Dosimetric assessment of the field abutment region in head and neck treatments using a multileaf collimator

Energy Technology Data Exchange (ETDEWEB)

Abdel-Hakim, K.; Nishimura, T.; Sakahara, H. [Dept. of Radiology, Hamamatsu Univ. School of Medicine, Hamamatsu (Japan); Takaih, M.; Suzuki, S. [Dept. of Informatics, Hamamatsu Univ. School of Medicine, Hamamatsu (Japan)

2003-05-01

overdose could be smoothed out by overlaps of both leaf ends by 0.8 mm from both lateral and anterior portals. The ideal jaw position was found to be at 1 mm away from the beam central axis in any combination. Conclusion: The use of MLCs for photon field junction matching is appropriate and represents an alternative approach to the problem of field matching using the asymmetric jaws in head and neck treatments. asymmetric jaws in head and neck treatments. (orig.)

Dosimetric assessment of the field abutment region in head and neck treatments using a multileaf collimator

International Nuclear Information System (INIS)

Abdel-Hakim, K.; Nishimura, T.; Sakahara, H.; Takaih, M.; Suzuki, S.

2003-01-01

out by overlaps of both leaf ends by 0.8 mm from both lateral and anterior portals. The ideal jaw position was found to be at 1 mm away from the beam central axis in any combination. Conclusion: The use of MLCs for photon field junction matching is appropriate and represents an alternative approach to the problem of field matching using the asymmetric jaws in head and neck treatments. asymmetric jaws in head and neck treatments. (orig.)

Model of the material removal function and an experimental study on a magnetorheological finishing process using a small ball-end permanent-magnet polishing head.

Science.gov (United States)

Chen, Mingjun; Liu, Henan; Cheng, Jian; Yu, Bo; Fang, Zhen

2017-07-01

In order to achieve the deterministic finishing of optical components with concave surfaces of a curvature radius less than 10 mm, a novel magnetorheological finishing (MRF) process using a small ball-end permanent-magnet polishing head with a diameter of 4 mm is introduced. The characteristics of material removal in the proposed MRF process are studied. The model of the material removal function for the proposed MRF process is established based on the three-dimensional hydrodynamics analysis and Preston's equation. The shear stress on the workpiece surface is calculated by means of resolving the presented mathematical model using a numerical solution method. The analysis result reveals that the material removal in the proposed MRF process shows a positive dependence on shear stress. Experimental research is conducted to investigate the effect of processing parameters on the material removal rate and improve the surface accuracy of a typical rotational symmetrical optical component. The experimental results show that the surface accuracy of the finished component of K9 glass material has been improved to 0.14 μm (PV) from the initial 0.8 μm (PV), and the finished surface roughness Ra is 0.0024 μm. It indicates that the proposed MRF process can be used to achieve the deterministic removal of surface material and perform the nanofinishing of small curvature radius concave surfaces.

Automatic planning of head and neck treatment plans

DEFF Research Database (Denmark)

Hazell, Irene; Bzdusek, Karl; Kumar, Prashant

2016-01-01

radiation dose planning (dosimetrist) and potentially improve the overall plan quality. This study evaluates the performance of the Auto-Planning module that has recently become clinically available in the Pinnacle3 radiation therapy treatment planning system. Twenty-six clinically delivered head and neck...... as the previously delivered clinical plans. For all patients, the Auto-Planning tool produced clinically acceptable head and neck treatment plans without any manual intervention, except for the initial target and OAR delineations. The main benefit of the method is the likely improvement in the overall treatment......Treatment planning is time-consuming and the outcome depends on the person performing the optimization. A system that automates treatment planning could potentially reduce the manual time required for optimization and could also pro-vide a method to reduce the variation between persons performing...

Characterization of the head end cells at the West Valley Nuclear Fuel Reprocessing Plant

International Nuclear Information System (INIS)

Vance, R.F.

1986-11-01

The head-end cells at the West Valley Nuclear Fuel Reprocessing Plant are characterized in this report. These cells consist of the Process Mechanical Cell (PMC) where irradiated nuclear fuel was trimmed of excess hardware and sheared into short segments; and the General Purpose Cell (GPC) where the segments were collected and stored prior to dissolution, and leached hulls were packaged for disposal. Between 1966 and 1972, while Nuclear Fuels Services operated the plant, these cells became highly contaminated with radioactive materials. The purpose of this characterization work was to develop technical information as a basis of decontamination and decommissioning planning and engineering. It was accomplished by performing remote in-cell visual examinations, radiation surveys, and sampling. Supplementary information was obtained from available written records, out-of-cell inspections, and interviews with plant personnel

Treatment of recurrences in head and neck cancers occurring in irradiated site

International Nuclear Information System (INIS)

Pernot, M.

1994-01-01

We'll consider as recurrences the elevate relapses occurring at least six months after the first treatment end. The recurrences however frequent it is, is bad codified and everybody does what he can in the presence of a relapse. The number of retreated lesions should be in inverse proportion of the efficiency of the initial treatment. The surgery made large progresses during these last 15 years. The external radiotherapy is seldom a very good treatment indication of head and neck cancer recurrences in previously irradiated site. Iridium 192 wires may be used as implantations with low dose rate. For the cavity proper of mouth, we have counted 159 relapses at the level of the sole primary tumour. The tonsil neoplasms are often treated by a sole external irradiation or in association with curietherapy. For a larynx neoplasm the ideal starting treatment is that one which allows to cure the tumour while protecting the speaking and the swallowing. 83 refs

Physician perspectives on legal processes for resolving end-of-life disputes.

Science.gov (United States)

Chidwick, Paula; Sibbald, Robert

2011-01-01

In order to understand how to effectively approach end-of-life disputes, this study surveyed physicians' attitudes towards one process for resolving end-of-life disputes, namely, the Consent and Capacity Board of Ontario. In this case, the process involved examining interpretation of best interests between substitute decision-makers and medical teams. Physicians who made "Form G" applications to the Consent and Capacity Board of Ontario that resulted in a decision posted on the open-access database, Canadian Legal Information Institute (CanLii), were identified and surveyed. This purposive sample led to 13 invitations to participate and 12 interviews (92% response rate). Interviews were conducted using a prescribed interview guide. No barriers to the Consent and Capacity Board process were reported. Applications were made when physicians reached an impasse with the family and further treatment was perceived to be "unethical." The most significant challenge reported was the delay when appeals were launched. Appeals extended the process for an indefinite period of time making it so lengthy it negated any perceived benefits of the process. Benefits included that a neutral third party, namely the Consent and Capacity Board, was able to assess best interests. Also, when decisions were timely, further harm to the patient was minimized. Physicians reported this particular approach, namely the Consent and Capacity Board has a mechanism that is worthwhile, patient centred, process oriented, orderly and efficient for resolving end-of-life disputes and, in particular, determining best interests. However, unless the appeal process can be adjusted to respond to the ICU context there is a risk of not serving the best interest of patients. Physicians would recommend framing end-of-life treatment plans in the positive instead of negative, for example, propose palliative care and no escalation of treatment as opposed to withdrawal.

A Preliminary Shielding Study on the Integrated Operation Verification System in the Head-End Hot-Cell of the Pyro-processing

Energy Technology Data Exchange (ETDEWEB)

Kim, Jinhwam; Kim, Yewon; Park, Se-Hwan; Ahn, Seong-Kyu; Cho, Gyuseong [KAIST, Daejeon (Korea, Republic of)

2016-10-15

Nuclear power accounts for more than 30 percent of power production in Korea. Its significance has annually been increased. Disposal spent fuel containing uranium, transuranic elements, and fission products is unavoidable byproduct of nuclear power production. it is recognized that finding appropriate sites for interim storage of disposal spent fuel is not easy because isolated sites should be required. Pyro-processing technology, Pyro-processing should be operated under high radiation environment in hot-cell structures. Because of this reason, all workers should be unauthorized to access inside the hot-cell areas under any circumstances except for acceptable dose verification and a normal operation should be remotely manipulated. For the reliable normal operation of pyroprocessing, it is noted that an evaluation of the space dose distribution in the hot-cell environments is necessary in advance in order to determine which technologies or instruments can be utilized on or near the process as the Integrated Operation Verification System (IOVS) is measured. Not like the electroreduction and electro-refining hot-cells, the head-end hot-cell equips Camera Radiation Detector (CRD) in which plutonium is securely measured and monitored for the safeguard of the pyro-processing. Results have been obtained using F2 surface tally in order to observe the magnitude of the gamma-ray and neutron flux which pass through the surface of the process cell. Furthermore, T-mesh tally has also been used to obtain the space dose distribution in the headend hot-cell. The hot-cell was divided into 7,668 cells in which each dimension was 1 x 1 x 1m for the T-mesh tally. To determine the position of the CRD and the surveillance camera, divergent approaches were required. Because the purpose of the CRD which contains a gamma-ray detector and a neutron detector is to identify the material composition as the process proceeds, the position in which detectable flux is exposed is required, whereas

Leadership in nursing: analysis of the process of choosing the heads.

Science.gov (United States)

de Moura, Gisela Maria Schebella Souto; de Magalhaes, Ana Maria Müller; Dall'agnol, Clarice Maria; Juchem, Beatriz Cavalcanti; Marona, Daniela dos Santos

2010-01-01

The process of choosing heads can be strategic to achieve desired results in nursing care. This study presents an exploratory and descriptive research that aims to analyze the process of choosing heads for the ward, in the nursing area of a teaching hospital in Porto Alegre. Data was collected from registered nurses, technicians and nursing auxiliaries through a semi-structured interview technique and free choice of words. Three theme categories emerged from content analysis: process of choosing heads, managerial competences of the head-to-be and team articulation. Leadership was the word most frequently associated with the process of choosing heads. The consultation process for the choice of the leader also contributes to the success of the manager, as it makes the team members feel co-responsible for the results achieved and legitimizes the head-to-be in their group.

Hybrid disassembly system for cellular telephone end-of-life treatment

Energy Technology Data Exchange (ETDEWEB)

Kniebel, M.; Basdere, B.; Seliger, G. [Technical Univ. Berlin, Inst. for Machine Tools and Factory Management, Dept. of Assembly Technology and Factory Management, Berlin (Germany)

2004-07-01

Concern over the negative environmental impacts associated with the production, use, and end-of-life (EOL) of cellular telephones is particularly high due to large production volumes and characteristically short time scales of technological and stylistic obsolescence. Landfilled or incinerated cellular telephones create the potential for release of toxic substances. The European legislation has passed the directive on Waste of Electrical and Electronic Equipment (WEEE) to regulate their collection and appropriate end-of-life treatment. Manufacturers must conduct material recycling or remanufacturing processes to recover resources. While recovery rates can hardly be met economically by material recycling, remanufacturing and reusing cellular phones is developing into a reasonable alternative. Both end-of-life options require disassembly processes for WEEE compliant treatment. Due to the high number of different cell phone variants and their typical design that fits components into tight enclosing spaces, cellular phone disassembly becomes a challenging task. These challenges and the expected high numbers of phones to be returned in the course of the WEEE urges for automated disassembly. A hybrid disassembly system has been developed to ensure the mass-treatment of obsolete cellular phones. It has been integrated into a prototypical remanufacturing factory for cellular phones that has been planned based on market data. (orig.)

[Diagnosis and treatment characteristics of head-wind sha in She medicine].

Science.gov (United States)

Zou, Guangyi; Xu, Xiangdong; Zheng, Songming; Yan, Lianhe; Lei, Houxing; Zhang, Qiao-ling; Xiang, Yingmei; Ye, Yiping; Song, Liwei

2015-03-01

The diagnosis and treatment characteristics of head-wind sha in She medicine were analyzed and summarized. By visiting She-nationality villages and towns in Zhejiang province and Fujian province and interviewing hundreds of doctors of She medicine, the sha diagnosis, sha differentiation, experience and theory of treatment were arranged, and a comprehensive summary on theory and application of head-wind sha in She medicine such as pathogeny, name of disease, mechanism, diagnosis, differential diagnosis and treatment was made. It is believed that the methods of diagnosis and treatment in She medicine for head-wind sha could effectively enhance curative effect, safety and patients' quality of life, and the further research should be carried out.

Cetuximab in the treatment of head and neck cancer: preliminary results outside clinical trials

Science.gov (United States)

Dequanter, Didier; Shahla, Mohammad; Paulus, Pascal; Lothaire, Phillippe

2010-01-01

Introduction: The purpose of this study was to evaluate the clinical efficacy in our daily practice, outside clinical trials, of cetuximab plus radiotherapy in a majority of treatment-naive patients with locoregionally advanced head and neck squamous cell carcinomas. Methods: A retrospective study was performed to evaluate outcomes in patients who were treated definitively with cetuximab and radiotherapy (ExRT). Patients with stage III or IV, nonmetastatic, measurable squamous cell carcinoma of the head and neck (SCCHN) were eligible. Results: There were 18 males and two females. The median age was 61 years (range from 49 to 87 years old). Concurrent radiotherapy and cetuximab was used, in first line, in 17 patients with locally advanced disease; two patients with recurrent SCCHN, who were intolerant of Cisplatin-based regimens, were treated with radiotherapy combined with weekly cetuximab; and 1 patient received cetuximab and radiotherapy postoperatively. The median time of response was 10 months (range from 2 to 24 months). A partial response was observed in 11 cases; a complete response in nine cases. The occurrence of grade 2–3 skin toxicity was observed in 11 cases. Skin toxicity was clearly correlated with a better response and the duration of the response to the treatment. The use of cetuximab in combination with radiotherapy does not increase the side effects of radiotherapy. At the end of the follow-up, 17 patients died. Conclusion: Cetuximab, with its highly targeted mechanism of action and synergistic activity with current treatment modalities, is a valuable treatment option in head and neck patients. The effect of the epidermal growth factor receptor antagonist occurs without any change in the pattern and the severity of toxicity usually associated with head and neck radiation. Cetuximab seems not to provide the most benefit for patients with oropharyngeal cancers but will in patients with T4 tumors. However, the median duration of local control was

Cetuximab in the treatment of head and neck cancer: preliminary results outside clinical trials

International Nuclear Information System (INIS)

Dequanter, Didier; Shahla, Mohammad; Paulus, Pascal; Lothaire, Phillippe

2010-01-01

The purpose of this study was to evaluate the clinical efficacy in our daily practice, outside clinical trials, of cetuximab plus radiotherapy in a majority of treatment-naive patients with locoregionally advanced head and neck squamous cell carcinomas. A retrospective study was performed to evaluate outcomes in patients who were treated definitively with cetuximab and radiotherapy (ExRT). Patients with stage III or IV, nonmetastatic, measurable squamous cell carcinoma of the head and neck (SCCHN) were eligible. There were 18 males and two females. The median age was 61 years (range from 49 to 87 years old). Concurrent radiotherapy and cetuximab was used, in first line, in 17 patients with locally advanced disease; two patients with recurrent SCCHN, who were intolerant of Cisplatin-based regimens, were treated with radiotherapy combined with weekly cetuximab; and 1 patient received cetuximab and radiotherapy postoperatively. The median time of response was 10 months (range from 2 to 24 months). A partial response was observed in 11 cases; a complete response in nine cases. The occurrence of grade 2–3 skin toxicity was observed in 11 cases. Skin toxicity was clearly correlated with a better response and the duration of the response to the treatment. The use of cetuximab in combination with radiotherapy does not increase the side effects of radiotherapy. At the end of the follow-up, 17 patients died. Cetuximab, with its highly targeted mechanism of action and synergistic activity with current treatment modalities, is a valuable treatment option in head and neck patients. The effect of the epidermal growth factor receptor antagonist occurs without any change in the pattern and the severity of toxicity usually associated with head and neck radiation. Cetuximab seems not to provide the most benefit for patients with oropharyngeal cancers but will in patients with T4 tumors. However, the median duration of local control was less as described in the clinical trials

Role of awareness in head-neck acceleration in low velocity rear-end impacts.

Science.gov (United States)

Kumar, S; Narayan, Y; Amell, T

2000-03-01

Fourteen normal healthy seated and restrained young adults were delivered rear-end impacts of four intensities of acceleration. The chair was delivered a regulated and controlled pneumatic blow using a 30 cm cylinder to cause an acceleration of 0.5, 0.9, 1.1 and 1.4g. The accelerated chair was stopped suddenly by impacting the stopper at the other end of the 2 m long friction reduced track. In one set of trials, subjects were informed about the impending impact and in the other they were blindfolded and provided with loud auditory input to eliminate cues of the impact. The accelerations of the chair, shoulder and head of the participating subjects were measured triaxially and compared between levels of acceleration and expectation. The multiple analyses of variance revealed that the peak acceleration was significantly affected by the gender (P < 0.01), intensity of impact (P < 0.001), and expectation (P < 0.0001). The accelerations were significantly different in different axes (P < 0.001). A significant two-way interaction between acceleration and expectation (P < 0.03), and expectation and axes of acceleration (P < 0.02) would imply that awareness of the impending impact serves to significantly reduce the level of accelerations of head and neck.

An end-to-end assessment of range uncertainty in proton therapy using animal tissues

Science.gov (United States)

Zheng, Yuanshui; Kang, Yixiu; Zeidan, Omar; Schreuder, Niek

2016-11-01

Accurate assessment of range uncertainty is critical in proton therapy. However, there is a lack of data and consensus on how to evaluate the appropriate amount of uncertainty. The purpose of this study is to quantify the range uncertainty in various treatment conditions in proton therapy, using transmission measurements through various animal tissues. Animal tissues, including a pig head, beef steak, and lamb leg, were used in this study. For each tissue, an end-to-end test closely imitating patient treatments was performed. This included CT scan simulation, treatment planning, image-guided alignment, and beam delivery. Radio-chromic films were placed at various depths in the distal dose falloff region to measure depth dose. Comparisons between measured and calculated doses were used to evaluate range differences. The dose difference at the distal falloff between measurement and calculation depends on tissue type and treatment conditions. The estimated range difference was up to 5, 6 and 4 mm for the pig head, beef steak, and lamb leg irradiation, respectively. Our study shows that the TPS was able to calculate proton range within about 1.5% plus 1.5 mm. Accurate assessment of range uncertainty in treatment planning would allow better optimization of proton beam treatment, thus fully achieving proton beams’ superior dose advantage over conventional photon-based radiation therapy.

Radiotherapy in head and neck: a standard treatment?

International Nuclear Information System (INIS)

Santini Blasco, A; Torres Lopez, M; Apardian Manougian, R

1998-01-01

The present work is an exhaustive revision of the literature regarding the employment of combined treatments of radiochemotherapy in the head and neck neoplasms. The sanitary importance of this group of illnesses starts to become remarkable not only due to their frequency but for the high percentage of patients that present themselves for consultation with an advanced illness where the results of the classic treatments of surgery and radiotherapy are discouraging. These results are poor for the survival as well as in the quality of this. It analyzes the role of the different pharmaceuticals used in patients as well as the fundamentally different associations with radiotherapy: neoadjuvant, adjuvant and concomitant. These results allow to affirm that this treatment form is elected for those patients with advanced tumors of head and neck with a general state that allows to tolerate a bigger toxicity [es

A qualitative study of women's decision-making at the end of IVF treatment.

Science.gov (United States)

Peddie, V L; van Teijlingen, E; Bhattacharya, S

2005-07-01

The decision not to pursue further in vitro fertilization (IVF) after one or more unsuccessful attempts is an important and often difficult one for couples. Relatively little is known about the woman's perception of this decision-making process. The aim of this study was to examine patients' perspectives of decision-making, including circumstances influencing it and satisfaction with the decision-making process. Semi-structured interviews were conducted with a purposive sample of 25 women who had decided to end treatment after unsuccessful IVF treatment. Interviews were tape-recorded and transcribed by means of thematic analysis using the open coding technique. Women experienced difficulty in accepting that their infertility would remain unresolved. Many felt that they had started with unrealistic expectations of treatment success and felt vulnerable to the pressures of both the media and society. Although the decision to end treatment was difficult, it offered many women a way out of the emotional distress caused by IVF; however, the process of decision-making created a sense of 'confrontation' for the women in which they had to address issues they had previously avoided. Adoptive parents perceived less societal pressure than those who remained childless. Efforts to improve the psychological preparation of couples who decide to end IVF treatment should be directed towards examination of the existing system of consultation, which has certain limitations in terms of the quality of communication and the provision of post-treatment support. Further efforts to develop strategies, which facilitate the decision-making process, should be considered.

Brachytherapy for head and neck cancer. Treatment results and future prospect

International Nuclear Information System (INIS)

Shibuya, Hitoshi; Yoshimura, Ro-ichi; Miura, Masahiko; Ayukawa, Fumio; Watanabe, Hiroshi

2005-01-01

Following the increasing desire of many patients to keep the form and function of speech and swallowing, interstitial brachytherapy has become the main treatment for head and neck cancer. In addition, aged and physically handicapped patients who are refused general anesthesia have come to be referred to our clinic to receive less invasive and curative treatment. In the field of brachytherapy for head and neck cancers, less complicated and more superior treatment results have been achieved following the introduction of spacers, computer dosimetry and so on. As a result of these efforts, treatment results have come to fulfill the desire of patients and their families. During the past 43 years from 1962 to 2005, we have treated over 2, 100 patients of head and neck cancer including 850 with stage I·II oral tongue carcinoma by brachytherapy and acquired a lot of important and precious data including the treatment results, multiple primary cancers as well as radiation-induced cancers. (author)

Utilizing Domain Knowledge in End-to-End Audio Processing

DEFF Research Database (Denmark)

Tax, Tycho; Antich, Jose Luis Diez; Purwins, Hendrik

2017-01-01

to learn the commonly-used log-scaled mel-spectrogram transformation. Secondly, we demonstrate that upon initializing the first layers of an end-to-end CNN classifier with the learned transformation, convergence and performance on the ESC-50 environmental sound classification dataset are similar to a CNN......-based model trained on the highly pre-processed log-scaled mel-spectrogram features....

Long head of biceps: from anatomy to treatment

Directory of Open Access Journals (Sweden)

Marco Sarmento

2015-01-01

Full Text Available The long head of the biceps (LHB, tendinous structure of the proximal brachial biceps, has its well-known anatomy, which contrasts with its current functional characterization. Various forms of proximal anchor and intra–articular route, important for the correct interpretation of its contribution to the pathology of the shoulder as well as the treatment methodology, are described. Knowledge of its biomechanics results mainly from cadaveric studies that contradict each other. Already the few studies in vivo indicate a depressant and stabilizing action, anterior, for the humeral head. Its pathology is rarely isolated because it is almost always correlated with rotator cuff or labrum pathology. It can be divided into 3 major groups (inflammatory, instability and traumatic and subdivided according to its location. The anterior shoulder pain is the initial symptom of pathology of LHB Its perfect characterization is dependent on the associated injuries. Clinical tests are multiple and only their combination allows better sensitivity and specificity for LHB pathology. The arthro-MRI and dynamic ultrasound are able to increase proper diagnostic of the pathology of LHB. Treatment ranges from conservative and surgical. The latter includes the repair, tenotomy and tenodesis of LHB which can be performed by open or arthroscopic methodology. The author intends to review existing literature on all aspects related to the long head of the biceps from anatomy to treatment, presenting the latest results.

[Application of virtual reality in surgical treatment of complex head and neck carcinoma].

Science.gov (United States)

Zhou, Y Q; Li, C; Shui, C Y; Cai, Y C; Sun, R H; Zeng, D F; Wang, W; Li, Q L; Huang, L; Tu, J; Jiang, J

2018-01-07

Objective: To investigate the application of virtual reality technology in the preoperative evaluation of complex head and neck carcinoma and he value of virtual reality technology in surgical treatment of head and neck carcinoma. Methods: The image data of eight patients with complex head and neck carcinoma treated from December 2016 to May 2017 was acquired. The data were put into virtual reality system to built the three-dimensional anatomical model of carcinoma and to created the surgical scene. The process of surgery was stimulated by recognizing the relationship between tumor and surrounding important structures. Finally all patients were treated with surgery. And two typical cases were reported. Results: With the help of virtual reality, surgeons could adequately assess the condition of carcinoma and the security of operation and ensured the safety of operations. Conclusions: Virtual reality can provide the surgeons with the sensory experience in virtual surgery scenes and achieve the man-computer cooperation and stereoscopic assessment, which will ensure the safety of surgery. Virtual reality has a huge impact on guiding the traditional surgical procedure of head and neck carcinoma.

End-User Driven Business Process Composition

OpenAIRE

Stoitsev, Todor

2009-01-01

Business Process Management (BPM) solutions enable enterprises to consolidate and optimize their business operations and to gain competitive advantage in the fast evolving global market. Often, the only ones to understand the matter and complexity of business processes are the end users of enterprise software, who execute them on a daily basis. The need to involve end users in business process composition during the implementation of BPM solutions in enterprises is clearly perceived. However,...

Use of curium neutron flux from head-end pyroprocessing subsystems for the High Reliability Safeguards methodology

Energy Technology Data Exchange (ETDEWEB)

Borrelli, R.A., E-mail: r.angelo.borrelli@gmail.com

2014-10-01

The deployment of nuclear energy systems (NESs) is expanding around the world. Nations are investing in NESs as a means to establish energy independence, grow national economies, and address climate change. Transitioning to the advanced nuclear fuel cycle can meet growing energy demands and ensure resource sustainability. However, nuclear facilities in all phases of the advanced fuel cycle must be ‘safeguardable,’ where safety, safeguards, and security are integrated into a practical design strategy. To this end, the High Reliability Safeguards (HRS) approach is a continually developing safeguardability methodology that applies intrinsic design features and employs a risk-informed approach for systems assessment that is safeguards-motivated. Currently, a commercial pyroprocessing facility is used as the example system. This paper presents a modeling study that investigates the neutron flux associated with processed materials. The intent of these studies is to determine if the neutron flux will affect facility design, and subsequently, safeguardability. The results presented in this paper are for the head-end subsystems in a pyroprocessing facility. The collective results from these studies will then be used to further develop the HRS methodology.

Brachytherapy in the treatment of head and neck cancer

International Nuclear Information System (INIS)

Yoo, Seong Yul

1999-01-01

Brachytherapy has been proved to be an effective method for the purpose of increasing radiation dose to the tumor and reducing the dose to the surrounding normal tissue. In head and neck cancer, the rationale of brachytherapy is as follows; Firstly, early small lesion is radiocurative and the major cause of failure is local recurrence. Secondly, it can diminish evidently the dose to the normal tissue especially masseteric muscle and salivary gland. Thirdly, the anatomy of head and neck is suitable to various technique of brachytherapy. On background of accumulated experience of LDR iridium brachytherapy of head and neck cancer for the last 15 years, the author reviewed the history of radioisotope therapy, the characteristics of radionuclides, and some important things in the method, clinical technique and treatment planning. The author analyzed the clinical result of 185 cases of head and neck cancer treated in the Korea Cancer Center Hospital. Finally the future prospect of brachytherapy of head and neck cancer is discussed

European Research on Electrochemotherapy in Head and Neck Cancer (EURECA) project

DEFF Research Database (Denmark)

Plaschke, Christina Caroline; Bertino, Giulia; McCaul, James A.

2017-01-01

Aim Electrochemotherapy is an effective local treatment for cutaneous tumours and metastases. In this prospective trial, six European institutions investigated electrochemotherapy in recurrent, mucosal head and neck tumours. Patient and methods Forty-three patients with recurrent mucosal head....... Primary end-point was local tumour response. Secondary end-points were safety and toxicity, overall and progression free survival, and quality-of-life. Results Thirty-seven patients were evaluable for tumour response, pain score, side-effects and quality of life questionnaires. Six patients were...

Assessment and Treatment Considerations for Post Traumatic Stress Disorder at End of Life.

Science.gov (United States)

Glick, Debra M; Cook, Joan M; Moye, Jennifer; Kaiser, Anica Pless

2018-01-01

Post traumatic stress disorder (PTSD) may first emerge, reemerge, or worsen as individuals approach end of life and may complicate the dying process. Unfortunately, lack of awareness of the occurrence and/or manifestation of PTSD at end of life can lead to PTSD going unaddressed. Even if PTSD is properly diagnosed, traditional evidence-based trauma-focused treatments may not be feasible or advisable with this group as many patients at end of life often lack the physical and mental stamina to participate in traditional psychotherapy. This article reviews the clinical and empirical literature on PTSD at end of life, as well as discusses assessment and psychotherapy treatment issues with this neglected population. In addition, it expands on the current reviews of this literature 1-3 by extrapolating results from nontraditional treatment approaches with other patient populations. Elements of these approaches with patients sharing similar characteristics and/or comorbidities with patients with PTSD at end of life may provide additional benefits for the latter population. Clinical implications and suggestions for interdisciplinary care providers are provided.

Intensity of treatment in Swiss cancer patients at the end-of-life

Directory of Open Access Journals (Sweden)

Bähler C

2018-03-01

Full Text Available Caroline Bähler,1 Andri Signorell,1 Eva Blozik,1,2 Oliver Reich1 1Department of Health Sciences, Helsana Insurance Group, Zürich, Switzerland; 2Department of Medicine, University Medical Centre Freiburg, Freiburg im Breisgau, Germany Purpose: Current evidence on the care-delivering process and the intensity of treatment at the end-of-life of cancer patients is limited and remains unclear. Our objective was to examine the care-delivering processes in health care during the last months of life with real-life data of Swiss cancer patients. Patients and methods: The study population consisted of adult decedents in 2014 who were insured at Helsana Group. Data on the final cause of death were provided additionally by the Swiss Federal Statistical Office. Of the 10,275 decedents, 2,710 (26.4% died of cancer. Intensity of treatment and health care utilization (including transitions at their end-of-life were examined. Intensity measures included the following: last dose of chemotherapy within 14 days of death, a new chemotherapy regimen starting <30 days before death, more than one hospital admission or spending >14 days in hospital in the last month, death in an acute care hospital, more than one emergency visit and ≥1 intensive care unit admission in the last month of life. Results: In the last 6 months of life, 89.5% of cancer patients had ≥1 transition, with 87.2% being hospitalized. Within 30 days before death, 64.2% of the decedents had ≥1 intensive treatment, whereby 8.9% started a new chemotherapy. In the multinomial logistic regression model, older age, higher density of nursing home beds and home care nurses were associated with a decrease, while living in the Italian- or French-speaking part of Switzerland was associated with an increase in intensive care. Conclusion: Swiss cancer patients insured by Helsana Group experience a considerable number of transitions and intensive treatments at the end-of-life, whereby treatment intensity

EmptyHeaded: A Relational Engine for Graph Processing.

Science.gov (United States)

Aberger, Christopher R; Tu, Susan; Olukotun, Kunle; Ré, Christopher

2016-01-01

There are two types of high-performance graph processing engines: low- and high-level engines. Low-level engines (Galois, PowerGraph, Snap) provide optimized data structures and computation models but require users to write low-level imperative code, hence ensuring that efficiency is the burden of the user. In high-level engines, users write in query languages like datalog (SociaLite) or SQL (Grail). High-level engines are easier to use but are orders of magnitude slower than the low-level graph engines. We present EmptyHeaded, a high-level engine that supports a rich datalog-like query language and achieves performance comparable to that of low-level engines. At the core of EmptyHeaded's design is a new class of join algorithms that satisfy strong theoretical guarantees but have thus far not achieved performance comparable to that of specialized graph processing engines. To achieve high performance, EmptyHeaded introduces a new join engine architecture, including a novel query optimizer and data layouts that leverage single-instruction multiple data (SIMD) parallelism. With this architecture, EmptyHeaded outperforms high-level approaches by up to three orders of magnitude on graph pattern queries, PageRank, and Single-Source Shortest Paths (SSSP) and is an order of magnitude faster than many low-level baselines. We validate that EmptyHeaded competes with the best-of-breed low-level engine (Galois), achieving comparable performance on PageRank and at most 3× worse performance on SSSP.

The Janus Head Article - On Quality in the Documentation Process

Directory of Open Access Journals (Sweden)

Henrik Andersen

2006-03-01

Full Text Available The god Janus in Greek mythology was a two-faced god; each face had its own view of the world. Our idea behind the Janus Head article is to give you two different and maybe even contradicting views on a certain topic. In this issue the topic is quality in the documentation process. In the first half of this issue’s Janus Head Article translators from the international company Grundfos give us their view of quality and how quality is managed in the documentation process at Grundfos. In the second half of the Janus Head Article scholars from the University of Southern Denmark describe and discuss quality in the documentation process at Grundfos from a researcher’s point of view.

The Janus Head Article - On Quality in the Documentation Process

Directory of Open Access Journals (Sweden)

Henrik Andersen

2012-08-01

Full Text Available The god Janus in Greek mythology was a two-faced god; each face had its own view of the world. Our idea behind the Janus Head article is to give you two different and maybe even contradicting views on a certain topic. In this issue the topic is quality in the documentation process. In the first half of this issue’s Janus Head Article translators from the international company Grundfos give us their view of quality and how quality is managed in the documentation process at Grundfos. In the second half of the Janus Head Article scholars from the University of Southern Denmark describe and discuss quality in the documentation process at Grundfos from a researcher’s point of view.

Autologous Platelet Concentrates as Treatment for Avascular Necrosis of Femoral Head in a Dog.

Science.gov (United States)

Parra, Estefanía; Vergara, Andrea; Silva, Raúl F

2017-03-01

Avascular necrosis of the femoral head is a developmental disturbance that generally affects young dogs of small breeds and produces ischemic necrosis of the femoral head resulting in an incongruous and malformed joint. The most common treatment is the excisional arthroplasty of the head and femoral neck. The aim of this study is to describe the treatment of avascular necrosis in a Yorkshire dog using intra-articular injections of autologous platelet concentrate. Evaluations were made at 0, 15, 30, 60, and 120 days of treatment, describing the following parameters: clinical gait analysis, perimetry, goniometry, and radiographic evaluations. The results obtained in this case suggest that the autologous platelet concentrate may be an alternative for the treatment of avascular necrosis of the femoral head in dogs. Copyright © 2017 Elsevier Inc. All rights reserved.

Exploring the mechanisms of vehicle front-end shape on pedestrian head injuries caused by ground impact.

Science.gov (United States)

Yin, Sha; Li, Jiani; Xu, Jun

2017-09-01

In pedestrian-vehicle accidents, pedestrians typically suffer from secondary impact with the ground after the primary contact with vehicles. However, information about the fundamental mechanism of pedestrian head injury from ground impact remains minimal, thereby hindering further improvement in pedestrian safety. This study addresses this issue by using multi-body modeling and computation to investigate the influence of vehicle front-end shape on pedestrian safety. Accordingly, a simulation matrix is constructed to vary bonnet leading-edge height, bonnet length, bonnet angle, and windshield angle. Subsequently, a set of 315 pedestrian-vehicle crash simulations are conducted using the multi-body simulation software MADYMO. Three vehicle velocities, i.e., 20, 30, and 40km/h, are set as the scenarios. Results show that the top governing factor is bonnet leading-edge height. The posture and head injury at the instant of head ground impact vary dramatically with increasing height because of the significant rise of the body bending point and the movement of the collision point. The bonnet angle is the second dominant factor that affects head-ground injury, followed by bonnet length and windshield angle. The results may elucidate one of the critical barriers to understanding head injury caused by ground impact and provide a solid theoretical guideline for considering pedestrian safety in vehicle design. Copyright © 2017 Elsevier Ltd. All rights reserved.

Pyrochemical head-end treatment for fast reactor fuel elements

International Nuclear Information System (INIS)

Avogadro, A.

1978-01-01

The paper presents the R and D work performed at Ispra and Mol during the period 1965-1975 in order to find a way to overcome technical and economical difficulties arising when the conventional reprocessing is applied to fast reactor fuel elements. The work had been directed towards 3 specific topics: a) liquid-metal decladding of spent stainless steel - clad fuels (solinox process). b) oxidative pulverisation by fused salts and extraction of volatile fission products (satex process). c) Pyrochemical separation of plutonium from the bulk of the fuel

Poster - 44: Development and implementation of a comprehensive end-to-end testing methodology for linac-based frameless SRS QA using a modified commercial stereotactic anthropomorphic phantom

Energy Technology Data Exchange (ETDEWEB)

Liu, Derek; Mutanga, Theodore [University of Toronto, Carlo Fidani Peel Regional Cancer Center (Canada)

2016-08-15

Purpose: An end-to-end testing methodology was designed to evaluate the overall SRS treatment fidelity, incorporating all steps in the linac-based frameless radiosurgery treatment delivery process. The study details our commissioning experience of the Steev (CIRS, Norfolk, VA) stereotactic anthropomorphic head phantom including modification, test design, and baseline measurements. Methods: Repeated MR and CT scans were performed with interchanging inserts. MR-CT fusion accuracy was evaluated and the insert spatial coincidence was verified on CT. Five non-coplanar arcs delivered a prescription dose to a 15 mm spherical CTV with 2 mm PTV margin. Following setup, CBCT-based shifts were applied as per protocol. Sequential measurements were performed by interchanging inserts without disturbing the setup. Spatial and dosimetric accuracy was assessed by a combination of CBCT hidden target, radiochromic film, and ion chamber measurements. To facilitate film registration, the film insert was modified in-house by etching marks. Results: MR fusion error and insert spatial coincidences were within 0.3 mm. Both CBCT and film measurements showed spatial displacements of 1.0 mm in similar directions. Both coronal and sagittal films reported 2.3 % higher target dose relative to the treatment plan. The corrected ion chamber measurement was similarly greater by 1.0 %. The 3 %/2 mm gamma pass rate was 99% for both films Conclusions: A comprehensive end-to-end testing methodology was implemented for our SRS QA program. The Steev phantom enabled realistic evaluation of the entire treatment process. Overall spatial and dosimetric accuracy of the delivery were 1 mm and 3 % respectively.

Swallowing therapy and progressive resistance training in head and neck cancer patients undergoing radiotherapy treatment

DEFF Research Database (Denmark)

Hajdú, Sara F; Wessel, Irene; Johansen, Christoffer

2017-01-01

BACKGROUND: Head and neck cancer (HNC) patients are often challenged by treatment induced dysphagia and trismus. Traditionally, rehabilitation is initiated when loss of function has already occurred. There is increasing evidence that it is of benefit to patients to initiate an early rehabilitation...... process before and during treatment. HNC patients have a unique set of functional challenges such as pre- and post-treatment dysphagia, pain and weight loss. The aim of the trial is to investigate the effects of swallowing and mouth-opening exercises combined with progressive resistance training (PRT...

Clinical Value of High Mobility Group Box 1 and the Receptor for Advanced Glycation End-products in Head and Neck Cancer: A Systematic Review

Directory of Open Access Journals (Sweden)

Nguyen, Austin

2016-04-01

Full Text Available Introduction High mobility group box 1 is a versatile protein involved in gene transcription, extracellular signaling, and response to inflammation. Extracellularly, high mobility group box 1 binds to several receptors, notably the receptor for advanced glycation end-products. Expression of high mobility group box 1 and the receptor for advanced glycation end-products has been described in many cancers. Objectives To systematically review the available literature using PubMed and Web of Science to evaluate the clinical value of high mobility group box 1 and the receptor for advanced glycation end-products in head and neck squamous cell carcinomas. Data synthesis A total of eleven studies were included in this review. High mobility group box 1 overexpression is associated with poor prognosis and many clinical and pathological characteristics of head and neck squamous cell carcinomas patients. Additionally, the receptor for advanced glycation end-products demonstrates potential value as a clinical indicator of tumor angiogenesis and advanced staging. In diagnosis, high mobility group box 1 demonstrates low sensitivity. Conclusion High mobility group box 1 and the receptor for advanced glycation end-products are associated with clinical and pathological characteristics of head and neck squamous cell carcinomas. Further investigation of the prognostic and diagnostic value of these molecules is warranted.

Biased Brownian motion mechanism for processivity and directionality of single-headed myosin-VI.

Science.gov (United States)

Iwaki, Mitsuhiro; Iwane, Atsuko Hikikoshi; Ikebe, Mitsuo; Yanagida, Toshio

2008-01-01

Conventional form to function as a vesicle transporter is not a 'single molecule' but a coordinated 'two molecules'. The coordinated two molecules make it complicated to reveal its mechanism. To overcome the difficulty, we adopted a single-headed myosin-VI as a model protein. Myosin-VI is an intracellular vesicle and organelle transporter that moves along actin filaments in a direction opposite to most other known myosin classes. The myosin-VI was expected to form a dimer to move processively along actin filaments with a hand-over-hand mechanism like other myosin organelle transporters. However, wild-type myosin-VI was demonstrated to be monomer and single-headed, casting doubt on its processivity. Using single molecule techniques, we show that green fluorescent protein (GFP)-fused single-headed myosin-VI does not move processively. However, when coupled to a 200 nm polystyrene bead (comparable to an intracellular vesicle in size) at a ratio of one head per bead, single-headed myosin-VI moves processively with large (40 nm) steps. Furthermore, we found that a single-headed myosin-VI-bead complex moved more processively in a high-viscous solution (40-fold higher than water) similar to cellular environment. Because diffusion of the bead is 60-fold slower than myosin-VI heads alone in water, we propose a model in which the bead acts as a diffusional anchor for the myosin-VI, enhancing the head's rebinding following detachment and supporting processive movement of the bead-monomer complex. This investigation will help us understand how molecular motors utilize Brownian motion in cells.

Treatment of Childhood Head and Neck Cancer - Patient Version

Science.gov (United States)

Find diagnosis, staging, and treatment information for these head and neck cancers: hypopharynx, larynx, lip and oral cavity, neck cancer with occult primary, nasopharynx, oropharynx, paranasal sinus and nasal cavity, and salivary gland cancer.

Post-therapeutic surveillance strategies in head and neck squamous cell carcinoma

NARCIS (Netherlands)

Digonnet, Antoine; Hamoir, Marc; Andry, Guy; Haigentz, Missak; Takes, Robert P.; Silver, Carl E.; Hartl, Dana M.; Strojan, Primoz; Rinaldo, Alessandra; de Bree, Remco; Dietz, Andreas; Gregoire, Vincent; Paleri, Vinidh; Langendijk, Johannes A.; Vander Poorten, Vincent; Hinni, Michael L.; Rodrigo, Juan P.; Suarez, Carlos; Mendenhall, William M.; Werner, Jochen A.; Genden, Eric M.; Ferlito, Alfio

The management of head and neck squamous cell carcinomas does not end with the completion of ablative therapy. The oncologic objectives of post-treatment follow-up are to detect recurrences and second primary tumors; beyond that, follow-up should evaluate acute and chronic treatment-related side

Open-ended and Open-door Treatment Groups for Young People with Mental Illness.

Science.gov (United States)

Miller, Rachel; Mason, Susan E

2012-01-01

The concept of open-ended groups is expanded to include an open-door model (OEOD) wherein members with severe mental illnesses, including schizophrenia disorders and bi-polar, can join, leave, and re-enter groups as their life circumstances dictate their availability and willingness for treatment. This model is grounded on the work of Schopler and Galinsky's (1984/2006) and Galinsky and Schopler's (1989) theses on the value and processes of open-ended groups and includes perspectives on mutual aid and group development. Groupwork with the OEOD format is illustrated with examples taken from a group of 79 participants diagnosed with first-episode schizophrenia/schizoaffective disorders, 40 of who had co-occurring substance abuse. Of the 79 participants in the OEOD group program, 70 (89%) remained in treatment for the maximum of 3 years. The over-all value of group treatment for this population is reviewed along with the small number of available publications on open-ended and open-door-type groups.

Treatment of Pediatric Head and Neck Cancer - Health Professional Version

Science.gov (United States)

Find information about prognosis, staging, and treatment for the following head and neck cancer sites in children: esthesioneuroblastoma, larynx and papillomatosis, nasopharynx, oral cavity, and salivary gland.

On-field investigation and process modelling of end-of-life vehicles treatment in the context of Italian craft-type authorized treatment facilities.

Science.gov (United States)

Berzi, Lorenzo; Delogu, Massimo; Giorgetti, Alessandro; Pierini, Marco

2013-04-01

The present article analyses the current situation of End-of-Life-of-Vehicles (ELVs) management in Europe, with particular attention on Italian condition. Similarly to other European countries, metal recycling is the main activity of the whole system, but such situation is evolving due to the 2000/53/EC Directive, which sets out targets for Reuse, Recycling and Recovery of ELVs. Due to the relevance of the ELVs problem, in 2008 Italian Ministry of Environment subscribed a framework agreement with competent stakeholders as carmakers, dismantlers, shredders. The main result is an industrial plan to promote (amongst other objectives) technological progress for residual waste (Automotive Shredder Residue-ASR) treatment. According with Italian Trial 2006 analysis about ELVs, Reuse and Recycling rate is currently estimated to be about 81%. At the present time, dismantling plants constitute the first collection points for ELVs; for this reason, during 2009 an investigation has been done over a number of ten Authorized Treatment Facilities (ATFs) operating in Italy. The first step of the analysis was aimed to find out major practices and methods through observations of ATFs activities and interviews to operators. Furthermore, the depollution and dismantling treatments of about 70 different ELVs have been observed and timed in detail over a period of three months. The results included the identification of most relevant critical issues in ELVs treatment, such as distortions between scrapping activities and Directive's regulation, and the assessment of the time and of the resources needed to perform each operation. In the second step of the survey, a process simulation model has been built on the basis of such data. The model was aimed to include the real variability and all the uncertainties that are typical of dismantling activities; it is intended as a tool for process layout planning and for its management. Some control parameters have been introduced; these are able to

Specialists' meeting on gas-cooled reactor fuel development and spent fuel treatment

Energy Technology Data Exchange (ETDEWEB)

NONE

1985-07-01

Topics covered during the 'Specialists' meeting on gas-cooled reactor fuel development and spent fuel treatment' were as follows: Selection of constructions and materials, fuel element development concepts; Fabrication of spherical coated fuel particles and fuel element on their base; investigation of fuel properties; Spent fuel treatment and storage; Head-end processing of HTGR fuel elements; investigation of HTGR fuel regeneration process; applicability of gas-fluorine technology of regeneration of spent HTGR fuel elements.

Specialists' meeting on gas-cooled reactor fuel development and spent fuel treatment

International Nuclear Information System (INIS)

1985-01-01

Topics covered during the 'Specialists' meeting on gas-cooled reactor fuel development and spent fuel treatment' were as follows: Selection of constructions and materials, fuel element development concepts; Fabrication of spherical coated fuel particles and fuel element on their base; investigation of fuel properties; Spent fuel treatment and storage; Head-end processing of HTGR fuel elements; investigation of HTGR fuel regeneration process; applicability of gas-fluorine technology of regeneration of spent HTGR fuel elements

[SURGICAL HIP DISLOCATION APPROACH FOR TREATMENT OF FEMORAL HEAD FRACTURE].

Science.gov (United States)

Tang, Yanfeng; Liu, Youwen; Zhu, Yingjie; Li, Jianming; Li, Wuyin; Li, Qiyi; Jia, Yudong

2015-11-01

To discuss the value of surgical hip dislocation approach in the treatment of femoral head fracture. A retrospectively analysis was made on the clinical data of 15 patients with femoral head fractures treated through surgical hip dislocation approach between January 2010 and February 2013. There were 11 men and 4 women with an average age of 30.8 years (range, 15-63 years). The causes included traffic accident injury in 9 cases, falling injury from height in 5 cases, and sports injury in 1 case. According to Pipkin typing, 2 cases were rated as type I, 7 cases as type II, 1 case as type III, and 5 cases as type IV. The interval of injury and operation was 2-10 days (mean, 4.1 days). Reduction was performed in 10 patients within 6 hours after injury, and then bone traction was given for 4-6 weeks except 5 patients who received reduction in the other hospital. Primary healing of incision was obtained in all patients after surgery without complications of dislocation and lower limbs deep venous thrombosis. The mean follow-up time was 29.9 months (range, 25-36 months). During follow-up, there was no infection, breakage of internal fixation, or nonunion of femoral greater trochanter fracture. In 3 patients having necrosis of the femoral head, 2 had no obvious symptoms [staging as IIa and IIb respectively according to Association Research Circulation Osseous (ARCO) staging system], and 1 (stage IIIb) had nonunion of the femoral neck fracture, who underwent total hip arthroplasty (THA). In 4 patients having myositis ossificans (2 cases of grade I, 1 case of grade II, and 1 case of grade III based on Brooker grading), no treatment was given in 3 cases and the focus was removed during THA in 1 case. According to the Thompson-Epstein scale at last follow-up, the results were excellent in 9 cases, good in 3 cases, fair in 1 case, and poor in 2 cases, and the excellent and good rate was 80%. Surgical hip dislocation approach can not only protect the residual vessels of the

Selective Trapping of Volatile Fission Products with an Off-Gas Treatment System

Energy Technology Data Exchange (ETDEWEB)

B.R. Westphal; J.J. Park; J.M. Shin; G.I. Park; K.J. Bateman; D.L. Wahlquist

2008-07-01

A head-end processing step, termed DEOX for its emphasis on decladding via oxidation, is being developed for the treatment of spent oxide fuel by pyroprocessing techniques. The head-end step employs high temperatures to oxidize UO2 to U3O8 resulting in the separation of fuel from cladding and the removal of volatile fission products. Development of the head-end step is being performed in collaboration with the Korean Atomic Energy Research Institute (KAERI) through an International Nuclear Energy Research Initiative. Following the initial experimentation for the removal of volatile fission products, an off-gas treatment system was designed in conjunction with KAERI to collect specific fission gases. The primary volatile species targeted for trapping were iodine, technetium, and cesium. Each species is intended to be collected in distinct zones of the off-gas system and within those zones, on individual filters. Separation of the volatile off-gases is achieved thermally as well as chemically given the composition of the filter media. A description of the filter media and a basis for its selection will be given along with the collection mechanisms and design considerations. In addition, results from testing with the off-gas treatment system will be presented.

Femoral head injuries: Which treatment strategy can be recommended?

NARCIS (Netherlands)

Henle, Philipp; Kloen, Peter; Siebenrock, Klaus A.

2007-01-01

Despite different operative and non-operative treatment regimens, the outcome after femoral head fractures has changed little over the past decades. The initial trauma itself as well as secondary changes such as posttraumatic osteoarthritis, avascular necrosis or heterotopic ossification is often

Treatment of head and neck squamous cell carcinoma in elderly patients

International Nuclear Information System (INIS)

Honda, Keigo; Asato, Ryo; Tsuji, Jun; Kanda, Tomoko; Ushiro, Kohji; Watanabe, Yoshiki; Mori, Yusuke

2010-01-01

The object of this study was to clarify the characteristics of treatment for elderly head and neck squamous cell cancer patients. We conducted a chart review of 177 head and neck squamous cell cancer patients who had been treated at Kyoto Medical Center, from 2005 through 2009. All the collected data were analyzed to compare the clinical features and the treatment outcomes between the younger group ( or =75, EG, n=46). Male to female ratio was lower in EG (5.6:1 vs. 1.7:1, p<0.01). C urative treatment was performed in most of the patients with early disease (stage I-II) in both groups (96.7% vs. 90.5%), while the ratio of curative treatment was significantly lower in EG patients with advanced stage disease (stage III-IV) (92.3% vs. 52.0%, p<0.01). There was no significant difference in the frequency of adopted treatment modality (surgery or radiotherapy) between YG and EG. Adjuvant chemotherapy or postoperative radiotherapy was avoided in most of EG patients. Local complication rates after major surgery for advanced cases were similar in both groups (30.8% vs. 27.3%), while a higher systemic complication rate was observed in EG (0% vs. 27.3%). After curative treatment, there was no difference in disease specific three-year survival rates between YG and EG (100% vs. 100% in early stage disease, 65.2% vs. 60.6% in advanced disease, Kaplan-Meier curve). Although treatment of elderly patients with head and neck cancer can be inhibited by poor performance status and/or concomitant diseases, clinical results after curative treatment are comparable to those of younger patients. (author)

Treatment of Head and Neck Cancer in Adults - Patient Version

Science.gov (United States)

Find diagnosis, staging, and treatment information for these head and neck cancers: hypopharynx, larynx, lip and oral cavity, neck cancer with occult primary, nasopharynx, oropharynx, paranasal sinus and nasal cavity, and salivary gland cancer.

Improving Therapeutic Ratio in Head and Neck Cancer with Adjuvant and Cisplatin-Based Treatments

Directory of Open Access Journals (Sweden)

Loredana G. Marcu

2013-01-01

Full Text Available Advanced head and neck cancers are difficult to manage despite the large treatment arsenal currently available. The multidisciplinary effort to increase disease-free survival and diminish normal tissue toxicity was rewarded with better locoregional control and sometimes fewer side effects. Nevertheless, locoregional recurrence is still one of the main reasons for treatment failure. Today, the standard of care in head and neck cancer management is represented by altered fractionation radiotherapy combined with platinum-based chemotherapy. Targeted therapies as well as chronotherapy were trialled with more or less success. The aim of the current work is to review the available techniques, which could contribute towards a higher therapeutic ratio in the treatment of advanced head and neck cancer patients.

Initial treatment results using cyberknife for head and neck tumor

International Nuclear Information System (INIS)

Himei, Kengo; Katsui, Kuniaki; Yoshida, Atsushi; Takemoto, Mitsuhiro; Kobayashi, Mitsuru; Kuroda, Masahiro; Hiraki, Yoshio

2002-01-01

The CyberKnife, a medical device for stereotactic radiotherapy, is composed of a combination of a robot manipulator and LINAC. For the treatment of head and neck tumors, this system has been applied. Between June 2000 and January 2001, 18 patients with head and neck tumor were treated with this system because of tumor recurrence, difficulty in surgery or additional increase after external radiotherapy. The median age was 64 years. Primary lesions were skull base (4), nasopharynx (3), paranasal sinus (3), nasal cavity (2), lacrimal gland (1), oropharynx (1), oral floor (1), and buccul mucosa (1), metastatic lymph nodes were found in three. The prescribed dose was 12-38 Gy as for marginal dose. The response rate (CR+PR) was 44.4% and local control rate (CR+PR+NC) was 77.8%. The adverse effects were assessed by the NCI-CTC Version 2.0 and observed grade 3 in two cases. Our early experience indicates that this system could to be feasible for the treatment of locally advanced or recurrent head and neck tumor, and for the reduction of adverse effect and maintenance of useful QOL of patients. (author)

Prevention and treatment of the consequences of head and neck radiotherapy

NARCIS (Netherlands)

Vissink, A; Burlage, FR; Spijkervet, FKL; Jansma, J; Coppes, RP

The location of the primary tumor or lymph node metastases dictates the inclusion of the oral cavity, salivary glands, and jaws in the radiation treatment portals for patients who have head and neck cancer. The clinical sequelae of the radiation treatment include mucositis, hyposalivation, loss of

Detection of treatment setup errors between two CT scans for patients with head and neck cancer

International Nuclear Information System (INIS)

Ezzell, Leah C.; Hansen, Eric K.; Quivey, Jeanne M.; Xia Ping

2007-01-01

Accuracy of treatment setup for head and neck patients undergoing intensity-modulated radiation therapy is of paramount importance. The conventional method using orthogonal portal images can only detect translational setup errors while the most frequent setup errors for head and neck patients could be rotational errors. With the rapid development of image-guided radiotherapy, three-dimensional images are readily acquired and can be used to detect both translational and rotational setup errors. The purpose of this study is to determine the significance of rotational variations between two planning CT scans acquired for each of eight head and neck patients, who experienced substantial weight loss or tumor shrinkage. To this end, using a rigid body assumption, we developed an in-house computer program that utilizes matrix transformations to align point bony landmarks with an incremental best-fit routine. The program returns the quantified translational and rotational shifts needed to align the scans of each patient. The program was tested using a phantom for a set of known translational and rotational shifts. For comparison, a commercial treatment planning system was used to register the two CT scans and estimate the translational errors for these patients. For the eight patients, we found that the average magnitudes and standard deviations of the rotational shifts about the transverse, anterior-posterior, and longitudinal axes were 1.7±2.3 deg., 0.8±0.7 deg., and 1.8±1.1 deg., respectively. The average magnitudes and standard deviations of the translational shifts were 2.5±2.6 mm, 2.9±2.8 mm, 2.7±1.7 mm while the differences detected between our program and the CT-CT fusion method were 1.8±1.3 mm, 3.3±5.4 mm, and 3.0±3.4 mm in the left-right, anterior-posterior, and superior-inferior directions, respectively. A trend of larger rotational errors resulting in larger translational differences between the two methods was observed. In conclusion, conventional

Development and feasibility of a Swallowing intervention Package (SiP) for patients receiving radiotherapy treatment for head and neck cancer-the SiP study protocol.

Science.gov (United States)

Wells, Mary; King, Emma; Toft, Kate; MacAulay, Fiona; Patterson, Joanne; Dougall, Nadine; Hulbert-Williams, Nick; Boa, Sally; Slaven, Eleanor; Cowie, Julie; McGarva, John; Niblock, Patricia Gail; Philp, Julie; Roe, Justin

2016-01-01

Head and neck cancer (HNC) is the sixth most common cancer worldwide, and the functional, psychological and social consequences of HNC cancer and its treatment can be severe and chronic. Dysphagia (swallowing problems) affects up to two thirds of patients undergoing combined chemoradiotherapy. Recent reviews suggest that prophylactic swallowing exercises may improve a range of short- and long-term outcomes; however, the importance of psychological and behavioural factors on adherence to swallowing exercises has not been adequately studied. This study aims to develop and test the feasibility of a Swallowing intervention Package (SiP) designed in partnership with patients, speech and language therapists (SLTs) and other members of the head and neck multi-disciplinary team (MDT), for patients undergoing chemoradiotherapy (CRT) or radiotherapy (RT) for head and neck cancer. This feasibility study uses quantitative and qualitative research methods, within a quasi-experimental design, to assess whether patients will tolerate and adhere to the SiP intervention, which aspects of the intervention can be implemented and which cannot, whether treatment fidelity can be achieved across different contexts, whether study processes and outcome measures will be feasible and acceptable and to what extent the intervention is likely to have an impact on swallowing dysfunction and quality of life. Patients are being recruited from five sites in Scotland and England (three interventions and two usual care). The SLT based in the relevant intervention centre teaches the exercise programme and provides supporting materials. A combination of patient-reported outcome measures (PROMs), adherence measures and clinical swallowing assessments are used prior to intervention (baseline), at the end of treatment, 3 and 6 months post-treatment. This collaborative study has taken a unique approach to the development of a patient-centred and evidence-based swallowing intervention. The introduction of

Liposomal treatment of xerostomia, odor, and taste abnormalities in patients with head and neck cancer.

