing

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2010-01-01

    1.1 This practice describes procedures to be followed during remote field examination of installed ferromagnetic heat-exchanger tubing for baseline and service-induced discontinuities. 1.2 This practice is intended for use on ferromagnetic tubes with outside diameters from 0.500 to 2.000 in. [12.70 to 50.80 mm], with wall thicknesses in the range from 0.028 to 0.134 in. [0.71 to 3.40 mm]. 1.3 This practice does not establish tube acceptance criteria; the tube acceptance criteria must be specified by the using parties. 1.4 Units—The values stated in either inch-pound units or SI units are to be regarded separately as standard. The values stated in each system may not be exact equivalents; therefore, each system shall be used independently of the other. Combining values from the two systems may result in nonconformance with the standard. 1.5 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this practice to establ...

  5. What is the best position of the arms in mantle field for Hodgkin's disease?

    International Nuclear Information System (INIS)

    Pergolizzi, Stefano; Settineri, Nicola; Gaeta, Michele; Scribano, Emanuele; Santacaterina, Anna; Ascenti, Giorgio; Frosina, Pasquale; De Renzis, Costantino

    2000-01-01

    Purpose: To evaluate the best position of the arms in mantle field for Hodgkin's disease. Methods and Materials: In 12 patients, with surgical clips placed at the time of an axillary dissection for breast cancer, the radiological projection of the clips according to three arm positions was prospectively evaluated: akimbo (A), extended (E), and up over the head (U). The surgical clips were arbitrarily separated into two groups: lower and upper. In each patient, the distance between the surgical clips and chest wall was measured, and the possibility of shielding the lungs and humeral heads was evaluated. Results: The mean displacement of the lower clips away from the chest wall when the patients were in A, E, and U positions was 2.5, 3.0, and 4.6 cm, respectively. The upper group clips showed a lower difference in distance from chest wall. In the U position, there was always a clip of the lower group that projected over the humeral head, making it impossible to block this structure. Conclusion: In the A position, there is the possibility of blocking the humeral head, but it is necessary to irradiate more lung parenchyma. Type E treatment setup allows the shielding of both lung and humeral head, while maintaining adequate margins around the axillary nodes. In the U position, there is a greater possibility of shielding the lung parenchyma, but it is impossible to block the humeral heads

  6. State-of-the art comparability of corrected emission spectra. 2. Field laboratory assessment of calibration performance using spectral fluorescence standards.

    Science.gov (United States)

    Resch-Genger, Ute; Bremser, Wolfram; Pfeifer, Dietmar; Spieles, Monika; Hoffmann, Angelika; DeRose, Paul C; Zwinkels, Joanne C; Gauthier, François; Ebert, Bernd; Taubert, R Dieter; Voigt, Jan; Hollandt, Jörg; Macdonald, Rainer

    2012-05-01

    In the second part of this two-part series on the state-of-the-art comparability of corrected emission spectra, we have extended this assessment to the broader community of fluorescence spectroscopists by involving 12 field laboratories that were randomly selected on the basis of their fluorescence measuring equipment. These laboratories performed a reference material (RM)-based fluorometer calibration with commercially available spectral fluorescence standards following a standard operating procedure that involved routine measurement conditions and the data evaluation software LINKCORR developed and provided by the Federal Institute for Materials Research and Testing (BAM). This instrument-specific emission correction curve was subsequently used for the determination of the corrected emission spectra of three test dyes, X, QS, and Y, revealing an average accuracy of 6.8% for the corrected emission spectra. This compares well with the relative standard uncertainties of 4.2% for physical standard-based spectral corrections demonstrated in the first part of this study (previous paper in this issue) involving an international group of four expert laboratories. The excellent comparability of the measurements of the field laboratories also demonstrates the effectiveness of RM-based correction procedures.

  7. Reoperative sentinel lymph node biopsy after previous mastectomy.

    Science.gov (United States)

    Karam, Amer; Stempel, Michelle; Cody, Hiram S; Port, Elisa R

    2008-10-01

    Sentinel lymph node (SLN) biopsy is the standard of care for axillary staging in breast cancer, but many clinical scenarios questioning the validity of SLN biopsy remain. Here we describe our experience with reoperative-SLN (re-SLN) biopsy after previous mastectomy. Review of the SLN database from September 1996 to December 2007 yielded 20 procedures done in the setting of previous mastectomy. SLN biopsy was performed using radioisotope with or without blue dye injection superior to the mastectomy incision, in the skin flap in all patients. In 17 of 20 patients (85%), re-SLN biopsy was performed for local or regional recurrence after mastectomy. Re-SLN biopsy was successful in 13 of 20 patients (65%) after previous mastectomy. Of the 13 patients, 2 had positive re-SLN, and completion axillary dissection was performed, with 1 having additional positive nodes. In the 11 patients with negative re-SLN, 2 patients underwent completion axillary dissection demonstrating additional negative nodes. One patient with a negative re-SLN experienced chest wall recurrence combined with axillary recurrence 11 months after re-SLN biopsy. All others remained free of local or axillary recurrence. Re-SLN biopsy was unsuccessful in 7 of 20 patients (35%). In three of seven patients, axillary dissection was performed, yielding positive nodes in two of the three. The remaining four of seven patients all had previous modified radical mastectomy, so underwent no additional axillary surgery. In this small series, re-SLN was successful after previous mastectomy, and this procedure may play some role when axillary staging is warranted after mastectomy.

  8. Renormalization Group Equations of d=6 Operators in the Standard Model Effective Field Theory

    CERN Multimedia

    CERN. Geneva

    2015-01-01

    The one-loop renormalization group equations for the Standard Model (SM) Effective Field Theory (EFT) including dimension-six operators are calculated. The complete 2499 × 2499 one-loop anomalous dimension matrix of the d=6 Lagrangian is obtained, as well as the contribution of d=6 operators to the running of the parameters of the renormalizable SM Lagrangian. The presence of higher-dimension operators has implications for the flavor problem of the SM. An approximate holomorphy of the one-loop anomalous dimension matrix is found, even though the SM EFT is not a supersymmetric theory.

  9. Thermal neutron standard fields with the KUR heavy water facility

    International Nuclear Information System (INIS)

    Kanda, K.; Kobayashi, K.; Shibata, T.

    1978-01-01

    A heavy water facility attached to the KUR (Kyoto University Reactor, swimming pool type, 5 MW) yields pure thermal neutrons in the Maxwellian distribution. The facility is faced to the core of KUR and it contains about 2 tons of heavy water. The thickness of the layer is about 140 cm. The neutron spectrum was measured with the time of flight technique using a fast chopper. The measured spectrum was in good agreement with the Maxwellian distribution in all energy region for thermal neutrons. The neutron temperature was slightly higher than the heavy water temperature. The contamination of epithermal and fast neutrons caused by photo-neutrons of the γ-n reaction of heavy water was very small. The maximum intensity of thermal neutrons is 3x10 11 n/cm 2 sec. When the bismuth scatterer is attached, the gamma rays contamination is eliminated by the ratio of 0.05 of gamma rays to neutrons in rem. This standard neutron field has been used for such experiments as thermal neutron cross section measurement, detector calibration, activation analysis, biomedical purposes etc. (author)

  10. Comparison of 30-2 Standard and Fast programs of Swedish Interactive Threshold Algorithm of Humphrey Field Analyzer for perimetry in patients with intracranial tumors.

    Science.gov (United States)

    Singh, Manav Deep; Jain, Kanika

    2017-11-01

    To find out whether 30-2 Swedish Interactive Threshold Algorithm (SITA) Fast is comparable to 30-2 SITA Standard as a tool for perimetry among the patients with intracranial tumors. This was a prospective cross-sectional study involving 80 patients aged ≥18 years with imaging proven intracranial tumors and visual acuity better than 20/60. The patients underwent multiple visual field examinations using the two algorithms till consistent and repeatable results were obtained. A total of 140 eyes of 80 patients were analyzed. Almost 60% of patients undergoing perimetry with SITA Standard required two or more sessions to obtain consistent results, whereas the same could be obtained in 81.42% with SITA Fast in the first session itself. Of 140 eyes, 70 eyes had recordable field defects and the rest had no defects as detected by either of the two algorithms. Mean deviation (MD) (P = 0.56), pattern standard deviation (PSD) (P = 0.22), visual field index (P = 0.83) and number of depressed points at P 0.5% on MD and PSD probability plots showed no statistically significant difference between two algorithms. Bland-Altman test showed that considerable variability existed between two algorithms. Perimetry performed by SITA Standard and SITA Fast algorithm of Humphrey Field Analyzer gives comparable results among the patients of intracranial tumors. Being more time efficient and with a shorter learning curve, SITA Fast my be recommended as a standard test for the purpose of perimetry among these patients.

  11. Field Performance versus Standard Test Condition Efficiency of Tandem Solar Cells and the Specific Case of Perovskites/Silicon Devices

    KAUST Repository

    Dupre, Olivier; Niesen, Bjö rn; De Wolf, Stefaan; Ballif, Christophe

    2018-01-01

    efficiencies and calculate their energy yields using field data from Denver. We find that annual losses due to differences between operating conditions and standard test conditions are similar for single-junction and four-terminal tandem devices. The additional

  12. A Vehicular Mobile Standard Instrument for Field Verification of Traffic Speed Meters Based on Dual-Antenna Doppler Radar Sensor.

    Science.gov (United States)

    Du, Lei; Sun, Qiao; Cai, Changqing; Bai, Jie; Fan, Zhe; Zhang, Yue

    2018-04-05

    Traffic speed meters are important legal measuring instruments specially used for traffic speed enforcement and must be tested and verified in the field every year using a vehicular mobile standard speed-measuring instrument to ensure speed-measuring performances. The non-contact optical speed sensor and the GPS speed sensor are the two most common types of standard speed-measuring instruments. The non-contact optical speed sensor requires extremely high installation accuracy, and its speed-measuring error is nonlinear and uncorrectable. The speed-measuring accuracy of the GPS speed sensor is rapidly reduced if the amount of received satellites is insufficient enough, which often occurs in urban high-rise regions, tunnels, and mountainous regions. In this paper, a new standard speed-measuring instrument using a dual-antenna Doppler radar sensor is proposed based on a tradeoff between the installation accuracy requirement and the usage region limitation, which has no specified requirements for its mounting distance and no limitation on usage regions and can automatically compensate for the effect of an inclined installation angle on its speed-measuring accuracy. Theoretical model analysis, simulated speed measurement results, and field experimental results compared with a GPS speed sensor with high accuracy showed that the dual-antenna Doppler radar sensor is effective and reliable as a new standard speed-measuring instrument.

  13. Clinicopathologic features of sentinel node metastases predictive of positive axillary clearance in grade 1 invasive breast carcinoma.

    LENUS (Irish Health Repository)

    Hayes, B

    2012-02-01

    BACKGROUND: Sentinel node (SN) biopsy is widely used to stage breast carcinoma and, when positive, typically leads to axillary clearance (AC). AIMS: This study assesses clinicopathologic features of grade 1 breast carcinoma SNs with the aim of identifying a group of patients, who are likely to have a negative AC and can, therefore, safely be spared further surgery. RESULTS: Two hundred and forty-seven patients with grade 1 invasive carcinoma were identified, of whom 29 had a positive SN. Four patients (13.8%) had a positive AC. Positive AC occurred in 3 of 6 (50%) patients whose SN showed extranodal extension (EE), but in only 1 of 23 (4.3%) patients without EE. All patients were staged as pN1(sn) following SN biopsy: only one, who had a 5.27 mm metastasis with EE, was pN2 following AC. CONCLUSIONS: Extranodal extension is a significant predictor of a positive AC in this group. In its absence, AC did not alter the post-SN biopsy pN stage.