Science.gov (United States)

Heiser, Clemens; Hofauer, Benedikt; Scherer, Elias; Schukraft, Johannes; Knopf, Andreas

2016-04-01

Smell and taste disorders, sicca symptoms, can be detected in patients with head and neck cancer. The purpose of this study was to assess the utility of local liposomal application in the treatment of patients with head and neck cancers. Ninety-eight patients with head and neck cancer were included in this study. The groups were defined as: group 1 = only surgery; group 2 = surgery + adjuvant radiochemotherapy; and group 3 = primarily radiochemotherapy. All patients had finished cancer treatment and received liposomal sprays for the nose and mouth for 2 months (LipoNasal, LipoSaliva; Optima Pharmaceutical GmbH, Germany) and suffered from taste and smell disorders. We performed tests with "Sniffin' Sticks," "Taste Strips," and a xerostomia questionnaire before and after treatment. After application of liposomes, patients demonstrated a statistically significant increase in smell and taste, and reduced xerostomia. Our results demonstrate that using nonpharmaceutical liposomal sprays improve smell, taste, and symptoms of xerostomia in patients with head and neck cancer. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1232-E1237, 2016. © 2015 Wiley Periodicals, Inc.

Multi-institutional evaluation of end-to-end protocol for IMRT/VMAT treatment chains utilizing conventional linacs.

Science.gov (United States)

Loughery, Brian; Knill, Cory; Silverstein, Evan; Zakjevskii, Viatcheslav; Masi, Kathryn; Covington, Elizabeth; Snyder, Karen; Song, Kwang; Snyder, Michael

2018-03-20

We conducted a multi-institutional assessment of a recently developed end-to-end monthly quality assurance (QA) protocol for external beam radiation therapy treatment chains. This protocol validates the entire treatment chain against a baseline to detect the presence of complex errors not easily found in standard component-based QA methods. Participating physicists from 3 institutions ran the end-to-end protocol on treatment chains that include Imaging and Radiation Oncology Core (IROC)-credentialed linacs. Results were analyzed in the form of American Association of Physicists in Medicine (AAPM) Task Group (TG)-119 so that they may be referenced by future test participants. Optically stimulated luminescent dosimeter (OSLD), EBT3 radiochromic film, and A1SL ion chamber readings were accumulated across 10 test runs. Confidence limits were calculated to determine where 95% of measurements should fall. From calculated confidence limits, 95% of measurements should be within 5% error for OSLDs, 4% error for ionization chambers, and 4% error for (96% relative gamma pass rate) radiochromic film at 3% agreement/3 mm distance to agreement. Data were separated by institution, model of linac, and treatment protocol (intensity-modulated radiation therapy [IMRT] vs volumetric modulated arc therapy [VMAT]). A total of 97% of OSLDs, 98% of ion chambers, and 93% of films were within the confidence limits; measurements were found outside these limits by a maximum of 4%, consistent despite institutional differences in OSLD reading equipment and radiochromic film calibration techniques. Results from this test may be used by clinics for data comparison. Areas of improvement were identified in the end-to-end protocol that can be implemented in an updated version. The consistency of our data demonstrates the reproducibility and ease-of-use of such tests and suggests a potential role for their use in broad end-to-end QA initiatives. Copyright © 2018 American Association of Medical

Kinematics of a Head-Neck Model Simulating Whiplash

Science.gov (United States)

Colicchia, Giuseppe; Zollman, Dean; Wiesner, Hartmut; Sen, Ahmet Ilhan

2008-01-01

A whiplash event is a relative motion between the head and torso that occurs in rear-end automobile collisions. In particular, the large inertia of the head results in a horizontal translation relative to the thorax. This paper describes a simulation of the motion of the head and neck during a rear-end (whiplash) collision. A head-neck model that…

Accuracy of self-reported tobacco assessments in a head and neck cancer treatment population

International Nuclear Information System (INIS)

Warren, Graham W.; Arnold, Susanne M.; Valentino, Joseph P.; Gal, Thomas J.; Hyland, Andrew J.; Singh, Anurag K.; Rangnekar, Vivek M.; Cummings, K. Michael; Marshall, James R.; Kudrimoti, Mahesh R.

2012-01-01

Prospective analysis was performed of self-reported and biochemically confirmed tobacco use in 50 head and neck cancer patients during treatment. With 93.5% compliance to complete weekly self-report and biochemical confirmatory tests, 29.4% of smokers required biochemical assessment for identification. Accuracy increased by 14.9% with weekly vs. baseline self-reported assessments. Data confirm that head and neck cancer patients misrepresent true tobacco use during treatment.

Radiation dose reduction with dictionary learning based processing for head CT

International Nuclear Information System (INIS)

Chen, Yang; Shi, Luyao; Hu, Yining; Luo, Limin; Yang, Jiang; Yin, Xindao; Coatrieux, Jean-Louis

2014-01-01

In CT, ionizing radiation exposure from the scan has attracted much concern from patients and doctors. This work is aimed at improving head CT images from low-dose scans by using a fast Dictionary learning (DL) based post-processing. Both Low-dose CT (LDCT) and Standard-dose CT (SDCT) nonenhanced head images were acquired in head examination from a multi-detector row Siemens Somatom Sensation 16 CT scanner. One hundred patients were involved in the experiments. Two groups of LDCT images were acquired with 50 % (LDCT50 %) and 25 % (LDCT25 %) tube current setting in SDCT. To give quantitative evaluation, Signal to noise ratio (SNR) and Contrast to noise ratio (CNR) were computed from the Hounsfield unit (HU) measurements of GM, WM and CSF tissues. A blinded qualitative analysis was also performed to assess the processed LDCT datasets. Fifty and seventy five percent dose reductions are obtained for the two LDCT groups (LDCT50 %, 1.15 ± 0.1 mSv; LDCT25 %, 0.58 ± 0.1 mSv; SDCT, 2.32 ± 0.1 mSv; P < 0.001). Significant SNR increase over the original LDCT images is observed in the processed LDCT images for all the GM, WM and CSF tissues. Significant GM–WM CNR enhancement is noted in the DL processed LDCT images. Higher SNR and CNR than the reference SDCT images can even be achieved in the processed LDCT50 % and LDCT25 % images. Blinded qualitative review validates the perceptual improvements brought by the proposed approach. Compared to the original LDCT images, the application of DL processing in head CT is associated with a significant improvement of image quality.

The role of EGFR-targeting strategies in the treatment of head and neck cancer

Directory of Open Access Journals (Sweden)

Dequanter D

2012-07-01

Full Text Available Didier Dequanter, Mohammad Shahla, Pascal Paulus, Philippe H LothaireDepartment of Surgery, CHU Charleroi (Hopital Andre Vésale, Montigny le Tilleul, BelgiumAbstract: With its targeted mechanism of action and synergistic activity with current treatment modalities, cetuximab is a potentially valuable treatment option for patients with recurrent and/or metastatic squamous cell cancer of the head and neck who have progressed on cisplatin-based chemotherapy. The use of cetuximab in combination with radiotherapy as definitive treatment for locoregionally advanced squamous cell cancer of the head and neck is generally restricted to patients unfit to receive cisplatin-based chemoradiation, which is still considered the standard of care. The effect of this epidermal growth factor receptor antagonist occurs without any change in the pattern and the severity of toxicity usually associated with head and neck radiation.Keywords: cetuximab, SCCHN, radiotherapy

Stem cell treatment for avascular necrosis of the femoral head: current perspectives

Directory of Open Access Journals (Sweden)

Houdek MT

2014-04-01

Full Text Available Matthew T Houdek,1 Cody C Wyles,2 John R Martin,1 Rafael J Sierra11Department of Orthopedic Surgery, 2School of Medicine, Mayo Clinic, Rochester, MN, USAAbstract: Avascular necrosis (AVN of the femoral head is a progressive disease that predominantly affects younger patients. Although the exact pathophysiology of AVN has yet to be elucidated, the disease is characterized by a vascular insult to the blood supply of the femoral head, which can lead to collapse of the femoral head and subsequent degenerative changes. If AVN is diagnosed in the early stages of the disease, it may be possible to attempt surgical procedures which preserve the hip joint, including decompression of the femoral head augmented with concentrated bone marrow. The use of autologous stem cells has shown promise in halting the progression of AVN of the femoral head, and subsequently preventing young patients from undergoing total hip arthroplasty. The purpose of this study was to review the current use of stem cells for the treatment of AVN of the femoral head.Keywords: avascular necrosis, femoral head, osteonecrosis, stem cells, concentrated bone marrow

Hydrometallurgical treatment of plutonium. Bearing salt baths waste

International Nuclear Information System (INIS)

Bros, P.; Gozlan, J.P.; Lecomte, M.; Bourges, J.

1993-01-01

The salt flux issuing from the electrorefining of plutonium metal alloy in salt baths (KCI + NaCI) poses a difficult problem of the back-end alpha waste management. An alternative to the salt process promoted by Los Alamos Laboratory is to develop a hydrometallurgical treatment. A new process based on the electrochemistry technique in aqueous solution has been defined and tested successfully in the CEA. The diagram of the process exhibits two principal steps: in the head-end, a dissolution in HNO 3 medium accompanied with an electrolytic dechlorination leading to a quantitative elimination of chloride as CI 2 gas followed by its trapping one soda lime cartridge, a complete oxidative dissolution of the refractory Pu residues by electrogenerated Ag(II), in the back-end: the Pu and Am recoveries by chromatographic extractions. (authors). 10 figs., 9 refs

Review of the patient positioning reproducibility in head-and-neck radiotherapy using Statistical Process Control.

Science.gov (United States)

Moore, Sarah J; Herst, Patries M; Louwe, Robert J W

2018-05-01

A remarkable improvement in patient positioning was observed after the implementation of various process changes aiming to increase the consistency of patient positioning throughout the radiotherapy treatment chain. However, no tool was available to describe these changes over time in a standardised way. This study reports on the feasibility of Statistical Process Control (SPC) to highlight changes in patient positioning accuracy and facilitate correlation of these changes with the underlying process changes. Metrics were designed to quantify the systematic and random patient deformation as input for the SPC charts. These metrics were based on data obtained from multiple local ROI matches for 191 patients who were treated for head-and-neck cancer during the period 2011-2016. SPC highlighted a significant improvement in patient positioning that coincided with multiple intentional process changes. The observed improvements could be described as a combination of a reduction in outliers and a systematic improvement in the patient positioning accuracy of all patients. SPC is able to track changes in the reproducibility of patient positioning in head-and-neck radiation oncology, and distinguish between systematic and random process changes. Identification of process changes underlying these trends requires additional statistical analysis and seems only possible when the changes do not overlap in time. Copyright © 2018 Elsevier B.V. All rights reserved.

Semantic Complex Event Processing over End-to-End Data Flows

Energy Technology Data Exchange (ETDEWEB)

Zhou, Qunzhi [University of Southern California; Simmhan, Yogesh; Prasanna, Viktor K.

2012-04-01

Emerging Complex Event Processing (CEP) applications in cyber physical systems like SmartPower Grids present novel challenges for end-to-end analysis over events, flowing from heterogeneous information sources to persistent knowledge repositories. CEP for these applications must support two distinctive features - easy specification patterns over diverse information streams, and integrated pattern detection over realtime and historical events. Existing work on CEP has been limited to relational query patterns, and engines that match events arriving after the query has been registered. We propose SCEPter, a semantic complex event processing framework which uniformly processes queries over continuous and archived events. SCEPteris built around an existing CEP engine with innovative support for semantic event pattern specification and allows their seamless detection over past, present and future events. Specifically, we describe a unified semantic query model that can operate over data flowing through event streams to event repositories. Compile-time and runtime semantic patterns are distinguished and addressed separately for efficiency. Query rewriting is examined and analyzed in the context of temporal boundaries that exist between event streams and their repository to avoid duplicate or missing results. The design and prototype implementation of SCEPterare analyzed using latency and throughput metrics for scenarios from the Smart Grid domain.

In a bad place: Carers of patients with head and neck cancer experiences of travelling for cancer treatment.

Science.gov (United States)

Balfe, Myles; Keohane, Kieran; O' Brien, Katie; Gooberman-Hill, Rachael; Maguire, Rebecca; Hanly, Paul; O' Sullivan, Eleanor; Sharp, Linda

2017-10-01

To explore the effect that treatment-related commuting has on carers of patients with head and neck cancer. Semi-structured interviews, thematically analysed, with 31 carers. Treatment-related commuting had a considerable impact on carers of patients with head and neck cancer, both in practical terms (economic costs, disruption) and also in psychological terms. Many carers of patients with head and neck cancer described becoming distressed by their commute. Some carers from large urban cities appeared to have hidden commuting burdens. Some carers respond to commuting stress by 'zoning out' or becoming 'like zombies'. Treatment-related travel for head and neck cancer can have significant practical and psychological impacts. Health professionals should be aware of the impacts that commuting can have on head and neck caregivers. Health services may be able to take practical steps, such as providing subsidized parking, to address head and neck carergivers' difficulties. Copyright © 2017 Elsevier Ltd. All rights reserved.

Treatment of Head and Neck Cancer in Adults - Health Professional Version

Science.gov (United States)

Find information about prognosis, staging, and treatment for adult head and neck cancer sites: hypopharynx, larynx, lip and oral cavity, neck cancer with occult primary, nasopharynx, oropharynx, paranasal sinus and nasal cavity, and salivary gland cancer.

Analysis of head motion prior to and during proton beam therapy

International Nuclear Information System (INIS)

Schulte, Reinhard W.; Fargo, Ramiz A.; Meinass, Helmut J.; Slater, Jerry D.; Slater, James M.

2000-01-01

Purpose: We report on the use of a noninvasive patient motion monitoring system to evaluate the amount of head motion prior to and during proton radiation therapy sessions. Methods and Materials: Two optical displacement sensors, placed close to the patient's head, were used for online monitoring of the head position, with submillimeter accuracy. Motion data, including the difference between start and end position (Dx) and the maximum displacement during the recorded session (Dx-max), were acquired for pretreatment sessions to analyze alignment radiographs, and for treatment sessions. We have recorded 102 pretreatment and 99 treatment sessions in 16 patients immobilized with a thermoplastic mask, and 44 pretreatment and 56 treatment sessions in 13 patients immobilized with vacuum-assisted dental fixation. To avoid incorrect data analysis due to replicate observations, only 1 pretreatment and 1 treatment session per patient were selected at random for statistical comparison of mean or median motion parameters in different subgroups. Results: Both techniques showed similar immobilization efficiencies. The median Dx and Dx-max values were 0.18 mm and 0.46 mm, respectively, for 16 treatment sessions with mask immobilization, and 0.22 mm and 0.50 mm, respectively, for 13 treatment sessions with dental immobilization. Motion parameters for pretreatment and treatment sessions were not statistically different. Conclusion: Online verification of patient's head motion is feasible and provides valuable data for confirmation of proper treatment delivery in individual patients, as well as for the evaluation of different immobilization methods

Nonrigid Image Registration for Head and Neck Cancer Radiotherapy Treatment Planning With PET/CT

International Nuclear Information System (INIS)

Ireland, Rob H.; Dyker, Karen E.; Barber, David C.; Wood, Steven M.; Hanney, Michael B.; Tindale, Wendy B.; Woodhouse, Neil; Hoggard, Nigel; Conway, John; Robinson, Martin H.

2007-01-01

Purpose: Head and neck radiotherapy planning with positron emission tomography/computed tomography (PET/CT) requires the images to be reliably registered with treatment planning CT. Acquiring PET/CT in treatment position is problematic, and in practice for some patients it may be beneficial to use diagnostic PET/CT for radiotherapy planning. Therefore, the aim of this study was first to quantify the image registration accuracy of PET/CT to radiotherapy CT and, second, to assess whether PET/CT acquired in diagnostic position can be registered to planning CT. Methods and Materials: Positron emission tomography/CT acquired in diagnostic and treatment position for five patients with head and neck cancer was registered to radiotherapy planning CT using both rigid and nonrigid image registration. The root mean squared error for each method was calculated from a set of anatomic landmarks marked by four independent observers. Results: Nonrigid and rigid registration errors for treatment position PET/CT to planning CT were 2.77 ± 0.80 mm and 4.96 ± 2.38 mm, respectively, p = 0.001. Applying the nonrigid registration to diagnostic position PET/CT produced a more accurate match to the planning CT than rigid registration of treatment position PET/CT (3.20 ± 1.22 mm and 4.96 ± 2.38 mm, respectively, p = 0.012). Conclusions: Nonrigid registration provides a more accurate registration of head and neck PET/CT to treatment planning CT than rigid registration. In addition, nonrigid registration of PET/CT acquired with patients in a standardized, diagnostic position can provide images registered to planning CT with greater accuracy than a rigid registration of PET/CT images acquired in treatment position. This may allow greater flexibility in the timing of PET/CT for head and neck cancer patients due to undergo radiotherapy

A Study of the Effect of the Front-End Styling of Sport Utility Vehicles on Pedestrian Head Injuries

Directory of Open Access Journals (Sweden)

Guanjun Zhang

2018-01-01

Full Text Available Background. The number of sport utility vehicles (SUVs on China market is continuously increasing. It is necessary to investigate the relationships between the front-end styling features of SUVs and head injuries at the styling design stage for improving the pedestrian protection performance and product development efficiency. Methods. Styling feature parameters were extracted from the SUV side contour line. And simplified finite element models were established based on the 78 SUV side contour lines. Pedestrian headform impact simulations were performed and validated. The head injury criterion of 15 ms (HIC15 at four wrap-around distances was obtained. A multiple linear regression analysis method was employed to describe the relationships between the styling feature parameters and the HIC15 at each impact point. Results. The relationship between the selected styling features and the HIC15 showed reasonable correlations, and the regression models and the selected independent variables showed statistical significance. Conclusions. The regression equations obtained by multiple linear regression can be used to assess the performance of SUV styling in protecting pedestrians’ heads and provide styling designers with technical guidance regarding their artistic creations.

Volumetric visualization of head and neck CT data for treatment planning

International Nuclear Information System (INIS)

Lee, Jean S.; Jani, Ashesh B.; Pelizzari, Charles A.; Haraf, Daniel J.; Vokes, Everett E.; Weichselbaum, Ralph R.; Chen, George T.Y.

1999-01-01

Purpose: To demonstrate the utility of volume rendering, an alternative visualization technique to surface rendering, in the practice of CT based radiotherapy planning for the head and neck. Methods and Materials: Rendo-avs, a volume visualization tool developed at the University of Chicago, was used to volume render head and neck CT scans from two cases. Rendo-avs is a volume rendering tool operating within the graphical user interface environment of AVS (Application Visualization System). Users adjust the opacity of various tissues by defining the opacity transfer function (OTF), a function which preclassifies voxels by opacity prior to rendering. By defining the opacity map (OTF), the user selectively enhances and suppresses structures of various intensity. Additional graphics tools are available within the AVS network, allowing for the manipulation of perspective, field of view, data orientation. Users may draw directly on volume rendered images, create a partial surface, and thereby correlate objects in the 3D scene to points on original axial slices. Information in volume rendered images is mapped into the original CT slices via a Z buffer, which contains the depth information (Z coordinate) for each pixel in the rendered view. Locally developed software was used to project conventionally designed GTV contours onto volume rendered images. Results: The lymph nodes, salivary glands, vessels, and airway are visualized in detail without prior manual segmentation. Volume rendering can be used to explore the finer anatomic structures that appear on consecutive axial slices as 'points'. Rendo-avs allowed for acceptable interactivity, with a processing time of approximately 5 seconds per 256 x 256 pixel output image. Conclusions: Volume rendering is a useful alternative to surface rendering, offering high-quality visualization, 3D anatomic delineation, and time savings to the user, due to the elimination of manual segmentation as a preprocessing step. Volume rendered

Treatment of late sequelae after radiotherapy for head and neck cancer.

Science.gov (United States)

Strojan, Primož; Hutcheson, Katherine A; Eisbruch, Avraham; Beitler, Jonathan J; Langendijk, Johannes A; Lee, Anne W M; Corry, June; Mendenhall, William M; Smee, Robert; Rinaldo, Alessandra; Ferlito, Alfio

2017-09-01

Radiotherapy (RT) is used to treat approximately 80% of patients with cancer of the head and neck. Despite enormous advances in RT planning and delivery, a significant number of patients will experience radiation-associated toxicities, especially those treated with concurrent systemic agents. Many effective management options are available for acute RT-associated toxicities, but treatment options are much more limited and of variable benefit among patients who develop late sequelae after RT. The adverse impact of developing late tissue damage in irradiated patients may range from bothersome symptoms that negatively affect their quality of life to severe life-threatening complications. In the region of the head and neck, among the most problematic late effects are impaired function of the salivary glands and swallowing apparatus. Other tissues and structures in the region may be at risk, depending mainly on the location of the irradiated tumor relative to the mandible and hearing apparatus. Here, we review the available evidence on the use of different therapeutic strategies to alleviate common late sequelae of RT in head and neck cancer patients, with a focus on the critical assessment of the treatment options for xerostomia, dysphagia, mandibular osteoradionecrosis, trismus, and hearing loss. Copyright © 2017 Elsevier Ltd. All rights reserved.

BONE GRAFTING ENHANCED BY PLATELET-RICH PLASMA IN TREATMENT OF AVASCULAR NECROSIS OF FEMORAL HEAD

Directory of Open Access Journals (Sweden)

A. A. Korytkin

2018-01-01

Full Text Available Treatment of avascular necrosis of the femoral head is an issue of current interest while it affects young and employable people. So far there is no well-defined strategy of management which would help to postpone hip arthroplasty and further revision procedure. Hip sparing surgical treatment of avascular necrosis of the femoral head by bone grafting prior to head collapse proved to be a viable option not only during early stages of disease but also at advanced stages. Platelet-rich plasma (PRP addition to treatment plan potentially helps improving bone regeneration in situ.In this article the authors present a case of a 37 years old patient with avascular necrosis of the femoral head at a fragmentation stage (type 4B by ARCO. The authors centrifuged 15 ml of autologous whole blood (1500 RPM obtained by a special double-contoured syringe. During the surgical stage of treatment PRP and morselized bone graft were mixed to introduce and impact into the debrided zone of avascular necrosis. The authors also introduced 0.3–0.4 ml of PRP into the debrided zone of avascular necrosis after bone grafting. At 6 months follow-up CT images of the studied patient demonstrated signs of bone reorganization and no loss of femoral head sphericity. Preoperative Visual Analogue Scale (VAS, Harris Hip Score (HHS and Hip disability and Osteoarthritis Outcome Score (HOOS prior to treatment were 60, 45 and 33 points respectively. Postoperative VAS, HHS and HOOS scores were 10, 78 and 78 respectively. In the authors’ opinion, impaction bone grafting enhanced by PRP helps obtaining good and excellent outcomes not only at early but also at advanced stages of avascular necrosis.

Avascular Necrosis of the Femoral Head: Are Any Genes Involved?

Science.gov (United States)

Pouya, Farzaneh; Kerachian, Mohammad Amin

2015-01-01

Avascular necrosis of the femoral head (ANFH) is a pathologic process that results from interruption of blood supply to the femur bone resulting in the death of bone cells and collapse of the femoral head. Nontraumatic ANFH continues to be a significant challenge to orthopedic surgeons. While the exact mechanisms remain elusive, many new insights have emerged from research in the last decade that has given us a clearer picture of the pathogenesis of nontraumatic ANFH. Progression to the end stage of ANFH appears to be related to five main mechanisms: hypercoagulable conditions, angiogenesis suppressions, hyperadipogenesis, heritable states, and switching the bone remodelling into bone resorption. Researchers have been examining the pathogenic mechanisms of ANFH but none of these theories have been firmly confirmed although some appear more plausible than the others. All of these factors can switch bone remodelling into bone resorption, which can further lead to ANFH progression ending up to femoral head collapse. PMID:26213697

Treatment of Head and Neck Paragangliomas With External Beam Radiation Therapy

International Nuclear Information System (INIS)

Dupin, Charles; Lang, Philippe; Dessard-Diana, Bernadette; Simon, Jean-Marc; Cuenca, Xavier; Mazeron, Jean-Jacques; Feuvret, Loïc

2014-01-01

Purpose: To retrospectively assess the outcomes of radiation therapy in patients with head and neck paragangliomas. Methods and Materials: From 1990 to 2009, 66 patients with 81 head and neck paragangliomas were treated by conventional external beam radiation therapy in 25 fractions at a median dose of 45 Gy (range, 41.4-68 Gy). One case was malignant. The median gross target volume and planning target volume were 30 cm 3 (range, 0.9-243 cm 3 ) and 116 cm 3 (range, 24-731 cm 3 ), respectively. Median age was 57.4 years (range, 15-84 years). Eleven patients had multicentric lesions, and 8 had family histories of paraganglioma. Paragangliomas were located in the temporal bone, the carotid body, and the glomus vagal in 51, 18, and 10 patients, respectively. Forty-six patients had exclusive radiation therapy, and 20 had salvage radiation therapy. The median follow-up was 4.1 years (range, 0.1-21.2 years). Results: One patient had a recurrence of temporal bone paraganglioma 8 years after treatment. The actuarial local control rates were 100% at 5 years and 98.7% at 10 years. Patients with multifocal tumors and family histories were significantly younger (42 years vs 58 years [P=.002] and 37 years vs 58 years [P=.0003], respectively). The association between family predisposition and multifocality was significant (P<.001). Two patients had cause-specific death within the 6 months after irradiation. During radiation therapy, 9 patients required hospitalization for weight loss, nausea, mucositis, or ophthalmic zoster. Two late vascular complications occurred (middle cerebral artery and carotid stenosis), and 2 late radiation-related meningiomas appeared 15 and 18 years after treatment. Conclusion: Conventional external beam radiation therapy is an effective and safe treatment option that achieves excellent local control; it should be considered as a first-line treatment of choice for head and neck paragangliomas

TRISO-coated spent fuel processing using a Grind-Leach head-end

International Nuclear Information System (INIS)

Spencer, Barry B.; Del Cul, Guillermo D.; Mattus, Catherine H.; Collins, Emory D.

2005-01-01

Processing of TRISO-coated HTGR fuels with the grind-leach process requires that the fuel be finely pulverized for efficient and effective acid dissolution of the fuel components. Mechanical size reduction of the fuel is being investigated with jet mill technology as the final milling step. Laboratory experiments were performed with surrogates of crushed fuel compacts that indicate that milling to very small particle sizes is feasible. The size distribution of the milled product is sensitive to the solids feed rate, and the distribution may be bimodal which could support an effective solid-solid separation. (author)

Patient Choice of Nonsurgical Treatment Contributes to Disparities in Head and Neck Squamous Cell Carcinoma.

Science.gov (United States)

Parhar, Harman S; Anderson, Donald W; Janjua, Arif S; Durham, J Scott; Prisman, Eitan

2018-06-01

Objectives There are well-established outcome disparities among different demographic groups with head and neck squamous cell carcinoma (HNSCC). We aimed to investigate the potential contribution of patient choice of nonsurgical treatment to these disparities by estimating the rate of this phenomenon, identifying its predictors, and estimating the effect on cancer-specific survival. Study Design Retrospective nationwide analysis. Settings Surveillance, Epidemiology, and End Results Database (2004-2014). Subjects and Methods Patients with HNSCC, who were recommended for primary surgery, were included. Multivariable logistic regression was used to identify demographic and clinical factors associated with patient choice of nonsurgical treatment, and Kaplan Meier/Cox regression was used to analyze survival. Results Of 114,506 patients with HNSCC, 58,816 (51.4%) were recommended for primary surgery, and of those, 1550 (2.7%) chose nonsurgical treatment. Those who chose nonsurgical treatment were more likely to be older (67.1 ± 12.6 vs 63.6 ± 13.1, P unmarried (OR married, 0.50; 95% CI, 0.44-0.58), had an advanced tumor, and had a hypopharyngeal or laryngeal primary. Choice of nonsurgical treatment imparted a 2.16-fold (95% CI, 2.02-2.30) increased risk of cancer-specific death. Conclusion Of the patients, 2.7% chose nonsurgical treatment despite a provider recommendation that impairs survival. Choice of nonsurgical treatment is associated with older age, having Black or Asian ethnicity, being unmarried, having an advanced stage tumor, and having a primary site in the hypopharynx or larynx. Knowledge of these disparities may help providers counsel patients and help patients make informed decisions.

Monte Carlo simulation of radiation treatment machine heads

International Nuclear Information System (INIS)

Mohan, R.

1988-01-01

Monte Carlo simulations of radiation treatment machine heads provide practical means for obtaining energy spectra and angular distributions of photons and electrons. So far, most of the work published in the literature has been limited to photons and the contaminant electrons knocked out by photons. This chapter will be confined to megavoltage photon beams produced by medical linear accelerators and 60 Co teletherapy units. The knowledge of energy spectra and angular distributions of photons and contaminant electrons emerging from such machines is important for a variety of applications in radiation dosimetry

Femoral head allograft disinfection system using moderate heat

International Nuclear Information System (INIS)

Knaepler, H.; Von Garrel, T.

1999-01-01

The employment of a reliable thermal viral inactivation process, which minimally manipulates tissues, for surgically retrieved femoral head allografts addresses the increased concerns with virus transmissibility while minimizing the loss of biological properties. The newest European and German surgical bone banking guidelines have incorporated the use of independently validated then-nal viral inactivation methods in place of repeat serological testing of donor. Our investigations have shown that heat treatment at 80 degree C for a minimum of 10 minutes provides safe, good quality cancellous bone allografts and increases the cost-effectiveness and simplicity of managing a hospital frozen femoral head bone bank. Human femoral head centers were contaminated with different vegetative bacterial and viral suspensions. A core temperature of 80 degree C for 10 minutes was sufficient to fully inactivate 3 x 106 ml Staphylococcus aureus and Streptococcus faecalis, and >5 loglo steps of cytomeglia (herpes group), polio (enterovirus), and yellow fever (arbovirus) viruses. A one hour treatment in a water bath set at 80 degree sufficient to fully inactivate E. coli, proteus vulgaris, and Pseudomonas aerog. vegetative suspensions; 20 minutes was sufficient to fully inactivate the D antigen (rhesus factor) but had no effect on A or B antigens. Several biomechanical and biological properties of bone following a one hour treatment in a water bath set at 80 degree C were investigated. Employing compression and tension tests, 80 degree C treated human and porcine cancellous bone blocks showed reductions in properties ranging from 8-19% compared to untreated control groups. Osteointegration at 3 months following treatment of explanted and then reimplanted autograft rat diaphyseal segment was 15% less than untreated controls. Subsequently, a thermal disinfection system for femoral heads from living donors (Lobator Marburg Bone Bank System, Telos GmbH, Hungen, Germany) was developed. A

Hybrid life-cycle environmental and cost inventory of sewage sludge treatment and end-use scenarios: a case study from China.

Science.gov (United States)

Murray, Ashley; Horvath, Arpad; Nelson, Kara L

2008-05-01

Sewage sludge management poses environmental, economic, and political challenges for wastewater treatment plants and municipalities around the globe. To facilitate more informed and sustainable decision making, this study used life-cycle inventory (LCI) to expand upon previous process-based LCIs of sewage sludge treatmenttechnologies. Additionally, the study evaluated an array of productive end-use options for treated sewage sludge, such as fertilizer and as an input into construction materials, to determine how the sustainability of traditional manufacturing processes changes with sludge as a replacement for other raw inputs. The inclusion of the life-cycle of necessary inputs (such as lime) used in sludge treatment significantly impacts the sustainability profiles of different treatment and end-use schemes. Overall, anaerobic digestion is generally the optimal treatment technology whereas incineration, particularly if coal-fired, is the most environmentally and economically costly. With respect to sludge end use, offsets are greatest for the use of sludge as fertilizer, but all of the productive uses of sludge can improve the sustainability of conventional manufacturing practices. The results are intended to help inform and guide decisions about sludge handling for existing wastewater treatment plants and those that are still in the planning phase in cities around the world. Although additional factors must be considered when selecting a sludge treatment and end-use scheme, this study highlights how a systems approach to planning can contribute significantly to improving overall environmental sustainability.

40 CFR 63.487 - Batch front-end process vents-reference control technology.

Science.gov (United States)

2010-07-01

... § 63.487 Batch front-end process vents—reference control technology. (a) Batch front-end process vents... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Batch front-end process vents-reference control technology. 63.487 Section 63.487 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY...

Clinical response and safety of malathion shampoo for treatment of head lice in a primary school.

Science.gov (United States)

Wananukul, Siriwan; Chatproedprai, Susheera; Tempark, Therdpong; Wananukul, Winai

2011-04-01

Help eradicate or at least alleviating head lice in a primary school with malathion shampoo and to study clinical response and safety of malathion shampoo. All students were examined by using a fine-toothed lice comb to help detect live lice. Direct visual examination and the collection of nits for microscopic examination were performed to differentiate viable nits from empty nits. Diagnosis of head lice was made by the presence of lice. All students that had lice and/or nits were treated with malathion shampoo. Malathion shampoo was also provided for all family members. Pediculocidal efficacy was by the presence or absence of live lice. Blood for red blood cell cholinesterase activity was drawn in 32 volunteers before treatment and after the second treatment. At the first visit, 629 students were examined and 48 students had live head lice. The infestation rate was 13% in girls and 1.3% in boys. The cure rate was 93% after the first treatment. The reported side effects were nausea, a burning sensation, and irritation that was found in five (4%), 10 (7%) and three (2%) students respectively. The mean of RBC cholinesterase activity before and after two applications showed significant changes (p = 0.03). It was -7.5 +/- 4.1% reduction from the initial, but all were in the normal range. There was no report of clinical manifestation of malathion toxicity. Malathion shampoo is safe and effective in the treatment of head lice. There is significant skin absorption so a scalp examination for head lice should be done before subsequent application to avoid unnecessary exposure.

Prophylactic treatment of mycotic mucositis in radiotherapy of patients with head and neck cancers

Energy Technology Data Exchange (ETDEWEB)

Koc, M.; Aktas, E. [Ataturk Univ., Erzurum (Turkey). Medical School

2003-02-01

Patients undergoing radiotherapy for head and neck cancer are at increased risk of developing oral candidiasis. The objective of this study was to investigate the clinical Candida mucositis and interruptions in radiotherapy in patients suffering from head and neck cancer, receiving fluconazole in comparison with a control group without specific prophylaxis. Eighty consecutive patients were randomized in a prospective double-blind trial of prophylactic oral fluconazole or treatment with the same drug when mycotic infections appeared. Adult head and neck cancer patients who were undergoing treatment with radiotherapy and/or chemotherapy, radiotherapeutic coverage of the entire oropharynx and oral cavity at least 3 cm anterior to the retromolar trigone and receiving a total dose of more than 6000 cGy and Karnofsky Performance Status (KPS) >70 were included in the study. Group A received radiation therapy plus fluconazole (Fluzole 100 mg/day) starting from the sixth irradiation session throughout the treatment; 40 patients in group B received the same baseline treatment, but were given fluconazole only when mycotic infections appeared. We evaluated 37 patients in group A and the first 37 patients were evaluated in group B. Three of the patients in group A (8.1%) and 14 of the patients in group B (37.8%) demonstrated clinical candidasis. Radiotherapy was interrupted in all of these patients. The differences between the two groups were statistically significant with respect to clinical candidiasis (P=0.005). The median discontinuation time was 5 days (range, 3-7 days) in group A and 7 days (range, 4-10 days) in group B. The median dose resulting in clinical candidiasis was 3200 cGy (range, 2200-5800 cGy) in all groups. In the fluconazole group it was 4200 cGy and in the control group 2800 cGy. These results suggest that patients undergoing head and neck radiation therapy are at risk of developing candidiasis and that fluconazole may be used to reduce the frequency of

Prophylactic treatment of mycotic mucositis in radiotherapy of patients with head and neck cancers

International Nuclear Information System (INIS)

Koc, M.; Aktas, E.

2003-01-01

Patients undergoing radiotherapy for head and neck cancer are at increased risk of developing oral candidiasis. The objective of this study was to investigate the clinical Candida mucositis and interruptions in radiotherapy in patients suffering from head and neck cancer, receiving fluconazole in comparison with a control group without specific prophylaxis. Eighty consecutive patients were randomized in a prospective double-blind trial of prophylactic oral fluconazole or treatment with the same drug when mycotic infections appeared. Adult head and neck cancer patients who were undergoing treatment with radiotherapy and/or chemotherapy, radiotherapeutic coverage of the entire oropharynx and oral cavity at least 3 cm anterior to the retromolar trigone and receiving a total dose of more than 6000 cGy and Karnofsky Performance Status (KPS) >70 were included in the study. Group A received radiation therapy plus fluconazole (Fluzole 100 mg/day) starting from the sixth irradiation session throughout the treatment; 40 patients in group B received the same baseline treatment, but were given fluconazole only when mycotic infections appeared. We evaluated 37 patients in group A and the first 37 patients were evaluated in group B. Three of the patients in group A (8.1%) and 14 of the patients in group B (37.8%) demonstrated clinical candidasis. Radiotherapy was interrupted in all of these patients. The differences between the two groups were statistically significant with respect to clinical candidiasis (P=0.005). The median discontinuation time was 5 days (range, 3-7 days) in group A and 7 days (range, 4-10 days) in group B. The median dose resulting in clinical candidiasis was 3200 cGy (range, 2200-5800 cGy) in all groups. In the fluconazole group it was 4200 cGy and in the control group 2800 cGy. These results suggest that patients undergoing head and neck radiation therapy are at risk of developing candidiasis and that fluconazole may be used to reduce the frequency of

End-to-end tests using alanine dosimetry in scanned proton beams

Science.gov (United States)

Carlino, A.; Gouldstone, C.; Kragl, G.; Traneus, E.; Marrale, M.; Vatnitsky, S.; Stock, M.; Palmans, H.

2018-03-01

This paper describes end-to-end test procedures as the last fundamental step of medical commissioning before starting clinical operation of the MedAustron synchrotron-based pencil beam scanning (PBS) therapy facility with protons. One in-house homogeneous phantom and two anthropomorphic heterogeneous (head and pelvis) phantoms were used for end-to-end tests at MedAustron. The phantoms were equipped with alanine detectors, radiochromic films and ionization chambers. The correction for the ‘quenching’ effect of alanine pellets was implemented in the Monte Carlo platform of the evaluation version of RayStation TPS. During the end-to-end tests, the phantoms were transferred through the workflow like real patients to simulate the entire clinical workflow: immobilization, imaging, treatment planning and dose delivery. Different clinical scenarios of increasing complexity were simulated: delivery of a single beam, two oblique beams without and with range shifter. In addition to the dose comparison in the plastic phantoms the dose obtained from alanine pellet readings was compared with the dose determined with the Farmer ionization chamber in water. A consistent systematic deviation of about 2% was found between alanine dosimetry and the ionization chamber dosimetry in water and plastic materials. Acceptable agreement of planned and delivered doses was observed together with consistent and reproducible results of the end-to-end testing performed with different dosimetric techniques (alanine detectors, ionization chambers and EBT3 radiochromic films). The results confirmed the adequate implementation and integration of the new PBS technology at MedAustron. This work demonstrates that alanine pellets are suitable detectors for end-to-end tests in proton beam therapy and the developed procedures with customized anthropomorphic phantoms can be used to support implementation of PBS technology in clinical practice.

What are Head Cavities? - A History of Studies on Vertebrate Head Segmentation.

Science.gov (United States)

Kuratani, Shigeru; Adachi, Noritaka

2016-06-01

Motivated by the discovery of segmental epithelial coeloms, or "head cavities," in elasmobranch embryos toward the end of the 19th century, the debate over the presence of mesodermal segments in the vertebrate head became a central problem in comparative embryology. The classical segmental view assumed only one type of metamerism in the vertebrate head, in which each metamere was thought to contain one head somite and one pharyngeal arch, innervated by a set of cranial nerves serially homologous to dorsal and ventral roots of spinal nerves. The non-segmental view, on the other hand, rejected the somite-like properties of head cavities. A series of small mesodermal cysts in early Torpedo embryos, which were thought to represent true somite homologs, provided a third possible view on the nature of the vertebrate head. Recent molecular developmental data have shed new light on the vertebrate head problem, explaining that head mesoderm evolved, not by the modification of rostral somites of an amphioxus-like ancestor, but through the polarization of unspecified paraxial mesoderm into head mesoderm anteriorly and trunk somites posteriorly.

A randomized controlled trial of positioning treatments in infants with positional head shape deformities.

Science.gov (United States)

Hutchison, B Lynne; Stewart, Alistair W; De Chalain, Tristan B; Mitchell, Edwin A

2010-10-01

Randomized controlled trials of treatment for deformational plagiocephaly and brachycephaly have been lacking in the literature. Infants (n = 126) presenting to a plagiocephaly clinic were randomized to either positioning strategies or to positioning plus the use of a Safe T Sleep™ positioning wrap. Head shape was measured using a digital photographic technique, and neck function was assessed. They were followed up at home 3, 6 and 12 months later. There was no difference in head shape outcomes for the two treatment groups after 12 months of follow-up, with 42% of infants having head shapes in the normal range by that time. Eighty per cent of children showed good improvement. Those that had poor improvement were more likely to have both plagiocephaly and brachycephaly and to have presented later to clinic. Most infants improved over the 12-month study period, although the use of a sleep positioning wrap did not increase the rate of improvement. © 2010 The Author(s)/Journal Compilation © 2010 Foundation Acta Paediatrica.

Evaluation of radiotherapy methods for adaptative head and neck treatment with RapidArc®

International Nuclear Information System (INIS)

Mazaro, Sarah J.; Vasconcellos, Herminiane L.; Silva, Laura E. da; Bastos, Fernanda M.; Silva, Leonardo P. da; Alvaro S; Migoviski, Igor

2015-01-01

Head and neck cancer is considered a public health problem worldwide. The intensity-modulated techniques have shown benefit in the treatment of these sites, particularly with respect to reduction of deterministic effects of risk, such as parotid. Anatomical variations in cases of head and neck are very frequent and may lead, for example, to an overdose in the parotid. This can be mitigated if making use of adaptive radiation therapy. The work aims to analyze a methodology to redo the planning of treatments, through 02 acquisitions of TC. The results showed that, due to a reduction in the volumes of the parotid, the doses delivered to these organs are underestimated, which is relevant to readapt the treatment, with the addition of only a second scan without the need of the third. (author)

Treatment of lymphangiomas of the head and neck in children by intralesional injection of OK-432 (Picibanil).

Science.gov (United States)

Brewis, C; Pracy, J P; Albert, D M

2000-04-01

The treatments previously used for lymphangiomas of the head and neck in children-surgery and intralesional injection of sclerosants-are associated with significant morbidity. A new treatment-intralesional injection of OK-432-was used for lymphangiomas of the head and neck in 11 children. The results were total shrinkage in two, marked shrinkage in two, slight shrinkage in five and no response in two. The results were not affected by previous surgery nor by whether aspiration prior to injection was possible. There were no recurrences in those children in whom shrinkage occurred and no child had subsequent surgery following injection. The results of this series support those of previous series showing that OK-432 injection is an effective and safe treatment for lymphangiomas of the head and neck in children.

The treatment of cancer in the head and neck

International Nuclear Information System (INIS)

Sato, Yasuo; Nomura, Yasunari; Kobayashi, Takeo; Inouye, Kenbun; Kumazawa, Akiyoshi

1979-01-01

1,438 cases of head and neck tumors were seen in our clinic during the period from 1965 - 1978. Under our multidisciplinary treatment, average dosage of radiation for nasal-paranasal tumors was 200 rad, for oral-mesopharyngeal tumors 1,800 rad, for nasopharyngeal tumors 2,400 rad, for laryngeal tumors 3,400 rad and for hypopharyngeal tumors 4,400 rad. After reduction of tumor mass and topical cleaning procedure, 1) a dosage of radiation-number of patients curve shifted to lower left, 2) repeated surgeries for recurrences became less frequent, 3) extended surgeries were unnecessary and 4) social rehabilitation of patients was obtained much easier even in aged. Principles of our treatment were simple: short hospitalization and careful long term follow-up. Treatment plan should be decided according to clinical finding and course of illness in each cases. (author)

Targeted therapies and radiation for the treatment of head and neck cancer

International Nuclear Information System (INIS)

Kim, Gwi Eon

2004-01-01

The purpose of this review is to provide an update on novel radiation treatments for head and neck cancer. Despite the remarkable advances in chemotherapy and radiotherapy techniques, the management of advanced head and neck cancer remains challenging. Epidermal growth factor receptor (EGFR) is an appealing target for novel therapies in head and neck cancer because not only EGFR activation stimulates many important signaling pathways associated with cancer development and progression, and importantly, resistance to radiation. Furthermore, EGFR overexpression is known to be portended for a worse outcome in patients with advanced head and neck cancer. Two categories of compounds designed to abrogate EGFR signaling, such as monoclonal antibodies (Cetuximab) and tyrosine kinase inhibitors (ZD1839 and OSI-774) have been assessed and have been most extensively studied in preclinical models and clinical trials. Additional TKIs in clinical trials include a reversible agent, Cl-1033, which blocks activation of all erbB receptors. Encouraging preclinical data for head and neck cancers resulted in rapid translation into the clinic. Results from initial clinical trials show rather surprisingly that only minority of patients benefited from EGFR inhibition as monotherapy or in combination with chemotherapy. In this review, we begin with a brief summary of erbB-mediated signal transduction. Subsequently, we present data on prognostic-predictive value of erbB receptor expression in HNC followed by preclinical and clinical data on the role of EGFR antagonists alone or in combination with radiation in the treatment of HNC. Finally, we discuss the emerging thoughts on resistance to EGFR blockade and efforts in the development of multiple-targeted therapy for combination with chemotherapy or radiation. Current challenges for investigators are to determine (1) who will benefit from targeted agents and which agents are most appropriate to combine with radiation and/or chemotherapy, (2

Treatment of Head and Neck Paragangliomas With External Beam Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Dupin, Charles, E-mail: c.dupin@bordeaux.unicancer.fr [Department of Radiotherapy, Comprehensive Cancer Center, Institut Bergonié, Bordeaux (France); Lang, Philippe [Department of Radiotherapy, Pitié Salpétrière, Paris (France); Dessard-Diana, Bernadette [Department of Radiotherapy, Hopital Européen Georges Pompidou, Paris (France); Simon, Jean-Marc; Cuenca, Xavier; Mazeron, Jean-Jacques; Feuvret, Loïc [Department of Radiotherapy, Pitié Salpétrière, Paris (France)

2014-06-01

Purpose: To retrospectively assess the outcomes of radiation therapy in patients with head and neck paragangliomas. Methods and Materials: From 1990 to 2009, 66 patients with 81 head and neck paragangliomas were treated by conventional external beam radiation therapy in 25 fractions at a median dose of 45 Gy (range, 41.4-68 Gy). One case was malignant. The median gross target volume and planning target volume were 30 cm{sup 3} (range, 0.9-243 cm{sup 3}) and 116 cm{sup 3} (range, 24-731 cm{sup 3}), respectively. Median age was 57.4 years (range, 15-84 years). Eleven patients had multicentric lesions, and 8 had family histories of paraganglioma. Paragangliomas were located in the temporal bone, the carotid body, and the glomus vagal in 51, 18, and 10 patients, respectively. Forty-six patients had exclusive radiation therapy, and 20 had salvage radiation therapy. The median follow-up was 4.1 years (range, 0.1-21.2 years). Results: One patient had a recurrence of temporal bone paraganglioma 8 years after treatment. The actuarial local control rates were 100% at 5 years and 98.7% at 10 years. Patients with multifocal tumors and family histories were significantly younger (42 years vs 58 years [P=.002] and 37 years vs 58 years [P=.0003], respectively). The association between family predisposition and multifocality was significant (P<.001). Two patients had cause-specific death within the 6 months after irradiation. During radiation therapy, 9 patients required hospitalization for weight loss, nausea, mucositis, or ophthalmic zoster. Two late vascular complications occurred (middle cerebral artery and carotid stenosis), and 2 late radiation-related meningiomas appeared 15 and 18 years after treatment. Conclusion: Conventional external beam radiation therapy is an effective and safe treatment option that achieves excellent local control; it should be considered as a first-line treatment of choice for head and neck paragangliomas.

Experience of using MOSFET detectors for dose verification measurements in an end-to-end 192Ir brachytherapy quality assurance system.

Science.gov (United States)

Persson, Maria; Nilsson, Josef; Carlsson Tedgren, Åsa

Establishment of an end-to-end system for the brachytherapy (BT) dosimetric chain could be valuable in clinical quality assurance. Here, the development of such a system using MOSFET (metal oxide semiconductor field effect transistor) detectors and experience gained during 2 years of use are reported with focus on the performance of the MOSFET detectors. A bolus phantom was constructed with two implants, mimicking prostate and head & neck treatments, using steel needles and plastic catheters to guide the 192 Ir source and house the MOSFET detectors. The phantom was taken through the BT treatment chain from image acquisition to dose evaluation. During the 2-year evaluation-period, delivered doses were verified a total of 56 times using MOSFET detectors which had been calibrated in an external 60 Co beam. An initial experimental investigation on beam quality differences between 192 Ir and 60 Co is reported. The standard deviation in repeated MOSFET measurements was below 3% in the six measurement points with dose levels above 2 Gy. MOSFET measurements overestimated treatment planning system doses by 2-7%. Distance-dependent experimental beam quality correction factors derived in a phantom of similar size as that used for end-to-end tests applied on a time-resolved measurement improved the agreement. MOSFET detectors provide values stable over time and function well for use as detectors for end-to-end quality assurance purposes in 192 Ir BT. Beam quality correction factors should address not only distance from source but also phantom dimensions. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Evaluation of head movement periodicity and irregularity during locomotion of Caenorhabditis elegans

Directory of Open Access Journals (Sweden)

Ryuzo eShingai

2013-03-01

Full Text Available Caenorhabditis elegans is suitable for studying the nervous system, which controls behavior. C. elegans shows sinusoidal locomotion on an agar plate. The head moves not only sinusoidally but also more complexly, which reflects regulation of the head muscles by the nervous system. The head movement becomes more irregular with senescence. To date, the head movement complexity has not been quantitatively analyzed. We propose two simple methods for evaluation of the head movement regularity on an agar plate using image analysis. The methods calculate metrics that are a measure of how the head end movement is correlated with body movement. In the first method, the length along the trace of the head end on the agar plate between adjacent intersecting points of the head trace and the quasi-midline of the head trace, which was made by sliding an averaging window of 1/2 the body wavelength, was obtained. Histograms of the lengths showed periodic movement of the head and deviation from it. In the second method, the intersections between the trace of the head end and the trace of the 5 (near the pharynx or 50% (the mid-body point from the head end in the centerline length of the worm image were marked. The length of the head trace between adjacent intersections was measured, and a histogram of the lengths was produced. The histogram for the 5% point showed deviation of the head end movement from the movement near the pharynx. The histogram for the 50% point showed deviation of the head movement from the sinusoidal movement of the body center. Application of these methods to wild type and several mutant strains enabled evaluation of their head movement periodicity and irregularity, and revealed a difference in the age-dependence of head movement irregularity between the strains. A set of five parameters obtained from the histograms reliably identifies differences in head movement between strains.

Audiological findings in patients treated with radio- and concomitant chemotherapy for head and neck tumors

International Nuclear Information System (INIS)

Dell'Aringa, Ana Helena B; Isaac, Myrian L; Arruda, Gustavo V; Esteves, Maria Carolina BN; Dell'Aringa, Alfredo Rafael; Júnior, José Luis S; Rodrigues, Alexandre F

2009-01-01

To evaluate the functionality of the auditory system in patients who underwent radiotherapy and chemotherapy treatment with cisplatin to treat head and neck tumors. Case series with planned data collection. From May 2007 to May 2008 by the Department of Otorhinolaryngology and the Department of Oncology/Radiotherapy at Faculdade de Medicina de Marília. Audiological evaluation (Pure Tone Audiometry (air and bone conduction), Speech Audiometry, Tympanometry, Acoustic Reflex testing and Distortion Product Otoacoustic Emissions) was performed in 17 patients diagnosed with head and neck neoplasia and treated with chemotherapy, using cisplatin, and radiotherapy. 12 left ears (70.5%) and 11 right ears (64.7%) presented bilateral decreased hearing soon after the treatment for the frequency 1 kHz (mild auditory damage) and for the frequency 8 kHz (more significant auditory damage). Patients with head and neck cancer submitted to the conventional radiotherapy treatment, combined with the chemotherapy with cisplatin, presented a high incidence of decreased hearing by the end of treatment. Strong evidence was observed linking auditory alteration to the amount of radiotherapy treatment

Cetuximab: its unique place in head and neck cancer treatment

Directory of Open Access Journals (Sweden)

Specenier P

2013-04-01

Full Text Available Pol Specenier, Jan B Vermorken Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium Abstract: Head and neck cancer is the sixth most common cancer worldwide. At present, globally about 650,000 new cases of squamous cell carcinoma of the head and neck (SCCHN are diagnosed each year. The epidermal growth factor receptor (EGFR is almost invariably expressed in SCCHN. Overexpression of the EGFR is a strong and independent unfavorable prognostic factor in SCCHN. Cetuximab is a chimeric monoclonal antibody, which binds with high affinity to the extracellular domain of the human EGFR, blocking ligand binding, resulting in inhibition of the receptor function. It also targets cytotoxic immune effector cells towards EGFR-expressing tumor cells (antibody dependent cell-mediated cytotoxicity. The addition of cetuximab to radiotherapy (RT improves locoregional control and survival when compared to RT alone. The addition of cetuximab to platinum-based chemoradiation (CRT is feasible but does not lead to an improved outcome. Cetuximab plus RT has never been compared prospectively to CRT, which therefore remains the standard treatment for patients with locoregionally advanced SCCHN for whom surgery is not considered the optimal treatment, provided they can tolerate CRT. The addition of cetuximab to platinum-based chemotherapy prolongs survival in patients with recurrent or metastatic SCCHN. The combination of a platinum-based regimen and cetuximab should be considered as the standard first line regimen for patients who can tolerate this treatment. Keywords: SCCHN, cetuximab, recurrent metastatic, locoregionally advanced, chemoradiation

Outcomes of Vacuum-Assisted Therapy in the Treatment of Head and Neck Wounds.

Science.gov (United States)

Satteson, Ellen S; Crantford, John Clayton; Wood, Jeyhan; David, Lisa R

2015-10-01

Head and neck wounds can present a reconstructive challenge for the plastic surgeon. Whether from skin cancer, trauma, or burns, there are many different treatment modalities used to dress and manage complex head and neck wounds. Vacuum-assisted closure (VAC) therapy has been used on wounds of nearly every aspect of the body but not routinely in the head and neck area. This study was conducted to demonstrate our results using the VAC in the treatment of complex head and neck wounds. This is an IRB-approved, retrospective review of 69 patients with 73 head and neck wounds that were managed using the VAC between 1999 and 2008. The wound mechanism, location, and size, length of VAC therapy, patient comorbidities, use of radiation, complications, and ultimate outcome were assessed. In this patient population, the VAC was utilized because the standard reconstructive ladder was not a good option or had previously failed. Sixty-nine patients with complex head and neck wounds were treated with the wound VAC. The mean age of the patients was 66 years, with a range of 5-96 years. Males outnumbered females in this study nearly 2:1. Eighty-six percent of patients had wounds secondary to cancer, 8% secondary to trauma, 3% secondary to infection, and 3% secondary to burns. The VAC was used as a dressing over skin grafts in 50%, over Integra in 21%, and over open debrided wounds in 29%. Wounds healed without complication in 44% of the skin grafts, 67% of Integra-covered wounds, and 71% of debrided wounds. Minor complications included failure of complete graft take, failure of granulation tissue formation in open debrided wounds, infection, and hematoma formation under skin grafts. Major complications included positive cancer margins requiring reexcision and death secondary to pulmonary embolism, sepsis, and metastatic cancer. Most complications resolved with dressing changes, repeat grafting, or the administration of antibiotics. Our results demonstrate that the wound VAC

Are amphitheater headed canyons indicative of a particular formative process?

Science.gov (United States)

Ryan, A. J.; Whipple, K. X.; Johnson, J. P.