  14. New trends in the field of nuclear standardization on national, European and international level with the background of the German 'Energiewende'

    International Nuclear Information System (INIS)

    Winkler, Janine

    2014-01-01

    Participation in standardization in the nuclear energy field in Germany is still very high, because the involved parties have recognized that standards in the context of the energy transition in Germany will remain very important. However, in the last few years, international standardization has been carried out without German participation. Existing international bodies are currently greatly influenced by the leadership of France, which is also reflected in the content of international standards. In addition, on French initiative, a European body (CEN/TC 430 'Nuclear energy, nuclear technologies, and radiological protection') has been set up with the remit to replace all national standards in Europe with international standards. The present article summarizes this development and offers an overview for German experts on how they can respond to this trend. (orig.)

  15. Pectoralis-serratus interfascial plane block vs thoracic paravertebral block for unilateral radical mastectomy with axillary evacuation.

    Science.gov (United States)

    Hetta, Diab Fuad; Rezk, Khalid Mohammed

    2016-11-01

    The aim of this study was to evaluate the analgesic efficacy and safety of pectoralis-serratus interfascial plane block in comparison with thoracic paravertebral block for postmastectomy pain. A prospective randomized controlled study. Tertiary center, university hospital. Sixty-four adult women, American Society of Anesthesiologists physical status classes I, II, and III, scheduled for unilateral modified radical mastectomy with axillary evacuation. Patients were randomized to receive either pectoralis-serratus interfascial plane block, PS group (n=32), or thoracic paravertebral block, PV group (n=32). Twenty-four-hour morphine consumption and the time to rescue analgesic were recorded. The pain intensity evaluated by visual analog scale (VAS) score at 0, 2, 4, 8, 16, and 24hours postoperatively was also recorded. The median (interquartile range) postoperative 24-hour morphine consumption was significantly increased in PS group in comparison to PV group (PS vs PV), 20 mg (16-23 mg) vs 12 mg (10-14 mg) (Pplane block was safe and easy to perform and decreased intensity of postmastectomy pain, but it was inferior to thoracic paravertebral block. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Validity of Devices That Assess Body Temperature During Outdoor Exercise in the Heat

    Science.gov (United States)

    Casa, Douglas J; Becker, Shannon M; Ganio, Matthew S; Brown, Christopher M; Yeargin, Susan W; Roti, Melissa W; Siegler, Jason; Blowers, Julie A; Glaviano, Neal R; Huggins, Robert A; Armstrong, Lawrence E; Maresh, Carl M

    2007-01-01

    Context: Rectal temperature is recommended by the National Athletic Trainers' Association as the criterion standard for recognizing exertional heat stroke, but other body sites commonly are used to measure temperature. Few authors have assessed the validity of the thermometers that measure body temperature at these sites in athletic settings. Objective: To assess the validity of commonly used temperature devices at various body sites during outdoor exercise in the heat. Design: Observational field study. Setting: Outdoor athletic facilities. Patients or Other Participants: Fifteen men and 10 women (age = 26.5 ± 5.3 years, height = 174.3 ± 11.1 cm, mass = 72.73 ± 15.95 kg, body fat = 16.2 ± 5.5%). Intervention(s): We simultaneously tested inexpensive and expensive devices orally and in the axillary region, along with measures of aural, gastrointestinal, forehead, temporal, and rectal temperatures. Temporal temperature was measured according to the instruction manual and a modified method observed in medical tents at local road races. We also measured forehead temperatures directly on the athletic field (other measures occurred in a covered pavilion) where solar radiation was greater. Rectal temperature was the criterion standard used to assess the validity of all other devices. Subjects' temperatures were measured before exercise, every 60 minutes during 180 minutes of exercise, and every 20 minutes for 60 minutes of postexercise recovery. Temperature devices were considered invalid if the mean bias (average difference between rectal temperature and device temperature) was greater than ±0.27°C (±0.5°F). Main Outcome Measure(s): Temperature from each device at each site and time point. Results: Mean bias for the following temperatures was greater than the allowed limit of ±0.27°C (±0.5°F): temperature obtained via expensive oral device (−1.20°C [−2.17°F]), inexpensive oral device (−1.67°C [−3.00°F]), expensive axillary device (−2.58°C [−4

  17. Feynman rules for the Standard Model Effective Field Theory in R ξ -gauges

    Science.gov (United States)

    Dedes, A.; Materkowska, W.; Paraskevas, M.; Rosiek, J.; Suxho, K.

    2017-06-01

    We assume that New Physics effects are parametrized within the Standard Model Effective Field Theory (SMEFT) written in a complete basis of gauge invariant operators up to dimension 6, commonly referred to as "Warsaw basis". We discuss all steps necessary to obtain a consistent transition to the spontaneously broken theory and several other important aspects, including the BRST-invariance of the SMEFT action for linear R ξ -gauges. The final theory is expressed in a basis characterized by SM-like propagators for all physical and unphysical fields. The effect of the non-renormalizable operators appears explicitly in triple or higher multiplicity vertices. In this mass basis we derive the complete set of Feynman rules, without resorting to any simplifying assumptions such as baryon-, lepton-number or CP conservation. As it turns out, for most SMEFT vertices the expressions are reasonably short, with a noticeable exception of those involving 4, 5 and 6 gluons. We have also supplemented our set of Feynman rules, given in an appendix here, with a publicly available Mathematica code working with the FeynRules package and producing output which can be integrated with other symbolic algebra or numerical codes for automatic SMEFT amplitude calculations.

  18. Outcomes of sentinel lymph node dissection alone vs. axillary lymph node dissection in early stage invasive lobular carcinoma: a retrospective study of the surveillance, epidemiology and end results (SEER database.

    Directory of Open Access Journals (Sweden)

    Jun Wang

    Full Text Available The American College of Surgeons Oncology Group (ACOSOG Z0011 trial demonstrated no difference in local-regional recurrence (LRR, disease-specific survival (DSS or overall survival (OS for sentinel lymph node dissection (SLND and completion axillary lymph node dissection (ALND among patients undergoing breast-conserving therapy for clinical T1-T2, N0 breast cancer with 1 or 2 positive SLNs. However, Only 7% of study participants had invasive lobular carcinoma (ILC. Because ILC has a different pattern of metastases, frequently presenting as small foci requiring immunohistochemistry for detection, the applicability of ACOSOG Z0011 trial data to ILC patients is unclear.We identified all ILC patients in the Surveillance, Epidemiology, and End Results (SEER database (1998-2009 who met the ACOSOG Z0011 eligibility criteria. Patients were evaluated on the basis of the extent of axillary surgery (SLND alone or ALND, and the clinical outcomes of these 2 groups were compared.1269 patients (393 SLND and 876 ALND were identified from the SEER database. At a median follow-up time of 71 months, there were no differences in OS or disease-specific survival between the two groups.SLND alone may result in outcomes comparable to those achieved with ALND for patients with early-stage ILC who meet the ACOSOG Z0011 eligibility criteria.

  19. Decreased survival in patients with carcinoma of axillary tail versus upper outer quadrant breast cancers: a SEER population-based study

    Directory of Open Access Journals (Sweden)

    Gou ZC

    2018-05-01

    Full Text Available Zong-Chao Gou,1,2,* Xi-Yu Liu,1,2,* Yi Xiao,1,2 Shen Zhao,1,2 Yi-Zhou Jiang,1,2 Zhi-Ming Shao1–3 1Department of Breast Surgery, Cancer Institute, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China; 2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China; 3Institutes of Biomedical Sciences, Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: Carcinoma of the axillary tail of Spence (CATS is a poorly studied type of breast cancer. The clinicopathological characteristics and prognostic features of CATS are unclear. Methods: Using the Surveillance, Epidemiology, and End Results database, we identified 149,026 patients diagnosed with upper outer quadrant breast cancer (UOBC (n=146,343 or CATS (n=2,683. The median follow-up was 88 months. The primary and secondary outcomes were breast cancer-specific survival (BCSS and overall survival. The survival outcomes of UOBC and CATS were compared using competing risks analysis, log-rank test, Cox proportional hazards regression model, and propensity score matching method. Multivariate logistic regression was utilized to present the relationship between CATS and lymph node (LN metastasis. Results: CATS presented a higher grade, higher negative hormone receptor rate, and more positive nodal metastasis. The 10-year BCSS rate was worse for CATS than for UOBC (85.1% vs 87.3%, P=0.001. The multivariate Cox analysis showed a higher hazard ratio (HR for CATS over UOBC (BCSS: HR =1.20, P=0.001; overall survival: HR =1.11, P=0.019. The difference in the BCSS was also observed in a 1:1 matched cohort (BCSS P=0.019. A subgroup analysis revealed the inferior outcomes of CATS in the metastatic LN subgroup and the hormone receptor-negative subgroup. The multivariate logistic regression indicated that CATS is an independent contributing factor to LN metastasis. Conclusion: CATS

  20. Standards for holdup measurement

    International Nuclear Information System (INIS)

    Zucker, M.S.

    1982-01-01

    Holdup measurement, needed for material balance, depend intensively on standards and on interpretation of the calibration procedure. More than other measurements, the calibration procedure using the standard becomes part of the standard. Standards practical for field use and calibration techniques have been developed. While accuracy in holdup measurements is comparatively poor, avoidance of bias is a necessary goal

  1. Quantitative relations between beta-gamma mixed-field dosimeter responses and dose-equivalent conversion factors according to the testing standard

    International Nuclear Information System (INIS)

    Gupta, V.P.

    1982-08-01

    The conventional two-element personnel dosimeters, usually having two thick TLD (thermoluminescent dosimetry) ribbons, are used extensively for radiation protection dosimetry. Many of these dosimeters are used for the measurement of beta and gamma radiation doses received in mixed beta-gamma fields. Severe limitations exist, however, on the relative magnitudes and energies of these fields that may be measured simultaneously. Moreover, due to a well-known energy dependence of these dosimeters, particularly for the beta-radiations, systematic errors will occur whenever the differences in workplaces and calibration radiation energies exist. A simple mathematical approach is presented to estimate the deep and shallow dose equivalent values at different energies for such dosimeters. The formulae correlate the dosimeter responses and dose equivalent conversion factors at different energies by taking into account the guidelines of the adopted ANSI Standard N13.11 and the dosimetry practices followed by most dosimeter processors. This standard is to be used in a mandatory testing program in the United States

  2. Survival benefit of post-mastectomy radiotherapy in breast carcinoma patients with T1-2 tumor and 1-3 axillary lymph node(s) metastasis

    International Nuclear Information System (INIS)

    Duraker, N.; Demir, D.; Bati, B.; Yilmaz, B.D.; Bati, Y.; Sobutay, E.; Caynak, Z.C.

    2012-01-01

    The objective of this study was to investigate the role of post-mastectomy radiotherapy in breast carcinoma patients with a tumor size of 5 cm or smaller (T1-2) and 1-3 axillary lymph node(s) metastasis (N1). We retrospectively reviewed the file records of 575 patients receiving radiotherapy (452 patients) and not receiving radiotherapy (123 patients). In the whole series, locoregional recurrence-free survival was significantly better in patients receiving radiotherapy compared with patients not receiving radiotherapy (P 0.25 and in T2N1 breast carcinoma patients with a lymph node ratio of >0.08. In patients with a lymph node ratio equal to or less than these ratios, post-mastectomy radiotherapy could be omitted to avoid radiotherapy-related risks. (author)

  3. Comparison between predicted duct effectiveness from proposed ASHRAE Standard 152P and measured field data for residential forced air cooling systems; TOPICAL

    International Nuclear Information System (INIS)

    Siegel, Jeffrey A.; McWilliams, Jennifer A.; Walker, Iain S.

    2002-01-01

    The proposed ASHRAE Standard 152P ''Method of Test for Determining the Design and Seasonal Efficiencies of Residential Thermal Distribution Systems'' (ASHRAE 2002) has recently completed its second public review. As part of the standard development process, this study compares the forced air distribution system ratings provided by the public review draft of Standard 152P to measured field results. 58 field tests were performed on cooling systems in 11 homes in the summers of 1998 and 1999. Seven of these houses had standard attics with insulation on the attic floor and a well-vented attic space. The other four houses had unvented attics where the insulation is placed directly under the roof deck and the attic space is not deliberately vented. Each house was tested under a range of summer weather conditions at each particular site, and in some cases the amount of duct leakage was intentionally varied. The comparison between 152P predicted efficiencies and the measured results includes evaluation of the effects of weather, duct location, thermal conditions, duct leakage, and system capacity. The results showed that the difference between measured delivery effectiveness and that calculated using proposed Standard 152P is about 5 percentage points if weather data, duct leakage and air handler flow are well known. However, the accuracy of the standard is strongly dependent on having good measurements of duct leakage and system airflow. Given that the uncertainty in the measured delivery effectiveness is typically also about 5 percentage points, the Standard 152P results are acceptably close to the measured data

  4. Variations in the management of the axilla in screen-detected ductal carcinoma in situ: evidence from the UK NHS breast screening programme audit of screen detected DCIS.