2012-12-01

Tributary canyons with amphitheater-shaped heads have previously been interpreted as evidence for groundwater seepage erosion, particularly in environments where fluvial processes are assumed to be negligible. However, some have questioned whether this canyon morphology is truly diagnostic of a particular formative process. We seek to determine the relative roles of fluvial and groundwater-related processes and the strength of stratigraphic control on the Colorado Plateau through a combination of fieldwork and GIS analysis. Amphitheater valleys may have overhanging or steep-sided headwalls with a semicircular plan-view pattern. It is reasonable to assume that this form is a result of focused erosion at the base of the headwall (i.e. sapping). Two frequently cited agents may lead to undermining: plunge-pool scour at the base of waterfalls and seepage induced weathering and erosion where the groundwater table intersects the land surface. Both processes are enhanced where weaker, less permeable layers underlie stronger cap rock. We conducted preliminary fieldwork in two locations on the Colorado Plateau, where there are many classic examples of amphitheater headed canyons. The Escalante River landscape is highly variable with a range of canyon and valley-head forms, many of which cut through the thick Navajo Sandstone into the underlying shale and sand of the Kayenta Formation. Northeast of Escalante National Monument, at the base of the Henry Mountains, is Tarantula Mesa. The canyons there are also considerably variable, with nearly all containing at least one abrupt amphitheater knickpoint at the valley head or farther downstream. Our observations are presented here with an analysis of the canyon profiles, surrounding topography, and potential structural controls. We have found that nearly all amphitheaters in both locales show signs of groundwater seepage weathering and plausibly seepage erosion. However, many also contain plunge pools and evidence of substantial

Undesirable financial effects of head and neck cancer radiotherapy during the initial treatment period

Directory of Open Access Journals (Sweden)

Helen Egestad

2015-01-01

Full Text Available Background: Healthcare cost and reforms are at the forefront of international debates. One of the current discussion themes in oncology is whether and how patients’ life changes due to costs of cancer care. In Norway, the main part of the treatment costs is supported by general taxpayer revenues. Objectives: The objective of this study was to clarify whether head and neck cancer patients (n=67 in northern Norway experienced financial health-related quality of life (HRQOL deterioration due to costs associated with treatment. Design: HRQOL was examined by the European Organization for Research and Treatment of Cancer (EORTC QLQ-C30 in the beginning and in the end of radiation treatment in patients treated at the University Hospital in Northern Norway. Changes in financial HRQOL were calculated and compared by paired sample T-tests. Multiple regression analyses were used to examine correlations among gender, marital status, age and treatment with or without additional chemotherapy and changes in the HRQOL domain of financial difficulties. Results: The majority of score results at both time points were in the lower range (mean 15–25, indicating limited financial difficulties. We observed no statistically significant differences by gender, marital status and age. Increasing financial difficulties during treatment were reported by male patients and those younger than 65, that is, patients who were younger than retirement age. The largest effect was seen in singles. However, differences were not statistically significant. Conclusions: During the initial phase of the disease trajectory, no significant increase in financial difficulties was found. This is in line with the aims of the Norwegian public healthcare model. However, long-term longitudinal studies should be performed, especially with regard to the trends we observed in single, male and younger patients.

[Effect of vascular endothelial growth factor and tumor necrosis factor receptor for treatment of avascular necrosis of the femoral head in rabbits].

Science.gov (United States)

Hu, Zhi-ming; Zhou, Ming-qian; Gao, Ji-min

2008-12-01

To evaluate the therapeutic effect of vascular endothelial growth factor (VEGF) and tumor necrosis factor receptor (TNFR) on avascular necrosis of the femoral head in rabbits. Avascular necrosis of the femoral head was induced in 26 New Zealand white rabbits by injections of horse serum and prednisolone. The rabbits were then divided into VEGF/TNFR treatment group, VEGF treatment group, and untreated model group, with another 4 normal rabbits as the normal control group. In the two treatment groups, the therapeutic agents were injected percutaneously into the femoral head. Enzyme-linked immunosorbent assay was performed to determine the concentration of TNF-alpha in rabbit serum followed by pathological examination of the changes in the bone tissues, bone marrow hematopoietic tissue and the blood vessels in the femoral head. Compared with the model group, the rabbits with both VEGF and TNFR treatment showed decreased serum concentration of TNF-alpha with obvious new vessel formation, decreased empty bone lacunae in the femoral head and hematopoietic tissue proliferation in the bone marrow cavity. Percutaneous injection of VEGF and TNFR into the femoral head can significantly enhance bone tissue angiogenesis and ameliorate osteonecrosis in rabbits with experimental femoral head necrosis.

Study of pneumatic hydropulse filter for feed clarification in reprocessing plant head-end

International Nuclear Information System (INIS)

Siddiqui, I.A.; Shah, B.V.; Salunke, S.U.; Kumar, S.V.

1991-01-01

A Pneumatic Hydropulse (PHP) Filter with sintered stainless steel cartridges was tested for suitability in reprocessing plant head-end filtration. The filter was tested with simulated slurry containing between 25 and 400 ppm of calcium carbonate particulates in the size ranges 45 to 53 micron and 53 to 75 micron at varying flow rates. Procedures were developed for dislodging the layer of solids on the cartidridges and regenerating the filter remotely. Application of 5.4 kg/cm 2 air to the dome of the filter during regenaration was found to be optimum for dislodging the particulate layer on the cartridges. No difficulties due to choking of the filter cartridges were experienced during operation and good regeneration by remote operation was possible. Approach velocity at the filter medium was about 6 cm/min. The efficiency of regeneration was better than 90%. Filtration efficiency was found to be better than 90%. Solid loading capacity was found to increase with increase of particle size and feed concentration. (author). 2 figs., 10 tabs

SULFUR HEXAFLUORIDE TREATMENT OF USED NUCLEAR FUEL TO ENHANCE SEPARATIONS

Energy Technology Data Exchange (ETDEWEB)

Gray, J.; Torres, R.; Korinko, P.; Martinez-Rodriguez, M.; Becnel, J.; Garcia-Diaz, B.; Adams, T.

2012-09-25

Reactive Gas Recycling (RGR) technology development has been initiated at Savannah River National Laboratory (SRNL), with a stretch-goal to develop a fully dry recycling technology for Used Nuclear Fuel (UNF). This approach is attractive due to the potential of targeted gas-phase treatment steps to reduce footprint and secondary waste volumes associated with separations relying primarily on traditional technologies, so long as the fluorinators employed in the reaction are recycled for use in the reactors or are optimized for conversion of fluorinator reactant. The developed fluorination via SF{sub 6}, similar to the case for other fluorinators such as NF{sub 3}, can be used to address multiple fuel forms and downstream cycles including continued processing for LWR via fluorination or incorporation into a aqueous process (e.g. modified FLUOREX) or for subsequent pyro treatment to be used in advanced gas reactor designs such metal- or gas-cooled reactors. This report details the most recent experimental results on the reaction of SF{sub 6} with various fission product surrogate materials in the form of oxides and metals, including uranium oxides using a high-temperature DTA apparatus capable of temperatures in excess of 1000{deg}C . The experimental results indicate that the majority of the fission products form stable solid fluorides and sulfides, while a subset of the fission products form volatile fluorides such as molybdenum fluoride and niobium fluoride, as predicted thermodynamically. Additional kinetic analysis has been performed on additional fission products. A key result is the verification that SF{sub 6} requires high temperatures for direct fluorination and subsequent volatilization of uranium oxides to UF{sub 6}, and thus is well positioned as a head-end treatment for other separations technologies, such as the volatilization of uranium oxide by NF{sub 3} as reported by colleagues at PNNL, advanced pyrochemical separations or traditional full recycle

A study of the positioning errors of head and neck in the process of intensity modulation radiated therapy of nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Lin Chengguang; Lin Liuwen; Liu Bingti; Liu Xiaomao; Li Guowen

2011-01-01

Objective: To investigate the positioning errors of head and neck during intensity-modulated radiation therapy of nasopharyngeal carcinoma. Methods: Nineteen patients with middle-advanced nasopharyngeal carcinoma (T 2-4 N 1-3 M 0 ), treated by intensity-modulated radiation therapy, underwent repeated CT during their 6-week treatment course. All the patients were immobilized by head-neck-shoulder thermoplastic mask. We evaluated their anatomic landmark coordinated in a total of 66 repeated CT data sets and respective x, y, z shifts relative to their position in the planning CT. Results: The positioning error of the neck was 2.44 mm ± 2.24 mm, 2.05 mm ± 1.42 mm, 1.83 mm ± 1.53 mm in x, y, z respectively. And that of the head was 1.05 mm ± 0.87 mm, 1.23 mm ± 1.05 mm, 1.17 mm ± 1.55 mm respectively. The positioning error between neck and head have respectively statistical difference (t=-6.58, -5.28, -3.42, P=0.000, 0.000, 0.001). The system error of the neck was 2.33, 1.67 and 1.56 higher than that of the head, respectively in left-right, vertical and head-foot directions; and the random error of neck was 2.57, 1.34 and 0.99 higher than that of head respectively. Conclusions: In the process of the intensity-modulated radiation therapy of nasopharyngeal carcinoma, with the immobilization by head-neck-shoulder thermoplastic mask, the positioning error of neck is higher than that of head. (authors)

How word-beginnings constrain the pronunciations of word-ends in the reading aloud of English: the phenomena of head- and onset-conditioning

Directory of Open Access Journals (Sweden)

Anastasia Ulicheva

2015-12-01

Full Text Available Background. A word whose body is pronounced in different ways in different words is body-inconsistent. When we take the unit that precedes the vowel into account for the calculation of body-consistency, the proportion of English words that are body-inconsistent is considerably reduced at the level of corpus analysis, prompting the question of whether humans actually use such head/onset-conditioning when they read.Methods. Four metrics for head/onset-constrained body-consistency were calculated: by the last grapheme of the head, by the last phoneme of the onset, by place and manner of articulation of the last phoneme of the onset, and by manner of articulation of the last phoneme of the onset. Since these were highly correlated, principal component analysis was performed on them.Results. Two out of four resulting principal components explained significant variance in the reading-aloud reaction times, beyond regularity and body-consistency.Discussion. Humans read head/onset-conditioned words faster than would be predicted based on their body-consistency and regularity only. We conclude that humans are sensitive to the dependency between word-beginnings and word-ends when they read aloud, and that this dependency is phonological in nature, rather than orthographic.

Ipsilateral dislocation of the radial head associated with fracture of distal end of the radius: a case report and review of the literature

Directory of Open Access Journals (Sweden)

Gupta Vinay

2013-06-01

Full Text Available 【Abstract】Dislocation of the radial head in adults is uncommon. A simultaneous dislocation of the radial head and fracture of the ipsilateral distal end of radius with no other associated injuries is extremely rare. As far as we know, such an injury after an unusual mode of injury has been seldom reported in the English literature. We report such a case without any associated injuries or comorbidity. Closed reduction was performed within two hours after injury and results were satisfactory. Immobilisation was continued for 3 weeks. Gradual mobilisation was started after removal of the plaster under the supervision of a physiotherapist. At 6 months’ follow-up, the patient had no residual pain at the elbow with full flexion & extension. Almost full supination with a restriction of last 10 degrees of pronation was achieved. There was no evidence of instability of the elbow. Key words: Radial heads; Dislocations; Radius fractures

In Situ Measurement of Seeking Speed and Seeking Induced Head-Disk Interface Instability in Hard Disk Drives

Directory of Open Access Journals (Sweden)

Yu Wang

2015-01-01

Full Text Available This paper investigated the instability of head-disk interface caused by the voice coil motor (VCM end crashing the crash stop during the seeking of magnetic head. To make the whole process of that clear, an in situ measurement method based on maximum likelihood estimation and extended Kalman filter for seeking speed at component level was developed first and was then calibrated by a high speed camera. Given a crash between VCM end and crash stop that may be a consequence of the continuous increasing seeking speed, the seeking speed was carefully controlled by using our developed method to find a critical value that may induce vigorous head-disk interface instability. Acoustic emission sensor and laser Doppler vibrometer were used to capture the transient dynamic behaviors of magnetic head when the crash is happening. Damage analysis and mode identification were carried out to reveal the relationship between the damage patterns on disk surface and head dynamics. The results of this study are helpful to optimize the track seeking profile during the HDD operation, as well as the design of components such as head and head arm.

Mode of treatment affects quality of life in head and neck cancer survivors: Implications for holistic care.

Science.gov (United States)

Bower, Wendy Fiona; Vlantis, Alexander Christopher; Chung, Tiffany M L; Van Hasselt, C Andrew

2010-10-01

As adverse effects of live-saving treatment are unavoidable surgeons have a duty to address physical changes and quality of life issues that matter to head and neck (H&N) cancer patients. We propose a tailored holistic care package. This study compared the quality of life of H&N cancer survivors managed with different approaches in the follow-up phase after initial treatment and identified factors adversely impacting quality of life parameters. H&N cancer patients studied: 1) surgery only, 2) radiotherapy only, 3) surgery and radiotherapy, and 4) any combination of surgery, chemotherapy or radiotherapy. Patients unable to communicate in Cantonese, with thyroid cancer or end-of-life disease were excluded. EORTC QLQ-H&N35 Cantonese version was administered at least 1 year after initial H&N cancer treatment. Quality of life impairment was worse in all of the domains for combination therapy versus monotherapy patients. Scores between surgery or radiotherapy-only patients were not significantly different. Radiotherapy preceding surgery impacted significantly more on speech than surgery before the radiotherapy. Patients with advanced disease had more impairment of quality of life in each domain than patients with early disease. Coughing, eating problems, sticky saliva, and difficulties with social contact were all significant predictors of problems associated with a dry mouth.

The perception of (naked only) bodies and faceless heads relies on holistic processing: Evidence from the inversion effect.

Science.gov (United States)

Bonemei, Rob; Costantino, Andrea I; Battistel, Ilenia; Rivolta, Davide

2018-05-01

Faces and bodies are more difficult to perceive when presented inverted than when presented upright (i.e., stimulus inversion effect), an effect that has been attributed to the disruption of holistic processing. The features that can trigger holistic processing in faces and bodies, however, still remain elusive. In this study, using a sequential matching task, we tested whether stimulus inversion affects various categories of visual stimuli: faces, faceless heads, faceless heads in body context, headless bodies naked, whole bodies naked, headless bodies clothed, and whole bodies clothed. Both accuracy and inversion efficiency score results show inversion effects for all categories but for clothed bodies (with and without heads). In addition, the magnitude of the inversion effect for face, naked body, and faceless heads was similar. Our findings demonstrate that the perception of faces, faceless heads, and naked bodies relies on holistic processing. Clothed bodies (with and without heads), on the other side, may trigger clothes-sensitive rather than body-sensitive perceptual mechanisms. © 2017 The British Psychological Society.

All-in-one theranostic nanoagent for head and neck cancer treatment

Science.gov (United States)

Dreifuss, Tamar; Davidi, Erez Shmuel; Motiei, Menachem; Barnoy, Eran; Bragilovski, Dimitri; Lubimov, Leon; Kindler, Marc Jose Jonathan; Popovtzer, Aron; Popovtzer, Rachela

2018-02-01

Despite the significant improvement in the treatment paradigm of head and neck cancer, owing to advanced radiation techniques in combination with chemotherapy, resistance of tumors remains a critical problem, leading to poor outcomes and negative prognosis. In addition, chemotherapeutic agents result in severe systemic toxicity due to nonselective damaging of normal cells. Recently, nanoparticle-based approaches have gained broad attention for improving both radiation therapy and chemotherapy. In this study, we present a dual effect nanoplatform, consists of gold nanoparticles coated with glucose and cisplatin (CG-GNPs), which simultaneously acts as a radiosensitizer and as a carrier which specifically deliver cisplatin to head and neck tumor. Our CG-GNPs showed significant penetration into tumor cells and similar cellular toxicity as cisplatin alone. Moreover, in combination with radiation treatment, CG-GNPs led to greater tumor reduction than that of free cisplatin with radiation. Furthermore, our CG-GNPs also demonstrated highly efficient imaging capabilities, as they act as ideal tumor-targeted CT contrast agent. Therefore, this single nano-formulation is a promising theranostic agent that has the potential to increase the antitumor effect and allow imaging guided therapy.

Comparison of end-of-life tire treatment technologies: a Chinese case study.

Science.gov (United States)

Li, Xingfu; Xu, He; Gao, Yingnan; Tao, Yijun

2010-11-01

The aim of this paper is to compare different end-of-life tire (ELT) treatment technologies in China from an environmental and economic perspective. Four treatment technologies were evaluated: ambient grinding, devulcanization, pyrolysis and illegal tire oil extraction. Life cycle assessment (LCA) was applied to evaluate the potential environmental impact of each treatment based on the Eco-indicator 99 (Hierarchist approach) method provided by GaBi 4 software. The final result shows that pyrolysis represents the environmentally benign option while illegal tire oil extraction caused the worst damages. For the three legal treatments, although high credit was obtained when considering avoided impacts from recycled materials and energy, they have great impact as to respiratory effects (inorganic) dominantly contributed by energy production stage, which implies that the emphasis on environmental policies related to ELT treatment should shift from the control of emissions from treatment process to the reduction of energy consumption. A simplified comparison of net benefits and total impacts shows that the most eco-effective ELT treatment technology is pyrolysis, followed by dynamic devulcanization and ambient grinding. The illegal tire oil extraction, however, must be prohibited immediately because of its highest environmental pollution and lowest net benefit. Copyright © 2010 Elsevier Ltd. All rights reserved.

Failure pattern and salvage treatment after radical treatment of head and neck cancer

DEFF Research Database (Denmark)

Pagh, Anja; Grau, Cai; Overgaard, Jens

2016-01-01

Purpose The aim of the study was to test the hypothesis that head and neck cancer (HNC) patients benefit from specialized follow-up (FU), as this strategy ensures timely detection of relapses for successful salvage treatment. This was done by evaluation of the pattern of failure, the temporal...... recordings of recurrent disease in 567 patients with primary tumors of the larynx, pharynx, oral cavity, nasal cavity, paranasal sinuses and salivary glands. A review of medical records was performed in order to update and supplement the database. Results Failures of the 567 patients were primarily in T...

Analytical network process based optimum cluster head selection in wireless sensor network.

Science.gov (United States)

Farman, Haleem; Javed, Huma; Jan, Bilal; Ahmad, Jamil; Ali, Shaukat; Khalil, Falak Naz; Khan, Murad

2017-01-01

Wireless Sensor Networks (WSNs) are becoming ubiquitous in everyday life due to their applications in weather forecasting, surveillance, implantable sensors for health monitoring and other plethora of applications. WSN is equipped with hundreds and thousands of small sensor nodes. As the size of a sensor node decreases, critical issues such as limited energy, computation time and limited memory become even more highlighted. In such a case, network lifetime mainly depends on efficient use of available resources. Organizing nearby nodes into clusters make it convenient to efficiently manage each cluster as well as the overall network. In this paper, we extend our previous work of grid-based hybrid network deployment approach, in which merge and split technique has been proposed to construct network topology. Constructing topology through our proposed technique, in this paper we have used analytical network process (ANP) model for cluster head selection in WSN. Five distinct parameters: distance from nodes (DistNode), residual energy level (REL), distance from centroid (DistCent), number of times the node has been selected as cluster head (TCH) and merged node (MN) are considered for CH selection. The problem of CH selection based on these parameters is tackled as a multi criteria decision system, for which ANP method is used for optimum cluster head selection. Main contribution of this work is to check the applicability of ANP model for cluster head selection in WSN. In addition, sensitivity analysis is carried out to check the stability of alternatives (available candidate nodes) and their ranking for different scenarios. The simulation results show that the proposed method outperforms existing energy efficient clustering protocols in terms of optimum CH selection and minimizing CH reselection process that results in extending overall network lifetime. This paper analyzes that ANP method used for CH selection with better understanding of the dependencies of

Endovascular treatment of head and neck arteriovenous malformations

Energy Technology Data Exchange (ETDEWEB)

Dmytriw, A.A. [University Health Network, Joint Department of Medical Imaging, Toronto, Ontario (Canada); Ter Brugge, K.G.; Krings, T.; Agid, R. [Toronto Western Hospital, Division of Neuroradiology, Department of Medical Imaging, Toronto, Ontario (Canada)

2014-03-15

Head and neck arteriovenous malformations (H and N AVM) are associated with considerable clinical and psychosocial burden and present a significant treatment challenge. We evaluated the presentation, response to treatment, and outcome of patients with H and N AVMs treated by endovascular means at our institution. Patients with H and N AVMs treated by endovascular means from 1984 to 2012 were evaluated retrospectively. These included AVMs involving the scalp, orbit, maxillofacial, and upper neck localizations. Patient's clinical files, radiological images, catheter angiograms, and surgical reports were reviewed. Eighty-nine patients with H and N AVMs (46 females, 43 males; 48 small, 41 large) received endovascular therapy. The goals of treatment were curative (n = 30), palliative (n = 34), or presurgical (n = 25). The total number of endovascular treatment sessions was 244 (average of 1.5 per patient). The goal of treatment was met in 92.1 % of cases. Eventual cure was achieved in 42 patients accounting for 58.4 % (52/89) of all patients who underwent treatment for any goal. Twenty-eight of these patients were cured by embolization alone (28/89, 31.4 %) of which 18 were single-hole AVFs. Twenty-four were cured by planned surgical excision after presurgical embolization (24/89, 27 %). Seven patients (7/89, 7.2 %) suffered transient and two (2/89, 2.2 %) permanent endovascular treatment complications. Endovascular treatment is effective for H and N AVMs and relatively safe. It is particularly effective for symptom palliation and presurgical aid. Embolization is curative mostly in small lesions and single-hole fistulas. In patients with large non-curable H and N AVMs, endovascular therapy is often the only palliative option. (orig.)

[Decision-making processes in nursing and activities at the end of life in intensive care–An international comparative study].

Science.gov (United States)

Kohlen, Helen; McCarthy, Joan; Szylit Buosso, Regina; Gallagher, Ann; Andrews, Tom

2015-12-01

Intensive care units (ICUs) are traditionally settings that offer high technologically advanced treatment for those who are in critical situations due to an illness or accident. Questions regarding the withdrawal and withholding as well as the ending of life sustaining treatment are related to ethical dilemmas. Nurses’ decision-making processes and nursing activities in different countries are scarcely studied. Which end-of-life decision-making processes and activities that are performed by nurses can be identified and described? The objective is the identification of a nursing terrain regarding decision-making and activities in patient end-of-life care on the intensive care unit. Semi-structured interviews were conducted with 51 experienced nurses in university or hospital premises: 10 in Brazil, 9 in England, 10 in Germany, 10 in Ireland and 12 nurses in Palestine. The study used grounded theory to inform data collection and analysis. The finding of the study is the identification of a dynamic process in which activities with a focus on cure shift to activities with a focus on end-of-life care. The core category that emerged was ’negotiated reorienting’: The shift of activities implies negotiations between nurses and physicians, relatives as well as with oneself. Moreover the process is characterized by a constant re-orientation that is induced by changing patient data and the realisation of the whole situation. Nurses’ core practices are ’consensus seeking’ and ’emotional holding’ (sub-categories). In all countries a nursing terrain of activities in end-of-life care could be identified and described. However, it is unclear whether nursing activities connected to relatives of the patient are dominant in such a way that relations to dying patients and respect for their autonomy are put into the background. A field study could give answers to this question possible.

Effect of Pretreatment Anemia on Treatment Outcome of Concurrent Radiochemotherapy in Patients With Head and Neck Cancer

International Nuclear Information System (INIS)

Fortin, Andre; Wang Changshu; Vigneault, Eric

2008-01-01

Purpose: To investigate the effect of anemia on outcome of treatment with radiochemotherapy in patients with head-and-neck cancer. Methods and Materials: The data of 196 patients with Stage II-IV head-and-neck cancer treated with concomitant cisplatin-based radiochemotherapy were retrospectively reviewed. Anemia was defined according to World Health Organization criteria as hemoglobin 140 g/L. Conclusions: Anemia was strongly associated with local control and survival in this cohort of patients with head-and-neck cancer receiving radiochemotherapy

Current state and future of photodynamic therapy for the treatment of head and neck squamous cell carcinoma

Directory of Open Access Journals (Sweden)

Christina Mimikos

2016-06-01

Full Text Available Photodynamic therapy has shown promise in the treatment of early head and neck squamous cell carcinoma (SCC. In photodynamic therapy (PDT, a light sensitive drug (photosensitizer and visible light cause cancer cell death by the creation of singlet oxygen and free radicals, inciting an immune response, and vascular collapse. In this paper, we review several studies that demonstrate the effectiveness of PDT in the treatment of early stage SCC of the head and neck, with some showing a similar response rate to surgery. Two cases are presented to illustrate the effectiveness of PDT. Then, new advances are discussed including the discovery of STAT3 crosslinking as a potential biomarker for PDT response and interstitial PDT for locally advanced cancers. Keywords: Photodynamic therapy, PDT, Squamous cell carcinoma, Head and neck cancer

[Treatment of adult congenital muscular torticollis by multiple sternocleidomastoid head amputation].

Science.gov (United States)

Fu, Ronggang; Yin, Xiuqing; Yu, Rong

2012-02-01

To investigate the therapeutic method and effectiveness of multiple sternocleidomastoid head amputation for adult congenital muscular torticollis. Between March 2009 and February 2011, 19 patients with congenital muscular torticollis were treated with multiple sternocleidomastoid head amputation. There were 13 males and 6 females, aged 16-32 years (mean, 23.5 years). The X-ray films showed that 12 cases were accompanied with some extent cervical lateral bending and wedge change. Ten patients were with ipsilateral facial bradygenesis. Four patients had received single sternocleidomastoid head amputation. All of the 19 patients were treated with multiple sternocleidomastoid head amputation, then plaster support and neck collar were used after operation for 3-6 months. The wounds of all the 19 patients healed primarily, without infection or hematoma. Sixteen patients were followed up 5 months to 2 years (mean, 8 months). The head and neck malformations were ameliorated significantly. The effectiveness was assessed 2 weeks later, in 7 patients without cervical vertebral malformation results were excellent; in 12 patients with cervical vertebral malformation, the results were excellent in 1 case, good in 7 cases, and fair in 4 cases. The length between mastoid process and sternoclavicular joints was elongated (1.88 +/- 0.30) cm significantly after operation in patients without cervical vertebral malformation (t = 6.24, P = 0.00), showing no significant difference when compared with normal value (t = 1.87, P = 0.11); the length was elongated (3.38 +/- 0.30) cm significantly (t = 11.37, P = 0.00) after operation in patients with cervical vertebral malformation, but it was significant shorter than normal value (t = 12.19, P = 0.00). Multiple sternocleidomastoid head amputation is a safe and effective method for adult congenital muscular torticollis, which can improve the neck rotation function.

A tissue engineering strategy for the treatment of avascular necrosis of the femoral head.

Science.gov (United States)

Aarvold, A; Smith, J O; Tayton, E R; Jones, A M H; Dawson, J I; Lanham, S; Briscoe, A; Dunlop, D G; Oreffo, R O C

2013-12-01

Skeletal stem cells (SSCs) and impaction bone grafting (IBG) can be combined to produce a mechanically stable living bone composite. This novel strategy has been translated to the treatment of avascular necrosis of the femoral head. Surgical technique, clinical follow-up and retrieval analysis data of this translational case series is presented. SSCs and milled allograft were impacted into necrotic bone in five femoral heads of four patients. Cell viability was confirmed by parallel in vitro culture of the cell-graft constructs. Patient follow-up was by serial clinical and radiological examination. Tissue engineered bone was retrieved from two retrieved femoral heads and was analysed by histology, microcomputed tomography (μCT) and mechanical testing. Three patients remain asymptomatic at 22- to 44-month follow-up. One patient (both hips) required total hip replacement due to widespread residual necrosis. Retrieved tissue engineered bone demonstrated a mature trabecular micro-architecture histologically and on μCT. Bone density and axial compression strength were comparable to trabecular bone. Clinical follow-up shows this to be an effective new treatment for focal early stage avascular necrosis of the femoral head. Unique retrieval analysis of clinically translated tissue engineered bone has demonstrated regeneration of tissue that is both structurally and functionally analogous to normal trabecular bone. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Evaluation of Radiation-induced Class V Dental Caries in Patients with Head and Neck Cancers Undergoing Radiotherapy.

Science.gov (United States)

Mohammadi, Narmin; Seyednejad, Farshad; Oskoee, Parnian Alizadeh; Savadi Oskoee, Siavash; Ebrahimi Chaharom, Mohammad Esmaeil

2008-01-01

Salivary glands are very susceptible to radiation and any disturbances in their function are detrimental to the hard tissues in the oral cavity. The aim of this study was to evaluate posterior class V dental caries in patients with head and neck cancers undergoing radiotherapy. In this study, twenty seven patients undergoing conventional radiotherapy were included. Class V dental caries of posterior teeth in these patients were evaluated in three intervals: before treatment, 3 weeks after the initiation of the treatment, and at the end of the treatment. Differences of mean caries activity between intervals were evaluated using paired sample t-test. There were no class V decays prior to radiotherapy. Mean percentage of class V caries three weeks after radiotherapy and at the end of radiotherapy were 28.42% ± 14.41 and 67.05% ± 19.02, respectively. There were statistically signifi-cant differences in mean values among three stages (P = 0.00025). The results of the present study re-vealed that radiotherapy in patients with head and neck cancers causes class V dental caries on posteri-or teeth.

A Review of Recent Advances in the Diagnosis and Treatment Modalities for Long Head of Bicep Tendinopathy

Directory of Open Access Journals (Sweden)

Robert B. Lewis

2016-01-01

Full Text Available This article reviews the assessment and management of the pathology of the long head of the biceps tendon, a disease commonly encountered by primary care physicians and orthopedic surgeons. We include a discussion of relevant anatomy, function, pathoanatomy, natural history of the disease, diagnostic methods, and treatment options. Recent literature on the function of the long head of the bicep (LHB is reviewed. Literature on our evolving understanding of the pathoanatomy behind LHB tendinopathy is discussed. We also discuss the effectiveness of current diagnostic and treatment modalities.

Smoking has a negative impact upon health related quality of life after treatment for head and neck cancer

DEFF Research Database (Denmark)

Jensen, Kenneth; Jensen, Anders Bonde; Grau, Cai

2006-01-01

To examine the influence of smoking on observer based morbidity scores and patient assessed health related quality of life after treatment for head and neck cancer. The results of EORTC C30 and H&N35 questionnaires and DAHANCA morbidity scores were studied according to smoking status in 114...... recurrence free head and neck cancer patients. In contrast to observer based toxicity scoring, smoking had a significantly negative influence on 20 of the 33 quality of life scales. Previous smokers had quality of life scores in between never smokers and continuous smokers. Smoking after treatment of head...... and neck cancer adversely influenced a wide range of quality of life endpoints. Quitters had better quality of life than patients who continued to smoke after treatment, suggesting that smoking cessation may improve quality of life in addition to reducing the risk of new cancer. Udgivelsesdato: 2007-Feb...

Poster — Thur Eve — 29: Characterization of Patient Immobilization for Head and Neck Cancer Treatment

International Nuclear Information System (INIS)

Courneyea, L; Mullins, J; Howard, M; Beltran, C; Brinkmann, D; Pafundi, D

2014-01-01

Purpose: Evaluate an immobilization system to determine its adequacy for the reduced margins required for proton therapy. Methods: Twelve head-and-neck cancer patients were immobilized for conventional photon radiotherapy and imaged with pre- and post-treatment cone beam CTs (CBCTs) for each treatment fraction. To quantify the patient positioning reproducibility, each CBCT was registered to the simulation CT offline. Registrations were performed using auto-match tools and a matching volume-of-interest (VOI) consisting of a 5mm expansion around the mandible, occipital bone, C1/C2 and C7/T1. For each registration, the bony anatomy in the VOI was evaluated for agreement with the simulation position using 3 and 5mm margins. Registrations were initially restricted to translational corrections. If the bony anatomy did not agree with the simulation position to within 3mm or 5mm, the auto-match was repeated with 3 additional rotational corrections. Intrafraction motion was calculated as the difference between the pre- and post-treatment CBCT matches. Results: Pre-treatment patient positioning agreed with the simulation CT to within 3mm/5mm for 62%/86% of fractions using translational matching and 84%/100% of fractions when rotations were included. Intrafraction motion averaged 1.1±0.8mm, with 12% of fractions having >2mm intrafraction motion. Post-treatment positioning accuracy was 57%/84% and 80%/100% for registrations without/with rotations. For the mandible, positioning accuracy dropped from 93% pre-treatment to 82% post-treatment. Conclusion: If rotational corrections are available, the immobilization system studied created reproducible patient positioning to within 3mm for 84% of fractions. However, intrafraction motion caused additional anatomy to fall outside the 3mm margin by the end of treatment

Poster — Thur Eve — 29: Characterization of Patient Immobilization for Head and Neck Cancer Treatment

Energy Technology Data Exchange (ETDEWEB)

Courneyea, L; Mullins, J; Howard, M; Beltran, C; Brinkmann, D; Pafundi, D [Mayo Clinic, Rochester, MN (United States)

2014-08-15

Purpose: Evaluate an immobilization system to determine its adequacy for the reduced margins required for proton therapy. Methods: Twelve head-and-neck cancer patients were immobilized for conventional photon radiotherapy and imaged with pre- and post-treatment cone beam CTs (CBCTs) for each treatment fraction. To quantify the patient positioning reproducibility, each CBCT was registered to the simulation CT offline. Registrations were performed using auto-match tools and a matching volume-of-interest (VOI) consisting of a 5mm expansion around the mandible, occipital bone, C1/C2 and C7/T1. For each registration, the bony anatomy in the VOI was evaluated for agreement with the simulation position using 3 and 5mm margins. Registrations were initially restricted to translational corrections. If the bony anatomy did not agree with the simulation position to within 3mm or 5mm, the auto-match was repeated with 3 additional rotational corrections. Intrafraction motion was calculated as the difference between the pre- and post-treatment CBCT matches. Results: Pre-treatment patient positioning agreed with the simulation CT to within 3mm/5mm for 62%/86% of fractions using translational matching and 84%/100% of fractions when rotations were included. Intrafraction motion averaged 1.1±0.8mm, with 12% of fractions having >2mm intrafraction motion. Post-treatment positioning accuracy was 57%/84% and 80%/100% for registrations without/with rotations. For the mandible, positioning accuracy dropped from 93% pre-treatment to 82% post-treatment. Conclusion: If rotational corrections are available, the immobilization system studied created reproducible patient positioning to within 3mm for 84% of fractions. However, intrafraction motion caused additional anatomy to fall outside the 3mm margin by the end of treatment.

Effect of different rates of spent coffee grounds (SCG) on composting process, gaseous emissions and quality of end-product.

Science.gov (United States)

Santos, Cátia; Fonseca, João; Aires, Alfredo; Coutinho, João; Trindade, Henrique

2017-01-01

The use of spent coffee grounds (SCG) in composting for organic farming is a viable way of valorising these agro-industrial residues. In the present study, four treatments with different amounts of spent coffee grounds (SCG) were established, namely, C 0 (Control), C 10 , C 20 and C 40 , containing 0, 10, 20 and 40% of SCG (DM), respectively; and their effects on the composting process and the end-product quality characteristics were evaluated. The mixtures were completed with Acacia dealbata L. shoots and wheat straw. At different time intervals during composting, carbon dioxide (CO 2 ), methane (CH 4 ) and nitrous oxide (N 2 O) emissions were measured and selected physicochemical characteristics of the composts were evaluated. During the composting process, all treatments showed a substantial decrease in total phenolics and total tannins, and an important increase in gallic acid. Emissions of greenhouse gases were very low and no significant difference between the treatments was registered. The results indicated that SCG may be successfully composted in all proportions. However C 40 , was the treatment which combined better conditions of composting, lower GHG emissions and better quality of end product. Copyright © 2016 Elsevier Ltd. All rights reserved.

Magnetic Resonance Imaging (MRI) -- Head

Medline Plus

Full Text Available ... for Brain Tumors Radiation Therapy for Head and Neck Cancer Others : American Stroke Association National Stroke Association ... MRA) Magnetic Resonance, Functional (fMRI) - Brain Head and Neck Cancer Treatment Brain Tumor Treatment Magnetic Resonance Imaging ( ...

Dry refabrication technology development of spent nuclear fuel

International Nuclear Information System (INIS)

Park, Geun Il; Lee, J. W.; Song, K. C.

2012-04-01

Key technologies highly applicable to the development of advanced nuclear fuel cycle for the spent fuel recycling were developed using spent fuel and simulated spent fuel (SIMFUEL). In the frame work of dry process oxide products fabrication and the property characteristics of dry process products, hot cell experimental data for decladding, powdering and oxide product fabrication from low and high burnup spent fuel have been produced, basic technology for fabrication of spent fuel standard material has been developed, and remotely modulated welding equipment has been designed and fabricated. Also, fabrication technology of simulated dry process products was established and property models were developed based on reproducible property measurement data. In the development of head-end technology for dry refabrication of spent nuclear fuel and key technologies for volume reduction of head-end process waste which are essential in back-end fuel cycle field including pyro-processing, advanced head-end unit process technology development includes the establishment of experimental conditions for synthesis of porous fuel particles using a granulating furnace and for preparation of UO2 pellets, and fabrication and performance demonstration of engineering scale equipment for off-gas treatment of semi-volatile nuclides, and development of phosphate ceramic technology for immobilization of used filters. Radioactivation characterization and treatment equipment design of metal wastes from pretreatment process was conducted, and preliminary experiments of chlorination/electrorefining techniques for the treatment of hull wastes were performed. Based on the verification of the key technologies for head-end process via the hot-cell tests using spent nuclear fuel, pre-conceptual design for the head-end equipments was performed

Dry refabrication technology development of spent nuclear fuel

Energy Technology Data Exchange (ETDEWEB)

Park, Geun Il; Lee, J. W.; Song, K. C.; and others

2012-04-15

Key technologies highly applicable to the development of advanced nuclear fuel cycle for the spent fuel recycling were developed using spent fuel and simulated spent fuel (SIMFUEL). In the frame work of dry process oxide products fabrication and the property characteristics of dry process products, hot cell experimental data for decladding, powdering and oxide product fabrication from low and high burnup spent fuel have been produced, basic technology for fabrication of spent fuel standard material has been developed, and remotely modulated welding equipment has been designed and fabricated. Also, fabrication technology of simulated dry process products was established and property models were developed based on reproducible property measurement data. In the development of head-end technology for dry refabrication of spent nuclear fuel and key technologies for volume reduction of head-end process waste which are essential in back-end fuel cycle field including pyro-processing, advanced head-end unit process technology development includes the establishment of experimental conditions for synthesis of porous fuel particles using a granulating furnace and for preparation of UO2 pellets, and fabrication and performance demonstration of engineering scale equipment for off-gas treatment of semi-volatile nuclides, and development of phosphate ceramic technology for immobilization of used filters. Radioactivation characterization and treatment equipment design of metal wastes from pretreatment process was conducted, and preliminary experiments of chlorination/electrorefining techniques for the treatment of hull wastes were performed. Based on the verification of the key technologies for head-end process via the hot-cell tests using spent nuclear fuel, pre-conceptual design for the head-end equipments was performed.

Evaluation of DVH-based treatment plan verification in addition to gamma passing rates for head and neck IMRT

International Nuclear Information System (INIS)

Visser, Ruurd; Wauben, David J.L.; Groot, Martijn de; Steenbakkers, Roel J.H.M.; Bijl, Henk P.; Godart, Jeremy; Veld, Aart A. van’t; Langendijk, Johannes A.; Korevaar, Erik W.

2014-01-01

Background and purpose: Treatment plan verification of intensity modulated radiotherapy (IMRT) is generally performed with the gamma index (GI) evaluation method, which is difficult to extrapolate to clinical implications. Incorporating Dose Volume Histogram (DVH) information can compensate for this. The aim of this study was to evaluate DVH-based treatment plan verification in addition to the GI evaluation method for head and neck IMRT. Materials and methods: Dose verifications of 700 subsequent head and neck cancer IMRT treatment plans were categorised according to gamma and DVH-based action levels. Fractionation dependent absolute dose limits were chosen. The results of the gamma- and DVH-based evaluations were compared to the decision of the medical physicist and/or radiation oncologist for plan acceptance. Results: Nearly all treatment plans (99.7%) were accepted for treatment according to the GI evaluation combined with DVH-based verification. Two treatment plans were re-planned according to DVH-based verification, which would have been accepted using the evaluation alone. DVH-based verification increased insight into dose delivery to patient specific structures increasing confidence that the treatment plans were clinically acceptable. Moreover, DVH-based action levels clearly distinguished the role of the medical physicist and radiation oncologist within the Quality Assurance (QA) procedure. Conclusions: DVH-based treatment plan verification complements the GI evaluation method improving head and neck IMRT-QA

A co-design process developing heuristics for practitioners providing end of life care for people with dementia.

Science.gov (United States)

Davies, Nathan; Mathew, Rammya; Wilcock, Jane; Manthorpe, Jill; Sampson, Elizabeth L; Lamahewa, Kethakie; Iliffe, Steve

2016-08-02

The end of life for someone with dementia can present many challenges for practitioners; such as, providing care if there are swallowing difficulties. This study aimed to develop a toolkit of heuristics (rules-of-thumb) to aid practitioners making end-of-life care decisions for people with dementia. An iterative co-design approach was adopted using a literature review and qualitative methods, including; 1) qualitative interviews and focus groups with family carers and 2) focus groups with health and care professionals. Family carers were recruited from a national charity, purposively sampling those with experience of end-of-life care for a person with dementia. Health and care professionals were purposively sampled to include a broad range of expertise including; general practitioners, palliative care specialists, and geriatricians. A co-design group was established consisting of health and social care experts and family carers, to synthesise the findings from the qualitative work and produce a toolkit of heuristics to be tested in practice. Four broad areas were identified as requiring complex decisions at the end of life; 1) eating/swallowing difficulties, 2) agitation/restlessness, 3) ending life-sustaining treatment, and 4) providing "routine care" at the end of life. Each topic became a heuristic consisting of rules arranged into flowcharts. Eating/swallowing difficulties have three rules; ensuring eating/swallowing difficulties do not come as a surprise, considering if the situation is an emergency, and considering 'comfort feeding' only versus time-trialled artificial feeding. Agitation/restlessness encourages a holistic approach, considering the environment, physical causes, and the carer's wellbeing. Ending life-sustaining treatment supports practitioners through a process of considering the benefits of treatment versus quality-of-life and comfort. Finally, a heuristic on providing routine care such as bathing, prompts practitioners to consider adapting

Management of somatic pain induced by head-and-neck cancer treatment: definition and assessment. Guidelines of the French Oto-Rhino-Laryngology- Head and Neck Surgery Society (SFORL).

Science.gov (United States)

Binczak, M; Navez, M; Perrichon, C; Blanchard, D; Bollet, M; Calmels, P; Couturaud, C; Dreyer, C; Espitalier, F; Testelin, S; Albert, S; Morinière, S

2014-09-01

The authors present the guidelines of the French Oto-Rhino-Laryngology- Head and Neck Surgery Society (Société Française d'Oto-rhino-Laryngologie et de Chirurgie de la Face et du Cou [SFORL]) for the management of somatic pain induced by head-and-neck cancer treatment, and in particular the instruments needed for the definition and initial assessment of the various types of pain. A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group. The final version was established in a coordination meeting. The guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence. The priority is to eliminate tumoral recurrence when pain reappears or changes following head-and-neck cancer treatment. Neuropathic pain screening instruments and pain assessment scales should be used to assess pain intensity and treatment efficacy. Functional rehabilitation sessions should be prescribed to reduce musculoskeletal pain and prevent ankylosis and postural disorder. Psychotherapy and mind-body therapy, when available, should be provided in case of chronic pain. In case of recalcitrant complex pain, referral should be made to a multidisciplinary pain structure. The management of somatic pain induced by head-and-neck cancer treatment above all requires identifying and assessing the intensity of the various types of pain involved, their functional impact and their emotional component. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Quality of Life in Swallowing Disorders after Nonsurgical Treatment for Head and Neck Cancer

Directory of Open Access Journals (Sweden)

Silveira, Marta Halina

2014-12-01

Full Text Available Introduction Radiotherapy or chemoradiotherapy can result in severe swallowing disorders with potential risk for aspiration and can negatively impact the patient's quality of life (QOL. Objective To assess swallowing-related QOL in patients who underwent radiotherapy/chemoradiotherapy for head and neck cancer. Methods We interviewed 110 patients (85 men and 25 women who had undergone exclusive radiotherapy (25.5% or concomitant chemoradiotherapy (74.5% from 6 to 12 months before the study. The Quality of Life in Swallowing Disorders (SWAL-QOL questionnaire was employed to evaluate dysphagia-related QOL. Results The QOL was reduced in all domains for all patients. The scores were worse among men. There was a relationship between oral cavity as the primary cancer site and the fatigue domain and also between advanced cancer stage and the impact of food selection, communication, and social function domains. Chemoradiotherapy association, the presence of nasogastric tube and tracheotomy, and the persistence of alcoholism and smoking had also a negative effect on the QOL. Conclusions According to the SWAL-QOL questionnaire, the dysphagia-related impact on QOL was observed 6 to 12 months after the treatment ended.

Cryotherapy and radiotherapy combination in extensive and recurrent types of head and neck skin cancer treatment

International Nuclear Information System (INIS)

Pustynskij, I.N.; Paches, A.I.; Tkachev, S.I.; Tabolinovskaya, T.D.; Alieva, S.B.; Yagubov, A.S.; Slanina, S.V.; Bazhutova, G.A.

2007-01-01

The method of infiltrative skin cancer treatment based on different variants of radiotherapy and cryotherapy combination is described. During the period of 1988-2006 the Department of head and neck neoplasms of N. N. Blohin Russian Cancer Research Center provided radiation and cryogenic treatment of 94 patients with locally advanced head and neck epidermoid and basal cell cancer. For this purpose before every radiotherapy session the tumor was exposed to cryo cooling till freezing temperature (-5 degrees C). The total involution of tumors was observed at 91 patients. Residual tumors were removed surgically. The follow-up showed good functional and aesthetic results, retention of local tissues.

The Different Role of Working Memory in Open-Ended versus Closed-Ended Creative Problem Solving: A Dual-Process Theory Account

Science.gov (United States)

Lin, Wei-Lun; Lien, Yunn-Wen

2013-01-01

This study examined how working memory plays different roles in open-ended versus closed-ended creative problem-solving processes, as represented by divergent thinking tests and insight problem-solving tasks. With respect to the analysis of different task demands and the framework of dual-process theories, the hypothesis was that the idea…

Chryse 'Alien Head'

Science.gov (United States)

2005-01-01

26 January 2004 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows an impact crater in Chryse Planitia, not too far from the Viking 1 lander site, that to seems to resemble a bug-eyed head. The two odd depressions at the north end of the crater (the 'eyes') may have formed by wind or water erosion. This region has been modified by both processes, with water action occurring in the distant past via floods that poured across western Chryse Planitia from Maja Valles, and wind action common occurrence in more recent history. This crater is located near 22.5oN, 47.9oW. The 150 meter scale bar is about 164 yards long. Sunlight illuminates the scene from the left/lower left.

Quality control for electron beam processing of polymeric materials by end-point analysis

International Nuclear Information System (INIS)

DeGraff, E.; McLaughlin, W.L.

1981-01-01

Properties of certain plastics, e.g. polytetrafluoroethylene, polyethylene, ethylene vinyl acetate copolymer, can be modified selectively by ionizing radiation. One of the advantages of this treatment over chemical methods is better control of the process and the end-product properties. The most convenient method of dosimetry for monitoring quality control is post-irradiation evaluation of the plastic itself, e.g., melt index and melt point determination. It is shown that by proper calibration in terms of total dose and sufficiently reproducible radiation effects, such product test methods provide convenient and meaningful analyses. Other appropriate standardized analytical methods include stress-crack resistance, stress-strain-to-fracture testing and solubility determination. Standard routine dosimetry over the dose and dose rate ranges of interest confirm that measured product end points can be correlated with calibrated values of absorbed dose in the product within uncertainty limits of the measurements. (author)

Measurement of Design Process Front-End – Radical Innovation Approach

DEFF Research Database (Denmark)

Berg, Pekka; Pihlajamaa, Jussi; Hansen, Poul H. Kyvsgård

2014-01-01

The overall structure and the main characteristics of the future product are all decided in the front-end phase, which then strongly affects subsequent new product development activities. Recent studies indicate that these early front-end activities represent the most troublesome phase...... of the innovation process, and at the same time one of the greatest opportunities to improve the overall innovation capability of a company. In this paper dealing with the criteria we concentrate only for the objectives viewpoint and leave the attributes discussion to the future research. Two most crucial questions...... the innovation activities front end contains five assessment viewpoints as follows; input, process, output (including impacts), social environment and structural environment. Based on the results from our first managerial implications in three Finnish manufacturing companies we argue, that the developed model...

Aging Prisoners' Treatment Selection: Does Prospect Theory Enhance Understanding of End-of-Life Medical Decisions?

Science.gov (United States)

Phillips, Laura L.; Allen, Rebecca S.; Harris, Grant M.; Presnell, Andrew H.; DeCoster, Jamie; Cavanaugh, Ronald

2011-01-01

Purpose: With the rapid growth in the older inmate population and the economic impact of end-of-life treatments within the cash-strapped prison system, consideration should be given to inmate treatment preferences. We examined end-of-life treatment preferences and days of desired life for several health scenarios among male inmates incarcerated…

Osteonecrosis of femoral head: Treatment by core decompression and vascular pedicle grafting

Directory of Open Access Journals (Sweden)

Babhulkar Sudhir

2009-01-01

Full Text Available Background: Femoral head-preserving core decompression and bone grafting have shown excellent result in preventing collapse. The use of vascularized grafts have shown better clinical results. The vascular pedicle bone graft is an easy to perform operation and does not require special equipment. We analyzed and report a series of patients of osteonecrosis of femoral head treated by core decompression and vascular pedicle grafting of part of iliac crest based on deep circumflex iliac vessels. Materials and Methods: The article comprises of the retrospective study of 31 patients of osteonecrosis of femoral head in stage II and III treated with core decompression and vascular pedicle grafting by using part of iliac crest with deep circumflex iliac vessels from January 1990 to December 2005. The young patients with a mean age 32 years (18-52 years with a minimum follow-up of five years were included for analysis. Sixteen patients had osteonecrosis following alcohol abuse, 12 patients following corticosteroid consumption, 3 patients had idiopathic osteonecrosis. Nine patients were stage IIB, and 22 patients were stage IIIC according to ARCO′s system. The core decompression and vascular pedicle grafting was performed by anterior approach by using part of iliac crest with deep circumflex iliac vessels. Results: Digital subtraction arteriography performed in 9 patients at the end of 12 weeks showed the patency of deep circumflex artery in all cases, and bone scan performed in 6 other patients showed high uptake in the grafted area of the femoral head proving the efficacy of the operative procedure. Out of 31 patients, only one patient progressed to collapse and total joint replacement was advised. At the final follow up period of 5-8 years, Harris Hip Score improved mean ± SD of 28.2 ± 6.4 ( p < 0.05. Forty-eight percent of patients had an improvement in Harris Hip Score of more that 28 points. Conclusion: The core decompression and vascular pedicle

Development of Head-end Pyrochemical Reduction Process for Advanced Oxide Fuels

International Nuclear Information System (INIS)

Park, B. H.; Seo, C. S.; Hur, J. M.; Jeong, S. M.; Hong, S. S.; Choi, I. K.; Choung, W. M.; Kwon, K. C.; Lee, I. W.

2008-12-01

The development of an electrolytic reduction technology for spent fuels in the form of oxide is of essence to introduce LWR SFs to a pyroprocessing. In this research, the technology was investigated to scale a reactor up, the electrochemical behaviors of FPs were studied to understand the process and a reaction rate data by using U 3 O 8 was obtained with a bench scale reactor. In a scale of 20 kgHM/batch reactor, U 3 O 8 and Simfuel were successfully reduced into metals. Electrochemical characteristics of LiBr, LiI and Li 2 Se were measured in a bench scale reactor and an electrolytic reduction cell was modeled by a computational tool

Initial results of CyberKnife treatment for recurrent previously irradiated head and neck cancer

International Nuclear Information System (INIS)

Himei, Kengo; Katsui, Kuniaki; Yoshida, Atsushi

2003-01-01

The purpose of this study was to evaluate the efficacy of CyberKnife for recurrent previously irradiated head and neck cancer. Thirty-one patients with recurrent previously irradiated head and neck cancer were treated with a CyberKnife from July 1999 to March 2002 at Okayama Kyokuto Hospital were retrospectively studied. The accumulated dose was 28-80 Gy (median 60 Gy). The interval between CyberKnife treatment and previous radiotherapy was 0.4-429.5 months (median 16.3 months). Primary lesions were nasopharynx: 7, maxillary sinus: 6, tongue: 5, ethmoid sinus: 3, and others: 1. The pathology was squamous cell carcinoma: 25, adenoid cystic carcinoma: 4, and others: 2. Symptoms were pain: 8, and nasal bleeding: 2. The prescribed dose was 15.0-40.3 Gy (median 32.3 Gy) as for the marginal dose. The response rate (complete response (CR)+partial response (PR)) and local control rate (CR+PR+no change (NC)) was 74% and 94% respectively. Pain disappeared for 4 cases, relief was obtained for 4 cases and no change for 2 cases and nasal bleeding disappeared for 2 cases for an improvement of symptoms. An adverse effects were observed as mucositis in 5 cases and neck swelling in one case. Prognosis of recurrent previously irradiated head and neck cancer was estimated as poor. Our early experience shows that CyberKnife is expected to be feasible treatment for recurrent previously irradiated head and neck cancer, and for the reduction adverse effects and maintenance of useful quality of life (QOL) for patients. (author)

Articular reconstruction of the humeral head with autogenous allograft in the treatment of the osteonecrosis

Directory of Open Access Journals (Sweden)

Alberto Naoki Miyazaki

Full Text Available ABSTRACT The authors describe a surgical biological reconstruction of the humeral head with frozen autogenous allograft technique for the treatment of young patients with focal osteonecrosis of the humeral head. This represents a possible alternative, maybe even definitive for some patients, when compared to hemiarthroplasty or total shoulder arthroplasty. The technique consists of the fixation of a frozen autogenous allograft with previously-molded articular cartilage from the humeral head, after cleansing the osteonecrotic focus. Five patients under 50 years of age were treated, with three very satisfactory results, one patient was lost to follow-up, and one patient had an unsatisfactory result (converted to hemiarthroplasty. The study describes the technique in detail and the three cases with a longer follow-up time.

Docetaxel in the treatment of squamous cell carcinoma of the head and neck

Directory of Open Access Journals (Sweden)

Alexander Rapidis

2008-11-01

Full Text Available Alexander Rapidis1, Nicholas Sarlis2, Jean-Louis Lefebvre3, Merrill Kies41Department of Maxillofacial Surgery, Greek Anticancer Institute, Saint Savvas Hospital, Athens, Greece; 2Department of Medical Affairs, Oncology – US Sanofi-Aventis, Bridgewater, NJ, USA; 3Head and Neck Department, Centre Régional de Lutte Contre le Cancer de Lille, Lille, France; 4Department of Thoracic/Head and Neck Medical Oncology, The University of Texas – M.D. Anderson Cancer Center, Houston, TX, USAAbstract: Squamous cell carcinoma of the head and neck (SCCHN presents at a locally advanced (LA stage in many patients. Chemotherapy has been successfully integrated into first-line treatment programs, either during or prior to radiotherapy (RT – the cornerstone modality for local disease control of inoperable disease or when organ preservation is desired. Concomitant chemoradiotherapy (CCRT provides an absolute survival benefit when compared with other types of locoregional therapy that exclude chemotherapy. Nonetheless, distant metastases still represent the most common cause of treatment failure. Consequently, adding induction chemotherapy (ICT to definitive non-surgical local therapies with a curative intent has been vigorously explored in LA SCCHN. Recently, it has been shown that ICT using the combination of the taxane docetaxel with cisplatin–5-fluorouracil provides significant survival benefit over cisplatin–5-FU, when used before either definitive RT (TAX323 trial or carboplatin-based CCRT (TAX324 trial. Docetaxel is also being investigated in metastatic or recurrent (M/R disease, with promising initial results. It is very likely that the future management strategies of SCCHN will incorporate biologic agents as an add-on to docetaxel-containing schemas, administered either as ICT prior to CCRT in the LA setting or for the management of M/R disease.Keywords: chemoradiotherapy, chemotherapy, docetaxel, head and neck carcinoma, induction, locally

Determination of material distribution in heading process of small bimetallic bar

Science.gov (United States)

Presz, Wojciech; Cacko, Robert

2018-05-01

The electrical connectors mostly have silver contacts joined by riveting. In order to reduce costs, the core of the contact rivet can be replaced with cheaper material, e.g. copper. There is a wide range of commercially available bimetallic (silver-copper) rivets on the market for the production of contacts. Following that, new conditions in the riveting process are created because the bi-metal object is riveted. In the analyzed example, it is a small size object, which can be placed on the border of microforming. Based on the FEM modeling of the load process of bimetallic rivets with different material distributions, the desired distribution was chosen and the choice was justified. Possible material distributions were parameterized with two parameters referring to desirable distribution characteristics. The parameter: Coefficient of Mutual Interactions of Plastic Deformations and the method of its determination have been proposed. The parameter is determined based of two-parameter stress-strain curves and is a function of these parameters and the range of equivalent strains occurring in the analyzed process. The proposed method was used for the upsetting process of the bimetallic head of the electrical contact. A nomogram was established to predict the distribution of materials in the head of the rivet and the appropriate selection of a pair of materials to achieve the desired distribution.

Development of Head-end Pyrochemical Reduction Process for Advanced Oxide Fuels

Energy Technology Data Exchange (ETDEWEB)

Park, B. H.; Seo, C. S.; Hur, J. M.; Jeong, S. M.; Hong, S. S.; Choi, I. K.; Choung, W. M.; Kwon, K. C.; Lee, I. W. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2008-12-15

The development of an electrolytic reduction technology for spent fuels in the form of oxide is of essence to introduce LWR SFs to a pyroprocessing. In this research, the technology was investigated to scale a reactor up, the electrochemical behaviors of FPs were studied to understand the process and a reaction rate data by using U{sub 3}O{sub 8} was obtained with a bench scale reactor. In a scale of 20 kgHM/batch reactor, U{sub 3}O{sub 8} and Simfuel were successfully reduced into metals. Electrochemical characteristics of LiBr, LiI and Li{sub 2}Se were measured in a bench scale reactor and an electrolytic reduction cell was modeled by a computational tool.

Noncompliance to guidelines in head and neck cancer treatment; associated factors for both patient and physician

International Nuclear Information System (INIS)

Dronkers, Emilie A. C.; Mes, Steven W.; Wieringa, Marjan H.; Schroeff, Marc P. van der; Baatenburg de Jong, Robert J.

2015-01-01

Decisions on head and neck squamous cell carcinoma (HNSCC) treatment are widely recognized as being difficult, due to high morbidity, often involving vital functions. Some patients may therefore decline standard, curative treatment. In addition doctors may propose alternative, nonstandard treatments. Little attention is devoted, both in literature and in daily practice, to understanding why and when HNSCC patients or their physicians decline standard, curative treatment modalities. Our objective is to determine factors associated with noncompliance in head and neck cancer treatment for both patients and physicians and to assess the influence of patient compliance on prognosis. We did a retrospective study based on the medical records of 829 patients with primary HNSCC, who were eligible for curative treatment and referred to our hospital between 2010 and 2012. We analyzed treatment choice and reasons for nonstandard treatment decisions, survival, age, gender, social network, tumor site, cTNM classification, and comorbidity (ACE27). Multivariate analysis using logistic regression methods was performed to determine predictive factors associated with non-standard treatment following physician or patient decision. To gain insight in survival of the different groups of patients, we applied a Cox regression analysis. After checking the proportional hazards assumption for each variable, we adjusted the survival analysis for gender, age, tumor site, tumor stage, comorbidity and a history of having a prior tumor. 17 % of all patients with a primary HNSCC did not receive standard curative treatment, either due to nonstandard treatment advice (10 %) or due to the patient choosing an alternative (7 %). A further 3 % of all patients refused any type of therapy, even though they were considered eligible for curative treatment. Elderliness, single marital status, female gender, high tumor stage and severe comorbidity are predictive factors. Patients declining standard treatment

Front-end data processing the SLD data acquisition system

International Nuclear Information System (INIS)

Nielsen, B.S.

1986-07-01

The data acquisition system for the SLD detector will make extensive use of parallel at the front-end level. Fastbus acquisition modules are being built with powerful processing capabilities for calibration, data reduction and further pre-processing of the large amount of analog data handled by each module. This paper describes the read-out electronics chain and data pre-processing system adapted for most of the detector channels, exemplified by the central drift chamber waveform digitization and processing system

Linking computer-aided design (CAD) to Geant4-based Monte Carlo simulations for precise implementation of complex treatment head geometries

International Nuclear Information System (INIS)

Constantin, Magdalena; Constantin, Dragos E; Keall, Paul J; Narula, Anisha; Svatos, Michelle; Perl, Joseph

2010-01-01

Most of the treatment head components of medical linear accelerators used in radiation therapy have complex geometrical shapes. They are typically designed using computer-aided design (CAD) applications. In Monte Carlo simulations of radiotherapy beam transport through the treatment head components, the relevant beam-generating and beam-modifying devices are inserted in the simulation toolkit using geometrical approximations of these components. Depending on their complexity, such approximations may introduce errors that can be propagated throughout the simulation. This drawback can be minimized by exporting a more precise geometry of the linac components from CAD and importing it into the Monte Carlo simulation environment. We present a technique that links three-dimensional CAD drawings of the treatment head components to Geant4 Monte Carlo simulations of dose deposition. (note)

Biophysical stimulation in osteonecrosis of the femoral head

Directory of Open Access Journals (Sweden)

Massari Leo

2009-01-01

Full Text Available Osteonecrosis of the femoral head is the endpoint of a disease process that results from insufficient blood flow and bone-tissue necrosis, leading to joint instability, collapse of the femoral head, arthritis of the joint, and total hip replacement. Pain is the most frequent clinical symptom. Both bone tissue and cartilage suffer when osteonecrosis of the femoral head develops. Stimulation with pulsed electromagnetic fields (PEMFs has been shown to be useful for enhancing bone repair and for exerting a chondroprotective effect on articular cartilage. Two Italian studies on the treatment of avascular necrosis of the femoral head with PEMFs were presented in this review. In the first study, 68 patients suffering from avascular necrosis of the femoral head were treated with PEMFs in combination with core decompression and autologous bone grafts. The second one is a retrospective analysis of the results of treatment with PEMFs of 76 hips in 66 patients with osteonecrosis of the femoral head. In both studies clinical information and diagnostic imaging were collected at the beginning of the treatment and at the time of follow up. Statistical analysis was performed using chi-square test. Both authors hypothesize that the short-term effect of PEMF stimulation may be to protect the articular cartilage from the catabolic effect of inflammation and subchondral bone-marrow edema. The long-term effect of PEMF stimulation may be to promote osteogenic activity at the necrotic area and prevent trabecular fracture and subchondral bone collapse. PEMF stimulation represents an important therapeutic opportunity to resolve the Ficat stage-I or II disease or at least to delay the time until joint replacement becomes necessary.

Computer-assisted planning and dosimetry for radiation treatment of head and neck cancer in Cameroon

International Nuclear Information System (INIS)

Yomi, J.; Ngniah, A.; Kingue, S.; Muna, W.F.T.; Durosinmi-Etti, F.A.

1995-01-01

This evaluation was part of a multicenter, multinational study sponsored by the International Agency for Atomic Energy (Vienna) to investigate a simple, reliable computer-assisted planning and dosimetry system for radiation treatment of head and neck cancers in developing countries. Over a 13-month period (April 1992-April 1993), 120 patients with histologically-proven head or neck cancer were included in the evaluation. In each patient, planning and dosimetry were done both manually and using the computer-assisted system. The manual and computerized systems were compared on the basis of accuracy of determination of the outer contour, target volume, and critical organs; volume inequality resolution; structure heterogeneity correction; selection of the number, angle, and size of beams; treatment time calculation; availability of dosimetry predictions; and duration and cost of the procedure. Results demonstrated that the computer-assisted procedure was superior over the manual procedure, despite less than optimal software. The accuracy provided by the completely computerized procedure is indispensable for Level II radiation therapy, which is particularly useful in tumors of the sensitive, complex structures in the head and neck. (authors). 7 refs., 3 tabs

[Can the prophylactic treatment of mycotic mucositis improve the time of performing radiotherapy in head and neck tumors?].

Science.gov (United States)

Gava, A; Ferrarese, F; Tonetto, V; Coghetto, F; Marazzato, G; Zorat, P L

1996-04-01

Radiotherapy-related mucositis is the most frequent complication in the patients submitted to irradiation for head and neck cancers. Many such patients may develop mycotic infections which may lead to treatment discontinuation, with possible consequences on the local control of these cancers. In this study, we investigated the efficacy of fluconazole in preventing mycotic mucositis in 80 patients undergoing radiation therapy for head and neck cancers. The patients were randomized to two groups: 41 patients in group A received the supporting treatment we usually administer, plus fluconazole (50 mg/day) starting from the 6th irradiation session throughout the treatment; 39 patients in group B received the same baseline treatment, but were given the drug only when mycotic infections appeared. The clinical characteristics, treated sites, treatment doses and volumes were similar in the two groups of patients. Fluconazole was well tolerated and no early or late toxicity was observed. We had 1 mycotic mucositis and 14 non-scheduled treatment discontinuations in group A, vs. 19 and 30, respectively, in group B. Radiation therapy lasted 52.3 days (mean) in group A and 55.6 days (mean) in group B; the differences were statistically significant. In our experience, fluconazole, used prophylactically from the 6th radiotherapy session on, reduced the number of mycotic infections and improved radiotherapy schedule in our head and neck cancer patients.

Impact of Treatment Subsidies and Cash Payouts on Treatment Choices at the End of Life.

Science.gov (United States)

Finkelstein, Eric; Malhotra, Chetna; Chay, Junxing; Ozdemir, Semra; Chopra, Akhil; Kanesvaran, Ravindran

To examine the extent to which financial assistance, in the form of subsidies for life-extending treatments (LETs) or cash payouts, distorts the demand for end-of-life treatments. A discrete choice experiment was administered to 290 patients with cancer in Singapore to elicit preferences for LETs and only palliative care (PC). Responses were fitted to a latent class conditional logistic regression model. We also quantified patients' willingness to pay to avoid and willingness to accept a less effective LET or PC-only. We then simulated the effects of various LET subsidy and cash payout policies on treatment choices. We identified three classes of patients according to their preferences. The first class (26.1% of the sample) had a strong preference for PC and were willing to give up life expectancy gains and even pay for receiving only PC. The second class (29.8% of the sample) had a strong preference for LETs and preferred to extend life regardless of cost or quality of life. The final class (44.1% of the sample) preferred LETs to PC, but actively traded off costs and length and quality of life when making end-of-life treatment choices. Policy simulations showed that LET subsidies increase demand for LETs at the expense of demand for PC, but an equivalent cash payout was not shown to distort demand. Patients with cancer have heterogeneous end-of-life preferences. LET subsidies and cash payouts have differing effects on the use of LETs. Policymakers should be mindful of these differences when designing health care financing schemes for patients with life-limiting illnesses. Copyright © 2016. Published by Elsevier Inc.

A virtual phantom library for the quantification of deformable image registration uncertainties in patients with cancers of the head and neck.

Science.gov (United States)

Pukala, Jason; Meeks, Sanford L; Staton, Robert J; Bova, Frank J; Mañon, Rafael R; Langen, Katja M

2013-11-01

Deformable image registration (DIR) is being used increasingly in various clinical applications. However, the underlying uncertainties of DIR are not well-understood and a comprehensive methodology has not been developed for assessing a range of interfraction anatomic changes during head and neck cancer radiotherapy. This study describes the development of a library of clinically relevant virtual phantoms for the purpose of aiding clinicians in the QA of DIR software. These phantoms will also be available to the community for the independent study and comparison of other DIR algorithms and processes. Each phantom was derived from a pair of kVCT volumetric image sets. The first images were acquired of head and neck cancer patients prior to the start-of-treatment and the second were acquired near the end-of-treatment. A research algorithm was used to autosegment and deform the start-of-treatment (SOT) images according to a biomechanical model. This algorithm allowed the user to adjust the head position, mandible position, and weight loss in the neck region of the SOT images to resemble the end-of-treatment (EOT) images. A human-guided thin-plate splines algorithm was then used to iteratively apply further deformations to the images with the objective of matching the EOT anatomy as closely as possible. The deformations from each algorithm were combined into a single deformation vector field (DVF) and a simulated end-of-treatment (SEOT) image dataset was generated from that DVF. Artificial noise was added to the SEOT images and these images, along with the original SOT images, created a virtual phantom where the underlying "ground-truth" DVF is known. Images from ten patients were deformed in this fashion to create ten clinically relevant virtual phantoms. The virtual phantoms were evaluated to identify unrealistic DVFs using the normalized cross correlation (NCC) and the determinant of the Jacobian matrix. A commercial deformation algorithm was applied to the virtual

Influence of timer end-effects on Gamma knife (Type B) treatment

International Nuclear Information System (INIS)

Baba, Sadaaki; Ito, Teruo; Toyoda, Tatsuya; Wakamatsu, Osamu; Machida, Toru

2004-01-01

We investigated the influence of timer end-effects retrospectively in cases treated with Gamma knife (Type B) in the first year and in the fifth year after installation. Objects were 113 cases from April 1997 to December 1997 and 230 cases between January 2001 and December 2001. The influence of timer end-effects was calculated in the following formula: influence of timer end-effects=Σ (timer end-effects/shot time)/(number of lesions x number of shots). Ten factors such as the output at the center of polystyrene sphere phantom, the number of lesions, the number of shots, the delivered maximum absorbed dose, total irradiation time and the frequency in the use of each collimator helmet were examined as factors of the influence. The average values of timer end-effects were 4.7±0.27, 4.3±0.27, 3.6±0.24 and 3.5±0.29%/min. for 18, 14, 8 and 4 mm collimator helmets, respectively and depended on field size. We believe that the unit '%/min.' must be accepted instead of '%'. Gamma knife treatment is stereotactic radiosurgery and 40-50 Gy is irradiated within several hours with about ten shots. So the influence of timer end-effects was calculated 0.82±0.80% in 1997 and 0.51±0.41% in 2001 on average. These data suggest that there was little influence on the treatment. These figures were average values per lesion, so the influence may be more complicated in each part of lesions. The difference between the influence of timer end-effects in 1997 and 2001 was considered to be caused by the elongation of shot time according to Cobalt-60 decay, the reduction of the number of shots by frequent use of 14 mm collimator helmet, and the restriction of the number of treated lesions. (author)

Management of somatic pain induced by treatment of head and neck cancer: Postoperative pain. Guidelines of the French Oto-Rhino-Laryngology--Head and Neck Surgery Society (SFORL).

Science.gov (United States)

Espitalier, F; Testelin, S; Blanchard, D; Binczak, M; Bollet, M; Calmels, P; Couturaud, C; Dreyer, C; Navez, M; Perrichon, C; Morinière, S; Albert, S

2014-09-01

To present the guidelines of the French Oto-Rhino-Laryngology--Head and Neck Surgery Society (SFORL) concerning the management of somatic pain induced by the treatment of head and neck cancer, and in particular the management of early and late post-surgical pain. A multidisciplinary work group conducted a review of the scientific literature on the study topic. An editorial group subsequently read the resulting guidelines before validation. It is recommended to prevent onset of pain caused by malpositioning on the operating table, as well as pain related to postoperative care. During surgery, it is recommended to spare nerve and muscle structures as far as possible to limit painful sequelae. Management of early postoperative pain upon tumor resection and flap harvesting sites requires patient-controlled analgesia by morphine pump. Physical therapy is recommended after flap harvesting to minimize painful sequelae. Preventive and curative measures should be undertaken for appropriate management of post-surgical pain in the treatment of head and neck cancers. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Nonsurgical treatment of aggressive fibromatosis in the head and neck

International Nuclear Information System (INIS)

West, C.B. Jr.; Shagets, F.W.; Mansfield, M.J.

1989-01-01

Aggressive fibromatosis is a poorly defined, locally aggressive, yet histologically benign fibroblastic proliferative lesion that may occur in the head and neck. The lesion is highly cellular and locally infiltrative and has a propensity to invade and erode bone, compromising vital structures within the head and neck. However, it is not a true malignancy because it does not have malignant cytologic characteristics nor does it metastasize. We present two cases of aggressive fibromatosis occurring in young adult men. The first case involved a rapidly enlarging mass of the anterior maxilla that involved the upper lip, nasal alae, nasal septum, inferior turbinates, and hard palate. The patient underwent incisional biopsy to confirm the diagnosis. Because of difficulty in determining the actual margins of this extensive lesion and the significant morbidity that would have resulted from surgical resection, we elected to treat this patient with chemotherapy and radiation therapy. The second case was an extensive lesion involving the right temporal bone, pterygomaxillary space, and infratemporal, temporal, and middle cranial fossae. Incisional biopsy confirmed the diagnosis. Because of the lack of functional and cosmetic deficits and the unavoidable morbidity of a surgical resection, this patient was treated with radiation therapy. Although wide field resection is the most satisfactory form of treatment, in situations in which this modality would result in unacceptable morbidity or if surgical margins are positive, then radiation therapy and chemotherapy should be considered. Support for these therapeutic modalities is found in larger series of cases outside the head and neck

Advanced glycation End-products (AGEs): an emerging concern for processed food industries.

Science.gov (United States)

Sharma, Chetan; Kaur, Amarjeet; Thind, S S; Singh, Baljit; Raina, Shiveta

2015-12-01

The global food industry is expected to increase more than US $ 7 trillion by 2014. This rise in processed food sector shows that more and more people are diverging towards modern processed foods. As modern diets are largely heat processed, they are more prone to contain high levels of advanced glycation end products (AGEs). AGEs are a group of complex and heterogeneous compounds which are known as brown and fluorescent cross-linking substances such as pentosidine, non-fluorescent cross-linking products such as methylglyoxal-lysine dimers (MOLD), or non-fluorescent, non-cross linking adducts such as carboxymethyllysine (CML) and pyrraline (a pyrrole aldehyde). The chemistry of the AGEs formation, absorption and bioavailability and their patho-biochemistry particularly in relation to different complications like diabetes and ageing discussed. The concept of AGEs receptor - RAGE is mentioned. AGEs contribute to a variety of microvascular and macrovascular complications through the formation of cross-links between molecules in the basement membrane of the extracellular matrix and by engaging the receptor for advanced glycation end products (RAGE). Different methods of detection and quantification along with types of agents used for the treatment of AGEs are reviewed. Generally, ELISA or LC-MS methods are used for analysis of foods and body fluids, however lack of universally established method highlighted. The inhibitory effect of bioactive components on AGEs by trapping variety of chemical moieties discussed. The emerging evidence about the adverse effects of AGEs makes it necessary to investigate the different therapies to inhibit AGEs.

Evaluation of radiation-induced Class V dental caries in patients with head and neck cancers undergoing radiotherapy

Directory of Open Access Journals (Sweden)

Siavash Savadi Oskoee

2008-07-01

Full Text Available Background and aims. Salivary glands are very susceptible to radiation and any disturbances in their function are detrimental to the hard tissues in the oral cavity. The aim of this study was to evaluate posterior class V dental caries in patients with head and neck cancers undergoing radiotherapy. Materials and methods. In this study, twenty seven patients undergoing conventional radiotherapy were included. Class V dental caries of posterior teeth in these patients were evaluated in three intervals: before treatment, 3 weeks after the initiation of the treatment, and at the end of the treatment. Differences of mean caries activity between intervals were evaluated using paired sample t-test. Results. There were no class V decays prior to radiotherapy. Mean percentage of class V caries three weeks after radiotherapy and at the end of radiotherapy were 28.42% ± 14.41 and 67.05% ± 19.02, respectively. There were statistically significant differences in mean values among three stages (P = 0.00025. Conclusion. The results of the present study revealed that radiotherapy in patients with head and neck cancers causes class V dental caries on posterior teeth.

Experience on treatment of acute head injury combined with optic nerve damage

International Nuclear Information System (INIS)

Gao Heng; Feng Dongxia; Ma Yuanpin; Chen Jinqing

2000-01-01

Objective: To investigate the therapeutic principle for the management of acute head injury combined with optic nerve damage. Method: the clinical data of treatment and prognosis from 24 patients, in which 15 received operative and 9 conservative measures were collected and analyzed. Results: In 15 operated cases, the vision of 10 cases including one with blindness before operation was improved obviously, while those of other 5 did not get any improvement. In 9 conservatively treated cases, the vision was improved in 4 cases, deteriorated in 4 case and no change in 1 case with blindness after injury. Conclusion: One the optic nerve damage has been manifested by clinical or radiological evidences in acute head injury patients, despite it was primary or secondary reason, surgical optic nerve bone canal decompression should be done as soon as possible

Improving communication after ended adjuvant treatment - experiences of a coaching intervention

DEFF Research Database (Denmark)

Timmermann, Connie; Ammentorp, Jette; Birkelund, Regner

Background: Cancer is a potential life-threatening illness likely to trigger existential concerns related to the meaning of life, hope or faith. Such concerns have shown to influence patients’ perception of their identity and have also proven to worsen physical symptoms related to their cancer...... illness. To improve the conditions for cancer survivors the objective of this study was to develop and evaluate a coaching intervention aimed to improve the communication with the patients. Methods & Materials: Three nurses participated in a two-day training program focusing on coaching methods. A total...... of participating in the intervention were collected through qualitative interviews. Data were analyzed in accordance with the phenomenological-hermeneutic tradition. Results: The patients described a comprehensive process of regaining mental as well as physical strength and well-being after ended treatment...

Process for the fixing of a metallic end piece on a tubular component

International Nuclear Information System (INIS)

Charpin, Jean.

1975-01-01

Under this invention the process makes it possible to joint a tubular component and in particular a tubular filter and an end piece, with a connection of great mechanical strength, perfectly leak proof and with excellent corrosion resistance, particularly with respect to fluorinated by-products. This process is therefore of great worth in fixing to a bearer a thin ceramic compound tubular filter element, since such a filter can be used in particular for the separation of uranium isotopes by gaseous diffusion and for the separation of hydrocarbons in petrochemicals. To this end, the process under consideration is characterised in that it consists in depositing a layer of ceramic material, by hot projection, at the end of the tubular element and in sealing the end piece to the end of the tubular element by the hot projection of a ceramic or metallic substance [fr

General principles for treatment planning for squamous cell carcinoma of the head and neck

International Nuclear Information System (INIS)

Million, R.R.; Bova, F.J.

1987-01-01

Although squamous cell carcinoma of the head and neck represents only 5% of all malignancies, the head and neck area is one of the few anatomical areas remaining where radiotherapy is often used as the only modality for cure and often with substantial doses. There are at least 35 separate anatomical sites for origin of squamous cell carcinoma in the upper respiratory tract, and each site has its own distinctive pattern of spread, incidence of regional and distant metastases, and varying stages of presentation. It would be impossible in this short chapter to cover every contingency for treatment planning, and only general principles are outlined

HPV Positive Head and Neck Cancers: Molecular Pathogenesis and Evolving Treatment Strategies

Directory of Open Access Journals (Sweden)

Rüveyda Dok

2016-03-01

Full Text Available Head and neck squamous cell carcinoma (HNSCC is a highly heterogeneous disease that is the result of tobacco and/or alcohol abuse or infection with high-risk Human papillomaviruses. Despite the fact that HPV positive HNSCC cancers form a distinct clinical entity with better treatment outcome, all HNSCC are currently treated uniformly with the same treatment modality. At present, biologic basis of these different outcomes and their therapeutic influence are areas of intense investigation. In this review, we will summarize the molecular basis for this different outcome, novel treatment opportunities and possible biomarkers for HPV positive HNSCC. In particular, the focus will be on several molecular targeted strategies that can improve the chemoradiation response by influencing DNA repair mechanisms.

Housing First or no housing? Housing and homelessness at the end of alcohol and drug treatment.

Science.gov (United States)

Dyb, Evelyn

2016-10-01

The rate of alcohol and drug dependency is high among homeless persons in Norway as well as in other Western societies. National homeless surveys also show a certain correlation between discharge from institutions and homelessness. However, the rate of homelessness versus the rate with fixed abode at the end of specialised alcohol and drug treatment has not been examined using quantitative methods. A cross-sectional survey was conducted in alcohol and drug treatment units in the national health services and private clinics. The survey investigates the housing outcome at the end of treatment compared to the situation at the start of treatment using an individual questionnaire for patients ending treatment in a specific time window. Housing outcome is measured by the odds ratio of having a fixed abode at the end of treatment in relation to main intoxicating substance, type of treatment (in- and outpatient), completing versus cutting short the treatment, housing situation at the start of treatment, socioeconomic capital, mental health problems, individual plan, medical assisted treatment, and a set of background variables. The housing versus homeless situation hardly changes during the treatment period. In both a bivariate analysis and a simple multivariate model, principal intoxicating substance is the strongest predictor of having a fixed abode both before and after treatment. However, a more sophisticated analysis indicates that socioeconomic resources and social capital play along with the preferred intoxicating substance as predictors of having permanent housing. After more than a decade of a housing-led national homeless policy, and wide embracement of Housing First approaches in the European Union, homeless persons entering specialised alcohol and drug treatment are likely to return to the streets and hostels at the end of treatment. Access to housing after treatment is very limited for those lacking resources to solve their housing problem without assistance

Purex process

International Nuclear Information System (INIS)

Starks, J.B.

1977-01-01

The following aspects of the Purex Process are discussed: head end dissolution, first solvent extraction cycle, second plutonium solvent extraction cycle, second uranium solvent extraction cycle, solvent recovery systems, primary recovery column for high activity waste, low activity waste, laboratory waste evaporation, vessel vent system, airflow and filtration, acid recovery unit, fume recovery, and discharges to seepage basin

A project proposal for implementing intensity modulated radiotherapy (IMRT) for treatment of head and neck tumors

International Nuclear Information System (INIS)

Napoles Morales, Misleidy; Garcia Yip, Fernando; Rodriguez Machado, Jorge; Yanes Lopez, Yaima; Pomares Gomez, Yenes; Mena, Yailen

2009-01-01

Malignant tumors located in the structures of the head and neck, excluding the skull and its contents, constitute 10% of all cancers, remains the most frequent locations, which correspond to the oral cavity between 40 to 60%. Diagnosed between 60 to 80% in early stages and a 15 to 30% in more advanced forms of the disease. Radiotherapy and surgery are the essential therapeutic tools in the treatment of these tumors planning processes and administration of radiotherapy treatments currently in a situation of rapid and radical change. Since the beginning of radiotherapy to this day the greatest advances in treatment have been linked to a better definition of the tumor irradiation thus get a reduced dose in healthy tissue. The use of radiation, can be severe sequelae affecting quality of life of the patient, organs at risk receiving high dose and advanced technique of IMRT treatment planning and allows treatments shaped fields, especially when the target of radiation is irregular, with fewer side effects by limiting the dose in the tumor tissues and organs at risk and to allow us to increase the doses in the tumor. So we decided to develop a protocol for the implementation of IMRT, taking into account that we have the appropriate equipment, trained staff to develop this technique. (Author)

Optical fiber head for providing lateral viewing

Science.gov (United States)

Everett, Matthew J.; Colston, Billy W.; James, Dale L.; Brown, Steve; Da Silva, Luiz

2002-01-01

The head of an optical fiber comprising the sensing probe of an optical heterodyne sensing device includes a planar surface that intersects the perpendicular to axial centerline of the fiber at a polishing angle .theta.. The planar surface is coated with a reflective material so that light traveling axially through the fiber is reflected transverse to the fiber's axial centerline, and is emitted laterally through the side of the fiber. Alternatively, the planar surface can be left uncoated. The polishing angle .theta. must be no greater than 39.degree. or must be at least 51.degree.. The emitted light is reflected from adjacent biological tissue, collected by the head, and then processed to provide real-time images of the tissue. The method for forming the planar surface includes shearing the end of the optical fiber and applying the reflective material before removing the buffer that circumscribes the cladding and the core.

Boron Neutron Capture Therapy in the Treatment of Locally Recurred Head and Neck Cancer

International Nuclear Information System (INIS)

Kankaanranta, Leena; Seppaelae, Tiina; Koivunoro, Hanna; Saarilahti, Kauko; Atula, Timo; Collan, Juhani; Salli, Eero; Kortesniemi, Mika; Uusi-Simola, Jouni; Maekitie, Antti; Seppaenen, Marko; Minn, Heikki; Kotiluoto, Petri; Auterinen, Iiro; Savolainen, Sauli; Kouri, Mauri; Joensuu, Heikki

2007-01-01

Purpose: Head and neck carcinomas that recur locally after conventional irradiation pose a difficult therapeutic problem. We evaluated safety and efficacy of boron neutron capture therapy (BNCT) in the treatment of such cancers. Methods and Materials: Twelve patients with inoperable, recurred, locally advanced (rT3, rT4, or rN2) head and neck cancer were treated with BNCT in a prospective, single-center Phase I-II study. Prior treatments consisted of surgery and conventionally fractionated photon irradiation to a cumulative dose of 56-74 Gy administered with or without concomitant chemotherapy. Tumor responses were assessed using the RECIST (Response Evaluation Criteria in Solid Tumors) criteria and adverse effects using the National Cancer Institute common toxicity grading v3.0. Intravenously administered boronophenylalanine-fructose (BPA-F, 400 mg/kg) was used as the boron carrier. Each patient was scheduled to be treated twice with BNCT. Results: Ten patients received BNCT twice; 2 were treated once. Ten (83%) patients responded to BNCT, and 2 (17%) had tumor growth stabilization for 5.5 and 7.6 months. The median duration of response was 12.1 months; six responses were ongoing at the time of analysis or death (range, 4.9-19.2 months). Four (33%) patients were alive without recurrence with a median follow-up of 14.0 months (range, 12.8-19.2 months). The most common acute adverse effects were mucositis, fatigue, and local pain; 2 patients had a severe (Grade 3) late adverse effect (xerostomia, 1; dysphagia, 1). Conclusions: Boron neutron capture therapy is effective and safe in the treatment of inoperable, locally advanced head and neck carcinomas that recur at previously irradiated sites

Feasible modifications for the low-level waste treatment plant at Oak Ridge National Laboratory

International Nuclear Information System (INIS)

Chilton, J.M.

1984-06-01

Aqueous, low-level, radioactive wastes at Oak Ridge National Laboratory (ORNL) contain small amounts of 60 Co, 90 Sr, 137 Cs, and trace amounts of other radionuclides. These wastes are processed by passage through beds of a strong-acid cation exchange resin, and the treated water is then discharged to the environment. Studies show that pretreatment of the waste with a weak-acid cation exchange resin would result in a significant decrease in regeneration reagents and a saving of manpower. This can be accomplished in the present plant by piping changes on the existing columns. The effluent from the cation treatment process contains all of the radionuclides that are present in anionic form. Routinely, this consists only of approximately one-half of the 60 Co. Under certain conditions, other anions (such as 131 I) could be present. Studies show that these can be removed by use of an anion exchange resin bed at the end of the process. This would require the construction of an additional column, if the head-end treatment described above is also installed. 2 references, 2 figures, 2 tables

Role of growth hormone in stunted head growth after cranial irradiation

Energy Technology Data Exchange (ETDEWEB)

Clayton, P E; Shalet, S M; Price, D A; Surtees, R A; Pearson, D

1987-10-01

The head sizes of 38 patients, growth hormone (GH) deficient following craniospinal (n = 26) or cranial irradiation (n = 12), have been assessed before (n = 38) and on completion of GH therapy (n = 15) or at the end of a similar period of observation without GH (n = 7). These results were compared to the change in head size seen in idiopathic GH deficiency following GH therapy (n = 14). Before GH therapy, the latter had small heads (mean occipitofrontal circumference SD score (SDS) -1), which were relatively large compared to the height deficit (height SDS (CA) -4.7), and they exhibited catch-up growth with GH (delta occipitofrontal circumference SDS + 0.7, final occipitofrontal circumference SDS -0.2). In contrast, over a similar period all patients, who previously had received cranial irradiation in the dosage range 2700-4750 centi-Geigy, irrespective of the radiation schedule or GH treatment, showed a decrease in occipitofrontal circumference SDS (mean delta -0.9), a significant difference to the expected head growth of normal children over a similar period (p less than 0.01). We have noted that restricted head growth occurs in the years following cranial irradiation and is unaffected by GH therapy. Earlier work has shown that cranial irradiation may impair intelligence. The exact relationship between intellectual impairment and stunted head growth remains to be determined.

Front-end data processing using the bit-sliced microprocessor

International Nuclear Information System (INIS)

Machen, D.R.

1979-01-01

A state-of-the-art computing device, based upon the high-speed bit-sliced microprocessor, was developed into hardware for front-end data processing in both control and experiment applications at the Los Alamos Scientific Laboratory. The CAMAC Instrumentation Standard provides the framework for the high-speed hardware, allowing data acquisition and processing to take place at the data source in a CAMAC crate. 5 figures

Evaluation of Water Treatment Problems: Case Study of Maiduguri Water Treatment Plant (MWTP and Maiduguri Environs

Directory of Open Access Journals (Sweden)

M. N. Idris

2017-10-01

Full Text Available Water remains the most useful universal solvent to human being and other animals, because of its derivative importance. However, effort to improve on raw water treatment would continue to be a subject of concern, because the process procedures are been violated or not properly upheld. This study was carried out in order to identify peculiar problems associate with water treatment at the Maiduguri Water Treatment Plant (MWTP. This research study was based on prompt time-schedules and plant site-visits, interviewed questions were made and accessing the technology adopted in the process stages. Analytical data were obtained through the use of sampling bottles, camera, record sheets and other necessary laboratory equipment. The analysis showed that treated water contained excess chlorine and aluminum with 1.10mg/l and 0.68mg/l respectively. From this study, the following are the root causes: poor facility lay out, poor organizational and functional structures, wear of pump impellers and surface deterioration in the transmission line, lack of calibration test, constant head system not operation properly, lack of jar test conduction, improper maintenance of filter system, and the use of chemical coagulant. Inferences were made at the end of the research to enhance process efficiency, healthier and more economical treatment MWTP.

Nonverbal synchrony of head- and body-movement in psychotherapy: different signals have different associations with outcome

Directory of Open Access Journals (Sweden)

Fabian eRamseyer

2014-09-01

Full Text Available Objective: The coordination of patient’s and therapist’s bodily movement – nonverbal synchrony – has been empirically shown to be associated with psychotherapy outcome. This finding was based on dynamic movement patterns of the whole body. The present paper is a new analysis of an existing dataset (Ramseyer & Tschacher, 2011, which extends previous findings by differentiating movements pertaining to head and upper-body regions. Method: In a sample of 70 patients (37 female, 33 male treated at an outpatient psychotherapy clinic, we quantified nonverbal synchrony with an automated objective video-analysis algorithm (Motion Energy Analysis, MEA. Head- and body-synchrony was quantified during the initial 15 minutes of video-recorded therapy sessions. Micro-outcome was assessed with self-report post-session questionnaires provided by patients and their therapists. Macro-outcome was measured with questionnaires that quantified attainment of treatment goals and changes in experiencing and behavior at the end of therapy. Results: The differentiation of head- and body-synchrony showed that these two facets of motor coordination were differentially associated with outcome. Head-synchrony predicted global outcome of therapy, while body-synchrony did not, and body-synchrony predicted session outcome, while head-synchrony did not. Conclusions: The results pose an important amendment to previous findings, which showed that nonverbal synchrony embodied both outcome and interpersonal variables of psychotherapy dyads. The separation of head- and body-synchrony suggested that distinct mechanisms may operate in these two regions: Head-synchrony embodied phenomena with a long temporal extension (overall therapy success, while body-synchrony embodied phenomena of a more immediate nature (session-level success. More explorations with fine-grained analyses of synchronized phenomena in nonverbal behavior may shed additional light on the embodiment of

HTR combustion head end comparison of the shaft furnace and fluidized bed processes

Energy Technology Data Exchange (ETDEWEB)

Boehnert, R.; Kaiser, G.; Pirk, H.; Tillessen, U.

1975-01-15

Two methods are described for the combustion of the graphite of HTR fuel elements, a sufficient description of the principles being given to permit an understanding of the processes. The present state of the technology of the two processes is then compared on the basis of the results obtained at Gulf General Atomic. Finally, the possibilities of further development are examined using a pilot plant designed to deliver a reactor power of 7000 MWe as the basis. The present report is a collection of facts. It contains neither an evaluation nor a recommendation. A summarized comparison of the state of the technology and the possibilities of development is given in tabular form.

Oak Ridge National Laboratory West End Treatment Facility simulated sludge vitrification demonstration, Revision 1

International Nuclear Information System (INIS)

Cicero, C.A.; Bickford, D.F.; Bennert, D.M.; Overcamp, T.J.

1994-01-01

Technologies are being developed by the US Department of Energy's (DOE) Nuclear Facility sites to convert hazardous and mixed wastes to a form suitable for permanent disposal. Vitrification, which has been declared the Best Demonstrated Available Technology for high-level radioactive waste disposal by the EPA, is capable of producing a highly durable wasteform that minimizes disposal volumes through organic destruction, moisture evaporation, and porosity reduction. However, this technology must be demonstrated over a range of waste characteristics, including compositions, chemistries, moistures, and physical characteristics to ensure that it is suitable for hazardous and mixed waste treatment. These wastes are typically wastewater treatment sludges that are categorized as listed wastes due to the process origin or organic solvent content, and usually contain only small amounts of hazardous constituents. The Oak Ridge National Laboratory's (ORNL) West End Treatment Facility's (WETF) sludge is considered on of these representative wastes. The WETF is a liquid waste processing plant that generates sludge from the biodenitrification and precipitation processes. An alternative wasteform is needed since the waste is currently stored in epoxy coated carbon steel tanks, which have a limited life. Since this waste has characteristics that make it suitable for vitrification with a high likelihood of success, it was identified as a suitable candidate by the Mixed Waste Integrated Program (MWIP) for testing at CU. The areas of special interest with this sludge are (1) minimum nitrates, (2) organic destruction, and (3) waste water treatment sludges containing little or no filter aid

Swing of the Surgical Pendulum: A Return to Surgery for Treatment of Head and Neck Cancer in the 21st Century?

International Nuclear Information System (INIS)

Holsinger, F. Christopher; Weber, Randal S.

2007-01-01

Treatment for head and neck cancer has evolved significantly during the past 100 years. Beginning with Bilroth's total laryngectomy on New Year's Day in 1873, 'radical' surgery remained the only accepted treatment for head and neck cancer when optimal local and regional control was the goal. Bigger was still better when it came to managing the primary tumor and the neck. The 'commando' procedure and radical neck dissection were the hallmarks of this first generation of treatments of head-and-neck cancer. With the advent of microvascular reconstructive techniques, larger and more comprehensive resections could be performed. Despite these large resections and their 'mutilating' sequelae, overall survival did not improve. Even for intermediate-stage disease in head-and-neck cancer, the 5-year survival rate did not improve >50%. Many concluded that more than the scalpel was needed for optimal local and regional control, especially for intermediate- and advanced-stage disease. Most important, the multidisciplinary teams must identify and correlate biomarkers in the tumor and host that predict for a response to therapy and for optimal functional recovery. As the pendulum swings back, a scientific approach using tissue biomarkers for the response to treatment in the setting of multidisciplinary trials must emerge as the new paradigm. In the postgenomic era, treatment decisions should be made based on functional and oncologic parameters-not just to avoid perceived morbidity

Advanced Cancer and End-of-Life Preferences: Curative Intent Surgery Versus Noncurative Intent Treatment.

Science.gov (United States)

Schubart, Jane R; Green, Michael J; Van Scoy, Lauren J; Lehman, Erik; Farace, Elana; Gusani, Niraj J; Levi, Benjamin H

2015-12-01

People with cancer face complex medical decisions, including whether to receive life-sustaining treatments at the end of life. It is not unusual for clinicians to make assumptions about patients' wishes based on whether they had previously chosen to pursue curative treatment. We hypothesized that cancer patients who initially underwent curative intent surgery (CIS) would prefer more aggressive end-of-life treatments compared to patients whose treatment was noncurative intent (non-CIT). This study was a retrospective review of data from a large, randomized controlled trial examining the use of an online decision aid for advance care planning, "Making Your Wishes Known" (MYWK), with patients who had advanced cancer. We reviewed patients' medical records to determine which patients underwent CIS versus non-CIT. In the parent trial, conducted at an academic medical center (2007-2012), 200 patients were enrolled with stage IV malignancy or other poor prognosis cancer. Patients' preferences for aggressive treatment were measured in two ways: using patient-selected General Wishes statements generated by the decision aid and patient-selected wishes for specific treatments under various hypothetical clinical scenarios (Specific Wishes). We evaluated 79 patients. Of these, 48 had undergone initial CIS and 31 had non-CIT. Cancer patients who initially underwent CIS did not prefer more aggressive end-of-life treatments compared to patients whose treatment was non-CIT. Clinicians should avoid assumptions about patients' preferences for life-sustaining treatment based on their prior choices for aggressive treatment.

A randomized study of accelerated fractionation radiotherapy with and without mitomycin C in the treatment of locally advanced head and neck cancer

DEFF Research Database (Denmark)

Ezzat, M.; Shouman, T.; Zaza, K.

2005-01-01

Objectives: This single-institution study evaluates the feasibility of accelerated fractionation radiotherapy (AF) with and without mitomycin C (MMC) in the treatment of locally advanced head and neck cancer. Patients and Methods: Between May 1998 and October 2001, sixty patients with locally...... advanced stage III and IV of head and neck cancer were randomized into three treatment arms: (1) conventional fractionation radiotherapy (CF) (5 fractions per week); (2) accelerated fractionation radiotherapy (AF) (6 fractions per week); and (3) AF plus Mitomycin C (MMC). Results: The 2-year overall....... Key Words: Head and Neck cancer , Radiotherapy , Altered fractionation , Mitomycin C....

Computer simulation of processes in the dead–end furnace

International Nuclear Information System (INIS)

Zavorin, A S; Khaustov, S A; Zaharushkin, Russia N A

2014-01-01

We study turbulent combustion of natural gas in the reverse flame of fire–tube boiler simulated with the ANSYS Fluent 12.1.4 engineering simulation software. Aerodynamic structure and volumetric pressure fields of the flame were calculated. The results are presented in graphical form. The effect of the twist parameter for a drag coefficient of dead–end furnace was estimated. Finite element method was used for simulating the following processes: the combustion of methane in air oxygen, radiant and convective heat transfer, turbulence. Complete geometric model of the dead–end furnace based on boiler drawings was considered

Weekly Docetaxel, Cisplatin, and Cetuximab in Palliative Treatment of Patients with Squamous Cell Carcinoma of the Head and Neck.

Science.gov (United States)

Trieu, Vanessa; Pinto, Harlan; Riess, Jonathan W; Lira, Ruth; Luciano, Richard; Coty, Jessie; Boothroyd, Derek; Colevas, A Dimitrios

2018-03-14

Chemotherapy for recurrent, metastatic squamous cell carcinoma of the head and neck need not be known for extreme toxicity.The weekly regimen studied here has been demonstrated to be tolerable and effective. The objective of this study was to establish the response rate, progression-free survival (PFS) and overall survival (OS), and safety profile of weekly docetaxel, platinum, and cetuximab (TPC) in patients with relapsed or metastatic squamous cell carcinoma of the head and neck (SCCHN). Twenty-nine patients with metastatic or recurrent SCCHN with an Eastern Cooperative Oncology Group (ECOG) performance status <3 were enrolled in an institutional review board-approved phase II trial. This study permitted prior chemoradiation, radiation, and/or surgery, provided that 3 months had elapsed since the end of the potentially curative treatment. Patients received cisplatin 30 mg/m 2 or carboplatin area under the curve (AUC) 2, docetaxel 30 mg/m 2 , and cetuximab 250 mg/m 2 weekly for 3 weeks, followed by a break during the fourth week, for a 28-day cycle. Planned intrapatient dose modifications were based on individual toxicity. Twenty-seven patients received TPC and were evaluable for response and toxicity. Rates of complete response (CR), partial response (PR), and confirmed PR were 3%, 52%, and 30%, respectively. The overall objective response rate was 56%. Estimated median PFS and OS were 4.8 and 14.7 months, respectively. The rates of grade 3 and 4 worst-grade adverse events (AEs) per patient were 85% and 7%, respectively. Dose density through cycle 4 was preserved for all patients; however, treatment beyond cycle 6 with the TPC regimen proved unfeasible. Weekly docetaxel, cisplatin, and cetuximab is an effective regimen for patients with metastatic or recurrent SCCHN. Response rates, PFS, and OS compare favorably with other combination chemotherapy treatments. Grade 4 toxicity rates observed in this study were substantially lower than those described with regimens

Reactor vessel head permanent shield

International Nuclear Information System (INIS)

Hankinson, M.F.; Leduc, R.J.; Richard, J.W.; Malandra, L.J.

1989-01-01

A nuclear reactor is described comprising: a nuclear reactor pressure vessel closure head; control rod drive mechanisms (CRDMs) disposed within the closure head so as to project vertically above the closure head; cooling air baffle means surrounding the control rod drive mechanisms for defining cooling air paths relative to the control rod drive mechanisms; means defined within the periphery of the closure head for accommodating fastening means for securing the closure head to its associated pressure vessel; lifting lugs fixedly secured to the closure head for facilitating lifting and lowering movements of the closure head relative to the pressure vessel; lift rods respectively operatively associated with the plurality of lifting lugs for transmitting load forces, developed during the lifting and lowering movements of the closure head, to the lifting lugs; upstanding radiation shield means interposed between the cooling air baffle means and the periphery of the enclosure head of shielding maintenance personnel operatively working upon the closure head fastening means from the effects of radiation which may emanate from the control rod drive mechanisms and the cooling air baffle means; and connecting systems respectively associated with each one of the lifting lugs and each one of the lifting rods for connecting each one of the lifting rods to a respective one of each one of the lifting lugs, and for simultaneously connecting a lower end portion of the upstanding radiation shield means to each one of the respective lifting lugs

Impact of dysphagia on quality of life after treatment of head-and-neck cancer

International Nuclear Information System (INIS)

Nguyen, Nam P.; Frank, Cheryl; Moltz, Candace C.; Vos, Paul; Smith, Herbert J.; Karlsson, Ulf; Dutta, Suresh; Midyett, Allan; Barloon, Jessica; Sallah, Sabah

2005-01-01

Purpose: To evaluate the quality of life (QOL) associated with dysphagia after head-and-neck cancer treatment. Methods and materials: Of a total population of 104, a retrospective analysis of 73 patients who complained of dysphagia after primary radiotherapy (RT), chemoradiotherapy, and postoperative RT for head-and-neck malignancies were evaluated. All patients underwent a modified barium swallow examination to assess the severity of dysphagia, graded on a scale of 1-7. QOL was evaluated by the University of Washington (UW) and Hospital Anxiety and Depression questionnaires. The QOL scores obtained were compared with those from the 31 patients who were free of dysphagia after treatment. The QOL scores were also graded according to the dysphagia severity. Results: The UW and Hospital Anxiety and Depression scores were reduced and elevated, respectively, in the dysphagia group compared with the no dysphagia group (p = 0.0005). The UW scores were also substantially lower among patients with moderate-to-severe (Grade 4-7) compared with no or mild (Grade 2-3) dysphagia (p = 0.0005). The corresponding Hospital Anxiety (p = 0.005) and Depression (p = 0.0001) scores were also greater for the moderate-to-severe group. The UW QOL subscale scores showed a statistically significant decrease for swallowing (p = 0.00005), speech (p = 0.0005), recreation/entertainment (p = 0.0005), disfigurement (p = 0.0006), activity (p = 0.005), eating (p = 0.002), shoulder disability (p = 0.006), and pain (p = 0.004). Conclusion: Dysphagia is a significant morbidity of head-and-neck cancer treatment, and the severity of dysphagia correlated with a compromised QOL, anxiety, and depression. Patients with moderate-to-severe dysphagia require a team approach involving nutritional support, physical therapy, speech rehabilitation, pain management, and psychological counseling

Optimization of CNC end milling process parameters using PCA ...

African Journals Online (AJOL)

Optimization of CNC end milling process parameters using PCA-based Taguchi method. ... International Journal of Engineering, Science and Technology ... To meet the basic assumption of Taguchi method; in the present work, individual response correlations have been eliminated first by means of Principal Component ...

Waste form development and characterization in pyrometallurgical treatment of spent nuclear fuel

International Nuclear Information System (INIS)

Ackerman, J.

1998-01-01

Electrometallurgical treatment is a compact, inexpensive method that is being developed at Argonne National Laboratory to deal with spent nuclear fuel, primarily metallic and oxide fuels. In this method, metallic nuclear fuel constituents are electrorefined in a molten salt to separate uranium from the rest of the spent fuel. Oxide and other fuels are subjected to appropriate head end steps to convert them to metallic form prior to electrorefining. The treatment process generates two kinds of high-level waste--a metallic and a ceramic waste. Isolation of these wastes has been developed as an integral part of the process. The wastes arise directly from the electrorefiner, and waste streams do not contain large quantities of solvent or other process fluids. Consequently, waste volumes are small and waste isolation processes can be compact and rapid. This paper briefly summarizes waste isolation processes then describes development and characterization of the two waste forms in more detail

A model for emergency department end-of-life communications after acute devastating events--part II: moving from resuscitative to end-of-life or palliative treatment.

Science.gov (United States)

Limehouse, Walter E; Feeser, V Ramana; Bookman, Kelly J; Derse, Arthur

2012-11-01

The model for emergency department (ED) end-of-life communications after acute devastating events addresses decision-making capacity, surrogates, and advance directives, including legal definitions and application of these steps. Part II concerns communications moving from resuscitative to palliative and end-of-life treatments. After completing the steps involved in determining decision-making, emergency physicians (EPs) should consider starting palliative measures versus continuing resuscitative treatment. As communications related to these end-of-life decisions increasingly fall within the scope of emergency medicine (EM) practice, we need to become educated about and comfortable with them. © 2012 by the Society for Academic Emergency Medicine.

Radiotherapy through intensity modulation (IMRT). A new modality in the treatment of head and neck cancer

International Nuclear Information System (INIS)

Besa de C, Pelayo; Venencia M, Daniel

2006-01-01

Objective: To describe the treatment and evaluate the advantages of IMRT in the treatment of head and neck cancer. Material and methods: Four years ago, at the Cancer Center of the Pontificia Universidad Catolica, the IMRT technique for the treatment of head and neck tumors was implemented. The IMRT technique is based on modifying the intensity of the radiation beam through a multisheet collimator in order to produce a more exact distribution in the radiation doses. The results are evaluated with dose/ volume histograms. The distributions of doses and toxicity for tridimensional con formed therapy (CRT-3D) and IMRT are compared. Results: The distribution of the dose in the dose/volume histograms showed a better coverage of the white volume (PTV), with IMRT. The doses received by the organs under risk: salivary glands, eyes, ears and brain diminish with IMRT. The spinal marrow is protected with IMRT without dividing the treatment area, preventing points with lower dosage that could reduce control of the tumor. Conclusions: IMRT achieves a better conformation of the dose obtaining a better coverage of the tumor and higher protection of the organs under risk

Trismus following different treatment modalities for head and neck cancer: a systematic review of subjective measures.

Science.gov (United States)

Loh, Sook Y; Mcleod, Robert W J; Elhassan, Hassan A

2017-07-01

The aim of this review was to compare systematically the subjective measure of trismus between different interventions to treat head and neck cancer, particularly those of the oropharynx. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) Guidelines, Six databases were searched for the text using various terms which include "oropharyngeal/head and neck cancer", "trismus/mouth opening" and the various treatment modalities. Included in the review were clinical studies (> or =10 patients). Three observers independently assessed the papers identified. Among the six studies reviewed, five showed a significantly worst outcome with regard to the quality-of-life questionnaire scores for a radiotherapy or surgery and radiotherapy (RT) ± chemotherapy or chemoradiotherapy when compared to surgery alone. Only one study showed no significant difference between surgery alone and other treatment modalities. Subjective quality-of-life measures are a concurrent part of modern surgical practice. Although subjective measures were utilised to measure post operative trismus successfully, there was no consensus as to which treatment modality had overall better outcomes, with conflicting studies in keeping with the current debate in this field. Larger and higher quality studies are needed to compare all three treatment modalities.

Trunnion Failure of the Recalled Low Friction Ion Treatment Cobalt Chromium Alloy Femoral Head.

Science.gov (United States)

Urish, Kenneth L; Hamlin, Brian R; Plakseychuk, Anton Y; Levison, Timothy J; Higgs, Genymphas B; Kurtz, Steven M; DiGioia, Anthony M

2017-09-01

Gross trunnion failure (GTF) is a rare complication in total hip arthroplasty (THA) reported across a range of manufacturers. Specific lots of the Stryker low friction ion treatment (LFIT) anatomic cobalt chromium alloy (CoCr) V40 femoral head were recalled in August 2016. In part, the recall was based out of concerns for disassociation of the femoral head from the stem and GTF. We report on 28 patients (30 implants) with either GTF (n = 18) or head-neck taper corrosion (n = 12) of the LFIT CoCr femoral head and the Accolade titanium-molybdenum-zirconium-iron alloy femoral stems. All these cases were associated with adverse local tissue reactions requiring revision of the THA. In our series, a conservative estimate of the incidence of failure was 4.7% (n = 636 total implanted) at 8.0 ± 1.4 years from the index procedure. Failures were associated with a high-offset 127° femoral stem neck angle and increased neck lengths; 43.3% (13 of 30) of the observed failures included implant sizes outside the voluntary recall (27.8% [5 of 18] of the GTF and 75.0% [8 of 12] of the taper corrosion cases). Serum cobalt and chromium levels were elevated (cobalt: 8.4 ± 7.0 μg/mL; chromium: 3.4 ± 3.3 μ/L; cobalt/chromium ratio: 3.7). The metal artifact reduction sequence magnetic resonance imaging demonstrated large cystic fluid collections typical with adverse local tissue reactions. During revision, a pseudotumor was observed in all cases. Pathology suggested a chronic inflammatory response. Impending GTF could be diagnosed based on aspiration of black synovial fluid and an oblique femoral head as compared with the neck taper on radiographs. In our series of the recalled LFIT CoCr femoral head, the risk of impending GTF or head-neck taper corrosion should be considered as a potential diagnosis in a painful LFIT femoral head and Accolade titanium-molybdenum-zirconium-iron alloy THA with unknown etiology. Almost half of the failures we observed included sizes outside of the

The course of cervical dystonia with head tremor during botulinum toxin type A treatment

Directory of Open Access Journals (Sweden)

A. N. Korenko

2017-01-01

Full Text Available Objective: to evaluate the efficacy and safety of botulinum toxin type A (BTA injections into the neck muscles to reduce dystonic postures, head tremor, and pain syndrome in patients with cervical dystonia (CD within the first 8 cycles of treatment.Patients and methods. The investigation included 76 patients (26 (34% men and 50 (66% women with CD and dystonic head tremor, who were given BTA injections into the neck muscles for the first time. All the 76 patients received at least one cycle of BTA therapy. At the same type, 18 of these patients received 4 cycles of injections and 36 patients had 8 cycles. Injections were given when the symptoms of CD recurred or increased and the patient needed to be retreated. The interval between the injection cycles was arbitrary, but not less than 12 weeks. The doses of BTA agents per treatment cycle were as follows: Dysport was 400 to 1000 U, xeomin was 50 to 300 U, and Botox 200 to 300 U. The symptoms of CD were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS and the Tsui scale before the first injection of BTA and injection cycles 4 and 8; the presence or absence of head tremor was recorded.Results. The TWSTRS severity of CD symptoms decreased from 38 [36; 41] to 30 [27; 33] scores by injection cycle 4 (p < 0.001 and to 26 [23; 27] scores by cycle 8 (p<0.01. The Tsui severity of CD reduced from 9.3 [9; 10] to 7.2 [7; 8] scores by injection cycle 4 (p<0.001 and to 6.7 [6; 7] scores by cycle 8. The Tsui tremor scores decreased from 1.9 [1.6; 2.1] to 1.4 [1.1; 1.6] scores by injection cycle 4 and to 1.1 [0.9;1.4] scores by cycle 8 (p<0.01. Tremor completely disappeared in 6 (11% of patients by injection cycle 4 and in 6 (18% patients by cycle 8. According to Section 3 of the TWSTRS, pain intensity was reduced from 9.9 [8.9; 11.0] to 5.0 [3.3; 6.6] scores by injection cycle 4 (p<0.001 and to 2.1 [0.7; 3.6] scores by cycle 8 (p < 0.01; pain regressed completely in 12 (41

In vivo dosimetry with semiconductor and thermoluminescent detectors applied to head and neck cancer treatment

International Nuclear Information System (INIS)

Viegas, Claudio Castelo Branco

2003-03-01

In vivo dosimetry in radiotherapy, i. e, the assessment of the doses received by patients during their treatments, permits a verification of the therapy quality. A routine of in vivo dosimetry is, undoubtedly, a direct benefit for the patient. Unfortunately, in Brazil and in Latin America this procedure is still a privilege for only a few patients. This routine is of common application only in developed countries. The aim of this work is to show the viability and implementation of a routine in vivo dosimetry, using diodes semiconductors and thermoluminescent dosimeters (TLD), at the radiotherapy section of the National Institute of Cancer in Brazil, in the case of head and neck cancer treatment. In order to reach that aim, the characteristics of the response of diodes ISORAD-p and LiF:Mg;Ti (TLD-100) thermoluminescent detectors in powder form were determined. The performance of those detectors for in vivo dosimetry was tested using an RANDO Alderson anthropomorfic phantom and, once their adequacy proved for the kind of measurements proposed, they were used for dose assessment in the case of tumour treatments in the head and neck regions, for Cobalt-60 irradiations. (author)

Pancreaticoduodenectomy versus duodenum-preserving pancreatic head resection for the treatment of chronic pancreatitis.

Science.gov (United States)

Zheng, Zhenjiang; Xiang, Guangming; Tan, Chunlu; Zhang, Hao; Liu, Baowang; Gong, Jun; Mai, Gang; Liu, Xubao

2012-01-01

The objective of this study was to assess the efficacy and safety of pancreaticoduodenectomy (PD) and duodenum-preserving pancreatic head resection (DPPHR) for the treatment of chronic pancreatitis (CP). The 123 patients with CP who underwent pancreatic head resection between January 2004 and June 2009 were retrospectively analyzed. The preoperative variables, operative data, postoperative complications, and follow-up information were examined. There were no significant differences in clinical and morphological characteristics, pain relief, and jaundice status between the PD and DPPHR groups. The duration of operation was shorter (251.8 [SD, 43.1] vs 324.5 [SD, 41.4] minutes, P endocrine insufficiency was higher in PD group as compared with DPPHR group. Both procedures are equally effective in pain relief, but DPPHR is superior to PD in operative data, postoperative morbidity, improving quality of life, and preservation of exocrine and endocrine function.