    Science.gov (United States)

    Nicholson, S; Hanby, A; Clements, K; Kearins, O; Lawrence, G; Dodwell, D; Bishop, H; Thompson, A

    2015-01-01

    The diagnosis and surgical management of screen-detected Ductal Carcinoma In Situ (DCIS) remains controversial including a range of axillary approaches and consequent morbidity. This study examined the management of the axilla in all patients with DCIS presenting through the United Kingdom National Health Service Breast Screening Programme (UK NHS BSP). Retrospective analysis of the UK NHS BSP identified 26,696 women initially diagnosed with DCIS over the 8 years 1 April 2003-31 March 2011. The final breast pathology of these women was upgraded to invasive ductal cancer in 5564 (20.8%) women or micro-invasive cancer in 1031 (3.9%) women. At first operation, 5290 (26.3%) of the 20,094 women who had a final post-operative diagnosis of DCIS only underwent axillary surgery (72.4% at the time of mastectomy, 23.8% breast conservation surgery, 3.8% axillary surgery alone). Performance of axillary surgery reflected increasing tumour size, micro-invasion or increasing nuclear grade for the final diagnosis of DCIS. More extensive nodal surgery was performed in those undergoing mastectomy; 10.8% of women had more than 8 nodes removed. Overall, 12.0% of women with invasive cancer, 1.7% with micro-invasion, and 0.2% with DCIS alone, were ultimately node positive. Improved pre-operative sampling of DCIS, axillary assessment by ultrasound with needle biopsy for suspected metastases, risk stratification for sentinel node biopsy (for high grade or extensive DCIS) and avoiding axillary clearance for a pre-operative diagnosis of DCIS alone should reduce unnecessary axillary surgery. Standards using such criteria for axillary surgery in screen-detected DCIS should be integrated into the NHS BSP. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  5. MORBIDITY OF SENTINEL LYMPH NODE BIOPSY (SLNB ALONE VERSUS SLNB AND COMPLETION AXILLARY LYMPH NODE DISSECTION AFTER BREAST CANCER SURGERY- A PROSPECTIVE SINGLE CENTRE STUDY

    Directory of Open Access Journals (Sweden)

    Mythilidevi Sappa

    2017-11-01

    Full Text Available BACKGROUND ALND after breast cancer surgery is associated with considerable morbidity. We hypothesised- 1 The morbidity in patients undergoing SLN biopsy only is significantly lower compared with those after SLN and completion ALND level I and II; and 2 The intermediate survival rates, local and axillary recurrence rates were significantly equivalent in both the groups. MATERIALS AND METHODS Patients with early stage breast cancer (pT1 and pT2 ≤3 cm, cN0 were included between April 2010 and April 2016 in this prospective single centre study. All patients underwent SLN biopsy. In all patients with SLN macrometastases and most patients with SLN micrometastases (43 of 68 or isolated tumour cells (11 of 19, a completion ALND was performed. Postoperative morbidity was assessed based on a standardised protocol. RESULTS SLN biopsy alone was performed in 449 patients, whereas 210 patients underwent SLN and completion ALND. The median follow-ups were 31.0 and 29.5 months for the SLN and SLN and completion ALND groups, respectively. Intermediate-term follow-up information was available from 635 of 659 patients (96.4% of enrolled patients. The following results were found in the SLN versus SLN and completion ALND group- Presence of lymphoedema (3.5% vs. 19.1%, P <0.0001, impaired shoulder range of motion (3.5% vs. 11.3%, P <0.0001, shoulder/arm pain (8.1% vs. 21.1%, P <0.0001 and numbness (10.9% vs. 37.7%, P <0.0001. CONCLUSION The morbidity after SLN biopsy alone is not negligible, but significantly lower compared with ALND. The intermediate survival rates, local and axillary recurrence rates were equivalent in SLNB only and SLNB plus completion ALND groups.

  6. IEEE Std 383-1974: IEEE standard for type test of Class IE electric cables, field splices, and connections for nuclear power generating stations

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This standard provides direction for establishing type tests which may be used in qualifying Class 1E electric cables, field splices, and other connections for service in nuclear power generating stations. General guidelines for qualifications are given in IEEE Std 323-1974, Standard for Qualifying Class IE Electric Equipment for Nuclear Power Generating Stations. Categories of cables covered are those used for power control and instrumentation services. Though intended primarily to pertain to cable for field installation, this guide may also be used for the qualification of internal wiring of manufactured devices. This guide does not cover cables for service within the reactor vessel

  7. Effect of warming bupivacaine 0.5% on ultrasound-guided axillary plexus block. Randomized prospective double-blind study.

    Science.gov (United States)

    Trabelsi, W; Ben Gabsia, A; Lebbi, A; Sammoud, W; Labbène, I; Kchelfi, S; Ferjani, M

    2017-02-01

    To evaluate the effect of warming bupivacaine 0.5% on ultrasound-guided axillary brachial plexus block. Prospective, randomized, double-blind. Eighty patients undergoing elective or emergency surgery beyond the distal third of the upper limb were divided into two groups of 40 patients: the warm group received 15mL bupivacaine 0.5% heated to 37°C; the cold group received 15mL 0.5% bupivacaine stored for at least 24hours in the lower compartment of a refrigerator at 13-15°C. Onset and duration of sensory and motor blocks were evaluated every 5minutes for 40minutes. Postoperative pain was evaluated at 1, 3, 6, 12 and 24hours. Effective analgesia time was recorded as the interval between anesthetic injection and the first analgesia requirement (VAS>30mm). Time to onset of sensory and motor block was significantly shorter in the warm group, and mean duration of sensory and motor block and of postoperative analgesia significantly longer. Warming bupivacaine 0.5% to 37°C accelerated onset of sensory and motor block and extended action duration. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Reference and standard benchmark field consensus fission yields for U.S. reactor dosimetry programs

    International Nuclear Information System (INIS)

    Gilliam, D.M.; Helmer, R.G.; Greenwood, R.C.; Rogers, J.W.; Heinrich, R.R.; Popek, R.J.; Kellogg, L.S.; Lippincott, E.P.; Hansen, G.E.; Zimmer, W.H.

    1977-01-01

    Measured fission product yields are reported for three benchmark neutron fields--the BIG-10 fast critical assembly at Los Alamos, the CFRMF fast neutron cavity at INEL, and the thermal column of the NBS Research Reactor. These measurements were carried out by participants in the Interlaboratory LMFBR Reaction Rates (ILRR) program. Fission product generation rates were determined by post-irradiation analysis of gamma-ray emission from fission activation foils. The gamma counting was performed by Ge(Li) spectrometry at INEL, ANL, and HEDL; the sample sent to INEL was also analyzed by NaI(Tl) spectrometry for Ba-140 content. The fission rates were determined by means of the NBS Double Fission Ionization Chamber using thin deposits of each of the fissionable isotopes. Four fissionable isotopes were included in the fast neutron field measurements; these were U-235, U-238, Pu-239, and Np-237. Only U-235 was included in the thermal neutron yield measurements. For the fast neutron fields, consensus yields were determined for three fission product isotopes--Zr-95, Ru-103, and Ba-140. For these fission product isotopes, a separately activated foil was analyzed by each of the three gamma counting laboratories. The experimental standard deviation of the three independent results was typically +- 1.5%. For the thermal neutron field, a consensus value for the Cs-137 yield was also obtained. Subsidiary fission yields are also reported for other isotopes which were studied less intensively (usually by only one of the participating laboratories). Comparisons with EBR-II fast reactor yields from destructive analysis and with ENDF/B recommended values are given

  9. Probing CP-violating Higgs and gauge-boson couplings in the Standard Model effective field theory

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Felipe [University of Sussex, Department of Physics and Astronomy, Brighton (United Kingdom); Universidade Federal da Paraiba, Departamento de Fisica, Joao Pessoa, Paraiba (Brazil); Fuks, Benjamin [Sorbonne Universites, Universite Pierre et Marie Curie (Paris 06), UMR 7589, LPTHE, Paris (France); CNRS, UMR 7589, LPTHE, Paris (France); Institut Universitaire de France, Paris (France); Sanz, Veronica [University of Sussex, Department of Physics and Astronomy, Brighton (United Kingdom); Sengupta, Dipan [Universite Grenoble-Alpes, CNRS/IN2P3, Laboratoire de Physique Subatomique et de Cosmologie, Grenoble (France); Michigan State University, Department of Physics and Astronomy, East Lansing (United States)

    2017-10-15

    We study the phenomenological consequences of several CP-violating structures that could arise in the Standard Model effective field theory framework. Focusing on operators involving electroweak gauge and/or Higgs bosons, we derive constraints originating from Run I LHC data. We then study the capabilities of the present and future LHC runs at higher energies to further probe associated CP-violating phenomena and we demonstrate how differential information can play a key role. We consider both traditional four-lepton probes of CP-violation in the Higgs sector and novel new physics handles based on varied angular and non-angular observables. (orig.)

  10. In vitro propagation of Caesalpinia spinosa (Mol. O. Kuntz from axillary buds of selected trees

    Directory of Open Access Journals (Sweden)

    Jenny E Núñez Núñez

    2017-07-01

    Full Text Available Guarango or tara [Caesalpinia spinosa (Mol. O. Kuntz] is a tree native to the Andes, with great economic importance and for reforestation programs. The aim of this work was to in vitro propagate this specie from axillary buds of selected trees. During in vitro establishment, the effect of sodium hypochlorite (3.0% with different times of disinfection (5.0, 10, 15 min, as well as the effect of 6-BAP on the in vitro response of buds were studied. For multiplication, different combination of 6-BAP with 0.1 mg l-1 ANA were tested. A free-growth regulator culture medium was used for rooting. The best results for in vitro establishment were achieved with a disinfection treatment with sodium hypochlorite 3.0% for 10 minutes and cultivation in a culture medium with 0.25 mg l-1 6-BAP, which 90% of buds in vitro established, with a length of 6.71 cm. The highest multiplication rate of shoot (2.88 per explant was obtained with 1.0 mg l-1 6-BAP and 0.1 mg l-1 ANA, after 60 days of culture. The 55% of these shoots developed roots in a half-strength basal salts MS culture medium free of regulators of growth.   Keywords: biodiversity, conservation, forest plant, guarango, tissue culture

  11. Axillary bud and pericycle involved in the thickening process of the rhizophore nodes in Smilax species

    Directory of Open Access Journals (Sweden)

    B Appezzato-da-Glória

    Full Text Available AbstractThe species of the genus Smilax, popularly known as sarsaparilla, are widely used in folk medicine due to the antirheumatic properties of its underground structures. Smilax fluminensis and S. syphilitica occur in forested areas and form thickened stems called rhizophores from which adventitious roots grow. To provide information for more accurate identification of the commercialised product and for elucidating the process of stem thickening, a morphology and anatomy study of the underground organs of the two species was conducted. The adventitious roots differ in colour and diameter depending on the stage of development. They are white and have a larger diameter in the early stages of development, but as they grow, the adventitious roots become brown and have a smaller diameter due to the disintegration of the epidermis and virtually the entire cortex. In brown roots, the covering function is then performed by the lignified endodermis and the remaining walls of the cells from the last parenchyma cortical layer. These results are similar to those found in studies of other Smilax and suggest that the anatomy of the roots can be useful for identifying fraud in commercialised materials. The thickening process of the nodal regions of the rhizophores in both species involves the activity of axillary buds and pericyclic layers.