Pollution control technologies for the treatment of palm oil mill effluent (POME) through end-of-pipe processes.

Science.gov (United States)

Wu, Ta Yeong; Mohammad, Abdul Wahab; Jahim, Jamaliah Md; Anuar, Nurina

2010-07-01

Palm oil production is one of the major industries in Malaysia and this country ranks one of the largest productions in the world. In Malaysia, the total production of crude palm oil in 2008 was 17,734,441 tonnes. However, the production of this amount of crude palm oil results in even larger amounts of palm oil mill effluent (POME). In the year 2008 alone, at least 44 million tonnes of POME was generated in Malaysia. Currently, the ponding system is the most common treatment method for POME but other processes such as aerobic and anaerobic digestion, physicochemical treatment and membrane filtration may also provide the palm oil industries with possible insights into the improvement of POME treatment processes. Generally, open ponding offers low capital and operating costs but this conventional method is becoming less attractive because the methane produced is wasted to the atmosphere and the system can not be certified for Carbon Emission Reduction trading. On the other hand, anaerobic digestion of POME provides the fastest payback of investment because the treatment enables biogas recovery for heat generation and treated effluent for land application. Lastly, it is proposed herewith that wastewater management based on the promotion of cleaner production and environmentally sound biotechnologies should be prioritized and included as a part of the POME management in Malaysia for attaining sustainable development. This paper thus discusses and compares state-of-the-art POME treatment methods as well as their individual performances. Copyright 2010 Elsevier Ltd. All rights reserved.

Bisphosphonate-modified gold nanoparticles: a useful vehicle to study the treatment of osteonecrosis of the femoral head

Energy Technology Data Exchange (ETDEWEB)

Fanord, Fedena; Fairbairn, Korie; Bhethanabotla, Venkat; Gupta, Vinay K [Department of Chemical and Biomedical Engineering, University of South Florida, 4202 E. Fowler Avenue, ENB 118, Tampa, FL 33620 (United States); Kim, Harry [Shriners Hospitals for Children, 12502 USF Pine Drive, Tampa, FL 33612 (United States); Garces, Amanda, E-mail: vkgupta@usf.edu [Lisa Muma Weitz Microscopy and Cell Imaging, Department of Pathology and Cell Biology, University of South Florida, 12901 Bruce B Downs Boulevard, Tampa, FL 33612 (United States)

2011-01-21

Legg-Calve-Perthes disease (LCPD) is a juvenile form of osteonecrosis of the femoral head that presents in children aged 2-14 years. To date, there is no effective medical therapy for treating LCPD largely due to an inability to modulate the repair process, including the predominance of bone resorption. This investigation aims to evaluate the feasibility of using gold nanoparticles (GNPs) that are surface modified with a bisphosphonate compound for the treatment of osteonecrosis at the cellular level. Studies have found osteoclast-mediated resorption to be a process that contributes significantly to the pathogenesis of femoral head deformities arising from Perthes disease. Our in vitro model was designed to elucidate the effect of alendronate-(a bisphosphonate) modified GNPs, on osteoclastogenesis and osteoclast function. RAW 264.7 macrophage cells were cultured with recombinant mouse receptor activator of NF-{kappa}B ligand (RANKL), which stimulates osteoclastogenesis, and were then treated with alendronate-modified GNPs for 24, 48, and 72 h. Cell proliferation, osteoclast function, and osteoclast morphology were evaluated by trypan blue dye exclusion assay, tartrate-resistant acid phosphatase (TRAP) staining, and transmission electron microscopy (TEM) imaging. Comparative studies were performed with GNPs that were only stabilized with citrate ions and with alendronate alone. Neither osteoclastogenesis nor osteoclast function were adversely affected by the presence of the citrate-GNP. Alendronate-modified GNPs had an enhanced effect on inducing osteoclast apoptosis and impairing osteoclast function when compared to unbound alendronate populations.

Bisphosphonate-modified gold nanoparticles: a useful vehicle to study the treatment of osteonecrosis of the femoral head

International Nuclear Information System (INIS)

Fanord, Fedena; Fairbairn, Korie; Bhethanabotla, Venkat; Gupta, Vinay K; Kim, Harry; Garces, Amanda

2011-01-01

Legg-Calve-Perthes disease (LCPD) is a juvenile form of osteonecrosis of the femoral head that presents in children aged 2-14 years. To date, there is no effective medical therapy for treating LCPD largely due to an inability to modulate the repair process, including the predominance of bone resorption. This investigation aims to evaluate the feasibility of using gold nanoparticles (GNPs) that are surface modified with a bisphosphonate compound for the treatment of osteonecrosis at the cellular level. Studies have found osteoclast-mediated resorption to be a process that contributes significantly to the pathogenesis of femoral head deformities arising from Perthes disease. Our in vitro model was designed to elucidate the effect of alendronate-(a bisphosphonate) modified GNPs, on osteoclastogenesis and osteoclast function. RAW 264.7 macrophage cells were cultured with recombinant mouse receptor activator of NF-κB ligand (RANKL), which stimulates osteoclastogenesis, and were then treated with alendronate-modified GNPs for 24, 48, and 72 h. Cell proliferation, osteoclast function, and osteoclast morphology were evaluated by trypan blue dye exclusion assay, tartrate-resistant acid phosphatase (TRAP) staining, and transmission electron microscopy (TEM) imaging. Comparative studies were performed with GNPs that were only stabilized with citrate ions and with alendronate alone. Neither osteoclastogenesis nor osteoclast function were adversely affected by the presence of the citrate-GNP. Alendronate-modified GNPs had an enhanced effect on inducing osteoclast apoptosis and impairing osteoclast function when compared to unbound alendronate populations.

18F-fluorodeoxyglucose positron tomography is useful in evaluating the efficacy of multidisciplinary treatments for so-called borderline unresectable pancreatic head cancers

International Nuclear Information System (INIS)

Murakami, Makoto; Katayama, Kanji; Yamaguchi, Akio; Iida, Atsushi; Goi, Takanori; Hirono, Yasuo; Nagano, Hideki; Koneri, Kenji

2011-01-01

Currently, computed tomography (CT) is widely used to evaluate the efficacy of treatments on tumor regression in unresectable pancreatic head carcinomas. Recently, 18 F-fluorodeoxyglucose positron emission tomography (PET) examination has been used for the initial diagnosis of pancreatic tumors, for diagnosis of distant metastasis, and for recurrences of pancreatic carcinomas. PET has also been used for the qualitative diagnosis of existing tumors. The current study was designed to observe if PET examination can be used to gauge the efficacy of multidisciplinary treatments, and to estimate the prognosis for unresectable pancreatic head carcinomas in similar clinical stages and during therapy. This was a prospective cohort study and included 18 cases. All cases were unresectable pancreatic head cancers diagnosed as TNM classification stage 3, and had undergone identical multidisciplinary treatment regimens. The level of tumor markers, tumor-size reduction, and maximum standardized uptake values (SUV max ) were correlated with prognosis. Pearson's correlation and Kaplan-Meyer survival rate curves were used for statistical analysis. Tumor-size reduction in CTs and the transition of tumor markers were not related to patient prognosis. Cases in which post-treatment SUV max values were reduced to <3.0 were correlated with a more favorable prognosis and demonstrated extended survival rates. PET examination can be used to estimate the prognosis of unresectable pancreatic head carcinomas which have undergone multidisciplinary treatments. (author)

Understanding the Canadian adult CT head rule trial: use of the theoretical domains framework for process evaluation

Directory of Open Access Journals (Sweden)

Curran Janet A

2013-02-01

Full Text Available Abstract Background The Canadian CT Head Rule was prospectively derived and validated to assist clinicians with diagnostic decision-making regarding the use of computed tomography (CT in adult patients with minor head injury. A recent intervention trial failed to demonstrate a decrease in the rate of head CTs following implementation of the rule in Canadian emergency departments. Yet, the same intervention, which included a one-hour educational session and reminders at the point of requisition, was successful in reducing cervical spine imaging rates in the same emergency departments. The reason for the varied effect of the intervention across these two behaviours is unclear. There is an increasing appreciation for the use of theory to conduct process evaluations to better understand how strategies are linked with outcomes in implementation trials. The Theoretical Domains Framework (TDF has been used to explore health professional behaviour and to design behaviour change interventions but, to date, has not been used to guide a theory-based process evaluation. In this proof of concept study, we explored whether the TDF could be used to guide a retrospective process evaluation to better understand emergency physicians’ responses to the interventions employed in the Canadian CT Head Rule trial. Methods A semi-structured interview guide, based on the 12 domains from the TDF, was used to conduct telephone interviews with project leads and physician participants from the intervention sites in the Canadian CT Head Rule trial. Two reviewers independently coded the anonymised interview transcripts using the TDF as a coding framework. Relevant domains were identified by: the presence of conflicting beliefs within a domain; the frequency of beliefs; and the likely strength of the impact of a belief on the behaviour. Results Eight physicians from four of the intervention sites in the Canadian CT Head Rule trial participated in the interviews. Barriers

New analyses of the National Institute of Mental Health Treatment of Depression Collaborative Research Program: do different treatments reflect different processes?

Science.gov (United States)

Herbert, Gregory L; Callahan, Jennifer; Ruggero, Camilo J; Murrell, Amy R

2013-01-01

To determine whether or not different therapies have distinct patterns of change, it is useful to investigate not only the end result of psychotherapy (outcome) but also the processes by which outcomes are attained. The present study subjected data from the National Institute of Mental Health Treatment of Depression Collaborative Research Program to survival analyses to examine whether the process of psychotherapy, as conceptualized by the phase model, differed between psychotherapy treatment approaches. Few differences in terms of progression through phases of psychotherapy were identified between cognitive behavior therapy and interpersonal therapy. Additionally, results indicate that phases of psychotherapy may not represent discrete, sequentially invariant processes.

Evaluation of image-guidance protocols in the treatment of head and neck cancers

International Nuclear Information System (INIS)

Zeidan, Omar A.; Langen, Katja M.; Meeks, Sanford L.; Manon, Rafael R.; Wagner, Thomas H.; Willoughby, Twyla R.; Jenkins, D. Wayne; Kupelian, Patrick A.

2007-01-01

Purpose: The aim of this study was to assess the residual setup error of different image-guidance (IG) protocols in the alignment of patients with head and neck cancer. The protocols differ in the percentage of treatment fractions that are associated with image guidance. Using data from patients who were treated with daily IG, the residual setup errors for several different protocols are retrospectively calculated. Methods and Materials: Alignment data from 24 patients (802 fractions) treated with daily IG on a helical tomotherapy unit were analyzed. The difference between the daily setup correction and the setup correction that would have been made according to a specific protocol was used to calculate the residual setup errors for each protocol. Results: The different protocols are generally effective in reducing systematic setup errors. Random setup errors are generally not reduced for fractions that are not image guided. As a consequence, if every other treatment is image guided, still about 11% of all treatments (IG and not IG) are subject to three-dimensional setup errors of at least 5 mm. This frequency increases to about 29% if setup errors >3 mm are scored. For various protocols that require 15% to 31% of the treatments to be image guided, from 50% to 60% and from 26% to 31% of all fractions are subject to setup errors >3 mm and >5 mm, respectively. Conclusion: Residual setup errors reduce with increasing frequency of IG during the course of external-beam radiotherapy for head-and-neck cancer patients. The inability to reduce random setup errors for fractions that are not image guided results in notable residual setup errors

Seasonal and spatial evolution of trihalomethanes in a drinking water distribution system according to the treatment process.

Science.gov (United States)

Domínguez-Tello, A; Arias-Borrego, A; García-Barrera, Tamara; Gómez-Ariza, J L

2015-11-01

This paper comparatively shows the influence of four water treatment processes on the formation of trihalomethanes (THMs) in a water distribution system. The study was performed from February 2005 to January 2012 with analytical data of 600 samples taken in Aljaraque water treatment plant (WTP) and 16 locations along the water distribution system (WDS) in the region of Andévalo and the coast of Huelva (southwest Spain), a region with significant seasonal and population changes. The comparison of results in the four different processes studied indicated a clear link of the treatment process with the formation of THM along the WDS. The most effective treatment process is preozonation and activated carbon filtration (P3), which is also the most stable under summer temperatures. Experiments also show low levels of THMs with the conventional process of preoxidation with potassium permanganate (P4), delaying the chlorination to the end of the WTP; however, this simple and economical treatment process is less effective and less stable than P3. In this study, strong seasonal variations were obtained (increase of THM from winter to summer of 1.17 to 1.85 times) and a strong spatial variation (1.1 to 1.7 times from WTP to end points of WDS) which largely depends on the treatment process applied. There was also a strong correlation between THM levels and water temperature, contact time and pH. On the other hand, it was found that THM formation is not proportional to the applied chlorine dose in the treatment process, but there is a direct relationship with the accumulated dose of chlorine. Finally, predictive models based on multiple linear regressions are proposed for each treatment process.

Gait training using a hybrid assistive limb (HAL) attenuates head drop: A case report.

Science.gov (United States)

Miura, Kousei; Koda, Masao; Kadone, Hideki; Kubota, Shigeki; Shimizu, Yukiyo; Kumagai, Hiroshi; Nagashima, Katsuya; Mataki, Kentaro; Fujii, Kengo; Noguchi, Hiroshi; Funayama, Toru; Abe, Tetsuya; Sankai, Yoshiyuki; Yamazaki, Masashi

2018-03-31

Dropped head syndrome (DHS) is characterized by a chin-on-chest deformity, which can severely interfere with forward vision and impair activities of daily living. A standardized treatment strategy for DHS has not been established. To our knowledge, this is the first case report describing the efficacy of gait training using a hybrid assistive limb (HAL) for DHS. A 75-year-old man showed apparent head drop in a standing position, resulting in passively reducible chin-on-chest deformity. A radiograph image showed apparent cervical kyphosis. Center of gravity of the head (CGH)-C7 SVA was +115 mm, CL was -40°, and T1S 39°. The patient underwent a treatment program using HAL, in which gait training was mainly performed, 60 min a day, 5 days a week for 2 weeks (10 sessions). After 2-3 sessions, dropped head started to attenuate. At the end of 10 sessions, the patient was able to walk with normal posture and radiograph images showed cervical kyphosis dramatically decreased because of HAL training. CGH-C7 SVA was 42 mm, CL was -1.7°, and T1S was 30°. Three months' outpatient follow-up revealed a slight deterioration of cervical alignment. However, the patient was able to maintain a better cervical alignment than before HAL training and keep walking with forward vision. There were no complications in any HAL treatment session. In conclusion, gait training using HAL is an option for treatment of DHS in addition to previously reported neck extensor muscle training. Copyright © 2018 Elsevier Ltd. All rights reserved.

Enzymatic treatment of paper mill process waters; Entsyymit paperitehtaan kiertoveden kaesittelyssae - EKT 06

Energy Technology Data Exchange (ETDEWEB)

Mustranta, A.; Buchert, J. [VTT Biotechnology and Food Research, Espoo (Finland); Ekman, R.; Spetz, P. [Aabo Akademi, Turku (Finland). Lab. of Forest Products Chemistry; Luukko, K. [Helsinki Univ. of Technology, Otaniemi (Finland). Paper Technology

1998-12-31

Dissolved and colloidal substances (DCS) are dispersed into the process waters during different stages of pulp and paper production. These are lipophilic extractives (pitch), hydrophilic extractives (lignan) and carbohydrates, mainly hemicelluloses. These dissolved and colloidal substances accumulate during water circulation and results in impaired paper machine runnability. DCS can also interfere with wet-end process chemicals. In this project the chemical composition of the process waters of spruce TMP pulping have been characterized. Simultaneously, potential enzymes for modification of DCS has been produced and purified. The enzymatic treatments have been started with lipase acting on triglycerides present in extractives. The effect of enzymatic treatment on the properties of process waters and technical properties of the pulp have been evaluated. (orig.)

Enzymatic treatment of paper mill process waters; Entsyymit paperitehtaan kiertoveden kaesittelyssae - EKT 06

Energy Technology Data Exchange (ETDEWEB)

Mustranta, A; Buchert, J [VTT Biotechnology and Food Research, Espoo (Finland); Ekman, R; Spetz, P [Aabo Akademi, Turku (Finland). Lab. of Forest Products Chemistry; Luukko, K [Helsinki Univ. of Technology, Otaniemi (Finland). Paper Technology

1999-12-31

Dissolved and colloidal substances (DCS) are dispersed into the process waters during different stages of pulp and paper production. These are lipophilic extractives (pitch), hydrophilic extractives (lignan) and carbohydrates, mainly hemicelluloses. These dissolved and colloidal substances accumulate during water circulation and results in impaired paper machine runnability. DCS can also interfere with wet-end process chemicals. In this project the chemical composition of the process waters of spruce TMP pulping have been characterized. Simultaneously, potential enzymes for modification of DCS has been produced and purified. The enzymatic treatments have been started with lipase acting on triglycerides present in extractives. The effect of enzymatic treatment on the properties of process waters and technical properties of the pulp have been evaluated. (orig.)

Treatment results of chemoradiotherapy with 5-FU/CDGP for head and neck cancer

International Nuclear Information System (INIS)

Himei, Kengo; Katayama, Norihisa; Takemoto, Mitsuhiro; Kuroda, Masahiro; Nomiya, Shigenobu; Onoda, Tomoo; Tominaga, Susumu; Kanazawa, Susumu

2006-01-01

We investigated the safety and efficacy of alternative and concurrent chemoradiotherapy with 5-fluorouracil (FU)/nedaplatin (CDGP) for head and neck cancer. From January 2003 to August 2005, 19 patients with head and neck squamous cell carcinoma were treated in our institution. Alternative chemoradiotherapy (ACRT) was performed for 8 cases of nasopharyngeal cancer. Concurrent chemoradiotherapy (CCRT) was performed for 11 cases of other head and neck cancer. Median total dose of radiotherapy was 63 Gy. ACRT consisted of 5-FU at a dose of 500 mg/m 2 on days 1-5 and 28-32 and CDGP at a dose of 60 mg/m 2 on days 6 and 33. CCRT consisted of 5-FU at a dose of 500 mg/m 2 on days 1-4 and 28-31 and CDGP at a dose of 60 mg/m 2 on days 5 and 32. Median follow-up period was 13 months. CR+PR was admitted in five cases (63%) with ACRT, and in 9 cases (82%) with CCRT. Non-hematological adverse effects of grade 3 were admitted in eight cases (100%) of ACRT, and in 9 cases (82%) of CCRT. Chemoradiotherapy attained good results and non-hematological adverse effects were able to be managed by preserved treatment. (author)

Waiting times for diagnosis and treatment of head and neck cancer in Denmark in 2010 compared to 1992 and 2002

DEFF Research Database (Denmark)

Lyhne, N M; Christensen, A; Alanin, M C

2013-01-01

BACKGROUND AND AIM: Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time and the pot......BACKGROUND AND AIM: Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time...... and the potential influence of fast track by comparing waiting times in 2010 to 2002 and 1992. METHODS: Charts of all new patients diagnosed with squamous cell carcinoma of the oral cavity, pharynx and larynx at the five Danish head and neck oncology centres from January to April 2010 (n=253) were reviewed...

[Quality assurance in head and neck medical oncology].

Science.gov (United States)

Digue, Laurence; Pedeboscq, Stéphane

2014-05-01

In medical oncology, how can we be sure that the right drug is being administered to the right patient at the right time? The implementation of quality assurance criteria is important in medical oncology, in order to ensure that the patient receives the best treatment safely. There is very little literature about quality assurance in medical oncology, as opposed to radiotherapy or cancer surgery. Quality assurance must cover the entire patient care process, from the diagnosis, to the therapeutic decision and drug distribution, including its selection, its preparation and its delivery to the patient (administration and dosage), and finally the potential side effects and their management. The dose-intensity respect is crucial, and its reduction can negatively affect overall survival rates, as shown in breast and testis cancers for example. In head and neck medical oncology, it is essential to respect the few well-standardized recommendations and the dose-intensity, in a population with numerous comorbidities. We will first review quality assurance criteria for the general medical oncology organization and then focus on head and neck medical oncology. We will then describe administration specificities of head and neck treatments (chemoradiation, radiation plus cetuximab, postoperative chemoradiation, induction and palliative chemotherapy) as well as their follow-up. Lastly, we will offer some recommendations to improve quality assurance in head and neck medical oncology.

Up-front PET/CT changes treatment intent in patients with head and neck squamous cell carcinoma

Energy Technology Data Exchange (ETDEWEB)

Rohde, Max; Godballe, Christian [Odense University Hospital, Department of ORL - Head and Neck Surgery, Odense (Denmark); University of Southern Denmark, Department of Clinical Research, Odense (Denmark); Nielsen, Anne L.; Thomassen, Anders [Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark); Johansen, Joergen; Gyldenkerne, Niels [Odense University Hospital, Department of Oncology, Odense (Denmark); Soerensen, Jens A. [University of Southern Denmark, Department of Clinical Research, Odense (Denmark); Odense University Hospital, Department of Plastic Surgery, Odense (Denmark); Diaz, Anabel; Asmussen, Jon T. [Odense University Hospital, Department of Radiology, Odense (Denmark); Gerke, Oke [Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark); University of Southern Denmark, Centre of Health Economics Research, Odense (Denmark); Doessing, Helle; Bjoerndal, Kristine [Odense University Hospital, Department of ORL - Head and Neck Surgery, Odense (Denmark); Hoeilund-Carlsen, Poul Flemming [University of Southern Denmark, Department of Clinical Research, Odense (Denmark); Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark)

2018-04-15

In patients with newly diagnosed head and neck squamous cell carcinoma (HNSCC), we wanted to examine the differences in overall treatment decisions, i.e. curative versus palliative treatment intent, reached by a multidisciplinary team conference (MDTC) based on 18F-fluoro-deoxy-glucose-positron emission tomography/computed tomography (PET/CT) or chest X-ray + MRI of the head and neck (CXR/MRI). This was a prospective blinded cohort study based on paired data. Consecutive patients with histologically verified primary HNSCC were invited to participate. All included patients underwent CXR/MRI and PET/CT before diagnostic biopsy. An ordinary MDTC using all available imaging was conducted as per standard practice. After at least 3 months (to eliminate recall bias in the team), the first project MDTC was conducted, based on either CXR/MRI or PET/CT, and the tumor board drew conclusions regarding treatment. After an additional 3 months, a second project MDTC was conducted using the complementary imaging modality. A total of 307 patients were included. Based on CXR/MRI, 303 patients (99%) were recommended for curative treatment and only four patients (1%) for palliative treatment. Based on PET/CT, the MDTC concluded that 278 (91%) patients were suitable for curative treatment and 29 (9%) patients for palliative treatment. The absolute difference of 8% was statistically significant (95% CI: 4.8%-11.5%, p < 0.001). A PET/CT-based imaging strategy significantly changed the decisions regarding treatment intent made by a MDTC for patients diagnosed with HNSCC, when compared with the standard imaging strategy of CXR/MRI. (orig.)

Up-front PET/CT changes treatment intent in patients with head and neck squamous cell carcinoma

International Nuclear Information System (INIS)

Rohde, Max; Godballe, Christian; Nielsen, Anne L.; Thomassen, Anders; Johansen, Joergen; Gyldenkerne, Niels; Soerensen, Jens A.; Diaz, Anabel; Asmussen, Jon T.; Gerke, Oke; Doessing, Helle; Bjoerndal, Kristine; Hoeilund-Carlsen, Poul Flemming

2018-01-01

In patients with newly diagnosed head and neck squamous cell carcinoma (HNSCC), we wanted to examine the differences in overall treatment decisions, i.e. curative versus palliative treatment intent, reached by a multidisciplinary team conference (MDTC) based on 18F-fluoro-deoxy-glucose-positron emission tomography/computed tomography (PET/CT) or chest X-ray + MRI of the head and neck (CXR/MRI). This was a prospective blinded cohort study based on paired data. Consecutive patients with histologically verified primary HNSCC were invited to participate. All included patients underwent CXR/MRI and PET/CT before diagnostic biopsy. An ordinary MDTC using all available imaging was conducted as per standard practice. After at least 3 months (to eliminate recall bias in the team), the first project MDTC was conducted, based on either CXR/MRI or PET/CT, and the tumor board drew conclusions regarding treatment. After an additional 3 months, a second project MDTC was conducted using the complementary imaging modality. A total of 307 patients were included. Based on CXR/MRI, 303 patients (99%) were recommended for curative treatment and only four patients (1%) for palliative treatment. Based on PET/CT, the MDTC concluded that 278 (91%) patients were suitable for curative treatment and 29 (9%) patients for palliative treatment. The absolute difference of 8% was statistically significant (95% CI: 4.8%-11.5%, p < 0.001). A PET/CT-based imaging strategy significantly changed the decisions regarding treatment intent made by a MDTC for patients diagnosed with HNSCC, when compared with the standard imaging strategy of CXR/MRI. (orig.)

Simulation of 3D-treatment plans in head and neck tumors aided by matching of digitally reconstructed radiographs (DRR) and on-line distortion corrected simulator images

International Nuclear Information System (INIS)

Lohr, Frank; Schramm, Oliver; Schraube, Peter; Sroka-Perez, Gabriele; Seeber, Steffen; Schlepple, Gerd; Schlegel, Wolfgang; Wannenmacher, Michael

1997-01-01

Background and purpose: Simulation of 3D-treatment plans for head and neck malignancy is difficult due to complex anatomy. Therefore, CT-simulation and stereotactic techniques are becoming more common in the treatment preparation, overcoming the need for simulation. However, if simulation is still performed, it is an important step in the treatment preparation/execution chain, since simulation errors, if not detected immediately, can compromise the success of treatment. A recently developed PC-based system for on-line image matching and comparison of digitally reconstructed radiographs (DRR) and distortion corrected simulator monitor images that enables instant correction of field placement errors during the simulation process was evaluated. The range of field placement errors with noncomputer aided simulation is reported. Materials and methods: For 14 patients either a primary 3D-treatment plan or a 3D-boost plan after initial treatment with opposing laterals for head and neck malignancy with a coplanar or non-coplanar two- or three-field technique was simulated. After determining the robustness of the matching process and the accuracy of field placement error detection with phantom measurements, DRRs were generated from the treatment planning CT-dataset of each patient and were interactively matched with on-line simulator images that had undergone correction for geometrical distortion, using a landmark algorithm. Translational field placement errors in all three planes as well as in-plane rotational errors were studied and were corrected immediately. Results: The interactive matching process is very robust with a tolerance of <2 mm when suitable anatomical landmarks are chosen. The accuracy for detection of translational errors in phantom measurements was <1 mm and for in-plane rotational errors the accuracy had a maximum of only 1.5 deg.. For patient simulation, the mean absolute distance of the planned versus simulated isocenter was 6.4 ± 3.9 mm. The in

Salivary flow rate and pH after radiotherapy of the head and neck region

International Nuclear Information System (INIS)

Lima, Antonio Adilson Soares de; Figueiredo, Maria Antonia Zancanaro de; Krapf, Stella Maria Rigo; Souza, Fabiany Rodrigues de

2004-01-01

The most common sequelae in head and neck cancer patients submitted to radiotherapy (60Cobalt) is postirradiation hypo salivation. This leads to a change in oral physiology, and, as a consequence, the irradiated individual is susceptible to infections and caries lesions. The aim of this study was to evaluate the behaviour of stimulated whole saliva flow rate (SWSFR) during and after radiotherapy treatment for head and neck cancer by lateral opposed fields. Six samples of mechanically stimulated whole saliva were collected of each individual and evaluated by gravimetric method.The first sample was collected before radiotherapy; the second one after 1500 cGy dose; the third one after the last dose of treatment and the remainder samples in intervals of subsequent two months up to six months after the end of treatment. The SWSFR decreased in 50% after a dose of 1500 cGy (1/4 of received treatment). After radiation therapy, the SWSFR was 0,33 ml/min and after six months was 0,20 ml/min. These values represented, respectively, a decreasing in 64% and 78% of initial values (ANOVA, Tukey's Test p<0.05).Based in these results, the authors concluded radiotherapy when applied in malign neoplasms of the head and neck region by lateral opposed fields was able to decrease significantly salivary flow rate. Intensive preventive dental care during and after radiotherapy seems to be an useful tool to avoid radiation caries and their complications. (author)

Architecture of eukaryotic mRNA 3′-end processing machinery

Science.gov (United States)

Hill, Chris H.; Easter, Ashley D.; Emsley, Paul; Degliesposti, Gianluca; Gordiyenko, Yuliya; Santhanam, Balaji; Wolf, Jana; Wiederhold, Katrin; Dornan, Gillian L.; Skehel, Mark; Robinson, Carol V.; Passmore, Lori A.

2018-01-01

Newly transcribed eukaryotic precursor messenger RNAs (pre-mRNAs) are processed at their 3′ ends by the ~1-megadalton multiprotein cleavage and polyadenylation factor (CPF). CPF cleaves pre-mRNAs, adds a polyadenylate tail, and triggers transcription termination, but it is unclear how its various enzymes are coordinated and assembled. Here, we show that the nuclease, polymerase, and phosphatase activities of yeast CPF are organized into three modules. Using electron cryomicroscopy, we determined a 3.5-angstrom-resolution structure of the ~200-kilodalton polymerase module. This revealed four β propellers, in an assembly markedly similar to those of other protein complexes that bind nucleic acid. Combined with in vitro reconstitution experiments, our data show that the polymerase module brings together factors required for specific and efficient polyadenylation, to help coordinate mRNA 3′-end processing. PMID:29074584

Parotid saliva composition during and after irradiation of head and neck cancer

International Nuclear Information System (INIS)

Funegaard, U.; Franzen, L.; Ericson, Th.; Henriksson, R.

1994-01-01

Parotid saliva composition was studied before, during and up to 18 months after the irradiation period in 16 cancer patients treated for malignancies in the head and neck region. Stimulated parotid saliva was collected prior to radiotherapy and, when possible, weekly during treatment. New samples were taken 2, 4, 6, 12 and 18 months after the end of radiotherapy. Nine of the 16 patients were treated with bilateral irradiation fields and 7 patients with unilateral irradiation fields, with a total dose not exceeding 52 Gy. During the entire irradiation period the fraction of glands producing measurable volumes of saliva decreased to 40%. In the post irradiation period the number of active glands gradually increased and saliva secretion rate returned to an average of 72% of the initial value 18 months after the end of irradiation. The concentrations of the measured variables increased already during the first week of radiotherapy and at the end of the treatment period the concentrations for total protein, salivary peroxidase, hexosamine and salivary IgA were significantly increased. The concentrations for total protein, salivary peroxidase and salivary IgA were still increased 6 months after the end of irradiation. At the 18-months observation all concentrations had returned to normal. (author)

Dysphagia. Impact on quality of life after radio(chemo)therapy of head and neck cancer

Energy Technology Data Exchange (ETDEWEB)

Maurer, Julia; Hipp, Matthias; Koelbl, Oliver [Regensburg Univ. Medical Center (Germany). Dept. of Radiotherapy; Schaefer, Christof [Hospital St. Elisabeth Straubing (Germany). Dept. of Radiotherapy

2011-11-15

In the past, xerostomia was considered one of the most important determining factors of quality of life (QoL) after radiotherapy (RT) of the head and neck region. In addition, more recent studies have shown that RT-induced dysphagia has an essential influence on the QoL. Between September 2005 and August 2007, 35 patients with locally advanced squamous cell carcinoma of the head and neck region were included in the prospective study. Patients were treated by IMAT (intensity-modulated arc therapy) or IMRT (intensity-modulated radiotherapy) planned on 3D imaging. A total of 28 patients (80%) received concomitant chemotherapy. The evaluation of QoL (EORTC QLQ - C30, H and N C-35) and toxicities (CTC 2.0) were assessed at the beginning of, during, and after RT as well as up to 12 months after the end of therapy. At the end of therapy, 86% of the patients experienced difficulties in swallowing (62% CTC II-III ). Twelve months after the end of treatment, 15% still suffered from dysphagia CTC II-III . Concomitant chemotherapy exacerbated the incidence and gravity of dysphagia, resulting in increasing dietary problems. QoL (EORTC) was significantly affected by dysphagia. In particular, the global state of health and QoL were influenced at the end of treatment (p = 0.033) and at a later stage (p = 0.050). The findings of this study suggest that more emphasis should be placed on structured clinical diagnostics, therapy, and rehabilitation of deglutition problems. This means in particular to not only spare the parotids while planning the irradiation, but also to take into consideration the important structures for deglutition, like the retropharyngeal muscles. (orig.)

Dysphagia. Impact on quality of life after radio(chemo)therapy of head and neck cancer

International Nuclear Information System (INIS)

Maurer, Julia; Hipp, Matthias; Koelbl, Oliver; Schaefer, Christof

2011-01-01

In the past, xerostomia was considered one of the most important determining factors of quality of life (QoL) after radiotherapy (RT) of the head and neck region. In addition, more recent studies have shown that RT-induced dysphagia has an essential influence on the QoL. Between September 2005 and August 2007, 35 patients with locally advanced squamous cell carcinoma of the head and neck region were included in the prospective study. Patients were treated by IMAT (intensity-modulated arc therapy) or IMRT (intensity-modulated radiotherapy) planned on 3D imaging. A total of 28 patients (80%) received concomitant chemotherapy. The evaluation of QoL (EORTC QLQ - C30, H and N C-35) and toxicities (CTC 2.0) were assessed at the beginning of, during, and after RT as well as up to 12 months after the end of therapy. At the end of therapy, 86% of the patients experienced difficulties in swallowing (62% CTC II-III ). Twelve months after the end of treatment, 15% still suffered from dysphagia CTC II-III . Concomitant chemotherapy exacerbated the incidence and gravity of dysphagia, resulting in increasing dietary problems. QoL (EORTC) was significantly affected by dysphagia. In particular, the global state of health and QoL were influenced at the end of treatment (p = 0.033) and at a later stage (p = 0.050). The findings of this study suggest that more emphasis should be placed on structured clinical diagnostics, therapy, and rehabilitation of deglutition problems. This means in particular to not only spare the parotids while planning the irradiation, but also to take into consideration the important structures for deglutition, like the retropharyngeal muscles. (orig.)

The Impact of Radiation Treatment Time on Survival in Patients With Head and Neck Cancer

International Nuclear Information System (INIS)

Shaikh, Talha; Handorf, Elizabeth A.; Murphy, Colin T.; Mehra, Ranee; Ridge, John A.; Galloway, Thomas J.

2016-01-01

Purpose: To assess the impact of radiation treatment time (RTT) in head and neck cancers on overall survival (OS) in the era of chemoradiation. Methods and Materials: Patients with diagnoses of tongue, hypopharynx, larynx, oropharynx, or tonsil cancer were identified by use of the National Cancer Database. RTT was defined as date of first radiation treatment to date of last radiation treatment. In the definitive setting, prolonged RTT was defined as >56 days, accelerated RTT was defined as 49 days, accelerated RTT was defined as <40 days, and standard RTT was defined as 40 to 49 days. We used χ"2 tests to identify predictors of RTT. The Kaplan-Meier method was used to compare OS among groups. Cox proportional hazards model was used for OS analysis in patients with known comorbidity status. Results: 19,531 patients were included; 12,987 (67%) had a standard RTT, 4,369 (34%) had an accelerated RTT, and 2,165 (11%) had a prolonged RTT. On multivariable analysis, accelerated RTT (hazard ratio [HR] 0.84; 95% confidence interval [CI] 0.73-0.97) was associated with an improved OS, and prolonged RTT (HR 1.25; 95% CI 1.14-1.37) was associated with a worse OS relative to standard RTT. When the 9,200 (47%) patients receiving definitive concurrent chemoradiation were examined, prolonged RTT (HR 1.29; 95% CI 1.11-1.50) was associated with a worse OS relative to standard RTT, whereas there was no significant association between accelerated RTT and OS (HR 0.76; 95% CI 0.57-1.01). Conclusion: Prolonged RTT is associated with worse OS in patients receiving radiation therapy for head and neck cancer, even in the setting of chemoradiation. Expeditious completion of radiation should continue to be a quality metric for the management of head and neck malignancies.

Migration from full-head mask to "open-face" mask for immobilization of patients with head and neck cancer.

Science.gov (United States)

Li, Guang; Lovelock, D Michael; Mechalakos, James; Rao, Shyam; Della-Biancia, Cesar; Amols, Howard; Lee, Nancy

2013-09-06

To provide an alternative device for immobilization of the head while easing claustrophobia and improving comfort, an "open-face" thermoplastic mask was evaluated using video-based optical surface imaging (OSI) and kilovoltage (kV) X-ray radiography. A three-point thermoplastic head mask with a precut opening and reinforced strips was developed. After molding, it provided sufficient visible facial area as the region of interest for OSI. Using real-time OSI, the head motion of ten volunteers in the new mask was evaluated during mask locking and 15minutes lying on the treatment couch. Using a nose mark with reference to room lasers, forced head movement in open-face and full-head masks (with a nose hole) was compared. Five patients with claustrophobia were immobilized with open-face masks, set up using OSI and kV, and treated in 121 fractions, in which 61 fractions were monitored during treatment using real-time OSI. With the open-face mask, head motion was found to be 1.0 ± 0.6 mm and 0.4° ± 0.2° in volunteers during the experiment, and 0.8 ± 0.3 mm and 0.4° ± 0.2° in patients during treatment. These agree with patient motion calculated from pre-/post-treatment OSI and kV data using different anatomical landmarks. In volunteers, the head shift induced by mask-locking was 2.3 ± 1.7 mm and 1.8° ± 0.6°, and the range of forced movements in the open-face and full-head masks were found to be similar. Most (80%) of the volunteers preferred the open-face mask to the full-head mask, while claustrophobic patients could only tolerate the open-face mask. The open-face mask is characterized for its immobilization capability and can immobilize patients sufficiently (< 2 mm) during radiotherapy. It provides a clinical solution to the immobilization of patients with head and neck (HN) cancer undergoing radiotherapy, and is particularly beneficial for claustrophobic patients. This new open-face mask is readily adopted in radiotherapy clinic as a superior alternative to

Oral cavity changes following treatment of oncologic patients with tumors of the head and neck

International Nuclear Information System (INIS)

Lyubenov, T.; Vasilev, V.; Boneva, I.

1982-01-01

Changes mainly in the soft tissue structures of the oral cavity (salivary glands and mucosa, following ionizing radiation treatment of tumors of the head and neck), were studied. The relationship between the morphologic characteristics of the lesions and the dose and, on the other hand, the correlation with the clinical symptoms are discussed. (authors)

Management of osteonecrosis of the femoral head: A novel technique

Directory of Open Access Journals (Sweden)

Ahmed M Samy

2016-01-01

Full Text Available Background: Osteonecrosis of the femoral head (ONFH is a debilitating disease in orthopedics, frequently progressing to femoral head collapse and osteoarthritis. It is thought to be a multifactorial disease. ONFH ultimately results in femoral head collapse in 75-85% of untreated patients. Total hip arthroplasty (THA yields satisfactory results in the treatment of the end stage of the disease. However, disease typically affects males between the ages of 20 and 40 years and joint replacement is not the ideal option for younger patients. Recently, mesenchymal stem cells and platelet rich plasma (PRP have been used as an adjunct to core decompression to improve clinical success in the treatment of precollapse hips. Materials and Methods: A prospective study of 40 hips in 30 patients was done. There were 19 males and 11 females with a mean age 36.7 ± 6.93 years. The indication for the operation was restricted primarily to modified Ficat stages IIb and III. 16 hips (40% had stage IIb and 24 hips (60% had stage III ONFH. The period of follow up ranged between 36-50 months with a mean 41.4 ± 3.53 months. All patients were assessed clinically during pre- and post-operative period according to the Harris Hip Score (HHS, Visual Analog Score (VAS and radiologically by X-rays. Magnetic resonance imaging (MRI was done preoperatively to confirm the diagnosis and every 6 months postoperatively for assessment of healing. The operative procedure include removal of necrotic area with drilling then the cavity was filled with a composite of bone graft mixed with PRP. Results: The mean HHS improved from 46.0 ± 7.8 preoperatively to 90.28 ± 19 at the end of followup ( P < 0.0001. The mean values of VAS were 78 ± 21 and 35 ± 19 at preoperatively period and final followup, respectively, with an average reduction of 43 points. Conclusion: We found that the use of PRP with collagen sheet can increase the reparable capacity after drilling of necrotic segment in stage

The comparison of 5-field conformal radiotherapy techniques for the treatment of prostate cancer: The best for femoral head sparing

International Nuclear Information System (INIS)

Zare, Mahkameh; Lashkari, Marzieh; Ghalehtaki, Reza; Ghasemi, Arash; Dehghan Manshadi, Hamidreza; Mir, Ali; Noorollahi, Somayeh; Alamolhoda, Mahboobeh

2016-01-01

External radiotherapy is a standard treatment procedure for localized prostate cancer. Given the relatively high long term survival treatment complications have been brought in center of attention. In this planning study, between 2012 and 2014, CT simulation data of 90 consecutive high-risk prostate cancer patients were collected. In the first phase, all were planned for whole pelvis irradiation up to 46Gy in 23 daily fractions. In the second phase, only the prostate gland was the target of radiation. Next, the subjects were divided randomly into three groups and each received a unique 5field conformal radiation plan including Plan A (Gantry angle: 0, 60, 120, 240, and 300), Plan B (Gantry angles: 0, 90, 120, 240, and 270) and Plan C (Gantry angles: 0, 60, 90, 270, and 300). The total dose was 70Gy. For each patient, the rectum, bladder, and both femoral heads were contoured as the at risk organs (OAR). From dose volume histograms, the proportional dose of PTV V100, the bladder and rectum V80 and V90 and femoral head V50 and V100 were calculated in all subjects and compared across plans. A statistically significant difference in the femoral head V50 and V100 was found between our studied 5field plans so that in Plan A (beam angles: 0, 60, 120, 240 and 300) less dose was received by both heads of femur. This study suggests that 5 field treatment planning including an anterior, two anterior oblique and two posterior oblique portals to be more proper for 3D conformal radiotherapy in order to spare femoral head with acceptable PTV coverage, and bladder and rectal doses.

[Acupotomy and acupuncture in the treatment of avascular necrosis of femoral head at the early and middle stages:a clinical randomized controlled trial].

Science.gov (United States)

Wang, Zhanyou; Zhou, Xuelong; Xie, Lishuang; Liang, Dongyue; Wang, Ying; Zhang, Hong-An; Zheng, Jinghong

2016-10-12

To compare the efficacy difference between acupotomy and acupuncture in the treatment of avascular necrosis of femoral head at the early and middle stages. The randomized controlled prospective study method was adopted. Sixty cases of avascular necrosis of femoral head at Ficat-ArletⅠto Ⅱ stages were randomized into an acupotomy group (32 cases) and an acupuncture group (28 cases) by the third part. In the acupotomy group, the acupotomy was adopted for the loose solution at the treatment sites of hip joint, once every two weeks, totally for 3 times. In the acupuncture group, ashi points around the hip joint were selected and stimulated with warm acupuncture therapy, once every day, for 6 weeks. Harris hip score was observed before and after treatment. The efficacy was evaluated in the two groups. Harris hip score was improved significantly after treatment in the two groups (both P avascular necrosis of femoral head at the early and middle stages.

Segregation and redistribution of end-of-process energetic materials

International Nuclear Information System (INIS)

McCabe, R.A.; Cummins, B.; Gonzalez, M.A.

1993-03-01

A system recovering then recycling or reusing end-of-process energetic materials has been developed at the Lawrence Livermore National Laboratory (LLNL). The system promotes separating energetic materials with high potential for reuse or recycling from those that have no further value. A feature of the system is a computerized electronic bulletin board for advertising the availability of surplus and recovered energetic materials and process chemicals to LLNL researchers, and for posting energetic materials, ''want ads.'' The system was developed and implemented to promote waste minimization and pollution prevention at LLNL

2-22 Study of Oxidation/reduction Volatilization Technology

Institute of Scientific and Technical Information of China (English)

Tan; Cunmin[1; Cao; Shiwei[1; Tian; Yuan[1; Qin; Zhi[1

2015-01-01

As an advanced dry head-end processing of spent fuel reprocessing, the oxidation-reduction volatilization technology will use for pulverizing uranium oxide ceramic pellets, decladding, and removal of most of volatile and semi-volatile fission elements, 3H, 14C, Kr, Xe, I, Cs, Ru and Tc, from fuel prior to main treatment process. The AIROX and ORIOX process, including circulation of oxidation in oxygen atmosphere and reduction in hydrogen atmosphere, researched on international at present, is considered to be the first choice for head-end processing.

Dissolution process for advanced-PWR-type fuels

International Nuclear Information System (INIS)

Black, D.E.; Decker, L.A.; Pearson, L.G.

1979-01-01

The new Fluorinel Dissolution Process and Fuel Storage (FAST) Facility at ICPP will provide underwater storage of spent PWR fuel and a new head-end process for fuel dissolution. The dissolution will be two-stage, using HF and HNO 3 , with an intermittent H 2 SO 4 dissolution for removing stainless steel components. Equipment operation is described

Key role of social work in effective communication and conflict resolution process: Medical Orders for Life-Sustaining Treatment (MOLST) Program in New York and shared medical decision making at the end of life.

Science.gov (United States)

Bomba, Patricia A; Morrissey, Mary Beth; Leven, David C

2011-01-01

In this article, the authors review the development of the Medical Orders for Life-Sustaining Treatment (MOLST) Program and recent landmark legislation in New York State in the context of advance care planning and shared medical decision making at the end of life. Social workers are central health care professionals in working with patients, families, practitioners, health care agents, and surrogates in the health systems and in the communication and conflict resolution process that is integral to health care decision making. The critical importance of ethics and end-of-life training and education for social workers is also addressed. Data from a pilot study evaluating interdisciplinary ethics training on legal and ethical content in communication and conflict resolution skills in health care decision making are reported. Recommendations are made for research on education and training of social workers, and investigation of the role and influence of systems in shaping social work involvement in end-of-life and palliative care.

Picibanil (OK-432) in the treatment of head and neck lymphangiomas in children

OpenAIRE

Rebuffini, Elena; Zuccarino, Luca; Grecchi, Emma; Carinci, Francesco; Merulla, Vittorio Emanuele

2012-01-01

Background: Picibanil (OK-432) is a lyophilized mixture of group A Streptococcus pyogenes with antineoplastic activity. Because of its capacity to produce a selective fibrosis of lymphangiomas (LMs), it has been approved by Japanese administration in 1995 for the treatment of LMs. Materials and Methods: We treated 15 children (age range: 6-60 months) affected by head and neck macrocystic LMs with intracystic injections (single dose of 0.2 mL) of Picibanil (1-3 injections). Results: Co...

Leakage pattern of linear accelerator treatment heads from multiple vendors

International Nuclear Information System (INIS)

Lonski, P.R.; Taylor, M.L.; Franich, R.D.; Harty, P.; Clements, N.; Kron, T.

2011-01-01

Full text: Patient life expectancy post-radiotherapy is becoming longer. Therefore, secondary cancers caused by radiotherapy treatment have more time to develop. Increasing attention is being given to out-of-field dose resulting from scatter and accelerator head leakage. Dose leakage from equivalent positions on Varian600C, Varian21-X, Siemens Primus and Elekta Synergy-II linacs were measured with TLD 1 00 H dosimeter chips and compared. Treatment parameters such as field size and beam energy were altered. Leakage doses are presented as a percentage of the dose to isocentre (5 Gy). Results illustrate significant variations in leakage dose between linac models where no model emits consistently lower amounts of radiation leakage for all treatment parameters. Results are shown below. Leakage through the collimator assembly in different units is varying as a function of location and unit design by more than a factor of 10. Differences are more pronounced in comparing Varian or Elekta models, which are fitted with an additional collimator separate from the MLC leaves, to the Siemens model, which uses MLC leaves as its only secondary collimator. Further measurements are currently being taken at the patient plane with a directional detector system to determine the spatial distribution of high leakage sources.

Design and Computational Fluid Dynamics Optimization of the Tube End Effector for Reactor Pressure Vessel Head Type VVER-1000

International Nuclear Information System (INIS)

Novosel, D.

2006-01-01

In this paper is presented development and optimization of the tube end effector design which should consist of 4 ultrasonic transducers, 4 Eddy Current's transducers and Radiation Proof Dot Camera. Basically, designing was conducted by main input requests, such as: inner diameter of a tested reactor pressure vessel head penetration tube, dimensions of a transducers and maximum allowable vertical movement of a manipulator connection rod in order to cover all inner tube surface. As is obvious, for ultrasonic testing should be provided the thin layer of liquid material (in our case water was chosen) which is necessary to make physical contact between transducer surface and investigated inner tube surface. By help of Computational Fluid Dynamics, determined were parameters of geometry, as the most important factor of transducer housing, hydraulically parameters for water supply and primary drain together implemented into this housing, movement of the end effectors (vertical and cylindrical) and finally, necessary equipment which has to provide all hydraulically and pneumatic requirements. As the cylindrical surface of the inner tube diameter was liquefied and contact between transducer housing and tested tube wasn't ideally covered, water leakage could occur in downstream direction. To reduce water leakage, which is highly contaminated, developed was second water drain by diffuser assembly which is driven by Venturi pipe, commercially called vacuum generator. Using the Computational Fluid Dynamic, obtained was optimized geometry of diffuser control volume with the highest efficiency, in other words, unobstructed fluid flux. Afterwards, the end effectors system was synchronized to the existing operable system for NDT methods all invented and designed by INETEC. (author)

Clinical analysis of interventional treatment for avascular necrosis of femoral head in adults

International Nuclear Information System (INIS)

Cao Dianbo; Yang Haishan; Zhao Yongsheng; Cheng Tilong

2001-01-01

Objective: To study the method and efficacy of interventional therapy for avascular necrosis of femoral head. Methods: A 5.0 F Cobra duct was first super selected into circumflex artery by applying Seldinger's technique and vasoactive drugs were perfused, then into inferior gluteal or obturator artery that are the branches of internal iliac artery. Dissolving and dilative drugs were perfused through micro-artery pump linked to the duct for three days on 30 cases (total 51 heads of femur). Results: Following interventional treatment, there were marked improvement of clinical symptoms, with relief or disappearance of pain (92.2%) and functional improvement in hip joint (87.5%). Increase of vessel numbers, disappearance of blank space, richness of parenchymal staining and establishment of collateral circulations were found around the hip joint. Repair of osteonecrosis at different degrees was observed on regular reexamination. Conclusion: Interventional therapy for ANFH had a significantly therapeutic effect after short-term follow-up

End-of-life content in treatment guidelines for life-limiting diseases.

Science.gov (United States)

Mast, Kimberly R; Salama, Marybeth; Silverman, Gabriel K; Arnold, Robert M

2004-12-01

Clinical guidelines are systematically developed statements that influence medical practice, education, and funding. Guidelines represent the consensus of leaders, often based on systematic reviews of the literature, regarding the "state of the art." To assess the degree to which end-of-life care is integrated into nationally developed guidelines for chronic, noncurable, life-limiting diseases. Four compendia were reviewed: The Healthcare Standards Directory ECRI, 2001; the Clinical Practice Guidelines Directory, 2000 edition; the National Guidelines Clearinghouse, (guideline.gov); and the National Library of Medicine's MEDLINE database on the OVID platform for guidelines on nine chronic diseases (chronic obstructive pulmonary disease, end-stage liver disease, amyotrophic lateral sclerosis, congestive heart failure, dementia, cerebrovascular accident, end-stage renal disease, cancer [breast, colon, prostate, lung], and human immunodeficiency virus). They were assessed by two reviewers for end-of-life content in 15 domains (e.g., epidemiology of death, symptom management, spiritual, family roles, and settings of care), the presence of eight specific terms dealing with palliative care, integration of palliative care information into the guideline, and descriptive variables. Not available. Each guideline was examined and rated on a 0-2 scale (0, absent content; 1, minimal content; 2, helpful content) using 15 end-of-life content domains. Scores from domains were summed and classified into 3 categories: 4 or less, minimal; 5-12, moderate; and more than 12, significant content. Ten percent of guidelines had significant palliative care content, 64% had minimal content, and 26% had moderate content. The least addressed domains dealt with spirituality, ethics, advocacy and family roles. When guidelines that dealt solely with prevention, acute exacerbations or complications of an illness, or specific treatment modalities were excluded 28% and 16% of these general guidelines

Geographic region: Does it matter in cutaneous melanoma of the head and neck?

Science.gov (United States)

Kılıç, Suat; Unsal, Aykut A; Chung, Sei Y; Samarrai, Ruwaa; Kılıç, Sarah S; Baredes, Soly; Eloy, Jean Anderson

2017-12-01

The head and neck are two of the most common locations for cutaneous melanoma. We present the first population-based analysis of geographic differences in anatomic subsite, clinicopathologic and demographical traits, histopathologic subtype, treatment modality, and disease-specific survival (DSS) of cutaneous head and neck melanoma (CHNM). Retrospective database analysis. The Surveillance, Epidemiology, and End Results database was queried for cases of CHNM reported between 2000 and 2013. Patients were grouped into East, Midwest, South, and West regions of the United States. Overall incidence, demographic traits, primary tumor site, clinicopathologic traits, histopathologic subtype, treatment modality, and DSS were compared among regions. There were 49,365 patients with CHNM identified. The West (4.60) and the South (4.42) had significantly higher incidence (per 100,000) than the East (3.84) and Midwest (3.65) (P regions (P region may play a significant role in CHNM. Incidence is higher in the South and the West. Incidence, histologic subtype, treatment modality, and DSS vary among regions. DSS is lower in the South than the West, even after accounting for other major prognostic factors. 4. Laryngoscope, 127:2763-2769, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Recent results of cetuximab use in the treatment of squamous cell carcinoma of the head and neck

Directory of Open Access Journals (Sweden)

Francesco Perri

2009-08-01

Full Text Available Francesco Perri1, Francesco Longo2, Franco Ionna2, Francesco Caponigro11Head and Neck Medical Oncology Unit, 2Head and Neck Surgery Unit, National Tumor Institute of Naples, Naples, ItalyAbstract: Cetuximab is a chimeric monoclonal antibody that targets the epidermal growth factor receptor. The role of cetuximab is paramount in several subsets of head and neck cancer. In particular, the EXTREME study has indicated cetuximab as the only drug to improve survival when associated with cisplatin and 5-fluorouracil in patients with recurrent/metastatic disease. Furthermore, cetuximab, both alone and in combination with cisplatin, is active in patients with recurrent/metastatic disease who have failed prior platinum-based chemotherapy. Cetuximab, given in association with radiation therapy, is a treatment of choice in first-line therapy of patients with locally advanced inoperable disease. In the same setting, the role of induction chemotherapy has gained considerable interest over the last few years and a number of efforts are being pursued to optimally integrate induction chemotherapy with radiation therapy plus cetuximab. The combination of cetuximab and other targeted therapies is among the most promising new perspectives for patients with head and neck cancer.Keywords: cetuximab, head and neck cancer, locally advanced, recurrent/metastatic

Prevention and control of sequels in the mouth of patients treated with radiation therapy for head and neck tumors

International Nuclear Information System (INIS)

Cardoso, Maria de Fatima Aparecida; Novikoff, Silviene; Tresso, Adriana; Segreto, Roberto Araujo; Cervantes, Onivaldo

2005-01-01

Surgery and radiation therapy are de main treatments for head and neck cancer. The side effects of the interaction of ionizing radiation on the tissues include dermatitis, mucositis, xerostomia, candidiasis, dysgeusia, dysphagia, caries, trismus, osteoradionecrosis. Objective: To assess dental condition of the patients using a protocol which allows avoiding or reducing the effects of radiation in the tissues of the oral cavity. Materials And Methods: Dental follow-up was performed before, during and up to 180 days after radiation therapy in 12 patients submitted to surgery and radiation therapy or radiation therapy alone. Results: The proportion of effects such as dermatitis, mucositis, dysgeusia, and dysphagia increased from the second week of the treatment until the end of the administrations. There was a clear decrease at the end of the treatment which was close to baseline values after 180 days. The reduction of xerostomia was slower and less effective. No case of caries, trismus, and osteoradionecrosis were observed during the assessment period. Conclusion: Regular dental follow-up associated with preventive measures such as prophylactic management of dental and oral diseases, adequate hygiene, mouth-washing with bicarbonate water and chamomile tea, and topic fluorine application contributed to improve the recovery conditions of patients with cancer of head and neck submitted to radiation therapy. (author)

Automation of radiation treatment planning. Evaluation of head and neck cancer patient plans created by the Pinnacle"3 scripting and Auto-Planning functions

International Nuclear Information System (INIS)

Speer, Stefan; Weiss, Alexander; Bert, Christoph; Klein, Andreas; Kober, Lukas; Yohannes, Indra

2017-01-01

Intensity-modulated radiotherapy (IMRT) techniques are now standard practice. IMRT or volumetric-modulated arc therapy (VMAT) allow treatment of the tumor while simultaneously sparing organs at risk. Nevertheless, treatment plan quality still depends on the physicist's individual skills, experiences, and personal preferences. It would therefore be advantageous to automate the planning process. This possibility is offered by the Pinnacle"3 treatment planning system (Philips Healthcare, Hamburg, Germany) via its scripting language or Auto-Planning (AP) module. AP module results were compared to in-house scripts and manually optimized treatment plans for standard head and neck cancer plans. Multiple treatment parameters were scored to judge plan quality (100 points = optimum plan). Patients were initially planned manually by different physicists and re-planned using scripts or AP. Script-based head and neck plans achieved a mean of 67.0 points and were, on average, superior to manually created (59.1 points) and AP plans (62.3 points). Moreover, they are characterized by reproducibility and lower standard deviation of treatment parameters. Even less experienced staff are able to create at least a good starting point for further optimization in a short time. However, for particular plans, experienced planners perform even better than scripts or AP. Experienced-user input is needed when setting up scripts or AP templates for the first time. Moreover, some minor drawbacks exist, such as the increase of monitor units (+35.5% for scripted plans). On average, automatically created plans are superior to manually created treatment plans. For particular plans, experienced physicists were able to perform better than scripts or AP; thus, the benefit is greatest when time is short or staff inexperienced. (orig.) [de

Automation of radiation treatment planning : Evaluation of head and neck cancer patient plans created by the Pinnacle3 scripting and Auto-Planning functions.