  12. The scientifically substantiated art of teaching: A study in the development of standards in the new academic field of neuroeducation (mind, brain, and education science)

    Science.gov (United States)

    Tokuhama-Espinosa, Tracey Noel

    Concepts from neuroeducation, commonly referred in the popular press as "brain-based learning," have been applied indiscreetly and inconsistently to classroom teaching practices for many years. While standards exist in neurology, psychology and pedagogy, there are no agreed upon standards in their intersection, neuroeducation, and a formal bridge linking the fields is missing. This study used grounded theory development to determine the parameters of the emerging neuroeducational field based on a meta-analysis of the literature over the past 30 years, which included over 2,200 documents. This research results in a new model for neuroeducation. The design of the new model was followed by a Delphi survey of 20 international experts from six different countries that further refined the model contents over several months of reflection. Finally, the revised model was compared to existing information sources, including popular press, peer review journals, academic publications, teacher training textbooks and the Internet, to determine to what extent standards in neuroeducation are met in the current literature. This study determined that standards in the emerging field, now labeled Mind, Brain, and Education: The Science of Teaching and Learning after the Delphi rounds, are the union of standards in the parent fields of neuroscience, psychology, and education. Additionally, the Delphi expert panel agreed upon the goals of the new discipline, its history, the thought leaders, and a model for judging quality information. The study culminated in a new model of the academic discipline of Mind, Brain, and Education science, which explains the tenets, principles and instructional guidelines supported by the meta-analysis of the literature and the Delphi response.

  13. The Inevitability of "Standard" English: Discursive Constructions of Standard Language Ideologies

    Science.gov (United States)

    Davila, Bethany

    2016-01-01

    Although standard language ideologies have been well researched and theorized, the practices that lead to the reproduction and enactment of these ideologies deserve attention. Specifically, there remains a need to study language that both reveals reliance on standard language ideologies and perpetuates these ideologies within the field of writing…

  14. Low-derivative operators of the Standard Model effective field theory via Hilbert series methods

    Energy Technology Data Exchange (ETDEWEB)

    Lehman, Landon; Martin, Adam [Department of Physics, University of Notre Dame,Nieuwland Science Hall, Notre Dame, IN 46556 (United States)

    2016-02-12

    In this work, we explore an extension of Hilbert series techniques to count operators that include derivatives. For sufficiently low-derivative operators, we conjecture an algorithm that gives the number of invariant operators, properly accounting for redundancies due to the equations of motion and integration by parts. Specifically, the conjectured technique can be applied whenever there is only one Lorentz invariant for a given partitioning of derivatives among the fields. At higher numbers of derivatives, equation of motion redundancies can be removed, but the increased number of Lorentz contractions spoils the subtraction of integration by parts redundancies. While restricted, this technique is sufficient to automatically recreate the complete set of invariant operators of the Standard Model effective field theory for dimensions 6 and 7 (for arbitrary numbers of flavors). At dimension 8, the algorithm does not automatically generate the complete operator set; however, it suffices for all but five classes of operators. For these remaining classes, there is a well defined procedure to manually determine the number of invariants. Assuming our method is correct, we derive a set of 535 dimension-8 N{sub f}=1 operators.

  15. Low-derivative operators of the Standard Model effective field theory via Hilbert series methods

    International Nuclear Information System (INIS)

    Lehman, Landon; Martin, Adam

    2016-01-01

    In this work, we explore an extension of Hilbert series techniques to count operators that include derivatives. For sufficiently low-derivative operators, we conjecture an algorithm that gives the number of invariant operators, properly accounting for redundancies due to the equations of motion and integration by parts. Specifically, the conjectured technique can be applied whenever there is only one Lorentz invariant for a given partitioning of derivatives among the fields. At higher numbers of derivatives, equation of motion redundancies can be removed, but the increased number of Lorentz contractions spoils the subtraction of integration by parts redundancies. While restricted, this technique is sufficient to automatically recreate the complete set of invariant operators of the Standard Model effective field theory for dimensions 6 and 7 (for arbitrary numbers of flavors). At dimension 8, the algorithm does not automatically generate the complete operator set; however, it suffices for all but five classes of operators. For these remaining classes, there is a well defined procedure to manually determine the number of invariants. Assuming our method is correct, we derive a set of 535 dimension-8 N_f=1 operators.

  16. Energy dependence of an ionization chamber with parallel plates in standard gamma and x-radiation fields

    International Nuclear Information System (INIS)

    Batistella, M.A.; Caldas, L.V.E.

    1988-09-01

    The characteristics of low energy X-radiation standard fields were determined and the energy dependence of a ionization chamber of the superficial type, with parallel plates and fixed volume, normally utilized in the dosimetry at the Radiotherapy level was studied. The possibility of adaptation of this chamber type for use in gamma radiation dosimetry was verified. Different thickness Lucite build-up caps, from 2.0 up to 5.5 mm, were produced and tested in 60 Co and 137 Cs gamma radiation fields. This type of detector, with the adequate build-up cap, presented a performance comparable to that of the thimble type ionization chamber. It was concluded that it is not necessary to use different kinds of chambers for each high and mean energy interval. The superficial chamber, specially produced to detect low energy X-radiation, may be adapted to detect gamma radiation. (author) [pt

  17. Standard Guide for Conducting Corrosion Tests in Field Applications

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2008-01-01

    1.1 This guide covers procedures for conducting corrosion tests in plant equipment or systems under operating conditions to evaluate the corrosion resistance of engineering materials. It does not cover electrochemical methods for determining corrosion rates. 1.1.1 While intended primarily for immersion tests, general guidelines provided can be applicable for exposure of test specimens in plant atmospheres, provided that placement and orientation of the test specimens is non-restrictive to air circulation. 1.2 The values stated in SI units are to be regarded as the standard. The values given in parentheses are for information only. 1.3 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use. See also 10.4.2.

  18. Value of sonomammography utilizing color Doppler technique in qualification of breast cancer patients for sentinel node identification

    International Nuclear Information System (INIS)

    Basta, P.; Wadowska-Jaszczynska, K.; Krysztopowicz, W.; Przybylska, P.; Wisniowski, Z.

    2007-01-01

    Sentinel node identification has become a standard procedure in the management of breast cancer. This procedure requires involvement of a multidisciplinary team and is rather costly. Ultrasonography (USG) of axillary lymph nodes is a method that gives hope for improving the quality of qualification of patients for the procedure. Eighty patients with grade I and II breast cancers underwent sentinel node identification followed by axillary lymphadenectomy. Pre-operative ultrasonography was employed to assess axillary lymph nodes, using the morphological and vascular characteristics as predictors of the presence of lymph node metastases. Sensitivity of sentinel node identification reached 89.3%, specificity - 100%, positive predictive value - 100%, negative predictive value - 93.5%, percentage of false negative results - 10.7%. Sensitivity of USG reached 68.75 %, and specificity - 70.31%. In the group of patients in whom the sentinel node was identified, the sensitivity of the method was 69.23 %, and specificity - 72.41%. Preoperative axillary lymph node ultrasonography in breast cancer patients, utilizing color Doppler technique, allows better selection of patients for sentinel node identification procedure. (author)

  19. Standard Wiggler magnets

    International Nuclear Information System (INIS)

    Winick, H.; Helm, R.H.

    1977-09-01

    Interest in Wiggler magnets (a close sequence of transverse fields with alternating polarity) to extend and enhance the spectrum of synchrotron radiation from electron storage rings has increased significantly during the past few years. Standard wigglers, i.e., wigglers in which interference effects on the spectrum of synchrotron radiation are not important, are considered. In standard wigglers the spectrum of synchrotron radiation has the same general shape as the spectrum from ring bending magnets. However, the critical energy of the wiggler spectrum may be different. The critical energy of the wiggler spectrum is given by epsilon/sub CW/ = epsilon/sub CB/(B/sub W//B/sub B/) where epsilon/sub CB/ is the critical energy from the bending magnets and B/sub W/ and B/sub B/ are the magnetic field strengths of the wiggler magnet and bending magnets respectively. Since most electron storage rings operate with relatively low bending magnet fields (B/sub B/ less than or equal to 12 kG), even a modest wiggler magnet field (less than or equal to 18 kG) can significantly increase the critical energy. Such magnets are planned for ADONE and SPEAR. Higher field (30 to 50 kG) superconducting magnets are planned at Brookhaven, Daresbury, and Novosibirsk to produce even larger increase in the critical energy. For some standard wigglers a further enhancement of the spectrum is produced due tothe superposition of the radiation from the individual poles. Wiggler designs are discussed as well as the effect of wigglers on the synchrotron radiation spectrum and on the operation of storage rings

  20. Phenomenological, symmetrical, field-theoretical aspects and mathematical considerations of the standard model

    International Nuclear Information System (INIS)

    Khodjaev, L.Sh.

    2004-01-01

    Full text: We review the conceptual foundation of Yang-Mills gauge field theories. On these gauge theories the Standard Model (SM) are constructed. The fundamental postulates and their immediate consequence of the SM are formulated. The SM is a Yang-Mills type gauge field theory basically dictated by the Generalized Gauge Principle (GGP). According to this principle all fundamental forces of nature such as strong, electroweak, gravitational are mediated by an exchange of the Yang-Mills gauge fields corresponding gauge group. The SM is constructed by extension of the global non-Abelian SU(3)xSU(2)xU(1) symmetry to the local SU(3)xSU(2)xU(1) symmetry under which the Lagrangian of the SM invariant. This full symmetry has to be broken by Higgs mechanism down to the Electroweak gauge symmetry. The concept of fundamental particles does not exist. To Look for not Fundamental Particles but Fundamental symmetries. By searching of more general theory it is natural to search first of all Global symmetries and then to learn consequences connected with the localization of the global symmetries like wise of SM. The SM is renormalizable and therefor potentially consist at all energy scales. The SM in principle can describe the properties of the Universe beginning at 10 -43 sec. after BIG BANG. A SM of the BIG BANG Particle physics provides one of the few windows of the high energy world beyond SM which is consistent with SM and Cosmology. All the fundamental particles of the SM such as quarks, leptons and weak intermediate vector-gauge Bosons except one Higgs boson H 0 have been discovered and there masses and spins have been determined. The SM is stunning. Until now, no cracks have been found. There is no experiment that contradicts the SM. Moreover there is nothing observed beyond the SM. The SM works better and better. We proposed to construct colour singular nuclear forces theory based on Quantum Chromodynamics (QCD). As well Theological aspects of the BIG BANG

  1. Tumour 18 F-FDG Uptake on preoperative PET/CT may predict axillary lymph node metastasis in ER-positive/HER2-negative and HER2-positive breast cancer subtypes

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin You; Lee, Suck Hong; Kim, Suk [Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Department of Radiology, Seo-gu, Busan (Korea, Republic of); Kang, Taewoo [Pusan National University Hospital, Busan Cancer Center, Busan (Korea, Republic of); Bae, Young Tae [Pusan National University Hospital, Department of Surgery, Busan (Korea, Republic of)

    2015-04-01

    To evaluate the association between tumour FDG uptake on preoperative PET/CT and axillary lymph node metastasis (ALNM) according to breast cancer subtype. The records of 671 patients with invasive breast cancer who underwent {sup 18} F-FDG PET/CT and surgery were reviewed. Using immunohistochemistry, tumours were divided into three subtypes: oestrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative, HER2-positive, and triple-negative. Tumour FDG uptake, expressed as maximum standardized uptake value (SUV{sub max}), and clinicopathological variables were analysed. ALNM was present in 187 of 461 ER-positive/HER2-negative, 54 of 97 HER2-positive, and 38 of 113 triple-negative tumours. On multivariate analysis, high tumour SUV{sub max} (≥4.25) (P < 0.001), large tumour size (>2 cm) (P = 0.003) and presence of lymphovascular invasion (P < 0.001) were independent variables associated with ALNM. On subset analyses, tumour SUV{sub max} maintained independent significance for predicting ALNM in ER-positive/HER2-negative (adjusted odds ratio: 3.277, P < 0.001) and HER2-positive tumours (adjusted odds ratio: 14.637, P = 0.004). No association was found for triple-negative tumours (P = 0.161). Tumour SUV{sub max} may be an independent prognostic factor for ALNM in patients with invasive breast cancer, especially in ER-positive/HER2-negative and HER2-positive subtypes, but not in those with triple-negative subtype. (orig.)