Science.gov (United States)

Speer, Stefan; Klein, Andreas; Kober, Lukas; Weiss, Alexander; Yohannes, Indra; Bert, Christoph

2017-08-01

Intensity-modulated radiotherapy (IMRT) techniques are now standard practice. IMRT or volumetric-modulated arc therapy (VMAT) allow treatment of the tumor while simultaneously sparing organs at risk. Nevertheless, treatment plan quality still depends on the physicist's individual skills, experiences, and personal preferences. It would therefore be advantageous to automate the planning process. This possibility is offered by the Pinnacle 3 treatment planning system (Philips Healthcare, Hamburg, Germany) via its scripting language or Auto-Planning (AP) module. AP module results were compared to in-house scripts and manually optimized treatment plans for standard head and neck cancer plans. Multiple treatment parameters were scored to judge plan quality (100 points = optimum plan). Patients were initially planned manually by different physicists and re-planned using scripts or AP. Script-based head and neck plans achieved a mean of 67.0 points and were, on average, superior to manually created (59.1 points) and AP plans (62.3 points). Moreover, they are characterized by reproducibility and lower standard deviation of treatment parameters. Even less experienced staff are able to create at least a good starting point for further optimization in a short time. However, for particular plans, experienced planners perform even better than scripts or AP. Experienced-user input is needed when setting up scripts or AP templates for the first time. Moreover, some minor drawbacks exist, such as the increase of monitor units (+35.5% for scripted plans). On average, automatically created plans are superior to manually created treatment plans. For particular plans, experienced physicists were able to perform better than scripts or AP; thus, the benefit is greatest when time is short or staff inexperienced.

In-situ treatment of PCP contaminated soil by electrokinetics-Fenton-biodegradation process

Energy Technology Data Exchange (ETDEWEB)

Yang, G.C.C.; Chen Jenteh [Inst. of Environmental Engineering, National Sun Yat-Sen Univ., Kaohsiung (Taiwan)

2001-07-01

This laboratory investigation was conducted to evaluate the treatment efficiency of a process combining electrokinetic remediation (EK), Fenton process, and biodegradation for treating a pentachlorophenol (PCP) contaminated soil. For EK-Fenton experiments, the results have indicated that an increase of treatment time (e.g., from 10 to 15 days) would substantially increase the overall treatment (i.e., removal and destruction) efficiency of PCP. Only a limited increase of the treatment efficiency would be found if the concentration of FeSO{sub 4} was increased from 0.0196M to 0.098M. When scrap iron power was employed as the catalyst, the residual PCP concentration for soil near the anode end was found to be lower than that of 0.0196M FeSO{sub 4}. But its overall treatment efficiency was only 56.58%, which is lower than 68.34% obtained by using 0.0196M FeSO{sub 4} and 0.35% H{sub 2}O{sub 2}. When H{sub 2}O{sub 2} concentration was further increased to 3.5%, an overall treatment efficiency of 79.77% would be obtained when 0.0196M FeSO{sub 4} was used. When treated by EK-biodegradation process with phenol enrichment bacteria, the overall treatment efficiency of PCP was as low as 25.67%. If PCP contaminated soil was pre-treated by EK-Fenton process and followed by EK-biodegradation, an overall treatment efficiency of 100% was found to be achievable. (orig.)

In-process weld sampling during hot end welds of type W overpacks

International Nuclear Information System (INIS)

Barnes, G.A.

1998-01-01

Establish the criteria and process controls to be used in obtaining, testing, and evaluating in-process weld sample during the hot end welding of Type W Overpack capsules used to overpack CsCl capsules for storage at WESF

Nutritional supplement during the treatment with ionizing radiations in patients with head and neck tumors in advanced stages

International Nuclear Information System (INIS)

Chon Rivas, Ivonne; Roca Muchuli, Carlos; Vilau Prieto, Luis; Rubio Hernandez, Maria C.; Rodriguez Diaz, Ronald; Leon, Roberto; Rodriguez Abascal, Alicia; Mederos, Nuria

2005-01-01

Malnutrition in the patient with advanced cancer favors immunosuppression and implies a low Karnofsky index, poor tolerance and response to the onco specific curative or palliative treatments, high susceptibility to infections and, as a result, a decline of the quality of life. Patients with head and neck tumors in advanced stages (III-IV) are one of the groups of high risk for malnutrition due to the reduction of the intake of nutrients, anorexia, alterations of the deglutition mechanism, and mechanical obstruction of the upper digestive tract, among other causes.Numerous studies show the convenience of the nutritional supplement in these patients during the onco specific treatment. A prospective study that included 15 patients with head and neck neoplasia in advanced stages, and with clinical signs of malnutrition, was conducted in order to evaluate the necessary calorie-energy supplement. All of them were administered an oral nutritional supplement (Adn-22 %) during the radiation treatment to assess the possibility of improving their tolerance and response to the treatment. Of the 15 studied cases, 13 presented complications in connection with the treatment, but most them were mild, and they did not affect in a significant way the time of duration and the total dose of treatment. There was a favorable response in relation to the tumor

Kleptomania after head trauma: two case reports and combination treatment strategies.

Science.gov (United States)

Aizer, Anat; Lowengrub, Katherine; Dannon, Pinhas N

2004-01-01

The purpose of this paper is to add to the growing number of reports about kleptomania occurring in relation to brain injury as well as to present the authors' findings regarding treatment strategies. The authors present two case reports of patients who developed the new onset of kleptomania after closed head trauma. Both patients had comorbid psychiatric symptoms associated with the kleptomania. Antidepressant monotherapy was not beneficial in reducing kleptomania in either patient. Kleptomanic behavior was successfully treated in both patients, however, through combination treatment using an antidepressant agent together with adjunctive cognitive behavioral therapy or adjunctive naltrexone. In one patient, single photon emission tomography showed a perfusion deficit in the left temporal lobe. Various hypotheses regarding this finding and the etiopathology of kleptomania are discussed. Review of current work in the field suggests that kleptomania is a heterogeneous disorder that shares features of both impulse and addiction disorders as well as affective spectrum disorders.

40 CFR 63.495 - Back-end process provisions-procedures to determine compliance using stripping technology.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Back-end process provisions-procedures to determine compliance using stripping technology. 63.495 Section 63.495 Protection of Environment...: Group I Polymers and Resins § 63.495 Back-end process provisions—procedures to determine compliance...

End-use matching for solar industrial process heat. Final report

Energy Technology Data Exchange (ETDEWEB)

Brown, K.C.; Hooker, D.W.; Rabl, A.; Stadjuhar, S.A.; West, R.E.

1980-01-01

Because of the large energy demand of industry (37% of US demand) and the wide spectrum of temperatures at which heat is required, the industrial sector appears to be very suitable for the matching of solar thermal technology with industrial process heat (IPH) requirements. A methodology for end-use matching has been devised, complete with required data bases and an evaluation program PROSYS/ECONMAT. Six cities in the United States were selected for an analysis of solar applications to IPH. Typical process heat requirements for 70% of the industrial plants in each city were identified and evaluated in conjunction with meteorological and economic data for each site to determine lowest-cost solar systems for each application. The flexibility and scope of PROSYS/ECONMAT is shown in a variety of sensitivity studies that expand the results of the six-city analysis. Case studies of two industrial plants were performed to evaluate the end-use matching procedure; these results are reported.

Characterization of changes in total body composition for patients with head and neck cancer undergoing chemoradiotherapy using dual-energy x-ray absorptiometry.

Science.gov (United States)

Jackson, William; Alexander, Neil; Schipper, Matthew; Fig, Lorraine; Feng, Felix; Jolly, Shruti

2014-09-01

Patients with head and neck cancer experience significant weight loss secondary to concurrent chemoradiotherapy (CCRT). Using dual-energy X-ray absorptiometry (DEXA) scans, we characterize total body composition changes during and after CCRT in order to develop novel clinical care models that will improve the patient's quality of life (QOL). Sixty DEXA scans were obtained from 12 patients undergoing CCRT for locally advanced squamous cell head and neck cancer. DEXAs were performed at baseline, during treatment, completion of CCRT, and then 1 and 2 months posttreatment. Mean weight loss by treatment end was 9.5 kg (10.2%; p = .0002). On average, lean body mass (LBM) decreased 10.2% (p = .001), and fat body mass (FBM) decreased 11.1% (p = .001) during CCRT. LBM began to normalize after completion of treatment, whereas FBM continued to decline. Substantial loss of muscle and FBM occurs in patients undergoing CCRT for head and neck cancer. To prevent long-term disability and QOL decline after curative CCRT, clinical care interventions incorporating aggressive nutrition/exercise counseling are needed. Copyright © 2013 Wiley Periodicals, Inc.

Phase II trial of combination treatment with paclitaxel, carboplatin and cetuximab (PCE) as first-line treatment in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (CSPOR-HN02).

Science.gov (United States)

Tahara, M; Kiyota, N; Yokota, T; Hasegawa, Y; Muro, K; Takahashi, S; Onoe, T; Homma, A; Taguchi, J; Suzuki, M; Minato, K; Yane, K; Ueda, S; Hara, H; Saijo, K; Yamanaka, T

2018-04-01

The standard of care for first-line treatment of recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) is combination treatment with platinum, 5-FU and cetuximab (PFE). However, this regimen requires hospitalization to ensure proper hydration and continuous infusion of 5-FU, and causes severe nausea and anorexia. We evaluated the efficacy and safety of paclitaxel, carboplatin and cetuximab (PCE) as first-line treatment in patients with R/M SCCHN. Eligibility criteria included recurrent and/or metastatic, histologically proven SCC of the oropharynx, oral cavity, hypopharynx or larynx; PS 0-1; adequate organ function; no suitable local therapy for R/M SCCHN; and no prior systemic chemotherapy for R/M SCCHN. Chemotherapy consisted of paclitaxel 100 mg/m2 on days 1, 8; carboplatin area under the blood concentration-time curve 2.5 on days 1, 8, repeated every 3 weeks for up to 6 cycles; and cetuximab at an initial dose of 400 mg/m2, followed by 250 mg/m2 weekly until disease progression or unacceptable toxicities. Primary end point was overall response rate. Secondary end points were safety, treatment completion rate, progression-free survival, overall survival, and clinical benefit rate. Planned sample size was 45 patients. Forty-seven subjects were accrued from July 2013 to October 2014. Of 45 evaluable, 40 were male; median age was 63 years; Eastern Cooperative Oncology Group Performance Status was 0/1 in 23/22 cases; site was the hypopharynx/oropharynx/oral cavity/larynx in 17/11/10/7 cases; and 36/9 cases were smokers/nonsmokers, respectively. Overall response rate, the primary end point, was 40%. Median overall survival was 14.7 months and progression-free survival was 5.2 months. Grade 3/4 adverse events included neutropenia (68%), skin reaction (15%), fatigue (9%) and febrile neutropenia (9%). A potentially treatment-related death occurred in one patient with intestinal pneumonia. The PCE regimen shows promising

The exploding head syndrome.

Science.gov (United States)

Green, M W

2001-06-01

This article reviews the features of an uncommon malady termed "the exploding head syndrome." Sufferers describe terrorizing attacks of a painless explosion within their head. Attacks tend to occur at the onset of sleep. The etiology of attacks is unknown, although they are considered to be benign. Treatment with clomipramine has been suggested, although most sufferers require only reassurance that the spells are benign in nature.

Pre-Radiotherapy dental evaluation criteria and treatment needs of oral side effects after head and neck radiotherapy

International Nuclear Information System (INIS)

Gonzalez-Arriagada, Wilfredo Alejandro; Santos-Silva, Alan Roger; Carvalho de Andrade, Marco Aurelio; De Andrade Elias, Rogerio; Ajudarte Lopes, Marcio

2010-01-01

The objective of this review is to present pre-radiotherapy evaluation criteria and the main needs for treatment of these patients after the radiation therapy. Were revised articles in English, Spanish and Portuguese language between 1995 and 2009 indexed in Pubmed and Scielo. The keywords were oral cancer and radiotherapy, complications in head and neck radiotherapy, oral pre-radiotherapy evaluation.The adverse complications of radiotherapy in head and neck area could be temporary or late. The late effects, such as radiation caries and osteorradionecrosis could be directly associated with the fact that previous dental evaluation was not performed and can severely affect the post-operatory quality of life. The participation of the dentist in the multidisciplinary team and dental evaluation of the patients that will receive radiotherapy in the head and neck area are of vital importance to improve the post-operatory quality of life of these patients

40 CFR 63.494 - Back-end process provisions-residual organic HAP limitations.

Science.gov (United States)

2010-07-01

... organic HAP limitations. 63.494 Section 63.494 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... § 63.494 Back-end process provisions—residual organic HAP limitations. (a) The monthly weighted average residual organic HAP content of all grades of elastomer processed, measured after the stripping operation...

Head and Neck Cancer—Patient Version

Science.gov (United States)

Head and neck cancers include cancers in the larynx (voice box), throat, lips, mouth, nose, and salivary glands. Start here to find information on head and neck cancer treatment in adults and children, causes and prevention, screening, research, and statistics.

Non-resectable tumors of head and neck.Opportunities chemoradiotherapy

International Nuclear Information System (INIS)

Cjedakov, Yi.Je.; Semykoz, N.G.; Rogaljev, A.V.; Ostapenko, Yu.V.; Gonchar, O.G.; Bondar, A.V.; Gorovenko, R.Je.

2015-01-01

This article is concerned with the treatment of non-resectable epithelial tumors of the head and neck. It gives a detailed account of the experience of radiation therapy in combination with selective regional chemotherapy administration as a method of combined treatment. According to the study result the complete tumor response was demonstrated in 5.3 % cases, participial tumor response - in 80.4 %, stable disease - in 10.7 %, progression of the tumor process - in 3.6 %. The reported adheres events and their treatment details are described for all severity as per NCI-CTCAE. The performed analysis suggests the preliminary study treatment results and the advantages of the selected scheme

Feasibility of Multimodal Deformable Registration for Head and Neck Tumor Treatment Planning

Energy Technology Data Exchange (ETDEWEB)

Fortunati, Valerio, E-mail: v.fortunati@erasmusmc.nl [Biomedical Imaging Group Rotterdam, Department of Medical Informatics and Radiology, Erasmus MC University Medical Center, Rotterdam (Netherlands); Verhaart, René F. [Hyperthermia Unit, Department of Radiation Oncology, Erasmus MC University Medical Center Cancer Institute, Rotterdam (Netherlands); Angeloni, Francesco [Istituto di Ricovero e Cura a Carattere Scientifico Foundation SDN for Research and High Education in Nuclear Diagnostics, Naples (Italy); Lugt, Aad van der [Department of Radiology, Erasmus MC University Medical Center, Rotterdam (Netherlands); Niessen, Wiro J. [Biomedical Imaging Group Rotterdam, Department of Medical Informatics and Radiology, Erasmus MC University Medical Center, Rotterdam (Netherlands); Faculty of Applied Sciences, Delft University of Technology, Delft (Netherlands); Veenland, Jifke F. [Biomedical Imaging Group Rotterdam, Department of Medical Informatics and Radiology, Erasmus MC University Medical Center, Rotterdam (Netherlands); Paulides, Margarethus M. [Hyperthermia Unit, Department of Radiation Oncology, Erasmus MC University Medical Center Cancer Institute, Rotterdam (Netherlands); Walsum, Theo van [Biomedical Imaging Group Rotterdam, Department of Medical Informatics and Radiology, Erasmus MC University Medical Center, Rotterdam (Netherlands)

2014-09-01

Purpose: To investigate the feasibility of using deformable registration in clinical practice to fuse MR and CT images of the head and neck for treatment planning. Method and Materials: A state-of-the-art deformable registration algorithm was optimized, evaluated, and compared with rigid registration. The evaluation was based on manually annotated anatomic landmarks and regions of interest in both modalities. We also developed a multiparametric registration approach, which simultaneously aligns T1- and T2-weighted MR sequences to CT. This was evaluated and compared with single-parametric approaches. Results: Our results show that deformable registration yielded a better accuracy than rigid registration, without introducing unrealistic deformations. For deformable registration, an average landmark alignment of approximatively 1.7 mm was obtained. For all the regions of interest excluding the cerebellum and the parotids, deformable registration provided a median modified Hausdorff distance of approximatively 1 mm. Similar accuracies were obtained for the single-parameter and multiparameter approaches. Conclusions: This study demonstrates that deformable registration of head-and-neck CT and MR images is feasible, with overall a significanlty higher accuracy than for rigid registration.

Feasibility of Multimodal Deformable Registration for Head and Neck Tumor Treatment Planning

International Nuclear Information System (INIS)

Fortunati, Valerio; Verhaart, René F.; Angeloni, Francesco; Lugt, Aad van der; Niessen, Wiro J.; Veenland, Jifke F.; Paulides, Margarethus M.; Walsum, Theo van

2014-01-01

Purpose: To investigate the feasibility of using deformable registration in clinical practice to fuse MR and CT images of the head and neck for treatment planning. Method and Materials: A state-of-the-art deformable registration algorithm was optimized, evaluated, and compared with rigid registration. The evaluation was based on manually annotated anatomic landmarks and regions of interest in both modalities. We also developed a multiparametric registration approach, which simultaneously aligns T1- and T2-weighted MR sequences to CT. This was evaluated and compared with single-parametric approaches. Results: Our results show that deformable registration yielded a better accuracy than rigid registration, without introducing unrealistic deformations. For deformable registration, an average landmark alignment of approximatively 1.7 mm was obtained. For all the regions of interest excluding the cerebellum and the parotids, deformable registration provided a median modified Hausdorff distance of approximatively 1 mm. Similar accuracies were obtained for the single-parameter and multiparameter approaches. Conclusions: This study demonstrates that deformable registration of head-and-neck CT and MR images is feasible, with overall a significanlty higher accuracy than for rigid registration

Amblyopia treatment of adults with dichoptic training using the virtual reality oculus rift head mounted display: preliminary results.

Science.gov (United States)

Žiak, Peter; Holm, Anders; Halička, Juraj; Mojžiš, Peter; Piñero, David P

2017-06-28

The gold standard treatments in amblyopia are penalizing therapies, such as patching or blurring vision with atropine that are aimed at forcing the use of the amblyopic eye. However, in the last years, new therapies are being developed and validated, such as dichoptic visual training, aimed at stimulating the amblyopic eye and eliminating the interocular supression. To evaluate the effect of dichoptic visual training using a virtual reality head mounted display in a sample of anisometropic amblyopic adults and to evaluate the potential usefulness of this option of treatment. A total of 17 subjects (10 men, 7 women) with a mean age of 31.2 years (range, 17-69 year) and anisometropic amblyopia were enrolled. Best corrected visual acuity (BCVA) and stereoacuity (Stereo Randot graded circle test) changes were evaluated after 8 sessions (40 min per session) of dichoptic training with the computer game Diplopia Game (Vivid Vision) run in the Oculus Rift OC DK2 virtual reality head mounted display (Oculus VR). Mean BCVA in amblyopic eye improved significantly from a logMAR value of 0.58 ± 0.35 before training to a post-training value of 0.43 ± 0.38 (p virtual reality head mounted display seems to be an effective option of treatment in adults with anisometropic amblyopia. Future clinical trials are needed to confirm this preliminary evidence. Trial ID: ISRCTN62086471 . Date registered: 13/06/2017. Retrospectively registered.

Tackling the challenges of fully immersive head-mounted AR devices

Science.gov (United States)

Singer, Wolfgang; Hillenbrand, Matthias; Münz, Holger

2017-11-01

The optical requirements of fully immersive head mounted AR devices are inherently determined by the human visual system. The etendue of the visual system is large. As a consequence, the requirements for fully immersive head-mounted AR devices exceeds almost any high end optical system. Two promising solutions to achieve the large etendue and their challenges are discussed. Head-mounted augmented reality devices have been developed for decades - mostly for application within aircrafts and in combination with a heavy and bulky helmet. The established head-up displays for applications within automotive vehicles typically utilize similar techniques. Recently, there is the vision of eyeglasses with included augmentation, offering a large field of view, and being unobtrusively all-day wearable. There seems to be no simple solution to reach the functional performance requirements. Known technical solutions paths seem to be a dead-end, and some seem to offer promising perspectives, however with severe limitations. As an alternative, unobtrusively all-day wearable devices with a significantly smaller field of view are already possible.

Facial preservation following extreme mummification: Shrunken heads.

Science.gov (United States)

Houlton, Tobias M R; Wilkinson, Caroline

2018-05-01

Shrunken heads are a mummification phenomenon unique to South America. Ceremonial tsantsa are ritually reduced heads from enemy victims of the Shuar, Achuar, Awajún (Aguaruna), Wampís (Huambisa), and Candoshi-Shapra cultures. Commercial shrunken heads are comparatively modern and fraudulently produced for the curio-market, often using stolen bodies from hospital mortuaries and graves. To achieve shrinkage and desiccation, heads undergo skinning, simmering (in water) and drying. Considering the intensive treatments applied, this research aims to identify how the facial structure can alter and impact identification using post-mortem depiction. Sixty-five human shrunken heads were assessed: 6 ceremonial, 36 commercial, and 23 ambiguous. Investigations included manual inspection, multi-detector computerised tomography, infrared reflectography, ultraviolet fluorescence and microscopic hair analysis. The mummification process disfigures the outer face, cheeks, nasal root and bridge form, including brow ridge, eyes, ears, mouth, and nose projection. Melanin depletion, epidermal degeneration, and any applied staining changes the natural skin complexion. Papillary and reticular dermis separation is possible. Normal hair structure (cuticle, cortex, medulla) is retained. Hair appears longer (unless cut) and more profuse following shrinkage. Significant features retained include skin defects, facial creases, hairlines and earlobe form. Hair conditions that only affect living scalps are preserved (e.g. nits, hair casts). Ear and nose cartilage helps to retain some morphological information. Commercial heads appear less distorted than ceremonial tsantsa, often presenting a definable eyebrow shape, vermillion lip shape, lip thickness (if mouth is open), philtrum form, and palpebral slit angle. Facial identification capabilities are considered limited, and only perceived possible for commercial heads. Copyright © 2018 Elsevier B.V. All rights reserved.

Migration from full‐head mask to “open‐face” mask for immobilization of patients with head and neck cancer

Science.gov (United States)

Lovelock, D. Michael; Mechalakos, James; Rao, Shyam; Della‐Biancia, Cesar; Amols, Howard; Lee, Nancy

2013-01-01

To provide an alternative device for immobilization of the head while easing claustrophobia and improving comfort, an “open‐face” thermoplastic mask was evaluated using video‐based optical surface imaging (OSI) and kilovoltage (kV) X‐ray radiography. A three‐point thermoplastic head mask with a precut opening and reinforced strips was developed. After molding, it provided sufficient visible facial area as the region of interest for OSI. Using real‐time OSI, the head motion of ten volunteers in the new mask was evaluated during mask locking and 15 minutes lying on the treatment couch. Using a nose mark with reference to room lasers, forced head movement in open‐face and full‐head masks (with a nose hole) was compared. Five patients with claustrophobia were immobilized with open‐face masks, set up using OSI and kV, and treated in 121 fractions, in which 61 fractions were monitored during treatment using real‐time OSI. With the open‐face mask, head motion was found to be 1.0 ± 0.6 mm and 0.4° ± 0.2° in volunteers during the experiment, and 0.8 ± 0.3 mm and 0.4° ± 0.2° in patients during treatment. These agree with patient motion calculated from pre‐/post‐treatment OSI and kV data using different anatomical landmarks. In volunteers, the head shift induced by mask‐locking was 2.3 ± 1.7 mm and 1.8° ± 0.6°, and the range of forced movements in the open‐face and full‐head masks were found to be similar. Most (80%) of the volunteers preferred the open‐face mask to the full‐head mask, while claustrophobic patients could only tolerate the open‐face mask. The open‐face mask is characterized for its immobilization capability and can immobilize patients sufficiently (face mask is readily adopted in radiotherapy clinic as a superior alternative to the standard full‐head mask. PACS numbers: 87.19.xj, 87.63.L‐, 87.59.‐e, 87.55.tg, 87.55.‐x PMID:24036878

Genetic alterations in head and neck squamous cell carcinomas

Directory of Open Access Journals (Sweden)

Nagai M.A.

1999-01-01

Full Text Available The genetic alterations observed in head and neck cancer are mainly due to oncogene activation (gain of function mutations and tumor suppressor gene inactivation (loss of function mutations, leading to deregulation of cell proliferation and death. These genetic alterations include gene amplification and overexpression of oncogenes such as myc, erbB-2, EGFR and cyclinD1 and mutations, deletions and hypermethylation leading to p16 and TP53 tumor suppressor gene inactivation. In addition, loss of heterozygosity in several chromosomal regions is frequently observed, suggesting that other tumor suppressor genes not yet identified could be involved in the tumorigenic process of head and neck cancers. The exact temporal sequence of the genetic alterations during head and neck squamous cell carcinoma (HNSCC development and progression has not yet been defined and their diagnostic or prognostic significance is controversial. Advances in the understanding of the molecular basis of head and neck cancer should help in the identification of new markers that could be used for the diagnosis, prognosis and treatment of the disease.

Psychological Factors Associated with Head and Neck Cancer Treatment and Survivorship : Evidence and Opportunities for Behavioral Medicine

Science.gov (United States)

Howren, M. Bryant; Christensen, Alan J.; Karnell, Lucy Hynds; Funk, Gerry F.

2013-01-01

Individuals diagnosed with head and neck cancer (HNC) not only face a potentially life-threatening diagnosis but must endure treatment that often results in significant, highly visible disfigurement and disruptions of essential functioning, such as deficits or complications in eating, swallowing, breathing, and speech. Each year, approximately…

Development of an Inflatable Head/Neck Restraint System for Ejection Seats

Science.gov (United States)

1977-02-28

crewman’s head . It has been observed that low pressures, about 2 psi (1.38 nt/cm2 ) to 4 psi (2.76 nt/cm2 ), create some "spring back" or trampoline ...neck ring Neck injury Head rotation 210 ABSTRACT (Continue on rev’erse side If necessary end identify by block number) 4A ringý-shaped inflatable head ...injuries due to violent forward head rotation at the time of ejection thrust and parachute opening shock. Inflation of the neck ring will,’ be conducted by a

Exploding head syndrome.

Science.gov (United States)

Sharpless, Brian A

2014-12-01

Exploding head syndrome is characterized by the perception of abrupt, loud noises when going to sleep or waking up. They are usually painless, but associated with fear and distress. In spite of the fact that its characteristic symptomatology was first described approximately 150 y ago, exploding head syndrome has received relatively little empirical and clinical attention. Therefore, a comprehensive review of the scientific literature using Medline, PsycINFO, Google Scholar, and PubMed was undertaken. After first discussing the history, prevalence, and associated features, the available polysomnography data and five main etiological theories for exploding head syndrome are summarized. None of these theories has yet reached dominance in the field. Next, the various methods used to assess and treat exploding head syndrome are discussed, as well as the limited outcome data. Finally, recommendations for future measure construction, treatment options, and differential diagnosis are provided. Copyright © 2014 Elsevier Ltd. All rights reserved.

The Impact of Radiation Treatment Time on Survival in Patients With Head and Neck Cancer

Energy Technology Data Exchange (ETDEWEB)

Shaikh, Talha [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Handorf, Elizabeth A. [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Murphy, Colin T. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Mehra, Ranee [Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Ridge, John A. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Galloway, Thomas J., E-mail: Thomas.Galloway@fccc.edu [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States)

2016-12-01

Purpose: To assess the impact of radiation treatment time (RTT) in head and neck cancers on overall survival (OS) in the era of chemoradiation. Methods and Materials: Patients with diagnoses of tongue, hypopharynx, larynx, oropharynx, or tonsil cancer were identified by use of the National Cancer Database. RTT was defined as date of first radiation treatment to date of last radiation treatment. In the definitive setting, prolonged RTT was defined as >56 days, accelerated RTT was defined as <47 days, and standard RTT was defined as 47 to 56 days. In the postoperative setting, prolonged RTT was defined as >49 days, accelerated RTT was defined as <40 days, and standard RTT was defined as 40 to 49 days. We used χ{sup 2} tests to identify predictors of RTT. The Kaplan-Meier method was used to compare OS among groups. Cox proportional hazards model was used for OS analysis in patients with known comorbidity status. Results: 19,531 patients were included; 12,987 (67%) had a standard RTT, 4,369 (34%) had an accelerated RTT, and 2,165 (11%) had a prolonged RTT. On multivariable analysis, accelerated RTT (hazard ratio [HR] 0.84; 95% confidence interval [CI] 0.73-0.97) was associated with an improved OS, and prolonged RTT (HR 1.25; 95% CI 1.14-1.37) was associated with a worse OS relative to standard RTT. When the 9,200 (47%) patients receiving definitive concurrent chemoradiation were examined, prolonged RTT (HR 1.29; 95% CI 1.11-1.50) was associated with a worse OS relative to standard RTT, whereas there was no significant association between accelerated RTT and OS (HR 0.76; 95% CI 0.57-1.01). Conclusion: Prolonged RTT is associated with worse OS in patients receiving radiation therapy for head and neck cancer, even in the setting of chemoradiation. Expeditious completion of radiation should continue to be a quality metric for the management of head and neck malignancies.

End point detection in ion milling processes by sputter-induced optical emission spectroscopy

International Nuclear Information System (INIS)

Lu, C.; Dorian, M.; Tabei, M.; Elsea, A.

1984-01-01

The characteristic optical emission from the sputtered material during ion milling processes can provide an unambiguous indication of the presence of the specific etched species. By monitoring the intensity of a representative emission line, the etching process can be precisely terminated at an interface. Enhancement of the etching end point is possible by using a dual-channel photodetection system operating in a ratio or difference mode. The installation of the optical detection system to an existing etching chamber has been greatly facilitated by the use of optical fibers. Using a commercial ion milling system, experimental data for a number of etching processes have been obtained. The result demonstrates that sputter-induced optical emission spectroscopy offers many advantages over other techniques in detecting the etching end point of ion milling processes

Odontogenic Inflammatory Processes of Head and Neck in Computed Tomography Examinations

International Nuclear Information System (INIS)

Wabik, Aleksandra; Hendrich, Barbara K.; Nienartowicz, Jan; Guziński, Maciej; Sąsiadek, Marek J.

2014-01-01

Infections of odontogenic origin are the most common cause of inflammatory disease of head and neck region. Computed tomography allows for defining localization and extent of inflammatory lesions, visualizes soft tissue involvement, presence of an abscess or an osteolytic lesion around causative tooth. The aim of this study was to assess pathways, by which odontogenic infections spread into respective deep head and neck structures in computed tomography examination, taking into account the following criteria: frequency of involvement of respective deep cervical spaces, possibility to determine a probable causative tooth and concordance with the results of clinical examination. Thirty-eight patients cervicofacial inflammatory disease had undergone CT examination of head and neck region with a 64-slice CT scanner after intravenous contrast administration. Abscess was reported in 30 (79%) cases, while inflammatory infiltration was diagnosed in remaining 8 (21%) patients. There was full concordance between radiological report and intraoperative report In 33 cases (87%). The most commonly involved cervical space was masticator space – 31 patients (82%), followed by submandibular space – 27 patients (71%). Dental examination was impossible in 29 patient because of trismus. During analysis of CT studies we evaluated maxillary and mandibular alveolar processes for presence of osteolytic bone lesions around causative teeth roots and we found them in 30 cases (79%). In 32 cases (84%) cervicofacial infection were of mandibular odontogenic origin. In most cases CT study in patients suspected of odontogenic craniofacial infection revealed presence of an abscess, needing urgent surgery. Inflammatory infiltration of dental origin most frequently involves masticator space, followed by submandibular space. In most cases CT scanning allows for identification of causative teeth, especially when trismus makes detailed clinical examination impossible

Erosion estimation of guide vane end clearance in hydraulic turbines with sediment water flow

Science.gov (United States)

Han, Wei; Kang, Jingbo; Wang, Jie; Peng, Guoyi; Li, Lianyuan; Su, Min

2018-04-01

The end surface of guide vane or head cover is one of the most serious parts of sediment erosion for high-head hydraulic turbines. In order to investigate the relationship between erosion depth of wall surface and the characteristic parameter of erosion, an estimative method including a simplified flow model and a modificatory erosion calculative function is proposed in this paper. The flow between the end surfaces of guide vane and head cover is simplified as a clearance flow around a circular cylinder with a backward facing step. Erosion characteristic parameter of csws3 is calculated with the mixture model for multiphase flow and the renormalization group (RNG) k-𝜀 turbulence model under the actual working conditions, based on which, erosion depths of guide vane and head cover end surfaces are estimated with a modification of erosion coefficient K. The estimation results agree well with the actual situation. It is shown that the estimative method is reasonable for erosion prediction of guide vane and can provide a significant reference to determine the optimal maintenance cycle for hydraulic turbine in the future.

Extraction of high value added gelatin biopolymer from black tilapia (Oreochromis mossambicus) head bones

Energy Technology Data Exchange (ETDEWEB)

Sockalingam, K., E-mail: gd130106@siswa.uthm.edu.my; Abdullah, H. Z., E-mail: hasan@uthm.edu.my [Faculty of Mechanical and Manufacturing Engineering, Universiti Tun Hussein Onn Malaysia, 86400 Parit Raja, Batu Pahat, Johor (Malaysia)

2015-07-22

Black tilapia (Oreochromis mossambicus) fish head bones were evaluated for its possibilities in extracting gelatin. Head bones were subjected to pre-treatment with 3% of hydrochloric acid (HCl) for demineralization before undergoes thermal extraction process. The raw head bones were characterized via Scanning Electron Microscopy (SEM) in order to investigate the external and internal surface morphology. SEM images also reveal the presence of collagen fiber with 1 µm diameter in the head bone. The black tilapia fish head bones yields 5.75 % of gelatin in wet weight basis, indicating the possibility of this fish species as sources of gelatin. Further characterizations were done on both raw head bones and extracted gelatin through Fourier Transform Infrared Spectroscopy (FTIR) and proximate analysis. The head bones gelatin shows high protein (10.55%) and ash (3.11 %) content with low moisture. This further proves the effectiveness of demineralization and extraction method used. The black tilapia fish head bones are found to be a prospective source of gelatin with good chemical and functional properties.

Extraction of high value added gelatin biopolymer from black tilapia (Oreochromis mossambicus) head bones

Science.gov (United States)

Sockalingam, K.; Abdullah, H. Z.

2015-07-01

Black tilapia (Oreochromis mossambicus) fish head bones were evaluated for its possibilities in extracting gelatin. Head bones were subjected to pre-treatment with 3% of hydrochloric acid (HCl) for demineralization before undergoes thermal extraction process. The raw head bones were characterized via Scanning Electron Microscopy (SEM) in order to investigate the external and internal surface morphology. SEM images also reveal the presence of collagen fiber with 1 µm diameter in the head bone. The black tilapia fish head bones yields 5.75 % of gelatin in wet weight basis, indicating the possibility of this fish species as sources of gelatin. Further characterizations were done on both raw head bones and extracted gelatin through Fourier Transform Infrared Spectroscopy (FTIR) and proximate analysis. The head bones gelatin shows high protein (10.55%) and ash (3.11 %) content with low moisture. This further proves the effectiveness of demineralization and extraction method used. The black tilapia fish head bones are found to be a prospective source of gelatin with good chemical and functional properties.

Extraction of high value added gelatin biopolymer from black tilapia (Oreochromis mossambicus) head bones

International Nuclear Information System (INIS)

Sockalingam, K.; Abdullah, H. Z.

2015-01-01

Black tilapia (Oreochromis mossambicus) fish head bones were evaluated for its possibilities in extracting gelatin. Head bones were subjected to pre-treatment with 3% of hydrochloric acid (HCl) for demineralization before undergoes thermal extraction process. The raw head bones were characterized via Scanning Electron Microscopy (SEM) in order to investigate the external and internal surface morphology. SEM images also reveal the presence of collagen fiber with 1 µm diameter in the head bone. The black tilapia fish head bones yields 5.75 % of gelatin in wet weight basis, indicating the possibility of this fish species as sources of gelatin. Further characterizations were done on both raw head bones and extracted gelatin through Fourier Transform Infrared Spectroscopy (FTIR) and proximate analysis. The head bones gelatin shows high protein (10.55%) and ash (3.11 %) content with low moisture. This further proves the effectiveness of demineralization and extraction method used. The black tilapia fish head bones are found to be a prospective source of gelatin with good chemical and functional properties

Design of a coincidence processing board for a dual-head PET scanner for breast imaging

International Nuclear Information System (INIS)

Martinez, J.D.; Toledo, J.; Esteve, R.; Sebastia, A.; Mora, F.J.; Benlloch, J.M.; Fernandez, M.M.; Gimenez, M.; Gimenez, E.N.; Lerche, Ch.W.; Pavon, N.; Sanchez, F.

2005-01-01

This paper describes the design of a coincidence processing board for a dual-head Positron Emission Tomography (PET) scanner for breast imaging. The proposed block-oriented data acquisition system relies on a high-speed DSP processor for fully digital trigger and on-line event processing that surpasses the performance of traditional analog coincidence detection systems. A mixed-signal board has been designed and manufactured. The analog section comprises 12 coaxial inputs (six per head) which are digitized by means of two 8-channel 12-bit 40-MHz ADCs in order to acquire the scintillation pulse, the charge division signals and the depth of interaction within the scintillator. At the digital section, a state-of-the-art FPGA is used as deserializer and also implements the DMA interface to the DSP processor by storing each digitized channel into a fast embedded FIFO memory. The system incorporates a high-speed USB 2.0 interface to the host computer

The impact of use of Glutamine on patients with head and neck tumors in radiotherapy and chemotherapy treatment

International Nuclear Information System (INIS)

Boligon, Caroline Schardong; Huth, Adriane

2011-01-01

Introduction: patients with head and neck neoplasia usually show malnutrition or a nutritional risk, because of common symptoms like: dysphagia, odynophagia and xerostomia. Objective: this study aimed to verify the impact of using amino glutamine in patients with head and neck neoplasia and under radiotherapy and chemotherapy treatment concomitantly. Methods: the research was quantitative, cross-sectional, descriptive and exploratory. The data was collected from nutritional evaluation, and patients chart consultation. The patients were divided in a control group (without use of glutamine) and a test group (with use of glutamine). 16 patients, 13 of which were men and three were women, participated in the research. Results: The control group presented mucositis grades I to IV while patients who used the amino glutamine showed mucositis grades I to II only. It could be observed that the Nutritional Risk Index decreased, which represents higher nutritional risk in patients from the control group only. In patients who used glutamine, this decrease was not significant. Conclusion: these results suggest that the use of glutamine in patients with head and neck tumors and under antineoplastic therapy helps to maintain their nutritional stage and to prevent mucositis throughout their treatment, mainly grades III and IV, which prevents adequate and regular eating and nourishment. (author)

Picibanil (OK-432) in the treatment of head and neck lymphangiomas in children.

Science.gov (United States)

Rebuffini, Elena; Zuccarino, Luca; Grecchi, Emma; Carinci, Francesco; Merulla, Vittorio Emanuele

2012-12-01

Picibanil (OK-432) is a lyophilized mixture of group A Streptococcus pyogenes with antineoplastic activity. Because of its capacity to produce a selective fibrosis of lymphangiomas (LMs), it has been approved by Japanese administration in 1995 for the treatment of LMs. We treated 15 children (age range: 6-60 months) affected by head and neck macrocystic LMs with intracystic injections (single dose of 0.2 mL) of Picibanil (1-3 injections). Complete disappearance of the lesion was noticed in eight (53.33%) cases, a marked (>50%) reduction of LMs was found five (33.33%) cases, while a moderate (Picibanil side effects included fever, local inflammation, and transitory increase of blood platelets' concentration; a single case of anemia was resolved with concentrated red blood cells transfusion. Intracystic injection of Picibanil is an effective and safe treatment for macrocystic LMs in pediatric patients and may represent the treatment of choice in such cases, especially where surgical excision is associated with the risk of functional/cosmetic side effects.

Development of a head and neck companion module for the quality of life-radiation therapy instrument (QOL-RTI)

International Nuclear Information System (INIS)

Trotti, Andy; Johnson, Darlene J.; Gwede, Clement; Casey, Linda; Sauder, Bonnie; Cantor, Alan; Pearlman, James

1998-01-01

Purpose/Objective: A review of available head and neck quality of life (QOL) instruments reveals them to inadequately address important radiation related side effects, or to be too cumbersome for routine use. The purpose of this study was to develop a head and neck disease specific module as a companion to the previously developed quality of life - radiation therapy instrument (QOL-RTI). The goal was to create a more complete, yet concise, head and neck site-specific module geared toward patients receiving radiation therapy for head and neck cancer. Methods and Materials: This exploratory study included 34 consecutive patients undergoing definitive radiotherapy over a 6-7 week course (60-79.8 Gy). We developed and administered a 14-item questionnaire to all eligible patients treated with radiotherapy for head and neck cancer who were not already registered in another research study assessing quality of life (e.g., RTOG). During the treatment period, the QOL-RTI general tool and the head and neck (H and N) module were administered as follows: at baseline, at week four (for test-retest), and at the end of the treatment period. For validation purposes the QOL-RTI/H and N was compared to the functional assessment cancer tool head and neck (FACT-H and N) questionnaire. The FACT-H and N was administered one time at week 4, on the same day as the QOL-RTI/H and N. This report includes the treatment phase of the study (during the course of radiation). Results: Mean age was 62 years (range 40-75). Internal consistency of the module was satisfactory (Chronbach's α = 0.85). Test-retest yielded a correlation coefficient of 0.90 (p < 0.001). Concurrent validity, established by comparing the module to the FACT/H and N , yielded a correlation coefficient of 0.85. Significant changes in quality of life scores during a course of radiation was noted for both general quality of life tool and the site specific module. For the head and neck module, the difference in the mean baseline

[Value of angiography and embolisation in treatment of head and neck vascular malformations at Otolaryngology Department, Poznań University of Medical Sciences, Poland].

Science.gov (United States)

Wróbel, Maciej; Kopeć, Tomasz; Juszkat, Robert; Szyfterl, Witold; Borucki, Łukasz

2008-01-01

Angiography is an invasive, radiological investigation of vascular system. It plays an important role within variety of diagnostic tools in head and neck pathologies. In selected cases with well defined tumor supply vessels, angiography may be combined with intravascular obliteration. This possibility widen indications, which comprise diagnostic arteriographies - visualization of blood supply and extension of vascularization; therapeutic and diagnostic arteriographies - palliative or radical in character, dependent on pathology; and therapeutic angiographies as adjuvant therapy prior to surgical treatment. Authors present their experience with endovascular techniques application in head and neck pathologies. Material comprised 59 angiographies performed in patients treated at Otolaryngology Department at Poznań University of Medical Sciences between 2000-2007. In conclusion authors emphasize advantages and disadvantages, as well as, the role of the endovascular treatment in head and neck surgery.

Botulinum toxin for treatment of restrictive strabismus.

Science.gov (United States)

Merino, Pilar S; Vera, Rebeca E; Mariñas, Laura G; Gómez de Liaño, Pilar S; Escribano, Jose V

To study the types of acquired restrictive strabismus treated in a tertiary hospital and the outcome of treatment with botulinum toxin. We performed a 10-year retrospective study of patients with restrictive strabismus aged ≥18 years who were treated with botulinum toxin. Treatment was considered successful if the final vertical deviation was ≤5 PD, horizontal deviation ≤10 PD, with no head turn or diplopia. We included 27 cases (mean age, 61.9 years). Horizontal strabismus was diagnosed in 11.1%, vertical in 51.9%, and mixed in 37%. Strabismus was secondary to cataract surgery in 6 cases, high myopia in 6, orbital fractures in 5, retinal surgery in 5, Graves ophthalmopathy in 4, and repair of conjunctival injury in 1 case. Diplopia was diagnosed in all patients, head turn in 33.3%. The initial deviation was 14 PD (range, 2-40), the mean number of injections per patient was 1.6 (range, 1-3), and the mean dose was 9.5 IU (range, 2.5-22.5). At the end of follow-up, diplopia was recorded in 59.3%, head turn in 18.5%, surgical treatment in 51.9%, and need for prism glasses in 14.8%. Outcome was successful in 37% of patients (4 high myopia, 3 orbital fractures, 2 post-surgical retinal detachment, and 1 post-cataract surgery). Mean follow-up was 3±1.8 years. Vertical deviation was observed in half of the sample. The most frequent deviation was secondary to cataract surgery and high myopia. Treatment with botulinum toxin was successful in one-third of the patients at the end of follow-up. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

Anthesis, the infectious process and disease progress curves for fusarium head blight in wheat

Directory of Open Access Journals (Sweden)

Erlei Melo Reis

2016-06-01

Full Text Available ABSTRACT Fusarium head blight of wheat (Triticum aestivum, caused by the fungus Gibberella zeae, is a floral infecting disease that causes quantitative and qualitative losses to winter cereals. In Brazil, the sanitary situation of wheat has led to research in order to develop strategies for sustainable production, even under adverse weather conditions. To increase the knowledge of the relationship among the presence of anthesis, the infectious process, the disease progress and the saprophytic fungi present in wheat anthers, studies were conducted in the experimental field of University of Passo Fundo (UPF, using the cultivar Marfim, in the 2011 growing season. The disease incidence in spikes and spikelets was evaluated. The presence of exserted anthers increased the spike exposure time to the inoculum. The final incidence of fusarium head blight, in the field, was dependent on the presence of exserted anthers. The disease followed an aggregation pattern and its evolution increased with time, apparently showing growth according to secondary cycles. The fungi isolated from exserted anthers (Alternaria sp., Fusarium sp., Drechslera spp. and Epicoccum sp. did not compete for the infection site of fusarium head blight in wheat, not interfering with the incidence of F. graminearum.

Spanish Instruction in Head Start and Dual Language Learners' Academic Achievement.

Science.gov (United States)

Miller, Elizabeth B

2017-09-01

Data from the Head Start Impact Study ( N = 1,141) and the Head Start Family and Child Experiences Survey, 2009 Cohort ( N = 825) were used to investigate whether Spanish instruction in Head Start differentially increased Spanish-speaking Dual Language Learners' (DLLs) academic achievement. Although hypothesized that Spanish instruction would be beneficial for DLLs' early literacy and math skills, results from residualized growth models showed there were no such positive associations. Somewhat surprisingly, DLL children instructed in Spanish had higher English receptive vocabulary skills at the end of the Head Start year than those not instructed, with children randomly assigned to Head Start and instructed in Spanish having the highest scores. Policy implications for Head Start-eligible Spanish-speaking DLLs are discussed.

Effects of face/head and whole body cooling during passive heat stress on human somatosensory processing.

Science.gov (United States)

Nakata, Hiroki; Namba, Mari; Kakigi, Ryusuke; Shibasaki, Manabu

2017-06-01

We herein investigated the effects of face/head and whole body cooling during passive heat stress on human somatosensory processing recorded by somatosensory-evoked potentials (SEPs) at C4' and Fz electrodes. Fourteen healthy subjects received a median nerve stimulation at the left wrist. SEPs were recorded at normothermic baseline (Rest), when esophageal temperature had increased by ~1.2°C (heat stress: HS) during passive heating, face/head cooling during passive heating (face/head cooling: FHC), and after HS (whole body cooling: WBC). The latencies and amplitudes of P14, N20, P25, N35, P45, and N60 at C4' and P14, N18, P22, and N30 at Fz were evaluated. Latency indicated speed of the subcortical and cortical somatosensory processing, while amplitude reflected the strength of neural activity. Blood flow in the internal and common carotid arteries (ICA and CCA, respectively) and psychological comfort were recorded in each session. Increases in esophageal temperature due to HS significantly decreased the amplitude of N60, psychological comfort, and ICA blood flow in the HS session, and also shortened the latencies of SEPs (all, P body temperature. Copyright © 2017 the American Physiological Society.

Flexible End2End Workflow Automation of Hit-Discovery Research.

Science.gov (United States)

Holzmüller-Laue, Silke; Göde, Bernd; Thurow, Kerstin

2014-08-01

The article considers a new approach of more complex laboratory automation at the workflow layer. The authors purpose the automation of end2end workflows. The combination of all relevant subprocesses-whether automated or manually performed, independently, and in which organizational unit-results in end2end processes that include all result dependencies. The end2end approach focuses on not only the classical experiments in synthesis or screening, but also on auxiliary processes such as the production and storage of chemicals, cell culturing, and maintenance as well as preparatory activities and analyses of experiments. Furthermore, the connection of control flow and data flow in the same process model leads to reducing of effort of the data transfer between the involved systems, including the necessary data transformations. This end2end laboratory automation can be realized effectively with the modern methods of business process management (BPM). This approach is based on a new standardization of the process-modeling notation Business Process Model and Notation 2.0. In drug discovery, several scientific disciplines act together with manifold modern methods, technologies, and a wide range of automated instruments for the discovery and design of target-based drugs. The article discusses the novel BPM-based automation concept with an implemented example of a high-throughput screening of previously synthesized compound libraries. © 2014 Society for Laboratory Automation and Screening.

Aging Prisoners’ Treatment Selection: Does Prospect Theory Enhance Understanding of End-of-Life Medical Decisions?

Science.gov (United States)

Phillips, Laura L.; Allen, Rebecca S.; Harris, Grant M.; Presnell, Andrew H.; DeCoster, Jamie; Cavanaugh, Ronald

2011-01-01

Purpose: With the rapid growth in the older inmate population and the economic impact of end-of-life treatments within the cash-strapped prison system, consideration should be given to inmate treatment preferences. We examined end-of-life treatment preferences and days of desired life for several health scenarios among male inmates incarcerated primarily for murder. Design and Methods: Inmates over the age of 45 who passed a cognitive screening completed face-to-face interviews (N = 94; mean age = 57.7; SD = 10.68). Results: We found a 3-way interaction indicating that the effect of parole expectation on desire for life-sustaining treatment varied by race/ethnicity and treatment. Minority inmates desired cardiopulmonary resuscitation or feeding tubes only if they believed that they would be paroled. The model predicting desire for palliative care was not significant. Future days of desired life were related to prospective health condition, fear of death, negative affect, and trust in prison health care. Caucasian inmates expressed a desire for more days of life out of prison, whereas minority inmates did not differ in days of desired life either in or out of prison. Minorities wanted more days of life than Caucasians but only if they believed that they would be paroled. Implications: End-of-life care for the burgeoning inmate population is costly, and active life-sustaining treatments may not be desired under certain conditions. Specifically, expectation of parole but not current functional ability interacts with future illness condition in explaining inmates’ desire for active treatment or days of desired life in the future. PMID:21593007

Integrated process analysis of treatment systems for mixed low level waste

International Nuclear Information System (INIS)

Cooley, C.R.; Schwinkendorf, W.E.; Bechtold, T.E.

1997-10-01

Selection of technologies to be developed for treatment of DOE's mixed low level waste (MLLW) requires knowledge and understanding of the expected costs, schedules, risks, performance, and reliability of the total engineered systems that use these technologies. Thus, an integrated process analysis program was undertaken to identify the characteristics and needs of several thermal and nonthermal systems. For purposes of comparison, all systems were conceptually designed for a single facility processing the same amount of waste at the same rate. Thirty treatment systems were evaluated ranging from standard incineration to innovative thermal systems and innovative nonthermal chemical treatment. Treating 236 million pounds of waste in 20 years through a central treatment was found to be the least costly option with total life cycle cost ranging from $2.1 billion for a metal melting system to $3.9 billion for a nonthermal acid digestion system. Little cost difference exists among nonthermal systems or among thermal systems. Significant cost savings could be achieved by working towards maximum on line treatment time per year; vitrifying the final waste residue; decreasing front end characterization segregation and sizing requirements; using contaminated soil as the vitrifying agent; and delisting the final vitrified waste form from Resource Conservation and Recovery Act (RCRA) Land Disposal Restriction (LDR) requirements

A Clinical Concept for Interfractional Adaptive Radiation Therapy in the Treatment of Head and Neck Cancer

Energy Technology Data Exchange (ETDEWEB)

Jensen, Alexandra D., E-mail: Alexandra.Jensen@med.uni-heidelberg.de [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany); Nill, Simeon [Department of Medical Physics, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Huber, Peter E. [Clinical Co-Operation Unit Radiation Oncology, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Bendl, Rolf [Department of Medical Physics, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Debus, Juergen; Muenter, Marc W. [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany)

2012-02-01

Purpose: To present an approach to fast, interfractional adaptive RT in intensity-modulated radiation therapy (IMRT) of head and neck tumors in clinical routine. Ensuring adequate patient position throughout treatment proves challenging in high-precision RT despite elaborate immobilization. Because of weight loss, treatment plans must be adapted to account for requiring supportive therapy incl. feeding tube or parenteral nutrition without treatment breaks. Methods and Materials: In-room CT position checks are used to create adapted IMRT treatment plans by stereotactic correlation to the initial setup, and volumes are adapted to the new geometry. New IMRT treatment plans are prospectively created on the basis of position control scans using the initial optimization parameters in KonRad without requiring complete reoptimization and thus facilitating quick replanning in daily routine. Patients treated for squamous cell head and neck cancer (SCCHN) in 2006-2007 were evaluated as to necessity/number of replannings, weight loss, dose, and plan parameters. Results: Seventy-two patients with SCCHN received IMRT to the primary site and lymph nodes (median dose 70.4 Gy). All patients received concomitant chemotherapy requiring supportive therapy by feeding tube or parenteral nutrition. Median weight loss was 7.8 kg, median volume loss was approximately 7%. Fifteen of 72 patients required adaptation of their treatment plans at least once. Target coverage was improved by up to 10.7% (median dose). The increase of dose to spared parotid without replanning was 11.7%. Replanning including outlining and optimization was feasible within 2 hours for each patient, and treatment could be continued without any interruptions. Conclusion: To preserve high-quality dose application, treatment plans must be adapted to anatomical changes. Replanning based on position control scans therefore presents a practical approach in clinical routine. In the absence of clinically usable online

A Clinical Concept for Interfractional Adaptive Radiation Therapy in the Treatment of Head and Neck Cancer

International Nuclear Information System (INIS)

Jensen, Alexandra D.; Nill, Simeon; Huber, Peter E.; Bendl, Rolf; Debus, Jürgen; Münter, Marc W.

2012-01-01

Purpose: To present an approach to fast, interfractional adaptive RT in intensity-modulated radiation therapy (IMRT) of head and neck tumors in clinical routine. Ensuring adequate patient position throughout treatment proves challenging in high-precision RT despite elaborate immobilization. Because of weight loss, treatment plans must be adapted to account for requiring supportive therapy incl. feeding tube or parenteral nutrition without treatment breaks. Methods and Materials: In-room CT position checks are used to create adapted IMRT treatment plans by stereotactic correlation to the initial setup, and volumes are adapted to the new geometry. New IMRT treatment plans are prospectively created on the basis of position control scans using the initial optimization parameters in KonRad without requiring complete reoptimization and thus facilitating quick replanning in daily routine. Patients treated for squamous cell head and neck cancer (SCCHN) in 2006–2007 were evaluated as to necessity/number of replannings, weight loss, dose, and plan parameters. Results: Seventy-two patients with SCCHN received IMRT to the primary site and lymph nodes (median dose 70.4 Gy). All patients received concomitant chemotherapy requiring supportive therapy by feeding tube or parenteral nutrition. Median weight loss was 7.8 kg, median volume loss was approximately 7%. Fifteen of 72 patients required adaptation of their treatment plans at least once. Target coverage was improved by up to 10.7% (median dose). The increase of dose to spared parotid without replanning was 11.7%. Replanning including outlining and optimization was feasible within 2 hours for each patient, and treatment could be continued without any interruptions. Conclusion: To preserve high-quality dose application, treatment plans must be adapted to anatomical changes. Replanning based on position control scans therefore presents a practical approach in clinical routine. In the absence of clinically usable online

A clinical concept for interfractional adaptive radiation therapy in the treatment of head and neck cancer.