  2. Development of the neutron reference calibration field using a 252Cf standard source surrounded with PMMA moderators

    International Nuclear Information System (INIS)

    Yoshida, T.; Kanai, K.; Tsujimura, N.

    2002-01-01

    The authors developed the neutron reference calibration fields using a 252 Cf standard source surrounded with PMMA moderators at the Japan Nuclear Cycle Development (JNC), Tokai Works. The moderators are co-axial, hollow cylinders made of lead-contained PMMA with a thickness of 13.5, 35.0, 59.5 and 77.0mm, and the 252 Cf source is guided to the geometric center of moderators by the pneumatic system. These fields can provide the moderated neutron spectra very similar to those encountered around the globe-boxes of the fabrication process of MOX (PuO 2 -UO 2 mixed oxide) fuel. The neutron energy spectrum at the reference calibration point was evaluated from the calculations by MCNP4B and the measurements by the INS-type Bonner multi-sphere spectrometer and the hydrogen-filled proportional counters. The calculated neutron spectra were in good agreements with the measured ones. These fields were characterized in terms of the neutron fluence rate, spectral composition and ambient dose equivalent rate, and have served for the response-characterization of various neutron survey instruments

  3. Standardized structure of electronic records for information exchange

    International Nuclear Information System (INIS)

    Galabova, Sevdalina; Trencheva, Tereza; Trenchev, Ivan

    2009-01-01

    In the paper is presented the structure of the electronic record whose form is standardized in ISO 2709:2008. This International Standard describes a generalized structure, a framework designed specially for communications between data processing systems and not for use as a processing format within systems.Basic terms are defined as follows: character, data field, directory, directory map, field, field separator etc. It’s presented the general structure of a record. The application analysis of this structure shows the effective information exchange in the widest range.The purpose of this research is to find out advantages and structure of the information exchange format standardized in ISO 2709:2008. Key words: Standardized structure, electronic records, exchange formats, data field, directory, directory map, indicators, identifiers

  4. Hidden spin-3/2 field in the standard model

    Energy Technology Data Exchange (ETDEWEB)

    Demir, Durmus; Karahan, Canan; Sargin, Ozan [Izmir Institute of Technology, Department of Physics, Urla (Turkey); Korutlu, Beste [TUeBITAK National Metrology Institute, Gebze, Kocaeli (Turkey)

    2017-09-15

    Here we show that a massive spin-3/2 field can hide in the SM spectrum in a way revealing itself only virtually. We study collider signatures and loop effects of this field, and determine its role in Higgs inflation and its potential as dark matter. We show that this spin-3/2 field has a rich linear collider phenomenology and motivates consideration of a neutrino-Higgs collider. We also show that the study of Higgs inflation, dark matter and dark energy can reveal more about the neutrino and dark sector. (orig.)

  5. A review of the literature and discussion: establishing a consensus for the definition of post-mastectomy pain syndrome to provide a standardized clinical and research approach.

    Science.gov (United States)

    Brackstone, Murial

    2016-09-01

    Chronic pain presents a management challenge for physicians and patients alike, and post-mastectomy pain is no exception. In this issue, Waltho and Rockwell present a review of post-mastectomy pain syndrome (PMPS) and propose a standard definition that should allow future studies to be comparable. The proposed definition of "post-breast surgery pain syndrome" includes pain after any type of breast surgery that is of at least moderate intensity and comprises neuropathic qualities, that is present in the ipsilateral breast/chest/arm, that lasts longer than 6 months and is present at least half the time. Further work is needed to clarify whether this pain syndrome is in fact driven by neuralgia resulting from the axillary dissection component of breast cancer surgery.

  6. The axillary approach to raising the latissimus dorsi free flap for facial re-animation: a descriptive surgical technique.

    Science.gov (United States)

    Leckenby, Jonathan; Butler, Daniel; Grobbelaar, Adriaan

    2015-01-01

    The latissimus dorsi flap is popular due to the versatile nature of its applications. When used as a pedicled flap it provides a robust solution when soft tissue coverage is required following breast, thoracic and head and neck surgery. Its utilization as a free flap is extensive due to the muscle's size, constant anatomy, large caliber of the pedicle and the fact it can be used for functional muscle transfers. In facial palsy it provides the surgeon with a long neurovascular pedicle that is invaluable in situations where commonly used facial vessels are not available, in congenital cases or where previous free functional muscle transfers have been attempted, or patients where a one-stage procedure is indicated and a long nerve is required to reach the contra-lateral side. Although some facial palsy surgeons use the trans-axillary approach, an operative guide of raising the flap by this method has not been provided. A clear guide of raising the flap with the patient in the supine position is described in detail and offers the benefits of reducing the risk of potential brachial plexus injury and allows two surgical teams to work synchronously to reduce operative time.

  7. De-identifying Swedish clinical text - refinement of a gold standard and experiments with Conditional random fields

    Directory of Open Access Journals (Sweden)

    Dalianis Hercules

    2010-04-01

    Full Text Available Abstract Background In order to perform research on the information contained in Electronic Patient Records (EPRs, access to the data itself is needed. This is often very difficult due to confidentiality regulations. The data sets need to be fully de-identified before they can be distributed to researchers. De-identification is a difficult task where the definitions of annotation classes are not self-evident. Results We present work on the creation of two refined variants of a manually annotated Gold standard for de-identification, one created automatically, and one created through discussions among the annotators. The data is a subset from the Stockholm EPR Corpus, a data set available within our research group. These are used for the training and evaluation of an automatic system based on the Conditional Random Fields algorithm. Evaluating with four-fold cross-validation on sets of around 4-6 000 annotation instances, we obtained very promising results for both Gold Standards: F-score around 0.80 for a number of experiments, with higher results for certain annotation classes. Moreover, 49 false positives that were verified true positives were found by the system but missed by the annotators. Conclusions Our intention is to make this Gold standard, The Stockholm EPR PHI Corpus, available to other research groups in the future. Despite being slightly more time-consuming we believe the manual consensus gold standard is the most valuable for further research. We also propose a set of annotation classes to be used for similar de-identification tasks.

  8. Statistical approach to Higgs boson couplings in the standard model effective field theory

    Science.gov (United States)

    Murphy, Christopher W.

    2018-01-01

    We perform a parameter fit in the standard model effective field theory (SMEFT) with an emphasis on using regularized linear regression to tackle the issue of the large number of parameters in the SMEFT. In regularized linear regression, a positive definite function of the parameters of interest is added to the usual cost function. A cross-validation is performed to try to determine the optimal value of the regularization parameter to use, but it selects the standard model (SM) as the best model to explain the measurements. Nevertheless as proof of principle of this technique we apply it to fitting Higgs boson signal strengths in SMEFT, including the latest Run-2 results. Results are presented in terms of the eigensystem of the covariance matrix of the least squares estimators as it has a degree model-independent to it. We find several results in this initial work: the SMEFT predicts the total width of the Higgs boson to be consistent with the SM prediction; the ATLAS and CMS experiments at the LHC are currently sensitive to non-resonant double Higgs boson production. Constraints are derived on the viable parameter space for electroweak baryogenesis in the SMEFT, reinforcing the notion that a first order phase transition requires fairly low-scale beyond the SM physics. Finally, we study which future experimental measurements would give the most improvement on the global constraints on the Higgs sector of the SMEFT.

  9. XML-based formulation of field theoretical models. A proposal for a future standard and data base for model storage, exchange and cross-checking of results

    International Nuclear Information System (INIS)

    Demichev, A.; Kryukov, A.; Rodionov, A.

    2002-01-01

    We propose an XML-based standard for formulation of field theoretical models. The goal of creation of such a standard is to provide a way for an unambiguous exchange and cross-checking of results of computer calculations in high energy physics. At the moment, the suggested standard implies that models under consideration are of the SM or MSSM type (i.e., they are just SM or MSSM, their submodels, smooth modifications or straightforward generalizations). (author)

  10. The Effects of Dextromethorphan on Driving Performance and the Standardized Field Sobriety Test.

    Science.gov (United States)

    Perry, Paul J; Fredriksen, Kristian; Chew, Stephanie; Ip, Eric J; Lopes, Ingrid; Doroudgar, Shadi; Thomas, Kelan

    2015-09-01

    Dextromethorphan (DXM) is abused most commonly among adolescents as a recreational drug to generate a dissociative experience. The objective of the study was to assess driving with and without DXM ingestion. The effects of one-time maximum daily doses of DXM 120 mg versus a guaifenesin 400 mg dose were compared among 40 healthy subjects using a crossover design. Subjects' ability to drive was assessed by their performance in a driving simulator (STISIM® Drive driving simulator software) and by conducting a standardized field sobriety test (SFST) administered 1-h postdrug administration. The one-time dose of DXM 120 mg did not demonstrate driving impairment on the STISIM® Drive driving simulator or increase SFST failures compared to guaifenesin 400 mg. Doses greater than the currently recommended maximum daily dose of 120 mg are necessary to perturb driving behavior. © 2015 American Academy of Forensic Sciences.

  11. Design standards for experimental and field studies to evaluate diagnostic accuracy of tests for infectious diseases in aquatic animals.

    Science.gov (United States)

    Laurin, E; Thakur, K K; Gardner, I A; Hick, P; Moody, N J G; Crane, M S J; Ernst, I

    2018-05-01

    Design and reporting quality of diagnostic accuracy studies (DAS) are important metrics for assessing utility of tests used in animal and human health. Following standards for designing DAS will assist in appropriate test selection for specific testing purposes and minimize the risk of reporting biased sensitivity and specificity estimates. To examine the benefits of recommending standards, design information from published DAS literature was assessed for 10 finfish, seven mollusc, nine crustacean and two amphibian diseases listed in the 2017 OIE Manual of Diagnostic Tests for Aquatic Animals. Of the 56 DAS identified, 41 were based on field testing, eight on experimental challenge studies and seven on both. Also, we adapted human and terrestrial-animal standards and guidelines for DAS structure for use in aquatic animal diagnostic research. Through this process, we identified and addressed important metrics for consideration at the design phase: study purpose, targeted disease state, selection of appropriate samples and specimens, laboratory analytical methods, statistical methods and data interpretation. These recommended design standards for DAS are presented as a checklist including risk-of-failure points and actions to mitigate bias at each critical step. Adherence to standards when designing DAS will also facilitate future systematic review and meta-analyses of DAS research literature. © 2018 John Wiley & Sons Ltd.

  12. Bounds on the Higgs mass in the standard model and the minimal supersymmetric standard model

    CERN Document Server

    Quiros, M.

    1995-01-01

    Depending on the Higgs-boson and top-quark masses, M_H and M_t, the effective potential of the {\\bf Standard Model} can develop a non-standard minimum for values of the field much larger than the weak scale. In those cases the standard minimum becomes metastable and the possibility of decay to the non-standard one arises. Comparison of the decay rate to the non-standard minimum at finite (and zero) temperature with the corresponding expansion rate of the Universe allows to identify the region, in the (M_H, M_t) plane, where the Higgs field is sitting at the standard electroweak minimum. In the {\\bf Minimal Supersymmetric Standard Model}, approximate analytical expressions for the Higgs mass spectrum and couplings are worked out, providing an excellent approximation to the numerical results which include all next-to-leading-log corrections. An appropriate treatment of squark decoupling allows to consider large values of the stop and/or sbottom mixing parameters and thus fix a reliable upper bound on the mass o...

  13. Simple standard problem for the Preisach moving model

    International Nuclear Information System (INIS)

    Morentin, F.J.; Alejos, O.; Francisco, C. de; Munoz, J.M.; Hernandez-Gomez, P.; Torres, C.