Science.gov (United States)

Jensen, Alexandra D; Nill, Simeon; Huber, Peter E; Bendl, Rolf; Debus, Jürgen; Münter, Marc W

2012-02-01

To present an approach to fast, interfractional adaptive RT in intensity-modulated radiation therapy (IMRT) of head and neck tumors in clinical routine. Ensuring adequate patient position throughout treatment proves challenging in high-precision RT despite elaborate immobilization. Because of weight loss, treatment plans must be adapted to account for requiring supportive therapy incl. feeding tube or parenteral nutrition without treatment breaks. In-room CT position checks are used to create adapted IMRT treatment plans by stereotactic correlation to the initial setup, and volumes are adapted to the new geometry. New IMRT treatment plans are prospectively created on the basis of position control scans using the initial optimization parameters in KonRad without requiring complete reoptimization and thus facilitating quick replanning in daily routine. Patients treated for squamous cell head and neck cancer (SCCHN) in 2006-2007 were evaluated as to necessity/number of replannings, weight loss, dose, and plan parameters. Seventy-two patients with SCCHN received IMRT to the primary site and lymph nodes (median dose 70.4 Gy). All patients received concomitant chemotherapy requiring supportive therapy by feeding tube or parenteral nutrition. Median weight loss was 7.8 kg, median volume loss was approximately 7%. Fifteen of 72 patients required adaptation of their treatment plans at least once. Target coverage was improved by up to 10.7% (median dose). The increase of dose to spared parotid without replanning was 11.7%. Replanning including outlining and optimization was feasible within 2 hours for each patient, and treatment could be continued without any interruptions. To preserve high-quality dose application, treatment plans must be adapted to anatomical changes. Replanning based on position control scans therefore presents a practical approach in clinical routine. In the absence of clinically usable online correction methods, this approach allows significant

Impact of comorbidity on treatment outcome in head and neck squamous cell carcinoma – A systematic review

International Nuclear Information System (INIS)

Bøje, Charlotte Rotbøl

2014-01-01

The significant association with tobacco and alcohol combined with advanced age at time of diagnosis predispose head and neck squamous cell carcinoma (HNSCC) patients to increased risk of comorbidities. The presence of comorbidity affects treatment, treatment selection and subsequent outcome. Multiple studies have demonstrated comorbidity to be a strong prognostic factor for survival, and therefore comorbidity can be a major confounder in clinical trials. This review provides a summary of the current literature on comorbidity in head and neck cancer, measurements of comorbidity, the impact of comorbidity on treatment, treatment selection, and survival. A systematic search was performed in six electronic databases. In all, 31 papers were selected for this review. A meta-analysis on the prognostic impact of comorbidity was performed including 10 studies. Furthermore, 21 studies concerning comorbidity were reviewed. Several valid indices to classify comorbidity were described in the literature, none proven to be superior over the other. The prevalence of comorbidity increased with age and the presence of comorbidity influenced treatment and treatment selection. Furthermore, comorbidity was associated with lower socio economic status and increased the risk of early retirement after treatment. The meta-analysis on comorbidity as a prognostic factor, including 22,932 patients, showed that overall survival was significantly worsened among patients with comorbidity (HR = 1.38 (1.32–1.43)). Increasing comorbidity-score was associated with increased risk of death. Comorbidity is important in HNSCC and significantly impacts on overall survival. Trials concerning HNSCC should always include information on comorbidity and randomized trials should stratify patients according to comorbidity in order to avoid bias in the study

Primary tendinitis of the long head of the biceps.

Science.gov (United States)

Post, M; Benca, P

1989-09-01

Seventeen patients with chronic painful shoulders who showed evidence of isolated bicipital tendinitis involving only the extracapsular, intertubercular portion of the long head of the biceps were chosen for surgical treatment when conservative treatment failed. The patients were thought to have primary bicipital tendinitis. The latter condition is secondary to other shoulder pathologies. Thirteen patients had tenodeses and four patients had transfer of the long head of the biceps to the origin of the conjoined tendon. Overall, excellent and good results were noted in 94% of both groups of patients when the long head of the biceps was tenodesed or transferred. Whether or not the long head of the biceps is a significant depressor of the humeral head requires further investigation.

Characteristics and intraoperative treatments associated with head and neck free tissue transfer complications and failures.

Science.gov (United States)

Hand, William R; McSwain, Julie R; McEvoy, Matthew D; Wolf, Bethany; Algendy, Abdalrahman A; Parks, Matthew D; Murray, John L; Reeves, Scott T

2015-03-01

To investigate the association between perioperative patient characteristics and treatment modalities (eg, vasopressor use and volume of fluid administration) with complications and failure rates in patients undergoing head and neck free tissue transfer (FTT). A retrospective review of medical records. Perioperative hospitalization for head and neck FTT at 1 tertiary care medical center between January 1, 2009, and October 31, 2011. Consecutive patients (N=235) who underwent head and neck FTT. Demographic, patient characteristic, and intraoperative data were extracted from medical records. Complication and failure rates within the first 30 days were collected In a multivariate analysis controlling for age, sex, ethnicity, reason for receiving flap, and type and volume of fluid given, perioperative complication was significantly associated with surgical blood loss (P=.019; 95% confidence interval [CI], 1.01-1.16), while the rate of intraoperative fluid administration did not reach statistical significance (P=.06; 95% CI, 0.99-1.28). In a univariate analysis, FTT failure was significantly associated with reason for surgery (odds ratio, 5.40; P=.03; 95% CI, 1.69-17.3) and preoperative diagnosis of coronary artery disease (odds ratio, 3.60; P=.03; 95% CI, 1.16-11.2). Intraoperative vasopressor administration was not associated with either FTT complication or failure rate. FTT complications were associated with surgical blood loss but not the use of vasoactive drugs. For patients undergoing FTT, judicious monitoring of blood loss may help stratify the risk of complication and failure. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Simulation of saltwater movement in the Floridan aquifer system, Hilton Head Island, South Carolina

Science.gov (United States)

Bush, Peter W.

1988-01-01

Freshwater to supply Hilton Head Island, S.C., is obtained from the upper permeable zone of the Upper Floridan aquifer. Long-term pumping at Savannah, Ga., and the steadily increasing pumping on Hilton Head Island, have lowered Upper Floridan heads near the center of the island from about 10 feet above sea level to about 6 to 7 feet below sea level. The seaward hydraulic gradient that existed before pumping began has been reversed, thus increasing the potential for saltwater intrusion. Simulations of predevelopment, recent, and future ground-water flow in the Floridan aquifer system beneath the north end of Hilton Head Island and Port Royal Sound are presented. A finite-element model for fluid-density-dependent ground-water flow and solute transport was used in cross section. The general configuration of the simulated predevelopment flowfield is typical of a coastal aquifer having a seaward gradient in the freshwater. The freshwater flows toward Port Royal Sound over an intruding wedge of saltwater. The simulated flowfield at the end of 1983 shows that ground water in the Floridan aquifer system beneath most of Hilton Head Island has reversed its predevelopment direction and is moving toward Savannah. The distribution of chloride concentrations, based on simulation at the end of 1983, is about the same as the predevelopment distribution of chloride concentrations obtained from simulation. Results of two 50-year simulations from 1983 to 2034 suggest that there will be no significant threat of saltwater intrusion into the upper permeable zone of the Upper Floridan aquifer if heads on Hilton Head Island remain at current levels for the next 45 to 50 years. However, if head decline continues at the historical rate, any flow that presently occurs from the north end of the island toward Port Royal Sound will cease, allowing lateral intrusion of saltwater to proceed. Even under these conditions, chloride concentrations in the upper permeable zone of the Upper Floridan

Study of medicines’ market for the treatment of seborrheic dermatitis of the pilar part of head

Directory of Open Access Journals (Sweden)

V. A. Solodovnik

2018-03-01

Full Text Available Modern arsenal of medicines and cosmetics used for the therapy of seborrheic dermatitis of the pilar part of head is various enough. Today pharmaceutical market keeps developing and constitutes a complex system that causes the necessity of its investigation and forming the informational base concerning the dynamics of assortment, prices and availability of medicines. The aim of work is forming the informational file about medicines and cosmetics which are used in treatment of seborrheic dermatitis of the pilar part of head and advisability substantiation of the creation of new medication with Octopirox on the base of marketing analysis. Materials and methods. As informative materials we used: the State register of medications of Ukraine; reference book of medications «Compendium on-line»; internet resources on the search of medications in the pharmacies of Ukraine “GeoApteka” and “Tabletki.ua”. A marketing method, monitoring methods, logical generalization, groupment and graphic methods were applied in-process of research. Results. Complex marketing evaluation of the Ukrainian pharmaceutical market of medications used for the therapy of seborrheic dermatitis of the pilar part of head was carried out taking into account heterogeneous structure in two trends: medicines and cosmetics. Conclusion. Modern arsenal of medicines was organized in two trends: segment of medicines consists of 26 medications of D01A subgroup “Antifungals for topical use” and D11A subgroup “Other dermatologic medications”; “КС” segment has 71 cosmetics (cosmetics with Octopirox prevail – 12 propositions. In form of making, the liquids prevail – shampoo, tonics, solutions, serums. All tools concerning “Order of dispensing” are available without a prescription but before their using the doctor's advice taking into account individuality of each patient is needed. The analyzable market segment is characterized by the deficiency of combined drugs

Definition of Terms Used in Limitation of Treatment and Providing Palliative Care at the End of Life: The Indian Council of Medical Research Commission Report

Science.gov (United States)

Salins, Naveen; Gursahani, Roop; Mathur, Roli; Iyer, Shivakumar; Macaden, Stanley; Simha, Nagesh; Mani, Raj Kumar; Rajagopal, M. R.

2018-01-01

Background: Indian hospitals, in general, lack policies on the limitation of inappropriate life-sustaining interventions at the end of life. To facilitate discussion, preparation of guidelines and framing of laws, terminologies relating to the treatment limitation, and providing palliative care at the end-of-life care (EOLC) need to be defined and brought up to date. Methodology: This consensus document on terminologies and definitions of terminologies was prepared under the aegis of the Indian Council of Medical Research. The consensus statement was created using Nominal Group and Delphi Method. Results: Twenty-five definitions related to the limitations of treatment and providing palliative care at the end of life were created by reviewing existing international documents and suitably modifying it to the Indian sociocultural context by achieving national consensus. Twenty-five terminologies defined within the scope of this document are (1) terminal illness, (2) actively dying, (3) life-sustaining treatment, (4) potentially inappropriate treatment, (5) cardiopulmonary resuscitation (CPR), (6) do not attempt CPR, (7) withholding life-sustaining treatment, (8) withdrawing life-sustaining treatment, (9) euthanasia (10) active shortening of the dying process, (11) physician-assisted suicide, (12) palliative care, (13) EOLC, (14) palliative sedation, (15) double effect, (16) death, (17) best interests, (18) health-care decision-making capacity, (19) shared decision-making, (20) advance directives, (21) surrogates, (22) autonomy, (23) beneficence, (24) nonmaleficence, and (25) justice.

Head and Neck Cancer—Health Professional Version

Science.gov (United States)

Head and neck cancers include hypopharyngeal, laryngeal, lip and oral cavity, metastatic squamous neck, nasopharyngeal, oropharyngeal, paranasal sinus, and salivary gland cancers. Find evidence-based information on head and neck cancer treatment, causes and prevention, research, screening, and statistics.

Head and neck: treatment of primary and relapsed nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Wang, C.C.

1995-01-01

Purpose/Objective: Nasopharyngeal carcinoma (NPC) is not a common malignancy of the head and neck in the United States and presents a great challenge to the radiation oncologists in this country. Its management is radiotherapeutic and technically demanding and calls for careful treatment techniques to include the primary and the lymphatic drainage areas to high doses while sparing the neighboring organs such as the spinal cord, eyes, temporal lobes and midrain. This refresher course will review the clinical course, pattern of spread with manifestations of various neurologic syndromes of the disease. The radiotherapeutic management of primary lesion will be discussed in detail including the treatment techniques, placement of the irradiation portals, dose levels, etc. Treatment results as reported in the literature as well as those achieved at the MGH will be presented. Special emphasis will be placed on the routine use of intracavitary implant to boost the primary site and its technical aspects. Relapsed NPC after previous radiation therapy presents a difficult problem in management, but can be re-irradiated with occasional success by observing careful technique and fractionated intracavitary brachytherapy and the local control rates will be briefly covered. Recurrent disease in the neck will be managed by neck dissection. Xerostomia is undesirable and common sequelae following radical radiation therapy for NPC. Efforts are being made to decrease its magnitude by using higher energies of photons, i.e. 10 MV to spare a portion of the parotid glands with some promising results. Because of the unique location of the primary lesion, currently a modified BID program (MBID) is used and its techniques and treatment concept are discussed

The Natural History and Treatment Outcomes of Perineural Spread of Malignancy within the Head and Neck.

Science.gov (United States)

Warren, Timothy A; Nagle, Christina M; Bowman, James; Panizza, Benedict J

2016-04-01

Understanding the natural history of diseases enables the clinician to better diagnose and treat their patients. Perineural spread of head and neck cancers are poorly understood and often diagnosis is delayed resulting in poorer outcomes and more debilitating treatments. This article reviews a large personal series of head and neck malignancy presenting with perineural spread along almost exclusively the trigeminal and/or facial nerves. A detailed analysis of squamous cell carcinoma of cutaneous origin is presented including an analysis of likely primaries, which most often have occurred months to years prior. The importance of early detection is reinforced by the highly significant (p < 0.0001) differences in disease specific survival, which occur, depending on how far along a cranial nerve the disease has been allowed to spread.

Management of radiation therapy-induced mucositis in head and neck cancer patients. Part II: supportive treatments

Directory of Open Access Journals (Sweden)

Wei Cheong Ngeow

2011-12-01

Full Text Available Oropharyngeal mucositis is the acute inflammatory and ulcerative reaction of the oral mucosa following radiation therapy to the head and neck region. It is such a common problem that nearly all head and neck cancer patients develop some degree of mucositis. This complication is usually transient in nature but it also represents an important clinical problem as it is a painful, debilitating, dose-dependent side effect for which there is no widely acceptable prophylaxis or effective treatment. As several authoritative groups have recently either undertaken systematic reviews or issued guidelines on the management of mucositis, it is the aim of this review instead, to provide an overview of all the remedies and pharmaceutical agents available, as well as highlighting to researchers the gaps that need to be filled.

Prevalence and clinical significance of cancer cachexia based on time from treatment in advanced-stage head and neck squamous cell carcinoma.

Science.gov (United States)

Kwon, Minsu; Kim, Rock Bum; Roh, Jong-Lyel; Lee, Sang-Wook; Kim, Sung-Bae; Choi, Seung-Ho; Nam, Soon Yuhl; Kim, Sang Yoon

2017-04-01

The purpose of this study was to identify the prevalence of cancer cachexia and its prognostic impact in patients with advanced head and neck squamous cell carcinoma (HNSCC). The prevalence of cancer cachexia was analyzed according to the follow-up periods during the first year after curative initial treatment. Recurrences, noncancer health events (NCHEs), and cause-specific survival outcomes were also analyzed according to the incidence of cancer cachexia during follow-up. Cancer cachexia was identified in 22 (6.1%), 148 (41%), 66 (18.4%), and 65 (18.7%) of 361 enrolled patients at pretreatment, immediately after treatment, 6-months after treatment, and 12-months after treatment, respectively. Sustained or newly developed cachexia at 6 and 12 months showed a significant association with recurrence and NCHE occurrence (p cachexia had a higher probability of cancer-specific death, noncancerous death, and overall death (p Cachexia prevalence at 6 and 12 months after treatment for HNSCC indicates a higher chance of recurrence, NCHE, and death. © 2016 Wiley Periodicals, Inc. Head Neck 39: 716-723, 2017. © 2016 Wiley Periodicals, Inc.

One trial treatment for postoperative fistulas of irradiated malignant tumors in the head and neck

International Nuclear Information System (INIS)

Sakai, Noboru; Nagahashi, Tatsumi; Nakamaru, Yuji; Asai, Toshiyuki; Kurihara, Hideo; Katoh, Akio; Yokohama, Masaki; Gotohda, Hiroyuki; Inuyama, Yukio

1995-01-01

It is very difficult to treat postoperative fistulas of irradiated malignant tumors in the head and neck. These fistulas generally require either surgical or conservative therapy, but the poor healing induced by irradiation means that a long time is required to obtain a complete cure. As one of the conservative therapies for these wounds, we first applied alcloxa powder which had been used as the treatment of either decubitis or ulcers, and we thus were able to obtain a complete cure in 8 patients without the need for any reconstructive surgery. The number of days required to obtain a complete cure of the fistulas ranged from 9 to 84 days, with an average of 39.8 days. These results indicated that this powder had an excellent efficacy on wound healing, and it should thus be used frequently on incurable postoperative fistulas after irradiation in head and neck malignancies. (author)

One trial treatment for postoperative fistulas of irradiated malignant tumors in the head and neck

Energy Technology Data Exchange (ETDEWEB)

Sakai, Noboru; Nagahashi, Tatsumi; Nakamaru, Yuji; Asai, Toshiyuki; Kurihara, Hideo; Katoh, Akio; Yokohama, Masaki; Gotohda, Hiroyuki; Inuyama, Yukio [Hokkaido Univ., Sapporo (Japan). School of Medicine

1995-03-01

It is very difficult to treat postoperative fistulas of irradiated malignant tumors in the head and neck. These fistulas generally require either surgical or conservative therapy, but the poor healing induced by irradiation means that a long time is required to obtain a complete cure. As one of the conservative therapies for these wounds, we first applied alcloxa powder which had been used as the treatment of either decubitis or ulcers, and we thus were able to obtain a complete cure in 8 patients without the need for any reconstructive surgery. The number of days required to obtain a complete cure of the fistulas ranged from 9 to 84 days, with an average of 39.8 days. These results indicated that this powder had an excellent efficacy on wound healing, and it should thus be used frequently on incurable postoperative fistulas after irradiation in head and neck malignancies. (author).

SU-F-P-37: Implementation of An End-To-End QA Test of the Radiation Therapy Imaging, Planning and Delivery Process to Identify and Correct Possible Sources of Deviation

International Nuclear Information System (INIS)

Salinas Aranda, F; Suarez, V; Arbiser, S; Sansogne, R

2016-01-01

Purpose: To implement an end-to-end QA test of the radiation therapy imaging, planning and delivery process, aimed to assess the dosimetric agreement accuracy between planned and delivered treatment, in order to identify and correct possible sources of deviation. To establish an internal standard for machine commissioning acceptance. Methods: A test involving all steps of the radiation therapy: imaging, planning and delivery process was designed. The test includes analysis of point dose and planar dose distributions agreement between TPS calculated and measured dose. An ad hoc 16 cm diameter PMMA phantom was constructed with one central and four peripheral bores that can accommodate calibrated electron density inserts. Using Varian Eclipse 10.0 and Elekta XiO 4.50 planning systems, IMRT, RapidArc and 3DCRT with hard and dynamic wedges plans were planned on the phantom and tested. An Exradin A1SL chamber is used with a Keithley 35617EBS electrometer for point dose measurements in the phantom. 2D dose distributions were acquired using MapCheck and Varian aS1000 EPID.Gamma analysis was performed for evaluation of 2D dose distribution agreement using MapCheck software and Varian Portal Dosimetry Application.Varian high energy Clinacs Trilogy, 2100C/CD, 2000CR and low energy 6X/EX where tested.TPS-CT# vs. electron density table were checked for CT-scanners used. Results: Calculated point doses were accurate to 0.127% SD: 0.93%, 0.507% SD: 0.82%, 0.246% SD: 1.39% and 0.012% SD: 0.01% for LoX-3DCRT, HiX-3DCRT, IMRT and RapidArc plans respectively. Planar doses pass gamma 3% 3mm in all cases and 2% 2mm for VMAT plans. Conclusion: Implementation of a simple and reliable quality assurance tool was accomplished. The end-to-end proved efficient, showing excellent agreement between planned and delivered dose evidencing strong consistency of the whole process from imaging through planning to delivery. This test can be used as a first step in beam model acceptance for clinical

Validation of a cylindrical phantom for verification of radiotherapy treatments in head and neck with special techniques

International Nuclear Information System (INIS)

Vargas, Nicolas M.; Garcia, Marcia; Piriz, Gustavo; Perez, Niurka

2011-01-01

Verification of radiotherapy treatments in head and neck requires, among other things, small volume chambers and a phantom to reproduce the geometry and density of the anatomical structure. New documents from the ICRU (International Commission on Radiation Units and Measurements), Report 83, established the need for quality control in radiotherapy with special techniques such as IMRT (intensity-modulated radiation therapy). In this study, we built a cylindrical acrylic phantom with standing water, containing seven measuring points in the transverse plane and free location (0-20 cm) in the longitudinal plane. These points of measurement are constituted by cavities for the accommodation of the ionization chamber of 7 mm of mayor diameter (semi flex, pinpoint with build cup). The results of the phantom validation yielded percentage differences less than 1% in fixed beams and less than 2.5% in arc therapy for TPS Eclipse calculation. The preparation of this phantom, particularly made to verify the head and neck treatments, was simple and reliable for checking the dose in radiotherapy with fixed beams and/or special techniques such as arc therapy or IMRT, so that will be sent to various radiotherapy centers in the country for dosimetric verification in such treatments. (author)

Validation of a cylindrical phantom for verification of radiotherapy treatments in head and neck with special techniques

Energy Technology Data Exchange (ETDEWEB)

Vargas, Nicolas M.; Garcia, Marcia, E-mail: nimoralesv@gmail.com [Universidad de La Frontera, Temuco (Chile). Dept. de Ciencias Fisicas; Piriz, Gustavo [Instituto Nacional del Cancer, Santiago (Chile). Fisica Medica; Perez, Niurka [Instituto de Salud Publica, Santiago (Chile). QA Radioterapia. Inst. de Salud Publica

2011-07-01

Verification of radiotherapy treatments in head and neck requires, among other things, small volume chambers and a phantom to reproduce the geometry and density of the anatomical structure. New documents from the ICRU (International Commission on Radiation Units and Measurements), Report 83, established the need for quality control in radiotherapy with special techniques such as IMRT (intensity-modulated radiation therapy). In this study, we built a cylindrical acrylic phantom with standing water, containing seven measuring points in the transverse plane and free location (0-20 cm) in the longitudinal plane. These points of measurement are constituted by cavities for the accommodation of the ionization chamber of 7 mm of mayor diameter (semi flex, pinpoint with build cup). The results of the phantom validation yielded percentage differences less than 1% in fixed beams and less than 2.5% in arc therapy for TPS Eclipse calculation. The preparation of this phantom, particularly made to verify the head and neck treatments, was simple and reliable for checking the dose in radiotherapy with fixed beams and/or special techniques such as arc therapy or IMRT, so that will be sent to various radiotherapy centers in the country for dosimetric verification in such treatments. (author)

Effect of Variant End of Injection Period on Combustion Process of Biodiesel Combustion

Directory of Open Access Journals (Sweden)

Khalid Amir

2016-01-01

Full Text Available Biodiesel is an alternative fuel as a replacement to the standard diesel fuel in combustion diesel engine. The biodiesel fuel has a significantly influences throughout the combustion process and exhaust emission. The purpose of this research is to investigate the combustion process behavior during the End of Injection (EOI period and operates under variant conditions using Rapid Compression Machine (RCM. Experimental of RCM is used to simulate a combustion process and combustion characteristics of diesel engine combustion. Three types of biodiesel blend which are B5, B10 and B15 were tested at several injection pressures of 80 MPa, 90 MPa and 130 MPa under different ambient temperatures, 750 K to 1100 K. The results of this study showed that the ignition delay slightly reduced with increasing the content of biodiesel blends from B5, B10 and B15 and became more shorten as the injection pressure been enhanced. As the injection pressure increased, the behavior of combustion pressure at end of injection is reduced, radically increased the NOX emission. It is noted that the process of combustion at the end of injection increased as the ambient temperature is rising. In fact, higher initial ambient temperature improved the fuel atomization and mixing process. Under the biodiesel combustion with higher ambient temperature condition, the exhaust emission of CO, O2, and HC became less but increased in NOX emission. Besides, increased in blends of biodiesel ratio are found to enhance the combustion process, resulted a decreased in HC emissions.

Drug treatment at the end of life: an epidemiologic study in nursing homes.

Science.gov (United States)

Jansen, Kristian; Schaufel, Margrethe Aase; Ruths, Sabine

2014-12-01

To examine drug treatment in nursing home patients at the end of life, and identify predictors of palliative drug therapy. A historical cohort study. Three urban nursing homes in Norway. All patients admitted from January 2008 and deceased before February 2013. Drug prescriptions, diagnoses, and demographic data were collected from electronic patient records. Palliative end-of-life drug treatment was defined on the basis of indication, drug, and formulation. 524 patients were included, median (range) age at death 86 (19-104) years, 59% women. On the day of death, 99.4% of the study population had active prescriptions; 74.2% had palliative drugs either alone (26.9%) or concomitantly with curative/preventive drugs (47.3%). Palliative drugs were associated with nursing home, length of stay > 16 months (AOR 2.10, 95% CI 1.12-3.94), age (1.03, 1.005-1.05), and a diagnosis of cancer (2.12, 1.19-3.76). Most initiations of palliative drugs and withdrawals of curative/preventive drugs took place on the day of death. Palliative drug therapy and drug therapy changes are common for nursing home patients on the last day of life. Improvements in end-of-life care in nursing homes imply addressing prognostication and earlier response to palliative needs.

Treatment of lymphatic malformations of head and neck with OK-432 sclerotherapy induce systemic inflammatory response.

Science.gov (United States)

Närkiö-Mäkelä, Mervi; Mäkelä, Teppo; Saarinen, Pia; Salminen, Päivi; Julkunen, Ilkka; Pitkäranta, Anne

2011-01-01

Systemic immune responses after OK-432 (Picibanil) sclerotherapy in patients with head and neck lymphatic malformations (LM) were examined to achieve a better understanding of the mechanism of OK-432 sclerotherapy and to evaluate the long-term treatment outcome. Serum samples from 17 consecutive patients with head and neck LMs were collected during a total of 26 OK-432 treatment episodes. Serum C-reactive protein (CRP), interleukins (IL) 1β, 6, 8, 10, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, RANTES, immune protein (IP)-10 and macrophage chemoattractant protein (MCP)-1 as well as blood leukocyte counts were determined. Clinical outcome of the treatment was evaluated at the last visit and from patient files. Elevated serum levels of IP-10 (means at baseline 702 ng/L, after 1 day 1180 ng/L, after 4 weeks 691 ng/L) were seen on day one after OK-432 sclerotherapy (p < 0.05). C-reactive protein and leukocyte counts 1 day after treatment differed statistically significantly (p < 0.05) from the baseline. No significant differences with other cytokines investigated were observed. Patients with macrocystic LM responded better than patients with microcystic LM (p = 0.01). The elevated levels of IP-10, C-reactive protein and leukocyte levels indicate that OK-432 sclerotherapy induces systemic immune responses in patients with LM. The mechanisms of OK-432 sclerotherapy are still not precisely understood, but the IP-10 elevation may reflect local antiangiogenetic properties of immunoactivation induced by OK-432.

Ketamine PCA for treatment of end-of-life neuropathic pain in pediatrics.

Science.gov (United States)

Taylor, Matthew; Jakacki, Regina; May, Carol; Howrie, Denise; Maurer, Scott

2015-12-01

Control of neuropathic pain (NP) for children at end of life is challenging. Ketamine improves control of NP, but its use in children is not well described. We describe a retrospective case review of 14 children with terminal prognoses treated with ketamine patient-controlled analgesia (PCA) for management of opioid-refractory NP at the end of life. Median ketamine dose was 0.06 mg/kg/h (range 0.014-0.308 mg/kg/h) with a 0.05 mg/kg (range 0.03-0.5mg/kg) demand dose available every 15 minutes (range 10-60 minutes). All patients noted subjective pain relief with ketamine, and 79% had no adverse effects. Benzodiazepines limited neuropsychiatric side effects. Ketamine treatment arrested dose escalation of opioids in 64% of patients, and 79% were discharged to home hospice. Ketamine PCA is an effective, well-tolerated therapy for opioid-refractory NP in pediatric end-of-life care. © The Author(s) 2014.

Assessment of Parotid Gland Dose Changes During Head and Neck Cancer Radiotherapy Using Daily Megavoltage Computed Tomography and Deformable Image Registration

International Nuclear Information System (INIS)

Lee, Choonik; Langen, Katja M.; Lu Weiguo; Haimerl, Jason; Schnarr, Eric; Ruchala, Kenneth J.; Olivera, Gustavo H.; Meeks, Sanford L.; Kupelian, Patrick A.; Shellenberger, Thomas D.; Manon, Rafael R.

2008-01-01

Purpose: To analyze changes in parotid gland dose resulting from anatomic changes throughout a course of radiotherapy in a cohort of head-and-neck cancer patients. Methods and Materials: The study population consisted of 10 head-and-neck cancer patients treated definitively with intensity-modulated radiotherapy on a helical tomotherapy unit. A total of 330 daily megavoltage computed tomography images were retrospectively processed through a deformable image registration algorithm to be registered to the planning kilovoltage computed tomography images. The process resulted in deformed parotid contours and voxel mappings for both daily and accumulated dose-volume histogram calculations. The daily and cumulative dose deviations from the original treatment plan were analyzed. Correlations between dosimetric variations and anatomic changes were investigated. Results: The daily parotid mean dose of the 10 patients differed from the plan dose by an average of 15%. At the end of the treatment, 3 of the 10 patients were estimated to have received a greater than 10% higher mean parotid dose than in the original plan (range, 13-42%), whereas the remaining 7 patients received doses that differed by less than 10% (range, -6-8%). The dose difference was correlated with a migration of the parotids toward the high-dose region. Conclusions: The use of deformable image registration techniques and daily megavoltage computed tomography imaging makes it possible to calculate daily and accumulated dose-volume histograms. Significant dose variations were observed as result of interfractional anatomic changes. These techniques enable the implementation of dose-adaptive radiotherapy

Modifications to advanced Core decompression for treatment of Avascular necrosis of the femoral head

OpenAIRE

Landgraeber, Stefan; Warwas, Sebastian; Claßen, Tim; Jäger, Marcus

2017-01-01

Background “Advanced Core Decompression” (ACD) is a new technique for treatment of osteonecrosis of the femoral head (ONFH) that includes removal of the necrotic tissue using a percutaneous expandable reamer followed by refilling of the drill hole and the defect with an injectable, hard-setting, composite calcium sulphate (CaSO4)-calcium phosphate (CaPO4) bone graft substitute. As autologous bone has been shown to be superior to all other types of bone grafts, the aim of the study is to prese...

The origin and diversification of the developmental mechanisms that pattern the vertebrate head skeleton.

Science.gov (United States)

Square, Tyler; Jandzik, David; Romášek, Marek; Cerny, Robert; Medeiros, Daniel Meulemans

2017-07-15

The apparent evolvability of the vertebrate head skeleton has allowed a diverse array of shapes, sizes, and compositions of the head in order to better adapt species to their environments. This encompasses feeding, breathing, sensing, and communicating: the head skeleton somehow participated in the evolution of all these critical processes for the last 500 million years. Through evolution, present head diversity was made possible via developmental modifications to the first head skeletal genetic program. Understanding the development of the vertebrate common ancestor's head skeleton is thus an important step in identifying how different lineages have respectively achieved their many innovations in the head. To this end, cyclostomes (jawless vertebrates) are extremely useful, having diverged from jawed vertebrates approximately 400 million years ago, at the deepest node within living vertebrates. From this ancestral vantage point (that is, the node connecting cyclostomes and gnathostomes) we can best identify the earliest major differences in development between vertebrate classes, and start to address how these might translate onto morphology. In this review we survey what is currently known about the cell biology and gene expression during head development in modern vertebrates, allowing us to better characterize the developmental genetics driving head skeleton formation in the most recent common ancestor of all living vertebrates. By pairing this vertebrate composite with information from fossil chordates, we can also deduce how gene regulatory modules might have been arranged in the ancestral vertebrate head. Together, we can immediately begin to understand which aspects of head skeletal development are the most conserved, and which are divergent, informing us as to when the first differences appear during development, and thus which pathways or cell types might be involved in generating lineage specific shape and structure. Copyright © 2017 Elsevier Inc. All

Posterior-only spinal fusion without rib head resection for treating type I neurofibromatosis with intra-canal rib head dislocation

Directory of Open Access Journals (Sweden)

Dong Sun

2013-12-01

Full Text Available OBJECTIVES: Patients with Type I neurofibromatosis scoliosis with intra-canal rib head protrusion are extremely rare. Current knowledge regarding the diagnosis and treatment for this situation are insufficient. The purpose of this study is to share our experience in the diagnosis and surgical treatments for such unique deformities. METHODS: Six patients with Type I neurofibromatosis scoliosis with rib head dislocation into the spinal canal were diagnosed at our institution. Posterior instrumentation and spinal fusion without intra-canal rib head resection via a posterior-only approach was performed for deformity correction and rib head extraction. The efficacy and outcomes of the surgery were evaluated by measurements before, immediately and 24 months after the surgery using the following parameters: coronal spinal Cobb angle, apex rotation and kyphosis of the spine and the intra-canal rib head position. Post-operative complications, surgery time and blood loss were also evaluated. RESULTS: Patients were followed up for at least 24 months post-operatively. The three dimensional spinal deformity was significantly improved and the intra-canal rib head was significantly extracted from the canal immediately after the surgery. At follow-up 24 months after surgery, solid fusions were achieved along the fusion segments, and the deformity corrections and rib head positions were well maintained. There were no surgery-related complications any time after the surgery. CONCLUSIONS: Systematic examinations are needed to identify patients with Type I neurofibromatosis scoliosis with rib head dislocation into the canal who can be treated by posterior-only spinal fusion without rib head resection.

Collagen Type III Metabolism Evaluation in Patients with Malignant Head and Neck Cancer Treated with Radiotherapy

Directory of Open Access Journals (Sweden)

Klaudia Mazurek

2018-01-01

Full Text Available Ionizing radiation affects the metabolism of key proteins of extracellular matrix including type III collagen, an important component of human skin. The aim of the work is an analysis of the impact of radical and palliative radiotherapy on collagen type III synthesis in patients with head and neck cancer. The test group consisted of 56 males with histopathologically confirmed head and neck cancer, for whom radiotherapy was applied as a form of radical or palliative treatment. The level of procollagen III aminoterminal propeptide (PIIINP, which is a marker of collagen type III synthesis, was determined in blood serum before radiotherapy, immediately following radiotherapy, and 3 months after it was finished. As a result of radical radiotherapy a statistically significant decrease of PIIINP levels in serum (p<0.0001 was observed, both immediately after the radiotherapy and 3 months after the end of the treatment. Also the palliative radiotherapy caused a significant decrease of PIIINP right after the treatment (p=0.0052, as well as during the examination performed 3 months later (p=0.0004. The achieved results suggest that PIIINP can be used as a marker helpful in assessing radiation damage to connective tissue.

Do Older Korean Immigrants Engage in End-of-Life Communication?

Science.gov (United States)

Ko, Eunjeong; Roh, Soonhee; Higgins, Doreen

2013-01-01

End-of-life communication is an important process as it allows individuals' treatment preferences to be known, yet not every culture is receptive to such discussions. Planning for end-of-life care is not readily supported in Asian culture, and little is known about individuals' communication with family and health care professionals among older…

[Treatment of painful neuromas via end-to-side neurorraphy].

Science.gov (United States)

Aszmann, O C; Moser, V; Frey, M

2010-08-01

Management of the painful neuroma has been subject to controversy since the earliest descriptions of this disabling problem. Today, treatment is limited to resection of the neuroma and implantation of the nerve in a muscle at a location where it is safe from irritation and trauma. This however is not attainable in many cases and it is our clinical experience, that nerves without a target remain a source of constant discomfort and pain. Recently we reported of the feasibility of neuroma prevention through end-to-side neurorraphy into adjacent sensory and/or motor nerves to provide a target for axons deprived of their endorgan. Here we report of our first clinical experience with this method in sixteen patients with longstanding upper and lower extremity neuromas. 16 patients were included in this study. All had neuromas of different sensory nerves of both the upper and lower extremity. 11 were of iatrogenic origin, 5 were caused by different traumas. 8 had previous attempts to surgically treat the neuroma. Finally, all were treated by end-to-side neurorraphy into adjacent nerves. Postoperatively quantitative sensorymotor testing was performed to evaluate possible changes of nerve function of the recipient nerves. Pain was evaluated by visual analogue score and changes in pain medication. In no patient a sensory or motor deficit or painful sensations were induced in the target area of the recipient nerve. Some had dysaesthesias for about 6 months, which finally subsided. All but 1 patient improved in their symptoms at a follow-up of more than 2 years. Previous experimental work and present clinical results suggest that axons of a severed peripheral nerve that are provided with a pathway and target through an end-to-side coaptation will either be pruned or establish some type of end-organ contact so that a neuroma can be prevented without inducing sensory or motor dysfunctions in the recipient nerve. Georg Thieme Verlag KG Stuttgart New York.

General Anesthesia Versus Conscious Sedation in Acute Stroke Treatment: The Importance of Head Immobilization

Energy Technology Data Exchange (ETDEWEB)

Janssen, H., E-mail: hendrik.janssen@med.uni-muenchen.de [Ludwig-Maximilians-University Hospital, Department of Neuroradiology (Germany); Buchholz, G. [Ludwig-Maximilians-University Hospital, Department of Neurology (Germany); Killer, M. [Paracelsus Medical University, Neurology/Research Institute of Neurointervention (Austria); Ertl, L.; Brückmann, H. [Ludwig-Maximilians-University Hospital, Department of Neuroradiology (Germany); Lutz, J. [Ingolstadt Hospital, Department of Neuroradiology (Germany)

2016-09-15

PurposeWhile today mechanical thrombectomy is an established treatment option for main branch occlusions in anterior circulation stroke, there is still an ongoing debate on the kind of anesthesia to be preferred. Introducing a simple method for head stabilization, we analyzed safety and duration of endovascular recanalization procedures under general anesthesia (GA) and conscious sedation (CS).MethodsWe retrospectively identified 84 consecutive patients who underwent mechanical thrombectomy owing to acute anterior circulation stroke. Fifty-three were treated under GA and 31 under CS equipped with a standard cervical collar to reduce head movement. We evaluated recanalization results, in-house time to start recanalization, procedure times, technical and clinical complication rates, and conversion rates from CS to GA.ResultsRecanalization of mTICI ≥2b was achieved in 80 % under CS and in 81 % under GA. Median in-house time to start recanalization for CS was 60 min (IQR 28; 44–72) and 77 min (IQR 23; 68–91) for GA (P = 0.001). Median procedure time under CS was 35 min (IQR 43; 69–25) and 41 min (IQR 43; 66–23) for GA (P = 0.9). No major complications such as ICH occurred in either group, and no conversions from CS to GA were necessary.ConclusionMechanical thrombectomy can be performed faster and safely under CS in combination with simple head immobilization using a standard cervical collar.

General Anesthesia Versus Conscious Sedation in Acute Stroke Treatment: The Importance of Head Immobilization

International Nuclear Information System (INIS)

Janssen, H.; Buchholz, G.; Killer, M.; Ertl, L.; Brückmann, H.; Lutz, J.

2016-01-01

PurposeWhile today mechanical thrombectomy is an established treatment option for main branch occlusions in anterior circulation stroke, there is still an ongoing debate on the kind of anesthesia to be preferred. Introducing a simple method for head stabilization, we analyzed safety and duration of endovascular recanalization procedures under general anesthesia (GA) and conscious sedation (CS).MethodsWe retrospectively identified 84 consecutive patients who underwent mechanical thrombectomy owing to acute anterior circulation stroke. Fifty-three were treated under GA and 31 under CS equipped with a standard cervical collar to reduce head movement. We evaluated recanalization results, in-house time to start recanalization, procedure times, technical and clinical complication rates, and conversion rates from CS to GA.ResultsRecanalization of mTICI ≥2b was achieved in 80 % under CS and in 81 % under GA. Median in-house time to start recanalization for CS was 60 min (IQR 28; 44–72) and 77 min (IQR 23; 68–91) for GA (P = 0.001). Median procedure time under CS was 35 min (IQR 43; 69–25) and 41 min (IQR 43; 66–23) for GA (P = 0.9). No major complications such as ICH occurred in either group, and no conversions from CS to GA were necessary.ConclusionMechanical thrombectomy can be performed faster and safely under CS in combination with simple head immobilization using a standard cervical collar.

Evaluation of End-Products in Architecture Design Process: A Fuzzy Decision-Making Model

Directory of Open Access Journals (Sweden)

Serkan PALABIYIK

2012-06-01

Full Text Available This paper presents a study on the development of a fuzzy multi-criteria decision-making model for the evaluation of end products of the architectural design process. Potentials of the developed model were investigated within the scope of architectural design education, specifically an international design studio titled “Design for Disassembly and Reuse: Design & Building Multipurpose Transformable Pavilions.” The studio work followed a design process that integrated systematic and heuristic thinking. The design objectives and assessment criteria were clearly set out at the beginning of the process by the studio coordinator with the aim of narrowing the design space and increasing awareness of the consequences of design decisions. At the end of the design process, designs produced in the studio were evaluated using the developed model to support decision making. The model facilitated the identification of positive and negative aspects of the designs and selection of the design alternative that best met the studio objectives set at the beginning.

Fuel rod pellet loading head

International Nuclear Information System (INIS)

Howell, T.E.

1975-01-01

An assembly for loading nuclear fuel pellets into a fuel rod comprising a loading head for feeding pellets into the open end of the rod is described. The pellets rest in a perforated substantially V-shaped seat through which air may be drawn for removal of chips and dust. The rod is held in place in an adjustable notched locator which permits alignment with the pellets

Treatment modalities of oral mucositis after radiation of head and neck cancers

International Nuclear Information System (INIS)

Lapeyre, M.; Charra-Brunaud, C.; Kaminsky, M.C.; Geoffrois, L.; Dolivet, G.; Pourel, N.; Marchal, C.; Bey, P.; Maire, F.; Simon, M.; Toussaint, B.

2001-01-01

Acute mucositis is common after radiotherapy for head and neck cancers. During the past 3 decades, there was a gradual evolution in the treatment modalities for locally advanced carcinomas (concomitant radio-chemotherapy, accelerated radiotherapy). These new strategies are accompanied by an increase in early mucosal reactions. At the present time, there is no widely accepted prophylaxis or effective treatment. Many traditional remedies or new agents seem ineffective (Sucralfate, Chlorhexidine, GM-CSF, Silver nitrate, Prostaglandin, anti-oxidants, Benzydamine hydrochloride), while others seem promising (Povidone-iodine, nonabsorbable antibiotic lozenges and anti-fungal, local GM-CSF, Glutamide, Low-energy laser, corticosteroids). Radioprotectors are controversial and should be only used in experimental protocols and not in routine practice. However, some recommendations can be proposed: general prevention and global care before cancer therapy should be systematic (oral hygiene, dental and periodontal treatment, advice to avoid the use of tobacco and alcohol); frequent oral rinsing with a bland mouthwash (Povidone-iodine or others) should be used at the start of treatment because there are significant modifications of the oral microflora increased by a disturbed salivary flow; these mouthwashes could be associated with nonabsorbable antibiotic lozenges or anti-fungal topical (bicarbonates, Amphotericine B); Systematic percutaneous fluoroscopic gastrostomy should be decided before any aggressive treatments (concomitant radio-chemotherapy, accelerated radiotherapy); pain should be controlled; finally, the radiation technique should be optimized (mucosal sparing block, conformal radiotherapy and intensity modulated radiation therapy). (authors)

Optimization of lime treatment processes

International Nuclear Information System (INIS)

Zinck, J. M.; Aube, B. C.

2000-01-01

Lime neutralization technology used in the treatment of acid mine drainage and other acidic effluents is discussed. Theoretical studies and laboratory experiments designed to optimize the technology of lime neutralization processes and to improve the cost efficiency of the treatment process are described. Effluent quality, slaking temperature, aeration, solid-liquid separation, sludge production and geochemical stability have been studied experimentally and on site. Results show that through minor modification of the treatment process, costs, sludge volume generated, and metal released to the environment can be significantly reduced. 17 refs., 4 figs

Molecularly targeted therapy for the treatment of head and neck cancer: a review of the ErbB family inhibitors

Directory of Open Access Journals (Sweden)

Sacco AG

2016-04-01

Full Text Available Assuntina G Sacco,1 Francis P Worden2 1Department of Internal Medicine, Division of Hematology/Oncology, University of California at San Diego Moores Cancer Center, La Jolla, CA, USA; 2Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan Health System, Ann Arbor, MI, USA Abstract: The majority of patients with head and neck squamous cell carcinoma (HNSCC present with locally advanced disease, which requires site-specific combinations of surgery, radiation, and chemotherapy. Despite aggressive therapy, survival outcomes remain poor, and treatment-related morbidity is not negligible. For patients with recurrent or metastatic disease, therapeutic options are further limited and prognosis is dismal. With this in mind, molecularly targeted therapy provides a promising approach to optimizing treatment efficacy while minimizing associated toxicity. The ErbB family of receptors (ie, epidermal growth factor receptor [EGFR], ErbB2/human epidermal growth factor receptor [HER]-2, ErbB3/HER3, and ErbB4/HER4 is known to contribute to oncogenic processes, such as cellular proliferation and survival. EGFR, specifically, is upregulated in more than 90% of HNSCC, has been implicated in radiation resistance, and correlates with poorer clinical outcomes. The central role of EGFR in the pathogenesis of HNSCC suggests that inhibition of this pathway represents an attractive treatment strategy. As a result, EGFR inhibition has been extensively studied, with the emergence of two classes of drug therapy: monoclonal antibodies and tyrosine kinase inhibitors. While the monoclonal antibody cetuximab is currently the only US Food and Drug Administration–approved EGFR inhibitor for the treatment of HNSCC, numerous investigational drugs are being evaluated in clinical trials. This paper will review the role of the ErbB family in the pathogenesis of HNSCC, as well as the evidence-based data for the use of ErbB family inhibition in clinical

Physics of radiation therapy of head and neck tumors

International Nuclear Information System (INIS)

Almond, P.R.

1987-01-01

Radiotherapy treatment of head and neck cancers probably requires more individual planning than for any other cancer site because of the large number of variables that exist. The fact that tumors may be superficial or relatively deep-seated, the complex shape of the head and neck region, the presence of significant inhomogeneities such as bone and air spaces, and the need to spare critical structures such as the eyes or central nervous system all add to the need for careful considerations of the physical parameters involved in radiotherapy. In addition, the high mobility of the head allows it to assume a wide variety of positions so that techniques have had to be developed for careful simulation, repositioning, and immobilization during treatment. In the head and neck region shaping of the beam becomes important, and therefore, blocked fields, compensators, or wedges are often used. Although the specific radiotherapy techniques for each site of head and neck cancer are described in the various chapters of this book, a general description of the various types of radiation beams, radioactive sources, beam modifiers, treatment planning techniques, and treatment implementation is given in this chapter. The discussion is divided into three main categories: (1) external beam, (2) brachytherapy, and (3) simulation and immobilization

Implant-prosthetic rehabilitation after radiation treatment in head and neck cancer patients: a case-series report of outcome

Directory of Open Access Journals (Sweden)

Cotic Jasna

2016-02-01

Full Text Available Slovenia has a high burden of head and neck cancer. Patients are mostly treated with surgery followed by radiation therapy. Advanced surgical and prosthodontic techniques have expanded the rehabilitation options. The aim of the study was to review the outcome of implant-prosthetic treatment after radiation therapy.

An initial experience using concurrent paclitaxel and radiation in the treatment of head and neck malignancies

International Nuclear Information System (INIS)

Tishler, Roy B.; Busse, Paul M.; Norris, Charles M.; Rossi, Rene; Poulin, Mark; Thornhill, Lee; Costello, Rosemary; Peters, Edward S.; Colevas, A. Dimitrios; Posner, Marshall R.

1999-01-01

Background: Combined modality therapy plays a central role in the management of head and neck malignancies. This study examined the feasibility and preliminary results of treating a group of patients using concurrent bolus paclitaxel (Taxol TM ) and radiation therapy. Methods: Fourteen patients with a median age of 56 years (range 42-81) were treated. Paclitaxel was given every 3 weeks at a dose of 100 mg/m 2 concurrently with external beam radiation. The patients treated included those who had failed to achieve a complete response (CR) to induction chemotherapy with cisplatin, 5-fluorouracil, and leucovorin (PFL), or who had locally advanced disease not previously treated. Results: Median follow-up from the initiation of treatment is 40 months (range 23-48). The majority of patients (13/14) achieved clinical CRs at the primary site. The development of responses was characterized by a long time course. Three patients who were nonresponders (NRs) to induction PFL chemotherapy were treated. One was a clinical CR at the primary site, one did not achieve a CR, and the other had residual disease in the neck. Four patients have failed, one with local-regional disease, one with a marginal failure, one with distant metastases, and one was not rendered disease-free by the treatment. As expected, significant local toxicity was observed. Most patients were managed with the aid of a percutaneous endoscopic gastrostomy (PEG). Two patients experienced significant moist desquamation and required treatment breaks of greater than 1 week. Conclusion: Paclitaxel can be given on a 3-week schedule at 100 mg/m 2 concurrently with radiation. The preliminary results indicate good local responses and acceptable toxicity. This treatment approach merits further study in the treatment of head and neck malignancies, and should be considered as an option in other sites

Effect of Radiotherapy Interruptions on Survival in Medicare Enrollees With Local and Regional Head-and-Neck Cancer

International Nuclear Information System (INIS)

Fesinmeyer, Megan Dann; Mehta, Vivek; Blough, David; Tock, Lauri; Ramsey, Scott D.

2010-01-01

Purpose: To investigate whether interruptions in radiotherapy are associated with decreased survival in a population-based sample of head-and-neck cancer patients. Methods and Materials: Using the Surveillance, Epidemiology, and End Results-Medicare linked database we identified Medicare beneficiaries aged 66 years and older diagnosed with local-regional head-and-neck cancer during the period 1997-2003. We examined claims records of 3864 patients completing radiotherapy for the presence of one or more 5-30-day interruption(s) in therapy. We then performed Cox regression analyses to estimate the association between therapy interruptions and survival. Results: Patients with laryngeal tumors who experienced an interruption in radiotherapy had a 68% (95% confidence interval, 41-200%) increased risk of death, compared with patients with no interruptions. Patients with nasal cavity, nasopharynx, oral, salivary gland, and sinus tumors had similar associations between interruptions and increased risk of death, but these did not reach statistical significance because of small sample sizes. Conclusions: Treatment interruptions seem to influence survival time among patients with laryngeal tumors completing a full course of radiotherapy. At all head-and-neck sites, the association between interruptions and survival is sensitive to confounding by stage and other treatments. Further research is needed to develop methods to identify patients most susceptible to interruption-induced mortality.

Cytogenetic damage in circulating lymphocytes and buccal mucosa cells of head-and-neck cancer patients undergoing radiotherapy

International Nuclear Information System (INIS)

Minicucci, E.M.; Ribeiro, L.R.; Camargo, J.L.V. de; Salvadori, D.M.F.

2005-01-01

This study evaluated cytogenetic damage by measuring the frequency of micronucleated cells (MNC) in peripheral blood and buccal mucosa of head-and-neck cancer patients undergoing radiotherapy. MNC frequencies were assessed in 31 patients before, during, and after radiotherapy, and in 17 healthy controls matched for gender, age, and smoking habits. Results showed no statistically significant difference between patients and controls prior to radiotherapy in cytokinesis-blocked lymphocytes or buccal mucosa cells. During treatment, increased MNC frequencies were observed in both cell types. Micronucleated lymphocyte levels remained high in samples collected 30 to 140 days after the end of treatment, while MNC frequency in buccal mucosa decreased to values statistically similar to baseline values. There is controversy over the effects of age, smoking habit, tumor stage, and/or metastasis on MNC frequency. However, increased frequency of micronucleated buccal mucosa cells was seen in patients under 60 years old and in those with tumors >4 cm. In conclusion, the data show that radiotherapy has a potent clastogenic effect in circulating lymphocytes and buccal mucosa cells of head-and-neck cancer patients, and that the baseline MNC frequency in these two tissues is not a sensitive marker for head-and neck neoplasm. (author)

Coordination of head movements and speech in first encounter dialogues

DEFF Research Database (Denmark)

Paggio, Patrizia

2015-01-01

This paper presents an analysis of the temporal alignment be- tween head movements and associated speech segments in the NOMCO corpus of first encounter dialogues [1]. Our results show that head movements tend to start slightly before the onset of the corresponding speech sequence and to end...... slightly after, but also that there are delays in both directions in the range of -/+ 1s. Various factors that may influence delay duration are investigated. Correlations are found between delay length and the duration of the speech sequences associated with the head movements. Effects due to the different...

End-of-treatment and serial PET imaging in primary mediastinal B-cell lymphoma following dose-adjusted-EPOCH-R: A paradigm shift in clinical decision making.

Science.gov (United States)

Melani, Christopher; Advani, Ranjana; Roschewski, Mark; Walters, Kelsey M; Chen, Clara C; Baratto, Lucia; Ahlman, Mark A; Miljkovic, Milos D; Steinberg, Seth M; Lam, Jessica; Shovlin, Margaret; Dunleavy, Kieron; Pittaluga, Stefania; Jaffe, Elaine S; Wilson, Wyndham H

2018-05-10

Dose-adjusted-EPOCH-R obviates the need for radiotherapy in most patients with primary mediastinal B-cell lymphoma. End-of-treatment PET, however, does not accurately identify patients at risk of treatment failure, thereby confounding clinical decision making. To define the role of PET in primary mediastinal B-cell lymphoma following dose-adjusted-EPOCH-R, we extended enrollment and follow-up on our published phase II trial and independent series. Ninety-three patients received dose-adjusted-EPOCH-R without radiotherapy. End-of-treatment PET was performed in 80 patients, of whom 57 received 144 serial scans. One nuclear medicine physician from each institution blindly reviewed all scans from their respective institution. End-of-treatment PET was negative (Deauville 1-3) in 55 (69%) patients with one treatment failure (8-year event-free and overall survival of 96.0% and 97.7%). Among 25 (31%) patients with a positive (Deauville 4-5) end-of-treatment PET, there were 5 (20%) treatment failures (8-year event-free and overall survival of 71.1% and 84.3%). Linear regression analysis of serial scans showed a significant decrease in SUVmax in positive end-of-treatment PET non-progressors compared to an increase in treatment failures. Among 6 treatment failures, the median end-of-treatment SUVmax was 15.4 (range, 1.9-21.3) and 4 achieved long-term remission with salvage therapy. Virtually all patients with a negative end-of-treatment PET following dose-adjusted-EPOCH-R achieved durable remissions and should not receive radiotherapy. Among patients with a positive end-of-treatment PET, only 5/25 (20%) had treatment-failure. Serial PET imaging distinguished end-of-treatment PET positive patients without treatment failure, thereby reducing unnecessary radiotherapy by 80%, and should be considered in all patients with an initial positive PET following dose-adjusted-EPOCH-R (NCT00001337). Copyright © 2018, Ferrata Storti Foundation.

Small cell carcinoma of the head and neck: A comparative study by primary site based on population data.

Science.gov (United States)

Kuan, Edward C; Alonso, Jose E; Tajudeen, Bobby A; Arshi, Armin; Mallen-St Clair, Jon; St John, Maie A

2017-08-01

Small cell carcinoma (SmCC) of the head and neck is an extremely rare neuroendocrine malignancy. In this study, we describe the incidence and determinants of survival of patients with SmCC of the head and neck between the years of 1973 and 2012 using the Surveillance, Epidemiology, and End Results database as differed by primary site. Retrospective, population-based cohort study. A total of 237 cases of SmCC of the head and neck were identified, which was divided into sinonasal primaries (n = 82) and all other head and neck primaries (n = 155). Clinicopathologic and epidemiologic variables were analyzed as predictors of overall survival (OS) and disease-specific survival (DSS) based on the Kaplan-Meier method. More than half of sinonasal primaries presented with Kadish stage C or D. On multivariate analysis, surgery was the only independent predictor of improved DSS (P = .008) for sinonasal primaries; in contrast, radiation therapy was a favorable prognosticator for OS (P = .007) and DSS (P = .043) in extrasinonasal sites. Comparison of survival between sinonasal primaries and all other sites demonstrated that sinonasal SmCC had uniformly better OS (P = .002) and DSS (P = .006). SmCC in the head and neck remains rare, and sinonasal primaries appear to have improved survival compared to other sites. Based on these results, optimal treatment for sinonasal SmCC appears to be surgical therapy, whereas radiation therapy is the preferred treatment for SmCC of other primary sites, particularly the larynx. 4. Laryngoscope, 127:1785-1790, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

End-of-life decisions: Christian perspectives.

Science.gov (United States)

Stempsey, William E

1997-12-01

While legal rights to make medical treatment decisions at the end of one's life have been recognized by the courts, particular religious traditions put axiological and metaphysical meat on the bare bones of legal rights. Mere legal rights do not capture the full reality, meaning and importance of death. End-of-life decisions reflect not only the meaning we find in dying, but also the meaning we have found in living. The Christian religions bring particular understandings of the vision of life as a gift from God, human responsibility for stewardship of that life, the wholeness of the person, and the importance of the dying process in preparing spiritually for life beyond earthly life, to bear on end-of-life decisions.

Efficacy of Positive Thinking Training on the Family Process and Subjective Wellbeing of Female Heads of Household

Directory of Open Access Journals (Sweden)

محمد خدایاری فرد

2017-03-01

Full Text Available The present study was designed to investigate the efficacy of positive thinking training on family process and subjective wellbeing of female heads of household. The method was a semi-experimental with pretest-posttest and control group; and the study population included all female heads of household residing in Chaharbagh, Alborz province, who have at least one primary school-kid.  Using available sampling method, 50 women were selected among school-students’ mothers, and were randomly assigned into two equal groups of experimental and control groups. Both groups filled Self-Report Family Process Scale (SFPS and Subjective Wellbeing Questionnaire (SWQ. The experimental group received positive thinking training for eight 2-hours-sessions. Then, all participants were assessed again as the posttest. The data were analyzed by covariance analysis method. Findings showed that after the intervention family process scores of experimental group had been significantly improved, while subjective wellbeing scores had not significantly enhanced. Therefore, it can be told that the present program was effective in increasing the family process, though it went ineffective in improving subjective wellbeing in these irritable individuals. Thus, altering and enriching the program and conducting further investigations seems necessary.