    2004-01-01

    The present work proposes a simple magnetic system as a candidate for a Standard Problem for Preisach-based models. The system consists in a regular square array of magnetic particles totally oriented along the direction of application of an external magnetic field. The behavior of such system was numerically simulated for different values of the interaction between particles and of the standard deviation of the critical fields of the particles. The characteristic parameters of the Preisach moving model were worked out during simulations, i.e., the mean value and the standard deviation of the interaction field. For this system, results reveal that the mean interaction field depends linearly on the system magnetization, as the Preisach moving model predicts. Nevertheless, the standard deviation cannot be considered as independent of the magnetization. In fact, the standard deviation shows a maximum at demagnetization and two minima at magnetization saturation. Furthermore, not all the demagnetization states are equivalent. The plot standard deviation vs. magnetization is a multi-valuated curve when the system undergoes an AC demagnetization procedure. In this way, the standard deviation increases as the system goes from coercivity to the AC demagnetized state

  14. Standard Reference Development of nuclear material for Tensile and Hardness Test Properties

    International Nuclear Information System (INIS)

    Choo, Y. S.; Kim, D. S.; Yoo, B. O.; Ahn, S. B.; Baik, S. J.; Chun, Y. B.; Kim, K. H.; Hong, K. P.; Ryu, W. S.

    2007-12-01

    Standard reference is a official approved data such a coefficient of physics, approved material properties, and etc., which should be analyzed and evaluated by scientific method to acquire official approval for accuracy and credibility of measured data and information. So it could be used broadly and continuously by various fields of nation and society. It is classified to effective standard reference, verified standard reference, and certified standard reference. There are sixteen fields in designated standard references such a physical chemistry field, material field, metal field, and the others. The standard reference of neutron irradiated nuclear structural material is classified to metal field. This report summarized the whole processes about data collection, data production, data evaluation and the suggestion of details evaluation technical standard for tensile and hardness properties, which were achieved by carry out the project 'nuclear material standard reference development' as a result

  15. Standard Reference Development of nuclear material for Tensile and Hardness Test Properties

    Energy Technology Data Exchange (ETDEWEB)

    Choo, Y. S.; Kim, D. S.; Yoo, B. O.; Ahn, S. B.; Baik, S. J.; Chun, Y. B.; Kim, K. H.; Hong, K. P.; Ryu, W. S

    2007-12-15

    Standard reference is a official approved data such a coefficient of physics, approved material properties, and etc., which should be analyzed and evaluated by scientific method to acquire official approval for accuracy and credibility of measured data and information. So it could be used broadly and continuously by various fields of nation and society. It is classified to effective standard reference, verified standard reference, and certified standard reference. There are sixteen fields in designated standard references such a physical chemistry field, material field, metal field, and the others. The standard reference of neutron irradiated nuclear structural material is classified to metal field. This report summarized the whole processes about data collection, data production, data evaluation and the suggestion of details evaluation technical standard for tensile and hardness properties, which were achieved by carry out the project 'nuclear material standard reference development' as a result.

  16. Sentinel Lymph Node Biopsy and Isolated Tumor Cells in Invasive Lobular Versus Ductal Breast Cancer.

    Science.gov (United States)

    Truin, Wilfred; Roumen, Rudi M; Siesling, Sabine; van der Heiden-van der Loo, Margriet; Lobbezoo, Dorien J; Tjan-Heijnen, Vivianne C; Voogd, Adri C

    2016-08-01

    Sentinel lymph node (SLN) biopsy is the standard of care for axillary staging in invasive breast cancer. The introduction of SLN biopsy with an extensive pathology examination, in addition to the introduction of the 2002 TNM classification, led to different axillary classification outcomes. We evaluated the effect of axillary staging procedures and subsequent axillary nodal status in patients with invasive lobular carcinoma (ILC) versus invasive ductal carcinoma (IDC) from 1998 to 2013. The use of SLN biopsy and the nodal status distribution were analyzed in patients with stage T1-T2 ILC and IDC. Logistic regression analysis was performed to determine the independent effect of histologic type on the probability of the presence of isolated tumor cells (ITCs), micrometastases, and macrometastases. A total of 89,971 women were diagnosed, 10,146 with ILC (11%) and 79,825 with IDC (89%). The patients who had undergone SLN biopsy were more frequently diagnosed with ITCs than were those who had undergone axillary lymph node dissection only (odds ratio, 8.8; 95% confidence interval, 7.0-11.2). In 2013, the proportion of patients with ITCs in the axillary nodes was 8% in those with ILC and 4.4% in those with IDC. Patients with ILC were significantly more likely to have ITCs in their axillary lymph nodes than were patients with IDC (odds ratio, 1.8; 95% confidence interval, 1.6-2.0). With the introduction of SLN biopsy and the renewed 2002 TNM classification, patients with ILC have been more frequently diagnosed with ITCs than have patients with IDC. The clinical consequence of this finding must be established from further research. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. UV scale calibration transfer from an improved pyroelectric detector standard to field UV-A meters and 365 nm excitation sources

    Science.gov (United States)

    Eppeldauer, G. P.; Podobedov, V. B.; Cooksey, C. C.

    2017-05-01

    Calibration of the emitted radiation from UV sources peaking at 365 nm, is necessary to perform the ASTM required 1 mW/cm2 minimum irradiance in certain military material (ships, airplanes etc) tests. These UV "black lights" are applied for crack-recognition using fluorescent liquid penetrant inspection. At present, these nondestructive tests are performed using Hg-lamps. Lack of a proper standard and the different spectral responsivities of the available UV meters cause significant measurement errors even if the same UV-365 source is measured. A pyroelectric radiometer standard with spectrally flat (constant) response in the UV-VIS range has been developed to solve the problem. The response curve of this standard determined from spectral reflectance measurement, is converted into spectral irradiance responsivity with UV sources (with different peaks and distributions) without using any source standard. Using this broadband calibration method, yearly spectral calibrations for the reference UV (LED) sources and irradiance meters is not needed. Field UV sources and meters can be calibrated against the pyroelectric radiometer standard for broadband (integrated) irradiance and integrated responsivity. Using the broadband measurement procedure, the UV measurements give uniform results with significantly decreased uncertainties.

  18. A comparison of the Actigraph GT1M and GT3X accelerometers under standardized and free-living conditions

    International Nuclear Information System (INIS)

    Kaminsky, Leonard A; Ozemek, Cemal

    2012-01-01

    Prior to 2008, data collection from Actigraph accelerometers was only possible in the uniaxial mode. In 2009, Actigraph released the GT3X, which allows triaxial data collection. The purpose of this study was to determine if data collected by the GT3X in the uniaxial mode are comparable to its predecessor, the GT1M, under both standardized and free-living conditions. Thirty-four subjects (17 women and 17 men) provided complete data for this study. Subjects wore the accelerometers (one GT1M and one GT3X) on their waistband in line with the right and left anterior axillary lines. Each subject walked on a treadmill at speeds of 2.4, 3.2, 4.0, 4.8, 5.6 and 6.4 km h −1 for 5 min each, and then continued to wear both accelerometers for all waking hours for three consecutive days. Mean steady-state activity counts min –1 for both accelerometers were not statistically different for the standardized treadmill walking speeds and for mean minutes/day and activity counts/day for intensity classifications under the free-living condition. Based on comparisons made from both standardized walking speeds and free-living conditions, it is reasonable to compare data derived from either the GT1M or GT3X when collected in the uniaxial mode. (paper)

  19. USTUR Whole Body Case 0262: 33-y Follow-up of PuO2 In A Skin Wound and Associated Axillary Node

    Energy Technology Data Exchange (ETDEWEB)

    James, Anthony C.; Sasser, Lyle B.; Stuit, Dorothy B.; Wood, T. G.; Glover, Samuel E.; Lynch, Timothy P.; Dagle, Gerald E.

    2008-01-28

    This whole body donation case (USTUR Registrant) involved two suspected plutonium oxide (Pu) inhalation intakes, each indicated by a measurable Pu alpha activity in a single urine sample, followed about 1.5 y later by a puncture wound to the thumb while working in a Pu glovebox. The study is concerned with modeling simultaneously the biokinetics of deposition and retention in the respiratory tract and at the wound site; and the biokinetics of Pu subsequently transferred to other body organs, until the donor's death. Urine samples taken after the wound incident had readily measurable Pu alpha activity over the next 14 y, before dropping below the minimum detectable excretion rate (<0.4 mBq per day). The Registrant died about 33 y after the wound intake, at the age of 71, from hepatocellular carcinoma with extensive metastases. At autopsy, all major soft tissue organs were harvested for analysis of their Pu-238, Pu-239+240 and Am-241 content. The amount of Pu-239+240 retained at the wound site was 68 ± 7 Bq (1 SD), measured by low-energy planar Ge spectrometry. A further 56.0 ± 1.2 Bq was retained in an associated axillary lymph node, measured by radiochemistry. Simultaneous mathematical analysis (modelling) of all in vivo urinary excretion data, together with the measured lung, thoracic lymph node, wound, axillary lymph node and systemic tissue contents at death, yielded estimated intake amounts of 757 and 1504 Bq, respectively, for the first and second inhalation incidents, and 204 Bq for the total wound intake. The inhaled Pu material was highly insoluble, with an estimated long-term absorption rate from the lungs of 2 E-5 per day. The Pu material deposited at the wound site was mixed: 14% was rapidly absorbed, 49% was absorbed at the rate of about 6E-5 per day, and the remainder ( 37%) was absorbed extremely slowly (at the rate of about 5E-6 per day). Thus, it was estimated that only 40% of the Pu initially deposited in the wound had been absorbed

  20. Development of the standard classification system of technical information in the field of RI-biomics and its application to the web system

    International Nuclear Information System (INIS)

    Jang, Sol Ah; Kim, Joo Yeon; Park, Tai Jin

    2014-01-01

    RI-Biomics is a new concept that combines radioisotopes (RI) and Biomics. For efficient collection of information, establishment of database for technical information system and its application to the system, there is an increasing need for constructing the standard classification system of technical information by its systematical classification. In this paper, we have summarized the development process of the standard classification system of technical information in the field of RI-Biomics and its application to the system. Constructing the draft version for the standard classification system of technical information was based on that standard classification one in national science and technology in Korea. The final classification system was then derived through the reconstruction and the feedback process based on the consultation from the 7 experts. These results were applied to the database of technical information system after transforming as standard code. Thus, the standard classification system were composed of 5 large classifications and 20 small classifications, and those classification are expected to establish the foundation of information system by achieving the circular structure of collection-analysis-application of information

  1. Development of the neutron reference calibration field using a {sup 252}Cf standard source surrounded with PMMA moderators

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, T.; Kanai, K.; Tsujimura, N. [Japan Nuclear Cycle Development Institute, Ibaraki-ken (Japan)

    2002-07-01

    The authors developed the neutron reference calibration fields using a {sup 252} Cf standard source surrounded with PMMA moderators at the Japan Nuclear Cycle Development (JNC), Tokai Works. The moderators are co-axial, hollow cylinders made of lead-contained PMMA with a thickness of 13.5, 35.0, 59.5 and 77.0mm, and the {sup 252} Cf source is guided to the geometric center of moderators by the pneumatic system. These fields can provide the moderated neutron spectra very similar to those encountered around the globe-boxes of the fabrication process of MOX (PuO{sub 2}-UO{sub 2} mixed oxide) fuel. The neutron energy spectrum at the reference calibration point was evaluated from the calculations by MCNP4B and the measurements by the INS-type Bonner multi-sphere spectrometer and the hydrogen-filled proportional counters. The calculated neutron spectra were in good agreements with the measured ones. These fields were characterized in terms of the neutron fluence rate, spectral composition and ambient dose equivalent rate, and have served for the response-characterization of various neutron survey instruments.

  2. Comparing Geologic Data Sets Collected by Planetary Analog Traverses and by Standard Geologic Field Mapping: Desert Rats Data Analysis

    Science.gov (United States)

    Feng, Wanda; Evans, Cynthia; Gruener, John; Eppler, Dean

    2014-01-01

    Geologic mapping involves interpreting relationships between identifiable units and landforms to understand the formative history of a region. Traditional field techniques are used to accomplish this on Earth. Mapping proves more challenging for other planets, which are studied primarily by orbital remote sensing and, less frequently, by robotic and human surface exploration. Systematic comparative assessments of geologic maps created by traditional mapping versus photogeology together with data from planned traverses are limited. The objective of this project is to produce a geologic map from data collected on the Desert Research and Technology Studies (RATS) 2010 analog mission using Apollo-style traverses in conjunction with remote sensing data. This map is compared with a geologic map produced using standard field techniques.

  3. Radiation dose to the supraclavicular cavity for different field adjustments of post-irradiated mastectomized women

    International Nuclear Information System (INIS)

    Mueller, E.J.

    1972-01-01

    It was investigated by exact dose measurements in the supraclavicular fossa whether the skin reactions occasionally found in the median region of the supraclavicular fossa and in the adjoining regions of the neck of mastectomized women treated by conventional radiotherapy using four steady state fields are due to excessive amounts of radiation or to a special property of the skin at this point. X-ray dose measurements were performed by means of capacitor chambers. The highest X-ray doses are measured in the middle of the supraclavicular fossa as a result of direct supraclavicular field irradiation. The strong exposure of the skin as a result of this field setting is unavoidable and cannot be the cause of the skin reactions in the median region because the other areas of the skin are exposed even more strongly. A major fraction of the exposure of the skin in the supraclavicular fossa is contributed by the axillary field irradiation in which a non-uniformity of the angles is to be observed in repeated settings of the irradiation field, which has major consequences upon the skin of the supraclavicular fossa. It can be shown by intentional systematic variation of the angle of exposure that the radiation will be distributed most uniformly throughout the supraclavicular fossa at angles between 30 0 and 40 0 and, hence, that the exposure of the skin accordingly will not be concentrated upon a specific point. (orig./RF) [de

  4. Axillary Reconstruction for Hidradenitis Suppurativa with an Inner-Arm Transposition Flap Creating a Brachioplasty Effect

    Directory of Open Access Journals (Sweden)

    Daniel L. Ching

    2017-05-01

    Full Text Available BackgroundHidradenitis suppurativa (HS is a chronic skin condition that can affect any area with apocrine sweat glands and has the potential to involve multiple sites concurrently. Commonly affected sites include the axilla, groin, perineum and perianal areas. In this study we performed a literature review on the surgical methods for HS and describe an innovative technique for reconstructing axilla HS using an inner-arm transposition flap.MethodsWe reviewed all cases (5 cases from 4 patients of transposition flap reconstruction performed by the senior author at a single London tertiary hospital from 2008–2013. Patient related outcome measures were collected using the Derriford appearance scale (DAS 24 and a study specific questionnaire.ResultsAll patients were satisfied with their final result. One out of five cases had a complication but did not result in flap failure. There is no disease recurrence to date. DAS 24 scores collected demonstrated acceptable postoperative distress that did not deviate far from the norm tables while study specific questionnaire reveal desirable outcomes.ConclusionsWe have managed to achieve our aim through the use of the innovative inner-arm transposition flap. Our study hopes to provide an additional technique for axillary reconstruction. This technique offers the effective concealment of scars with the benefit of tightening of the arm tissue producing ‘brachioplasty like’ effects. All things considered it would be reasonable to conclude the innovative flap technique is a reliable, effective, and simple method that results in multiple benefits.

  5. Missed causative tumors in diagnosing tumor-induced osteomalacia with (18)F-FDG PET/CT: a potential pitfall of standard-field imaging.

    Science.gov (United States)

    Kaneuchi, Yoichi; Hakozaki, Michiyuki; Yamada, Hitoshi; Hasegawa, Osamu; Tajino, Takahiro; Konno, Shinichi

    2016-01-01

    We describe herein two tumor-induced osteomalacia (TIO) cases for whom the causative lesions, located in their popliteal fossa, that were not identified in the standard field of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT), which usually images only the head, trunk, and proximal parts of the extremities. A 47 years old Japanese man with multiple pathological fractures due to osteomalacia, accompanied by muscle weakness, hypophosphatemia, and an elevation of alkaline phosphatase (ALP) was referred to our hospital. A (18)F-FDG PET/CT scan was performed, but no (18)F-FDG uptake was detected in the standard field of imaging. Magnetic resonance imaging revealed a small subcutaneous tumor (1.9×1.2×0.6cm) of the left posteriomedial knee, displaying uniform enhancement on gadolinium-enhanced T1-weighted fat-suppression imaging. The tumor was resected widely and diagnosed as phosphaturic mesenchymal tumor, mixed connective tissue variant (PMTMCT). The other patient was a 31 years old Japanese woman with multiple pathological fractures, hypophosphatemia and elevated of ALP and was referred to our hospital on suspicion of TIO. Although the causative lesion was not identified in the standard field of (18)F-FDG PET/CT, (18)F-FDG uptake (SUVmax 2.9) was detected on the right knee in the additional whole-body (18)F-FDG PET/CT. Magnetic resonance imaging revealed a soft-tissue tumor (6.4×4.1×2.9cm) in the right posterior knee. Following biopsy, the tumor was marginally resected, and was pathologically diagnosed as PMTMCT. Once patients are suspected to have TIO, a whole-body nuclear imaging study such as (18)F-FDG PET/CT should be performed, in order not to miss the hidden causative tumor, especially occurring in the distal extremities.

  6. Recovery of the endangered Chatham petrel (Pterodroma axillaris: A review of conservation management techniques from 1990 to 2010

    Directory of Open Access Journals (Sweden)

    Helen Gummer

    2015-01-01

    Full Text Available Conservation of gadfly petrels, some of the most threatened seabirds, is frequently dependent on long-term research and management. We review 20 years of a program preventing the extinction of the Chatham petrel (Pterodroma axillaris, a New Zealand endemic once declining due to intense burrow competition from another native seabird. Breeding success in the early 1990s was unsustainably low (10–30%. Recovery measures started in 1992 when Chatham petrel burrows were converted and artificial entrances blockaded to exclude broad-billed prions (Pachyptila vittata. Pair and burrow fidelity were enhanced, though prions still posed a threat during Chatham petrel chick-rearing. Breeding success improved when prions were culled, however a less intensive and contentious solution was to introduce burrow flaps in 2001 which reduced interference from prospecting prions. Subsequently, breeding success increased to a mean 80% per annum. Finding burrows, primarily using radio-telemetry, increased those under management from eight in 1990 to 217 in 2010 when spotlight surveys indicated 72% of juvenile birds had fledged from managed burrows. Chick translocations to two other islands and increasing population size (from 200–400 birds in 1990 to an estimated 1400 birds by 2010 has improved the species IUCN status from Critically Endangered in 1990 to Endangered in 2013.

  7. Recommendation for axillary lymph node dissection in women with early breast cancer and sentinel node metastasis: A systematic review and meta-analysis of randomized controlled trials using the GRADE system.

    Science.gov (United States)

    Huang, Tsai-Wei; Kuo, Ken N; Chen, Kee-Hsin; Chen, Chiehfeng; Hou, Wen-Hsuan; Lee, Wei-Hwa; Chao, Tsu-Yi; Tsai, Jo-Ting; Su, Chih-Ming; Huang, Ming-Te; Tam, Ka-Wai

    2016-10-01

    In 2014, the American Society of Clinical Oncology published an updated clinical practice guideline on axillary lymph node dissection (ALND) for early-stage breast cancer patients. However, these recommendations have been challenged because they were based on data from only one randomized controlled trial (RCT). We evaluated the rationale of these recommendations by systematically reviewing RCTs using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system. We searched articles in the PubMed, EMBASE, CINAHL, Scopus, and Cochrane databases. The primary endpoints were overall survival (OS) and disease-free survival (DFS). The secondary endpoints were recurrence rate and surgical complications of axillary dissection. The quality of evidence was assessed using the GRADE profiler. Five eligible studies were retrieved and analyzed. We divided sentinel lymph node (SLN) metastasis into two categories: SLN micrometastasis and SLN macrometastasis. In patients with 1 or 2 SLN micrometastasis, no significant difference was observed in OS, DFS, or recurrence rate between the ALND and non-ALND groups. For patients with 1 or 2 SLN marcometastasis, only one trial with a moderate risk of bias was included, and non-ALND was the preferred management overall. However, ALND might be appropriate for patients who placed a greater emphasis on longer-term survival at any cost. We recommend non-ALND management for early breast cancer patients with 1 or 2 SLN micrometastasis or macrometastasis on the basis of a systematic review of the current evidence conducted using the GRADE system. However, the optimal practice of evidence-based medicine should incorporate patient preferences, particularly when evidence is limited. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  8. Critical Metadata for Spectroscopy Field Campaigns

    Directory of Open Access Journals (Sweden)

    Barbara A. Rasaiah

    2014-04-01

    Full Text Available A field spectroscopy metadata standard is defined as those data elements that explicitly document the spectroscopy dataset and field protocols, sampling strategies, instrument properties and environmental and logistical variables. Standards for field spectroscopy metadata affect the quality, completeness, reliability, and usability of datasets created in situ. Currently there is no standardized methodology for documentation of in situ spectroscopy data or metadata. This paper presents results of an international experiment comprising a web-based survey and expert panel evaluation that investigated critical metadata in field spectroscopy. The survey participants were a diverse group of scientists experienced in gathering spectroscopy data across a wide range of disciplines. Overall, respondents were in agreement about a core metadataset for generic campaign metadata, allowing for a prioritization of critical metadata elements to be proposed including those relating to viewing geometry, location, general target and sampling properties, illumination, instrument properties, reference standards, calibration, hyperspectral signal properties, atmospheric conditions, and general project details. Consensus was greatest among individual expert groups in specific application domains. The results allow the identification of a core set of metadata fields that enforce long term data storage and serve as a foundation for a metadata standard. This paper is part one in a series about the core elements of a robust and flexible field spectroscopy metadata standard.

  9. Standard NIM instrumentation system

    International Nuclear Information System (INIS)

    1990-05-01

    NIM is a standard modular instrumentation system that is in wide use throughout the world. As the NIM system developed and accommodations were made to a dynamic instrumentation field and a rapidly advancing technology, additions, revisions and clarifications were made. These were incorporated into the standard in the form of addenda and errata. This standard is a revision of the NIM document, AEC Report TID-20893 (Rev. 4) dated July 1974. It includes all the addenda and errata items that were previously issued as well as numerous additional items to make the standard current with modern technology and manufacturing practice

  10. Efficacy of Ultrasound-Guided Axillary Brachial Plexus Block for Analgesia During Percutaneous Transluminal Angioplasty for Dialysis Access

    International Nuclear Information System (INIS)

    Chiba, Emiko; Hamamoto, Kohei; Nagashima, Michio; Matsuura, Katsuhiko; Okochi, Tomohisa; Tanno, Keisuke; Tanaka, Osamu

    2016-01-01

    PurposeTo evaluate the efficacy and safety of ultrasound (US)-guided axillary brachial plexus block (ABPB) for analgesia during percutaneous transluminal angioplasty (PTA) for dialysis access.Subjects and MethodsTwenty-one patients who underwent PTA for stenotic dialysis access shunts and who had previous experience of PTA without sedation, analgesia, and anesthesia were included. The access type in all patients was native arteriovenous fistulae in the forearm. Two radiologists performed US-guided ABPB for the radial and musculocutaneous nerves before PTA. The patients’ pain scores were evaluated using a visual analog scale (VAS) after PTA, and these were compared with previous sessions without US-guided ABPB. The patient’s motor/sensory paralysis after PTA was also examined.ResultsThe mean time required to achieve US-guided ABPB was 8 min. The success rate of this procedure was 100 %, and there were no significant complications. All 21 patients reported lower VAS with US-guided ABPB as compared to without the block (p < 0.01). All patients expressed the desire for an ABPB for future PTA sessions, if required. Transient motor paralysis occurred in 8 patients, but resolved in all after 60 min.ConclusionUS-guided ABPB is feasible and effective for analgesia in patients undergoing PTA for stenotic dialysis access sites.Level of EvidenceLevel 4 (case series).

  11. Efficacy of Ultrasound-Guided Axillary Brachial Plexus Block for Analgesia During Percutaneous Transluminal Angioplasty for Dialysis Access

    Energy Technology Data Exchange (ETDEWEB)

    Chiba, Emiko, E-mail: chibaemi23@comet.ocn.ne.jp; Hamamoto, Kohei, E-mail: hkouhei917@gmail.com [Jichi Medical University, Department of Radiology, Saitama Medical Center (Japan); Nagashima, Michio, E-mail: nagamic00@gmail.com [Asahikawa Medical University, Department of Emergency Medicine (Japan); Matsuura, Katsuhiko, E-mail: kmatsur@gmail.com; Okochi, Tomohisa, E-mail: t-shachi@dj8.so-net.ne.jp; Tanno, Keisuke, E-mail: tankichi1974@gmail.com; Tanaka, Osamu, E-mail: otanaka@omiya.jichi.ac.jp [Jichi Medical University, Department of Radiology, Saitama Medical Center (Japan)

    2016-10-15

    PurposeTo evaluate the efficacy and safety of ultrasound (US)-guided axillary brachial plexus block (ABPB) for analgesia during percutaneous transluminal angioplasty (PTA) for dialysis access.Subjects and MethodsTwenty-one patients who underwent PTA for stenotic dialysis access shunts and who had previous experience of PTA without sedation, analgesia, and anesthesia were included. The access type in all patients was native arteriovenous fistulae in the forearm. Two radiologists performed US-guided ABPB for the radial and musculocutaneous nerves before PTA. The patients’ pain scores were evaluated using a visual analog scale (VAS) after PTA, and these were compared with previous sessions without US-guided ABPB. The patient’s motor/sensory paralysis after PTA was also examined.ResultsThe mean time required to achieve US-guided ABPB was 8 min. The success rate of this procedure was 100 %, and there were no significant complications. All 21 patients reported lower VAS with US-guided ABPB as compared to without the block (p < 0.01). All patients expressed the desire for an ABPB for future PTA sessions, if required. Transient motor paralysis occurred in 8 patients, but resolved in all after 60 min.ConclusionUS-guided ABPB is feasible and effective for analgesia in patients undergoing PTA for stenotic dialysis access sites.Level of EvidenceLevel 4 (case series).

  12. Secondary standard dosimetry laboratory (SSDL)

    International Nuclear Information System (INIS)

    Md Saion bin Salikin.

    1983-01-01

    A secondary Standard Dosimetry Laboratory has been established in the Tun Ismail Research Centre, Malaysia as a national laboratory for reference and standardization purposes in the field of radiation dosimetry. This article gives brief accounts on the general information, development of the facility, programmes to be carried out as well as other information on the relevant aspects of the secondary standard dosimetry laboratory. (author)

  13. Anatomy and nomenclature of murine lymph nodes: Descriptive study and nomenclatory standardization in BALB/cAnNCrl mice.

    Science.gov (United States)

    Van den Broeck, Wim; Derore, Annie; Simoens, Paul

    2006-05-30

    Murine lymph nodes are intensively studied but often assigned incorrectly in scientific papers. In BALB/cAnNCrl mice, we characterized a total of 22 different lymph nodes. Peripheral nodes were situated in the head and neck region (mandibular, accessory mandibular, superficial parotid, cranial deep cervical nodes), and at the forelimb (proper axillary, accessory axillary nodes) and hindlimb (subiliac, sciatic, popliteal nodes). Intrathoracic lymph nodes included the cranial mediastinal, tracheobronchal and caudal mediastinal nodes. Abdominal lymph nodes were associated with the gastrointestinal tract (gastric, pancreaticoduodenal, jejunal, colic, caudal mesenteric nodes) or were located along the major intra-abdominal blood vessels (renal, lumbar aortic, lateral iliac, medial iliac and external iliac nodes). Comparative and nomenclative aspects of murine lymph nodes are discussed. The position of the lymph nodes of BALB/cAnNCrl mice is summarized and illustrated in an anatomical chart containing proposals for both an official nomenclature according to the Nomina Anatomica Veterinaria and English terms.

  14. Relative device stability of anterior versus axillary needle decompression for tension pneumothorax during casualty movement: Preliminary analysis of a human cadaver model.

    Science.gov (United States)

    Leatherman, Matthew L; Held, Jenny M; Fluke, Laura M; McEvoy, Christian S; Inaba, Kenji; Grabo, Daniel; Martin, Matthew J; Earley, Angela S; Ricca, Robert L; Polk, Travis M

    2017-07-01

    Tension pneumothorax (tPTX) remains a significant cause of potentially preventable death in military and civilian settings. The current prehospital standard of care for tPTX is immediate decompression with a 14-gauge 8-cm angiocatheter; however, failure rates may be as high as 17% to 60%. Alternative devices, such as 10-gauge angiocatheter, modified Veress needle, and laparoscopic trocar, have shown to be potentially more effective in animal models; however, little is known about the relative insertional safety or mechanical stability during casualty movement. Seven soft-embalmed cadavers were intubated and mechanically ventilated. Chest wall thickness was measured at the second intercostal space at the midclavicular line (2MCL) and the fifth intercostal space along the anterior axillary line (5AAL). CO2 insufflation created a PTX, and needle decompression was then performed with a randomized device. Insertional depth was measured between hub and skin before and after simulated casualty transport. Thoracoscopy was used to evaluate for intrapleural placement and/or injury during insertion and after movement. Cadaver demographics, device displacement, device dislodgment, and injuries were recorded. Three decompressions were performed at each site (2MCL/5AAL), totaling 12 events per cadaver. Eighty-four decompressions were performed. Average cadaver age was 59 years, and body mass index was 24 kg/m. The CWT varied between cadavers because of subcutaneous emphysema, but the average was 39 mm at the 2MCL and 31 mm at the 5AAL. Following movement, the 2MCL site was more likely to become dislodged than the 5AAL (67% vs. 17%, p = 0.001). Median displacement also differed between 2MCL and 5AAL (23 vs. 2 mm, p = 0.001). No significant differences were noted in dislodgement or displacement between devices. Five minor lung injuries were noted at the 5AAL position. Preliminary results from this human cadaver study suggest the 5AAL position is a more stable and reliable location

  15. Molecular cloning, phylogenetic analysis, and expression patterns of LATERAL SUPPRESSOR-LIKE and REGULATOR OF AXILLARY MERISTEM FORMATION-LIKE genes in sunflower (Helianthus annuus L.).

    Science.gov (United States)

    Fambrini, Marco; Salvini, Mariangela; Pugliesi, Claudio

    2017-03-01

    The wild sunflower (Helianthus annuus) plants develop a highly branched form with numerous small flowering heads. The origin of a no branched sunflower, producing a single large head, has been a key event in the domestication process of this species. The interaction between hormonal factors and several genes organizes the initiation and outgrowth of axillary meristems (AMs). From sunflower, we have isolated two genes putatively involved in this process, LATERAL SUPPRESSOR (LS)-LIKE (Ha-LSL) and REGULATOR OF AXILLARY MERISTEM FORMATION (ROX)-LIKE (Ha-ROXL), encoding for a GRAS and a bHLH transcription factor (TF), respectively. Typical amino acid residues and phylogenetic analyses suggest that Ha-LSL and Ha-ROXL are the orthologs of the branching regulator LS and ROX/LAX1, involved in the growth habit of both dicot and monocot species. qRT-PCR analyses revealed a high accumulation of Ha-LSL transcripts in roots, vegetative shoots, and inflorescence shoots. By contrast, in internodal stems and young leaves, a lower amount of Ha-LSL transcripts was observed. A comparison of transcription patterns between Ha-LSL and Ha-ROXL revealed some analogies but also remarkable differences; in fact, the gene Ha-ROXL displayed a low expression level in all organs analyzed. In situ hybridization (ISH) analysis showed that Ha-ROXL transcription was strongly restricted to a small domain within the boundary zone separating the shoot apical meristem (SAM) and the leaf primordia and in restricted regions of the inflorescence meristem, beforehand the separation of floral bracts from disc flower primordia. These results suggested that Ha-ROXL may be involved to establish a cell niche for the initiation of AMs as well as flower primordia. The accumulation of Ha-LSL transcripts was not restricted to the boundary zones in vegetative and inflorescence shoots, but the mRNA activity was expanded in other cellular domains of primary shoot apical meristem as well as AMs. In addition, Ha

  16. Standard practice for production and evaluation of field metallographic replicas

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2001-01-01

    1.1 This practice covers recognized methods for the preparation and evaluation of cellulose acetate or plastic film replicas which have been obtained from metallographically prepared surfaces. It is designed for the evaluation of replicas to ensure that all significant features of a metallographically prepared surface have been duplicated and preserved on the replica with sufficient detail to permit both LM and SEM examination with optimum resolution and sensitivity. 1.2 This practice may be used as a controlling document in commercial situations. 1.3 The values stated in SI units are to be regarded as the standard. Inch-pound units given in parentheses are for information only. 1.4 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.

  17. Laboratory and field temperature preference and avoidance data of fish related to the establishment of standards

    International Nuclear Information System (INIS)

    Stauffer, J.R.; Cherry, D.S.; Dickson, K.L.; Cairns, J. Jr.

    1975-01-01

    Temperature preferences for important fish species in the New River in the vicinity of Appalachian Power Company's Glen Lyn, Virginia plant were determined independently by both field and laboratory studies. A relationship was demonstrated between the temperature preference data generated by the two approaches. Based on the temperature preference data the responses of fish to the thermal discharges can be predicted. From these data and from other data on the fish community structure, it was possible to determine that the thermal discharge was causing no appreciable harm to the fish community. Based on these studies it was concluded that the most reasonable approach to establishing thermal standards is to couple temperature preference studies with site specific studies. (U.S.)

  18. Standards for radiation protection instrumentation: design of safety standards and testing procedures

    International Nuclear Information System (INIS)

    Meissner, Frank

    2008-01-01

    This paper describes by means of examples the role of safety standards for radiation protection and the testing and qualification procedures. The development and qualification of radiation protection instrumentation is a significant part of the work of TUV NORD SysTec, an independent expert organisation in Germany. The German Nuclear Safety Standards Commission (KTA) establishes regulations in the field of nuclear safety. The examples presented may be of importance for governments and nuclear safety authorities, for nuclear operators and for manufacturers worldwide. They demonstrate the advantage of standards in the design of radiation protection instrumentation for new power plants, in the upgrade of existing instrumentation to nuclear safety standards or in the application of safety standards to newly developed equipment. Furthermore, they show how authorities may proceed when safety standards for radiation protection instrumentation are not yet established or require actualization. (author)

  19. LTE-Advanced Relay Technology and Standardization

    CERN Document Server

    Yuan, Yifei

    2013-01-01

    LTE-Advanced Relay Technology and Standardization provides a timely reference work for relay technology with the finalizing of LTE Release 10 specifications. LTE-Advanced is quickly becoming the global standard for 4G cellular communications. The relay technology, as one of the key features in LTE-Advanced, helps not only to improve the system coverage and capacity, but also to save the costs of laying wireline backhaul. As a leading researcher in the field of LTE-Advanced standards, the author provides an in-depth description of LTE-A relay technology, and explains in detail the standard specification and design principles.     Readers from both academic and industrial fields can find sections of interest to them: Sections 2 & 4 could benefit researchers in academia and those who are engaged in exploratory work, while Sections 3 & 4 are more useful to engineers. Dr. Yifei Yuan is the Technical Director at the Standards Department of ZTE Inc.

  20. Search for adequate quality standards for neutron radiography of nuclear fuel

    International Nuclear Information System (INIS)

    Domanus, J.C.

    1983-01-01

    Unlike in other fields of industrial radiography, where standard methods and procedures are used to control the quality of the radiographic image, no such standard exists for neutron radiography of nuclear fuel. To fill that gap it was felt that standardization work ought to be started in that field, too. Accordingly in 1979 an Euratom Neutron Radiography Working Group was constituted, which initiated standardization work in the field of neutron radiography of nuclear fuel. Finding adequate standards for image quality of neutron radiographs and checking the accuracy of dimension measurements from them were given first priority. (Auth.)