The value of routine follow-up after treatment for head and neck cancer. A National Survey from DAHANCA

DEFF Research Database (Denmark)

Pagh, Anja; Vedtofte, Thomas; Lynggaard, Charlotte Duch

2013-01-01

The post-treatment follow-up is well-integrated in the oncologic care tradition, based on the risk of developing recurrent disease or new primary tumors in treated patients. Furthermore, follow-up serves as an opportunity to monitor treatment effects and to provide clinical care of side effects....... In this study we measured the activity and effectiveness of routine follow-up in head and neck cancer and assessed the value of follow-up from the perspectives of both physicians and the patients....

Rotating head for air, gas and mud drilling

Energy Technology Data Exchange (ETDEWEB)

Pruitt, A.B.

1983-05-17

A rotating head assembly having roller thrust bearings rotatably journaling an inner barrel is provided with pump means for continuous forced circulation of lubricating oil to, and around, the thrust bearings during operation. A lubricating oil chamber substantially surrounds the bearings, which chamber is effectively sealed against leakage of oil fluids, and other debris, into the chamber and lubricating oil out of the chamber. The lower end of the rotatably journaled inner barrel is provided with a stripper rubber structured to enable use of the head with drill pipe of diverse outer diameters.

Intimacy processes and psychological distress among couples coping with head and neck or lung cancers.

Science.gov (United States)

Manne, Sharon; Badr, Hoda

2010-09-01

Couples coping with head and neck and lung cancers are at increased risk for psychological and relationship distress given patients' poor prognosis and aggressive and sometimes disfiguring treatments. The relationship intimacy model of couples' psychosocial adaptation proposes that relationship intimacy mediates associations between couples' cancer-related support communication and psychological distress. Because the components of this model have not yet been evaluated in the same study, we examined associations between three types of cancer-related support communication (self-disclosure, perceived partner disclosure, and protective buffering), intimacy (global and cancer-specific), and global distress among patients coping with either head and neck or lung cancer and their partners. One hundred and nine patients undergoing active treatment and their partners whose average time since diagnosis was 15 months completed cross-sectional surveys. For both patients and their partners, multilevel analyses using the actor-partner interdependence model showed that global and cancer-specific intimacy fully mediated associations between self- and perceived partner disclosure and distress; global intimacy partially mediated the association between protective buffering and distress. Evidence for moderated mediation was found; specifically, lower levels of distress were reported as a function of global and cancer-specific intimacy, but these associations were stronger for partners than for patients. Enhancing relationship intimacy by disclosing cancer-related concerns may facilitate both partners' adjustment to these illnesses. (c) 2010 John Wiley & Sons, Ltd.

Accounting for the fringe magnetic field from the bending magnet in a Monte Carlo accelerator treatment head simulation.

Science.gov (United States)

O'Shea, Tuathan P; Foley, Mark J; Faddegon, Bruce A

2011-06-01

Monte Carlo (MC) simulation can be used for accurate electron beam treatment planning and modeling. Measurement of large electron fields, with the applicator removed and secondary collimator wide open, has been shown to provide accurate simulation parameters, including asymmetry in the measured dose, for the full range of clinical field sizes and patient positions. Recently, disassembly of the treatment head of a linear accelerator has been used to refine the simulation of the electron beam, setting tightly measured constraints on source and geometry parameters used in simulation. The simulation did not explicitly include the known deflection of the electron beam by a fringe magnetic field from the bending magnet, which extended into the treatment head. Instead, the secondary scattering foil and monitor chamber were unrealistically laterally offset to account for the beam deflection. This work is focused on accounting for this fringe magnetic field in treatment head simulation. The magnetic field below the exit window of a Siemens Oncor linear accelerator was measured with a Tesla-meter from 0 to 12 cm from the exit window and 1-3 cm off-axis. Treatment head simulation was performed with the EGSnrc/BEAMnrc code, modified to incorporate the effect of the magnetic field on charged particle transport. Simulations were used to analyze the sensitivity of dose profiles to various sources of asymmetry in the treatment head. This included the lateral spot offset and beam angle at the exit window, the fringe magnetic field and independent lateral offsets of the secondary scattering foil and electron monitor chamber. Simulation parameters were selected within the limits imposed by measurement uncertainties. Calculated dose distributions were then compared with those measured in water. The magnetic field was a maximum at the exit window, increasing from 0.006 T at 6 MeV to 0.020 T at 21 MeV and dropping to approximately 5% of the maximum at the secondary scattering foil. It

Storage of intact heads prior to processing limits the shelf-life of fresh-cut Lactuca sativa L.

NARCIS (Netherlands)

Witkowska, I.M.; Woltering, E.J.

2014-01-01

Harvested lettuce heads are usually transported and stored for some period of time under a variety of conditions prior to processing. During storage, especially under suboptimal conditions, nutritional composition of the harvested produce continues to change. The possible impact of prior storage of

COMBINED COMPOST AND VERMICOMPOSTING PROCESS IN THE TREATMENT AND BIOCONVERSION OF SLUDGE

Directory of Open Access Journals (Sweden)

H. Alidadi, A. R. Parvaresh and M. R. Shamansouri

2005-10-01

Full Text Available Traditional thermophillic composting is commonly for treatment of sludge. A related technique as vermicomposting process, using earthworms to breakdown sludge, is also becoming popular. These two techniques have their inherent advantages and disadvantages. The combined approach suggested in this study to enhance the overall process and improve the products qualities. Two systems,vermicomposting and combined compost vermicomposting processes, have been investigated in this study. The sludge used in this study was obtained from the drying beds of South Isfahan wastewater treatment plant.The sludge mixed with sawdust to provide C/N ratio of 25/1.Eisenia fetida was the species of earthworms used in the vermicomposting processes.The results obtained indicates reduction in the amount of volatile solids,total carbon and C/N ratio with the vermicompost age,which indicates the reduction in the biodegradable organic content and mineralization of sludge. Also increase in phosphorus concentration by the end process because of mineralization of organic matter. The results indicate that, a system that combines the two mentioned processes not only shortens stabilization time, but also improves the products quality. Combining the two systems resulted in a product that was more stable and homogenous; the product could meet the pathogen reduction requirements.

Heading and head injuries in soccer.

Science.gov (United States)

Kirkendall, D T; Jordan, S E; Garrett, W E

2001-01-01

In the world of sports, soccer is unique because of the purposeful use of the unprotected head for controlling and advancing the ball. This skill obviously places the player at risk of head injury and the game does carry some risk. Head injury can be a result of contact of the head with another head (or other body parts), ground, goal post, other unknown objects or even the ball. Such impacts can lead to contusions, fractures, eye injuries, concussions or even, in rare cases, death. Coaches, players, parents and physicians are rightly concerned about the risk of head injury in soccer. Current research shows that selected soccer players have some degree of cognitive dysfunction. It is important to determine the reasons behind such deficits. Purposeful heading has been blamed, but a closer look at the studies that focus on heading has revealed methodological concerns that question the validity of blaming purposeful heading of the ball. The player's history and age (did they play when the ball was leather and could absorb significant amounts of water), alcohol intake, drug intake, learning disabilities, concussion definition and control group use/composition are all factors that cloud the ability to blame purposeful heading. What does seem clear is that a player's history of concussive episodes is a more likely explanation for cognitive deficits. While it is likely that the subconcussive impact of purposeful heading is a doubtful factor in the noted deficits, it is unknown whether multiple subconcussive impacts might have some lingering effects. In addition, it is unknown whether the noted deficits have any affect on daily life. Proper instruction in the technique is critical because if the ball contacts an unprepared head (as in accidental head-ball contacts), the potential for serious injury is possible. To further our understanding of the relationship of heading, head injury and cognitive deficits, we need to: learn more about the actual impact of a ball on the

Screening of Serum Protein Markers for Avascular Osteonecrosis of Femoral Head Differentially Expressed after Treatment with Yuanshi Shengmai Chenggu Tablets

Directory of Open Access Journals (Sweden)

Peng Deng

2018-01-01

Full Text Available Avascular necrosis of the femoral head (ANFH is an a frequently occurring orthopaedic disease with high morbidity. Traditional Chinese Medicine (TCM Yuanshi Shengmai Chenggu Tablet is a valid prescription for treating steroid-induced femoral head necrosis. However, there are rare investigations about the serum protein marker expression after the acting of drugs on hormone and TCM. In the present study, we aimed to systematically discover and validate the serum biomarkers expression difference in patients with steroid-induced avascular necrosis of femoral head (SANFH after taking Yuanshi Shengmai Chenggu Tablets (SANFH-TCM, so as to reveal the action mechanism of TCM from the molecular level by using isobaric tags for relative and absolute quantification (iTRAQ with multiple reaction monitoring quantification. Significant differences in fibrinogen alpha, fibrinogen beta, fibrinogen gamma, fibronectin, C-reactive protein, apolipoprotein A, apolipoprotein D, and apolipoprotein E were found among SANFH, SANFH-TCM, and healthy controls. Therefore, our study proposes potential biomarkers for SANFH diagnosis and for the prognosis of femoral head necrosis after Traditional Chinese Medicine treatment.

A multicentre ‘end to end’ dosimetry audit for cervix HDR brachytherapy treatment

International Nuclear Information System (INIS)

Palmer, Antony L.; Diez, Patricia; Gandon, Laura; Wynn-Jones, Andrea; Bownes, Peter; Lee, Chris; Aird, Edwin; Bidmead, Margaret; Lowe, Gerry; Bradley, David; Nisbet, Andrew

2015-01-01

Purpose: To undertake the first multicentre fully ‘end to end’ dosimetry audit for HDR cervix brachytherapy, comparing planned and delivered dose distributions around clinical treatment applicators, with review of local procedures. Materials and methods: A film-dosimetry audit was performed at 46 centres, including imaging, applicator reconstruction, treatment planning and delivery. Film dose maps were calculated using triple-channel dosimetry and compared to RTDose data from treatment planning systems. Deviations between plan and measurement were quantified at prescription Point A and using gamma analysis. Local procedures were also discussed. Results: The mean difference between planned and measured dose at Point A was −0.6% for plastic applicators and −3.0% for metal applicators, at standard uncertainty 3.0% (k = 1). Isodose distributions agreed within 1 mm over a dose range 2–16 Gy. Mean gamma passing rates exceeded 97% for plastic and metal applicators at 3% (local) 2 mm criteria. Two errors were found: one dose normalisation error and one applicator library misaligned with the imaged applicator. Suggestions for quality improvement were also made. Conclusions: The concept of ‘end to end’ dosimetry audit for HDR brachytherapy has been successfully implemented in a multicentre environment, providing evidence that a high level of accuracy in brachytherapy dosimetry can be achieved

Computed Tomography (CT) -- Head

Medline Plus

Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos About Us News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Head ...

Treatment of locally advanced adenoid cystic carcinoma of the head and neck with neutron radiotherapy

International Nuclear Information System (INIS)

Douglas, James G.; Laramore, George E.; Austin-Seymour, Mary; Koh Wuijin; Stelzer, Keith; Griffin, Thomas W.

2000-01-01

Purpose: To examine the efficacy of fast neutron radiotherapy for the treatment of locally advanced and/or recurrent adenoid cystic carcinoma of the head and neck and to identify prognostic variables associated with local-regional control and survival. Methods and Materials: One hundred fifty-nine patients with nonmetastatic, previously unirradiated, locally advanced, and/or recurrent adenoid cystic carcinoma (ACC) of the head and neck region were treated with fast neutron radiotherapy during the years 1985-1997. One hundred fifty-one patients had either unresectable disease, or gross residual disease (GRD) after an attempted surgical extirpation. Eight patients had microscopic residual disease and were analyzed separately. Sixty-two percent of patients had tumors arising in minor salivary glands, 29% in major salivary glands, and 9% in other sites such as the lacrimal glands, tracheal-bronchial tree, etc. Fifty-five percent of patients were treated for postsurgical recurrent disease and 13% of patients had lymph node involvement at the time of treatment. The median duration of follow-up was 32 months (range 3-142 months). Actuarial curves for survival, cause-specific survival, local-regional control, and the development of distant metastases are presented for times out to 11 years. Results: The 5-year actuarial local-regional tumor control rate for the 151 patients with GRD was 57%; the 5-year actuarial overall survival rate was 72%; and the 5-year actuarial cause-specific survival rate was 77%. Variables associated with decreased local-regional control in the patients with GRD as determined by multivariate analysis included base of skull involvement (p < 0.01) and biopsy only versus an attempted surgical resection prior to treatment (p = 0.03). Patients without these negative factors had an actuarial local-regional control rate of 80% at 5 years. Patients with microscopic residual disease (n = 8) had a 5-year actuarial local-regional control rate of 100%. Base of

Merkel cell carcinoma of the head and neck: poorer prognosis than non-head and neck sites.

Science.gov (United States)

Morand, G B; Madana, J; Da Silva, S D; Hier, M P; Mlynarek, A M; Black, M J

2016-04-01

Merkel cell carcinoma is a rare, aggressive neurocutaneous malignancy. This study investigated whether patients with Merkel cell carcinoma in the head and neck had poorer outcomes than patients with Merkel cell carcinoma located elsewhere. A retrospective study was performed of patients with Merkel cell carcinoma treated at the Jewish General Hospital in Montréal, Canada, from 1993 to 2013. Associations between clinicopathological characteristics and disease-free and disease-specific survival rates were examined according to the Kaplan-Meier method. Twenty-seven patients were identified. Although basic clinicopathological characteristics and treatments were similar between head and neck and non-head and neck Merkel cell carcinoma groups, disease-free and disease-specific survival rates were significantly lower in the head and neck Merkel cell carcinoma group (log-rank test; p = 0.043 and p = 0.001, respectively). Mortality was mainly due to distant metastasis. Patients with head and neck Merkel cell carcinoma had poorer survival rates than patients with non-head and neck Merkel cell carcinoma in our study. The tendency to obtain close margins, a less predictable metastatic pattern, and/or intrinsic tumour factors related to the head and neck may explain this discrepancy.

MODIFIED USE OF A DYNAMIC BITE OPENER - TREATMENT AND PREVENTION OF TRISMUS IN A CHILD WITH HEAD AND NECK-CANCER - A CASE-REPORT

NARCIS (Netherlands)

DIJKSTRA, PU; KROPMANS, TJB; TAMMINGA, RYJ

1992-01-01

Trismus may be a complication arising during or after treatment of patients with head and neck cancer. Treatment of trismus is difficult, making prevention very important. To prevent and treat trismus in a patient with a nasopharyngeal tumor, the Contract-Relax-Antagonist-Contract (CRAC) technique

Monoisocentric three-beam split field technique for conventional treatment in the head and neck cancer using asymmetrical collimators

International Nuclear Information System (INIS)

Sriram Prasath, S.; Prabagaran, C.; Sanyal, B.; Sarkar, B.

2008-01-01

The importance of treatment planning of head and neck malignancies arises from the necessity to achieve homogenous doses to localized target volume surrounded by normal structures, which can produce acute and long-term morbidity. In many radiotherapy departments, a commonly employed strategy is a 3-field technique. Bilateral parallel-opposed fields are matched to anterior lower neck field. When the target extends to the lower neck regions, abutment of upper and lower neck fields is required. Field matching represents a technical challenge for the Medical Physicist and Radiation Oncologist to treat multiple fields while avoiding their overlap on the spinal cord. The aim of this work is to review merits, limitations and recent approaches to optimize matchline dose in Monoisocentric technique in conventional treatment for head and neck cancers. Although the technique has many advantages, it is subjected to some systematic and random errors due to equipment and patient setup accuracies. To decrease the magnitude of matchline inhomogeneities, multi leaf collimator have been used. This method is viable and represents alternative approaches to the problem of field matching using the asymmetric jaws

Afatinib versus methotrexate as second-line treatment in patients with recurrent or metastatic squamous-cell carcinoma of the head and neck progressing on or after platinum-based therapy (LUX-Head & Neck 1)

DEFF Research Database (Denmark)

Machiels, Jean-Pascal H; Haddad, Robert I; Fayette, Jérôme

2015-01-01

BACKGROUND: Patients with recurrent or metastatic squamous-cell carcinoma of the head and neck (HNSCC) progressing after first-line platinum regimens have a poor prognosis and few treatment options. Afatinib, an irreversible ERBB family blocker, has shown efficacy in a phase 2 study in this setting......%]), and neutropenia (1 [... provide important new insights into the treatment of this patient population and support further investigations with irreversible ERBB family blockers in HNSCC. FUNDING: Boehringer Ingelheim....

CMOS front-end electronics for radiation sensors

CERN Document Server

AUTHOR|(CDS)2071026

2015-01-01

This book offers a comprehensive treatment of front-end electronics for radiation detection. It discusses the fundamental principles of signal processing for radiation detectors and describes circuits at the level of functional building blocks, omitting transistor-level implementation. It also covers important system-level topics commonly found in the world of front-end electronics for radiation sensors. The book develops the topics in detail, with a constant focus on practical problems. It also provides real implementation examples that offer insights and stimuli for more experienced engineers already working in the field.

ARTHROSCOPIC METHOD OF THE RADIAL HEAD FRACTURE OSTEOSYNTHESIS (СASE REPORT

Directory of Open Access Journals (Sweden)

I. A. Kuznetsov

2016-01-01

Full Text Available Radial head fractures constitute about 3% of all fractures and 30% within the group of elbow joint injuries. Conventional open surgical treatment is accompanied by an extensive soft tissue incision and sometimes by capsule release for adequate visualization. Arthroscopic methods feature relatively insignificant soft tissue trauma, allow to reduce pain syndrome in postoperative period and to accelerate rehabilitation. Besides, arthroscopy improves surgical view in cases of intraarticular fractures and facilitates a better anatomical reduction of articular surface. The authors demonstrate a clinical case of a patient with closed fractures of radial head and ulna coronoid process with displacement of left elbow joint fragments where arthroscopic surgery provided for good anatomical and functional results.

Dosimetric evaluation of abutted fields using asymmetric collimators for treatment of head and neck

International Nuclear Information System (INIS)

Saw, Cheng B.; Krishna, Komanduri V.; Enke, Charles A.; Hussey, David H.

2000-01-01

Purpose: The objective of this study was to reevaluate the dose nonuniformity of abutted fields defined using asymmetric collimators and one isocenter for treatment of the head and neck region. Methods and Materials: Bilateral parallel-opposed fields abutted to the anterior field at one isocenter were implemented in the treatment of head and neck. The effect of digital display tolerance can produce dose nonuniformity at the junction of the abutted fields. The amount of dose nonuniformity was quantified using both mathematical summation of dose profiles and by direct measurement of doses at the junction of the two abutted fields. The dose nonuniformity was obtained by irradiating the superior part of a film using bilateral parallel-opposed fields and the inferior part by an anterior field with a gap or an overlap. Dose profiles were taken at the depth of maximum dose for the anterior field across the abutted fields. The dose nonuniformity was determined for the case where the asymmetric jaw was set at -2 mm, -1 mm, 0, +1 mm, and +2 mm from the beam central axis. Results: The dose at the junction increases systematically as the abutment of the fields changes from a gap to an overlap. The dose nonuniformity with 1-mm gap and 1-mm overlap is about 15% underdose and overdose, respectively. Conclusion: Imperfect abutment of split fields due to digital display tolerance (no. +-no. 1 mm) of asymmetric collimator can cause an underdose or overdose of 15% of the delivered dose

NRS-2002 for pre-treatment nutritional risk screening and nutritional status assessment in head and neck cancer patients.

Science.gov (United States)

Orell-Kotikangas, Helena; Österlund, Pia; Saarilahti, Kauko; Ravasco, Paula; Schwab, Ursula; Mäkitie, Antti A

2015-06-01

The aim of this study was to assess the value of nutritional risk screening-2002 (NRS-2002) as a nutritional risk screening and status assessment method and to compare it with nutritional status assessed by subjective and objective methods in the screening of head and neck cancer patients. Sixty-five consecutive patients (50 male), with a median age of 61 years (range, 33-77), with head and neck squamous cell carcinoma (HNSCC) were enrolled prior to cancer therapy. Nutritional status was assessed by NRS-2002, patient-generated subjective global assessment (PG-SGA), handgrip strength (HGS) and mid-arm muscle area (MAMA). Twenty-eight percent of patients were at nutritional risk based on NRS-2002, and 34 % were malnourished according to PG-SGA, while 43 % had low HGS. NRS-2002 cut-off score of ≥3 compared with the nutritional status according to PG-SGA showed 77 % specificity and 98 % sensitivity (K = 0.78). NRS-2002 was able to predict malnutrition (PG-SGA BC) both in men (p nutrition screening in head and neck cancer patients prior to oncological treatment.

The current status of oncolytic viral therapy for head and neck cancer

Directory of Open Access Journals (Sweden)

Matthew O. Old

2016-06-01

Full Text Available Objective: Cancer affects the head and neck region frequently and leads to significant morbidity and mortality. Oncolytic viral therapy has the potential to make a big impact in cancers that affect the head and neck. We intend to review the current state of oncolytic viruses in the treatment of cancers that affect the head and neck region. Method: Data sources are from National clinical trials database, literature, and current research. Results: There are many past and active trials for oncolytic viruses that show promise for treating cancers of the head and neck. The first oncolytic virus was approved by the FDA October 2015 (T-VEC, Amgen for the treatment of melanoma. Active translational research continues for this and many other oncolytic viruses. Conclusion: The evolving field of oncolytic viruses is impacting the treatment of head and neck cancer and further trials and agents are moving forward in the coming years. Keywords: Head and neck squamous cell carcinoma, Oncolytic viruses, Clinical trials, Novel therapeutics

The value of routine follow-up after treatment for head and neck cancer. A national DAHANCA study

DEFF Research Database (Denmark)

Pagh, Anja; Vedtofte, Thomas; Lynggaard, Charlotte Duch

BACKGROUND: The post-treatment follow-up is well-integrated in the oncologic care tradition, based on the risk of developing recurrent disease or new primary tumors in treated patients. Furthermore, follow-up serves as an opportunity to monitor treatment effects and to provide clinical care of side...... effects. In this study we measured the activity and effectiveness of routine follow-up in head and neck cancer and assessed the value of follow-up from the perspectives of both physicians and the patients. PATIENTS AND METHODS: During a period of six weeks a prospective national cross section cohort...

Surgical treatment of pancreas divisum causing chronic pancreatitis: the outcome benefits of duodenum-preserving pancreatic head resection.

Science.gov (United States)

Schlosser, W; Rau, B M; Poch, B; Beger, H G

2005-01-01

Pancreas divisum (PD) represents a duct anomaly in the pancreatic head ducts, leading frequently leading to recurrent acute pancreatitis (rAP) or chronic pancreatitis (CP). Based on endoscopic retrograde cholangiopancreatography, pancreas divisum can be found in 1% to 6% of patients with pancreatitis. The correlation of this abnormality with pancreatic disease is an issue of continuing controversy. Because of the underlying duct anomalies and major pathomorphological changes in the pancreatic head, duodenum-preserving pancreatic head resection (DPPHR) offers an option for causal treatment. Thirty-six patients with pancreatitis caused by PD were treated surgically. Thirty patients suffered from CP, 6 from rAP. The mean duration of the disease was 47.5 and 49.8 months, respectively. The age at the time of surgery was 39.2 years in the CP group, and 27.6 years in the rAP group. Median hospitalization since diagnosis was 18.8 weeks for CP patients and 24.6 weeks for rAP patients. Previous procedures performed in these patients included endoscopic papillotomy (30%), duct stenting (14%), and surgical treatment (17%). The median preoperative pain score was 8 on a visual analog scale. According to the classification of pancreas divisum, 10 patients demonstrated a complete PD, 25 had a functionally incomplete PD, and 1 had a dorsal duct type. The pain status as well as the endocrine (oral glucose tolerance test) and exocrine (pancreolauryl test) function were evaluated preoperatively and early and late postoperatively with a median follow-up time of 39.3 months. There was no operative-related mortality. The follow-up was 100%; 4 patients died (1 from suicide, 1 from cardiac arrest, and 2 from cancer of the esophagus). Fifty percent of the patients were completely pain-free, 31% had a significant reduction of pain with a median pain score of 2 (P pancreatitis with a need for hospitalization. DPPHR reduced pain and preserved the endocrine function in the majority of patients

Anti EGFR therapy in the treatment of non-metastatic head and neck squamous cell carcinoma: The current evidence

Directory of Open Access Journals (Sweden)

Rony Benson

2016-09-01

Full Text Available Head and neck squamous cell carcinoma (HNSCC accounts for a large oncologic burden in the developing countries. In patients with locally advanced head and neck cancer multimodality treatment is warranted. Radiation therapy with concurrent chemotherapy has long been considered the standard for patients with disease involving the oropharynx, larynx and hypopharynx. However, addition of chemotherapy to radiotherapy increases treatment related toxicity by many folds and compliance rates decrease. In this context a systemic therapy, which when used concurrent with radiation with favorable toxicity profile is of great importance for improving disease control in locally advanced HNSCC. Anti-epithelial growth factor receptor targeted therapy emerged as a potential treatment option. In recent years many trials were conducted to find the optimum treatment option with the combination of these targeted agents. The initial trials showed excellent results with minimal morbidity and led to great enthusiasm across the globe to incorporate these regimens as a standard of care. However, subsequently many trials failed to maintain such results and now there is little agreement to the initial results achieved with these drugs. Based on the current evidence we cannot recommend the replacement of cisplatin with targeted therapy in concurrent setting. It may be considered in patients with altered renal parameters, hypersensitivity or intolerance to cisplatin. The addition of targeted therapy in addition to chemotherapy in the concurrent setting can’t also be recommended as the benefit is doubtful and is associated with a significant increase in toxicity.

Does hyperbaric oxygen treatment have the potential to increase salivary flow rate and reduce xerostomia in previously irradiated head and neck cancer patients? A pilot study

DEFF Research Database (Denmark)

Forner, Lone; Hansen, Ole Hyldegaard; von Brockdorff, Annet Schack

2011-01-01

in irradiated head and neck cancer patients. Eighty patients eligible for HBO treatment on the indication of prevention/treatment of osteoradionecrosis or soft tissue radiation injury were consecutively sampled, of whom 45 had hyposalivation (i.e. unstimulated whole saliva (UWS) flow rate......Irradiated head and neck cancer survivors treated in the Hyperbaric Oxygen (HBO) Unit, Copenhagen University Hospital, spontaneously reported improvement of radiation-induced dry mouth feeling. The aim of this pilot study was to evaluate salivary flow rate and xerostomia before and after HBO...

Effect of head size on 10B dose distribution

International Nuclear Information System (INIS)

Gupta, N.; Blue, T.E.; Gahbauer, R.

1992-01-01

Boron neutron capture therapy (BNCT) for treatment of brain tumors is based on the utilization of large epithermal-neutron fields. Epithermal neutrons thermalize at depths of ∼2.5 cm inside the head and provide a maximum thermal fluence at deep-seated tumor sites with minimum damage to normal tissue. Brain tissue is a highly scattering medium for epithermal and thermal neutrons; therefore, a broad treatment field enables epithermal neutrons to enter the head over a large area. These neutrons slow down as they undergo scattering collisions and contribute to the thermal-neutron fluence at the tumor location. With the use of large neutron fields, the size of the head affects the thermal-neutron distribution and thereby the 10 B absorbed dose distribution inside the head. In this paper, the authors describe measurements using a boron trifluoride (BF 3 )-filled proportional counter to determine the effect of head size on 10 B absorbed dose distributions for a broad field accelerator epithermal-neutron source

Flowsheet for shear/leach processing of N Reactor fuel at PUREX

International Nuclear Information System (INIS)

Enghusen, M.B.

1995-01-01

This document was originally prepared to support the restart of the PUREX plant using a new Shear/Leach head end process. However, the PUREX facility was shutdown and processing of the remaining N Reactor fuel is no longer considered an alternative for fuel disposition. This document is being issued for reference only to document the activities which were investigated to incorporate the shear/leach process in the PUREX plant

[Oral maxillofacial-head and neck tumor and holistic integrative medicine].

Science.gov (United States)

Zhang, C P

2017-08-09

The advance of clinical diagnosis and treatment in oral and maxillofacial-head and neck tumors has been through the process of specialization and multidisciplinary cooperation. In most cases, a single discipline cannot meet the requirements of diagnosis and treatment, which needs the cooperation of oral and maxillofacial surgery, otolaryngology and oncology approach and therapeutic method such as surgery, radiotherapy and chemotherapy. Holistic integrative medicine aims at integrating the most effective clinical practice experience and patients' individual situation and prognosis, establishing new medical mode conforming to the modern concept and fulfilling the medical system adapting to the specific characteristics of the diseases.

Modular reactor head shielding system

International Nuclear Information System (INIS)

Jacobson, E. B.

1985-01-01

An improved modular reactor head shielding system is provided that includes a frame which is removably assembled on a reactor head such that no structural or mechanical alteration of the head is required. The shielding system also includes hanging assemblies to mount flexible shielding pads on trolleys which can be moved along the frame. The assemblies allow individual pivoting movement of the pads. The pivoting movement along with the movement allowed by the trolleys provides ease of access to any point on the reactor head. The assemblies also facilitate safe and efficient mounting of the pads directly to and from storage containers such that workers have additional shielding throughout virtually the entire installation and removal process. The flexible shielding pads are designed to interleave with one another when assembled around the reactor head for substantially improved containment of radiation leakage

Evaluation of an automated knowledge based treatment planning system for head and neck

International Nuclear Information System (INIS)

Krayenbuehl, Jerome; Norton, Ian; Studer, Gabriela; Guckenberger, Matthias

2015-01-01

This study evaluated an automated inverse treatment planning algorithm, Pinnacle Auto-Planning (AP), and compared automatically generated plans with historical plans in a large cohort of head and neck cancer patients. Fifty consecutive patients treated with volumetric modulated arc therapy (Eclipse, Varian Medical System, Palo Alto, CA) for head and neck were re-planned with AP version 9.10. Only one single cycle of plan optimization using one single template was allowed for AP. The dose to the planning target volumes (PTV’s; 3–4 dose levels), the organs at risk (OAR’s) and the effective working time for planning was evaluated. Additionally, two experienced radiation oncologists blind-reviewed and ranked 10 plans. Dose coverage and dose homogeneity of the PTV were significantly improved with AP, however manually optimized plans showed significantly improved dose conformity. The mean dose to the parotid glands, oral mucosa, swallowing muscles, dorsal neck tissue and maximal dose to the spinal cord were significantly reduced with AP. In 64 % of the plans, the mean dose to any OAR (spinal cord excluded) was reduced by >20 % with AP in comparison to the manually optimized plans. In 12 % of the plans, the manually optimized plans showed reduced doses by >20 % in at least one OAR. The experienced radiation oncologists preferred the AP plan and the clinical plan in 80 and 20 % of the cases, respectively. The average effective working time was 3.8 min ± 1.1 min in comparison to 48.5 min ± 6.0 min using AP compared to the manually optimized plans, respectively. The evaluated automated planning algorithm achieved highly consistent and significantly improved treatment plans with potentially clinically relevant OAR sparing by >20 % in 64 % of the cases. The effective working time was substantially reduced with Auto-Planning

Clinical features of the exploding head syndrome.

Science.gov (United States)

Pearce, J M

1989-07-01

Fifty patients suffering from the "exploding head syndrome" are described. This hitherto unreported syndrome is characterised by a sense of an explosive noise in the head usually in the twilight stage of sleep. The associated symptoms are varied, but the benign nature of the condition is emphasised and neither extensive investigation nor treatment are indicated.

Clinical features of the exploding head syndrome.

OpenAIRE

Pearce, J M

1989-01-01

Fifty patients suffering from the "exploding head syndrome" are described. This hitherto unreported syndrome is characterised by a sense of an explosive noise in the head usually in the twilight stage of sleep. The associated symptoms are varied, but the benign nature of the condition is emphasised and neither extensive investigation nor treatment are indicated.

Progress in treatment of head and neck cancer. Pt. 1. Chemotherapy

International Nuclear Information System (INIS)

Stupp, R.; Vokes, E.E.; Chicago Univ., IL

1995-01-01

Cancer of the head and neck is commonly diagnosed in an advanced stage with a poor prognosis. New active agents and combinations have recently been identified. By adding chemotherapy to a multimodality approach with surgery and radiation therapy the outcome may be altered. We reviewed the more recently published literature on induction and adjuvant chemotherapy. No survival advantage has been shown for adjuvant chemotherapy. Organ preservation can be achieved with induction chemotherapy followed by limited surgery and radiation in approximately two thirds of the patients with laryngeal carcinoma. Patients achieving a complete response after induction chemotherapy have a better prognosis. Chemotherpy has consistently shown to reduce the frequency of distant metastases. Chemotherapy is indicated only in recurrent or metastatic disease. Induction chemotherapy is limited to laryngeal carcinoma with organ preservation as intent. Local recurrences and intercurrent morbidity are the main reasons for treatment failures. (orig.) [de

Users’ Perceptions Using Low-End and High-End Mobile-Rendered HMDs: A Comparative Study

Directory of Open Access Journals (Sweden)

M.-Carmen Juan

2018-02-01

Full Text Available Currently, it is possible to combine Mobile-Rendered Head-Mounted Displays (MR HMDs with smartphones to have Augmented Reality platforms. The differences between these types of platforms can affect the user’s experiences and satisfaction. This paper presents a study that analyses the user’s perception when using the same Augmented Reality app with two MR HMD (low-end and high-end. Our study evaluates the user’s experience taking into account several factors (control, sensory, distraction, ergonomics and realism. An Augmalpha-lowerented Reality app was developed to carry out the comparison for two MR HMDs. The application had exactly the same visual appearance and functionality for both devices. Forty adults participated in our study. From the results, there were no statistically significant differences for the users’ experience for the different factors when using the two MR HMDs, except for the ergonomic factors in favour of the high-end MR HMD. Even though the scores for the high-end MR HMD were higher in nearly all of the questions, both MR HMDs provided a very satisfying viewing experience with very high scores. The results were independent of gender and age. The participants rated the high-end MR HMD as the best one. Nevertheless, when they were asked which MR HMD they would buy, the participants chose the low-end MR HMD taking into account its price.

Research and advancement of treating avascular necrosis of the femoral head

International Nuclear Information System (INIS)

Wang Kaibing; Bai Bin; Wang Honghui; Sui Hong

2006-01-01

To undertake retrospective analysis of the research and advancement of treating avascular necrosis of the femoral head. After comparing the superiority and inferiority of different treatments and the present therapeutic status many therapeutic methods for avascular necrosis of the femoral head have been performed, commonly according to the staging of necrosis. Conservative therapy is suitable for stage 0-I, interventional therapy is suitable for stage II-III, operation is adapted for stage II-III and femoral head collapse or degenerative changes. Avascular necrosis of the femoral head is a chronic and dysfunctional illness. Comprehensive treatment according to different stage is now the most popular. Interventional therapy is the study focus of the avascular necrosis of the femoral head meanwhile. (authors)

Successful treatment of pill-swallowing difficulties with head posture practice.

Science.gov (United States)

Kaplan, Bonnie J; Steiger, Roberta A; Pope, Jamie; Marsh, Ashley; Sharp, Maegan; Crawford, Susan G

2010-05-01

Clinics often encounter neurologically intact patients who are unable to swallow pills. All of the interventions published previously have used traditional behavioural techniques, which are time consuming and often not helpful. To determine whether children who had never been able to swallow a whole pill could become successful as a result of an intervention based on head posture. A novel intervention was developed based on published research showing that changing head position alters swallowing dynamics. The method was developed in two studies of 240 adults and children, pilot tested in a study of 108 university students with very mild pill-swallowing discomfort, and then evaluated in a study of 41 children who had never successfully swallowed a pill in spite of much instruction and coaxing. Children were recruited from a tertiary paediatric hospital: 34 were clinic patients, four were their siblings or friends, and three were children of hospital staff. The primary intervention involved teaching five head positions (centre, up, down, left and right) followed by a two-week period of daily practice. EIGHT CHILDREN (ALL CLINIC REFERRALS) WITHDREW WITHOUT PRACTICING: four were too ill to practice (primarily due to sedation or nausea) and four simply refused to do the homework practice. All 33 of the children who were able and willing to practice daily were successful. Practice with head posture variations was successful in treating pill-swallowing difficulties in all 33 children who practiced for 14 days. A training video can be viewed at www.ucalgary.ca/research4kids/pillswallowing.

PWSCC Mitigation of alloy 182: Testing of various mitigation processes

International Nuclear Information System (INIS)

Curieres, I. de; Calonne, O.; Crooker, P.

2011-01-01

Since the mid nineties, Primary Water Stress Corrosion Cracking (PWSCC) of Alloy 182 welds has occurred. This affects different components, even ones that are considered to have 'low-susceptibility' due to a low operating temperature such as the 'low operating temperature' reactor pressure vessel (RPV) heads in the global PWR fleet and bottom-mounted instrumentation nozzles, a location where currently there is no ready-to-deploy repair or replacement solution. Hence, there is an incentive to identify effective remedial measures to delay or prevent PWSCC initiation, even at 'low temperature' RPV heads in order to avoid wholesale replacement in the future. Working with EPRI, Areva has assessed the efficiency of various technological processes including brushing, polishing or compressive stress methods to mitigate PWSCC in Alloy 182. A first phase of the program is completed and the results will be presented. The emphasis will be put on the program's different testing phases and the different mitigation processes that were tested. Efficiency of 'chemical' surface treatments is not yet proved. EPRI stabilized chromium had a deleterious effect on crack initiation that should be reproduced and understood before drawing a definitive conclusion. The electropolishing process considered does not seem to be sufficiently reliable on Alloy 182 surfaces but longer exposures are required for a more definitive evaluation of this treatment. All tested 'mechanical' surface treatments i.e. -) GE-RENEW brushing, -) Fiber laser peening (Toshiba), -) Water Jet Peening (Mitsubishi), -) Water Jet Peening (Hitachi), -) Combination of GE-RENEW and Hitachi WJP have successfully inhibited crack initiation even though the surface compressive stresses induced on U-ends are lower than those expected on massive components. Past experience shows that crack initiation occurs in less than 250 h on U-bends with 'heavily ground' reference surfaces. Thus, it can be deduced that the present results show

Recycling of end-of-life reverse osmosis membranes by oxidative treatment: a technical evaluation.

Science.gov (United States)

Coutinho de Paula, Eduardo; Gomes, Júlia Célia Lima; Amaral, Míriam Cristina Santos

2017-07-01

The adverse impacts caused by the disposal of thousands of tonnes per annum of reverse osmosis (RO) membranes modules have grown dramatically around the world. The objective of this study was to evaluate the technical feasibility of recycling by chemical oxidation of end-of-life RO membranes for applications in other separation processes with specifications less rigorous. The recycling technique consisted in to cause a membrane exposition with oxidant solutions in order to remove its aromatic polyamide layer and subsequent conversion to a porous membrane. The recycling technique was evaluated by water permeability and salt rejection tests before and after the oxidative treatments. Initially, membranes' chemical cleaning and pretreatment procedures were assessed. Among factors evaluated, the oxidizing agent, its concentration and pH, associated with the oxidative treatment time, showed important influence on the oxidation of the membranes. Results showed that sodium hypochlorite and potassium permanganate are efficient agents for the membrane recycling. The great increased permeability and decreased salt rejection indicated changes on membranes' selective properties. Scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), atomic force microscopy (AFM), and contact angle characterization techniques revealed marked changes on the main membranes' physical-chemical properties, such as morphology, roughness and hydrophobicity. Reuse of produced effluents and fouling tendency of recycled membranes were also evaluated.

Cosmetic wastewater treatment by the ZVI/H2O2 process.

Science.gov (United States)

Bogacki, Jan; Marcinowski, Piotr; Zapałowska, Ewa; Maksymiec, Justyna; Naumczyk, Jeremi

2017-10-01

The ZVI/H 2 O 2 process was applied for cosmetic wastewater treatment. Two commercial zero-valent iron (ZVI) types with different granulations were chosen: Hepure Ferrox PRB and Hepure Ferrox Target. In addition, the pH and stirring method influence on ZVI/H 2 O 2 process efficiency was studied. During the ZVI and ZVI/H 2 O 2 processes, linear Fe ions concentration increase was observed. The addition of H 2 O 2 significantly accelerated the iron dissolution process. The highest COD removal was obtained using finer ZVI (Hepure Ferrox Target) for doses of reagents ZVI/H 2 O 2 1500/1600 mg/L, in a H 2 O 2 /COD weight ratio 2:1, at pH 3.0 with stirring on a magnetic stirrer. After 120 min of the process, 84.0% COD removal (from 796 to 127 mg/L) was achieved. It was found that the efficiency of the process depends, as in the case of the Fenton process, on the ratio of the reagents (ZVI/H 2 O 2 ) and their dose in relation to the COD (H 2 O 2 /COD) but does not depend on the dose of the iron itself. Statistical analysis confirms that COD removal efficiency depends primarily on H 2 O 2 /COD ratio and ZVI granulation, but ZVI dose influence is not statistically significant. The head space, solid-phase microextraction, gas chromatography, mass spectrometry results confirm high efficiency of the ZVI/H 2 O 2 process.

Development of a head and neck companion module for the quality of life - radiation therapy instrument (QOL-RTI)

International Nuclear Information System (INIS)

Trotti, Andy; Johnson, Darlene J.; Gwede, Clement; Casey, Linda; Cantor, Alan

1997-01-01

Purpose/Objective: The purpose of this study is to develop a Likert version, disease specific module for the Quality of Life - Radiation Therapy Instrument (QOL-RTI) for head and neck patients. This module combined with the QOL-RTI may help us to determine what changes, if any, occur in the quality of life of patients receiving primary radiation therapy for head and neck cancer. A compelling reason to study head and neck patients is because of the extensive difficulties these patients experience while undergoing radiotherapy. Their psychological and emotional well-being may also have an adverse affect on their quality of life as they strive to cope with both a life-threatening disease and with the prospect of disfigurement or dysfunction that cannot be hidden from view. Many tools have been developed to measure quality of life, however, previously published literature has focused on quantifying functional status and toxicity assessment rather than the alteration of quality of life as perceived by the patient. This study, limited to patients receiving primary radiation, is expected to yield a tool that is applicable to the patient receiving multi-modality treatment for head and neck cancer and will be useful to the physician/nurse in determining interventions for these patients. Materials and Methods: This study is an uncontrolled, non-randomized exploratory study, including fifty (50) consecutive eligible patients undergoing definitive primary radiotherapy. The questionnaires were given to all eligible patients being treated with radiotherapy for head and neck cancer who are not already registered on another research study assessing Quality of Life (i.e. RTOG). During the 5-8 week treatment period, the QOL-RTI/H and N instrument is administered as follows: at baseline evaluation (immediately prior to the beginning of radiotherapy), at week four (4) two days in a row (for test-retest) and at the end of the treatment period. For validation purposes the QOL-RTI/H and

A prospective comparison of times to presentation and treatment of regional and remote head and neck patients in North Queensland, Australia.

Science.gov (United States)

Tan, J Y-A; Otty, Z A; Vangaveti, V N; Buttner, P; Varma, S C; Joshi, A J; Kelly, J; Collins, M; Sabesan, S S

2016-08-01

This study aims to examine differences between outer regional (OR) and remote/very remote (RVR) patients in northern Queensland, Australia in the times taken to receive various aspects of head and neck cancer management. Our study prospectively recruited head and neck cancer patients presenting to three North Queensland regional hospitals from January 2009 to January 2011. Data on demographic and cancer-specific details, comorbidities and timing of presentation to various services, were collected using a self-administered questionnaire that included two questions in relation to possible reason for delays to health services. Multivariate linear regression analyses were conducted to assess the effects of various demographic characteristics on time delays. Survival and disease recurrence data were analysed in 2014. One hundred and fifty-eight patients participated. RVR patients had significantly longer median times between diagnosis and first treatment compared with OR patients (P = 0.015). Indigenous patients had significant delays from diagnosis to first treatment (P = 0.013) and visit to first specialist and treatment (P = 0.031) compared to non-Indigenous patients. Longer median times between symptoms and first treatment was associated with low income (P = 0.03) and lower education level (P = 0.04). Disease recurrence was higher for RVR patients compared with OR patients (P = 0.04), without significant differences in overall survival. Possible reasons for delays included patient and professional factors. Significant delays in various aspects of head and neck cancer management were associated with remoteness, Indigenous and socioeconomic status. While patient and professional factors could be addressed at local levels, sustainable improvement in outcomes requires a state and national level approach. © 2016 Royal Australasian College of Physicians.

Effect of nitrogen fertilisation on the overall quality of minimally processed globe artichoke heads.

Science.gov (United States)

Lombardo, Sara; Restuccia, Cristina; Muratore, Giuseppe; Barbagallo, Riccardo N; Licciardello, Fabio; Pandino, Gaetano; Scifò, Giovanna O; Mazzaglia, Agata; Ragonese, Francesca; Mauromicale, Giovanni

2017-01-01

Although nitrogen (N) fertilisation is essential for promoting crop yield, it may also affect the produce quality. Here, the influence of three N fertiliser rates (0 kg ha -1 as a control, 200 kg ha -1 and 400 kg ha -1 referred to as N 0 , N 200 and N 400 , respectively) on the overall quality of minimally processed globe artichoke heads was investigated during refrigerated storage for 12 days. Throughout the storage time, N fertilised samples had higher inulin contents than those unfertilised. In addition, the respiratory quotient of N 200 and N 400 samples was 2-fold and 2.5-fold lower than N 0 ones, whose values were close to the normal range for vegetables. All the samples reported good microbiological standards, although N 200 and N 400 achieved lower mesophilic and psychotropic counts than N 0 throughout the storage time. After 8 and 12 days of refrigerated storage, the N 200 samples showed the highest scores of positive sensory descriptors. A fertiliser level of 200 kg N ha -1 is suitable for obtaining minimally processed globe artichoke heads with good nutritional, sensory and microbiological quality, characterised by low endogenous oxidase activities. Proper packaging systems and procedures are, however, crucial for extending the product shelf-life and, thus, promoting its exportation on a wider scale. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Randomized, investigator-blinded, controlled clinical study with lice shampoo (Licener®) versus dimethicone (Jacutin® Pedicul Fluid) for the treatment of infestations with head lice.

Science.gov (United States)

Semmler, Margit; Abdel-Ghaffar, Fathy; Gestmann, Falk; Abdel-Aty, Mohammed; Rizk, Ibrahim; Al-Quraishy, Saleh; Lehmacher, Walter; Hoff, Norman-Philipp

2017-07-01

The present clinical trial was conducted to obtain additional data for the safety and efficacy of a head lice shampoo that is free of silicone compared with an anti-head lice product containing dimethicone. Both products act by a physical mode of action. This randomized, investigator-blinded, controlled clinical study was conducted between July and November 2016 in households of two villages (Abou Rawash and Shandalat) in Egypt. Children older than 2 years with an active head lice infestation were treated with either a shampoo-based head lice treatment containing neem extract (Licener®) or dimethicone (Jacutin® Pedicul Fluid) on day 1 and additionally on day 9. Assessment for living lice by combing was conducted before and 1-2 h after treatment and on days 5 and 13. The main objective was to demonstrate a cure rate of the test product of at least 85% after a single application (day 5 and 9). Secondary objectives were to scrutinize patient safety and satisfaction as well as cure rates on day 13 after two treatments and the evaluation of ovicidal and licicidal efficacies of the products. Sixty-one children in the test-group (Licener®) and 58 children in the reference group (Jacutin® Pedicul Fluid) were included in this study. The test product and the reference product were very well tolerated. Both products exceeded the objective of cure rates of over 85% after single treatment (test group 60/60 = 100%; 95% CI = 94.04-100.00%; reference group 54/57 = 94.74%; 95% CI = 85.38-98.90%; p = 0.112; CI by Clopper-Pearson) and after two treatments (test group 58/58 = 100%; 95% CI = 93.84-100.00%; reference group 52/54 = 96.30%; 95% CI = 87.25-99.55%; p = 0.230) with higher cure rates and non-inferiority for the test product. The combined success rate shows significant superiority of the test product against the reference product (test group 58/58 = 100%; 95% CI = 93.84-100.00%; reference group 49/54 = 90.7%; 95% CI = 79.70-96.92%; p = 0

Head and Neck Cancers in Developing Countries

Directory of Open Access Journals (Sweden)

Poonam Joshi

2014-04-01

Full Text Available Head and neck cancers are the most common cancers in developing countries, especially in Southeast Asia. Head and neck cancers are more common in males compared to females. This is mainly attributed to tobacco, areca nut, alcohol, etc. Oral cancers are most common amongst all head and neck squamous cell cancers (HNSCC. HNSCC in the developing world differ from those in the Western world in terms of age, site of disease, etiology, and molecular biology. Poverty, illiteracy, advanced stage at presentation, lack of access to health care, and poor treatment infrastructure pose a major challenge in management of these cancers. The annual GDP (gross domestic product spent on health care is very low in developing countries compared to the developed countries. Cancer treatment leads to a significant financial burden on the cancer patients and their families. Several health programs have been implemented to curb this rising burden of disease. The main aims of these health programs are to increase awareness among people regarding tobacco and to improve access to health care facilities, early diagnosis, treatment, and palliative care.

Head Lice: Treatment

Science.gov (United States)

... before treatment using the hot water (130°F) laundry cycle and the high heat drying cycle. Clothing ... does not imply endorsement by the Public Health Service or by the U.S. Department of Health and ...

BGO front-end electronics and signal processing in the MXGS instrument for the ASIM mission

DEFF Research Database (Denmark)

Skogseide, Yngve; Cenkeramaddi, Linga Reddy; Genov, Georgi

2012-01-01

This paper presents the Bismuth Germanate Oxide (BGO) front-end electronics design and signal processing in Modular X- and Gamma ray sensor (MXGS) instrument onboard the Atmosphere Space Interaction Monitor (ASIM) mission, funded by the European Space Agency. University of Bergen is responsible...... for the design and development of the detector layers and readout electronics for the MXGS instrument. The principal objective of the instrument is to detect Terrestrial Gamma ray Flashes (TGFs), which are related to thunderstorm activity. The digital pulse processing scheme used in the MXGS BGO detector gives...... it a significantly higher rate capability than what has been achieved in other instruments used in the study of terrestrial gamma flashes. The front-end electronics for the BGO detector layer in MXGS system also uses fewer components compared to conventional analog front-ends for BGO detectors, thereby increasing...

Head and neck region consolidation radiotherapy and prophylactic cranial irradiation with hippocampal avoidance delivered with helical tomotherapy after induction chemotherapy for non-sinonasal neuroendocrine carcinoma of the upper airways

International Nuclear Information System (INIS)

Franco, Pierfrancesco; La Porta, Maria Rosa; Girelli, Giuseppe; Borca, Valeria Casanova; Pasquino, Massimo; Tofani, Santi; Ozzello, Franca; Ricardi, Umberto; Numico, Gianmauro; Migliaccio, Fernanda; Catuzzo, Paola; Cante, Domenico; Ceroni, Paola; Sciacero, Piera; Carassai, Pierpaolo; Canzi, Paolo

2012-01-01

Non-sinonasal neuroendocrine carcinomas (NSNECs) of the head and neck are considered an unfrequent clinico-pathological entity. Combined modality treatment represents an established therapeutic option for undifferentiated forms where distant metastasis is a common pattern of failure. We report on a case of NSNEC treated with sequential chemo-radiation consisting of 6 cycles of cisplatin and etoposide followed by loco-regional radiation to the head and neck and simultaneous prophylactic cranial irradiation to prevent from intracranial spread, delivered with helical tomotherapy with the 'hippocampal avoidance' technique in order to reduce neuro-cognitive late effects. One year after the end of the whole combined modality approach, the patient achieved complete remission, with no treatment-related sub-acute and late effects. The present report highlights the importance of multidisciplinary management for NSNECs of the head and neck, as the possibility to achieve substantial cure rates with mild side effects with modern radiotherapy techniques

TU-C-17A-09: Multi-Case Knowledge-Based IMRT Treatment Planning in Head and Neck Cancer: Are Six Heads Better Than One?

International Nuclear Information System (INIS)

Grzetic, S; Lutzky, C; Das, S; Lo, J

2014-01-01

Purpose: HNC IMRT treatment planning is a challenging process that relies heavily on the planner’s experience. Previously, we used the single, best match from a library of manually planned cases to semi-automatically generate IMRT plans for a new patient. The current multi-case Knowledge Based Radiation Therapy (MC-KBRT) study utilized different matching cases for each of six individual organs-at-risk (OARs), then combined those six cases to create the new treatment plan. Methods: From a database of 103 patient plans created by experienced planners, MC-KBRT plans were created for 40 (17 unilateral and 23 bilateral) HNC “query” patients. For each case, 2D beam’s-eye-view images were used to find similar geometric “match” patients separately for each of 6 OARs. Dose distributions for each OAR from the 6 matching cases were combined and then warped to suit the query case’s geometry. The dose-volume constraints were used to create the new query treatment plan without the need for human decision-making throughout the IMRT optimization. The optimized MC-KBRT plans were compared against the clinically approved plans and Version 1 (original KBRT) using the dose metrics: mean, median, and maximum (brainstem and cord+5mm) doses. Results: Compared to Version 1, MC-KBRT had no significant reduction of the dose to any of the OARs in either unilateral/bilateral cases. Compared to the manually-planned unilateral cases, there was significant reduction of the oral cavity mean/median dose (>2Gy) at the expense of the contralateral parotid. Compared to the manually-planned bilateral cases, reduction of dose was significant in the ipsilateral parotid, larynx, and oral cavity (>3Gy mean/median) while maintaining PTV coverage. Conclusion: MC-KBRT planning in head and neck cancer generates IMRT plans with equivalent dose sparing to manually created plans. MC-KBRT using multiple case matches does not show significant dose reduction compared to using a single match case with

A screening algorithm for early detection of major depressive disorder in head and neck cancer patients post-treatment: Longitudinal study.

Science.gov (United States)

Henry, Melissa; Rosberger, Zeev; Ianovski, Lola E; Hier, Michael; Zeitouni, Anthony; Kost, Karen; Mlynarek, Alex; Black, Martin; MacDonald, Christina; Richardson, Keith; Zhang, Xun; Fuhrmann, Fabienne; Chartier, Gabrielle; Frenkiel, Saul

2018-03-13

The primary purpose of this study was to identify predictors of Major Depressive Disorder in head and neck cancer (HNC) patients in the immediate post-treatment period (ie, at 3 months post-diagnosis), with a focus on previously unexamined historical and contextual factors. Prospective longitudinal study of 223 consecutive adults (72% participation) newly diagnosed with a first occurrence of primary HNC, including validated psychometric measures, Structured Clinical Interviews for DSM Disorders, and medical chart reviews. The 3-month period prevalence of Major Depressive Disorder was 20.4%; with point prevalences of 6.8% upon HNC diagnosis, 14.2% at 3 months, and 22.6% lifetime. Patients most susceptible to developing Major Depressive Disorder in the immediate post-treatment period: were diagnosed with advanced-stage cancer rather than early-stage cancer (O.R. = 4.94, P = 0.04), received surgery only (O.R. = 8.73, P = 0.04), presented a lifetime history of Anxiety Disorder on SCID-I (O.R. = 6.62; P = 0.01), and indicated higher pre-treatment levels of anxiety on the HADS (O.R. = 0.45, P = 0.05). Our results outline the predominant role of anxiety upon diagnosis as a precursor to post-treatment Major Depressive Disorder, suggesting the need for identification and prophylactic treatment of anxiety upon diagnosis in head and neck cancer patients. Further investigation into pathways by which pre-treatment anxiety predisposes to post-treatment Major Depressive Disorder in this population is warranted. Copyright © 2018 John Wiley & Sons, Ltd.

Correlation between radwaste processing and hazardous waste treatment processes

International Nuclear Information System (INIS)

Block, O.U.J.; Tulipano, F.J.

1988-01-01

The basic framework under SARA has established that preferred remedies are those which permanently and significantly reduce toxicity, mobility or volume of wastes. In the 1970's radwaste process designs at power plants received pressure to satisfy essentially the same criteria when increased emphasis was placed on limited disposal sites which resulted in rapidly escalating disposal costs. This paper provides a historical perspective of radwaste experience and discusses valuable insight to hazardous waste treatment technologies. The radwaste system experience is discussed in terms of providing a source of proven and reliable technologies. Discussion is presented on specific radwaste processes which are applicable technologies for hazardous waste treatment. The technologies presented include (a) Solidification, (b) Evaporation, and (c) Incineration. Experience is presented which establishes assurance that the treatment technologies will provide a permanent remedy to hazardous waste treatment. This paper describes typical radwaste solidification, evaporation and incineration processes at power plants. The design requirements and implementation of radwaste equipment is correlated to design requirement of hazardous waste equipment. Specific discussion is provided on how the available process equipment can reduce toxicity, mobility, and volume of waste. Discussion is presented on how the standard off the shelf processing equipment needs to be modified for radwaste and hazardous waste applications

A SURVEY OF PREVENTION AND TREATMENT REGIMENS FOR ORAL SEQUELAE RESULTING FROM HEAD AND NECK RADIOTHERAPY USED IN DUTCH RADIOTHERAPY INSTITUTES

NARCIS (Netherlands)

JANSMA, J; VISSINK, A; BOUMA, J; VERMEY, A; PANDERS, AK; SGRAVENMADE, EJ

1992-01-01

Radiation treatment plays an important role in the management of head and neck cancer. Unfortunately several radiation-induced side effects may occur including mucositis, hyposalivation, radiation caries, trismus and osteoradionecrosis. It is generally accepted that most side effects can be

Fractionation schedules for cancers of the head and neck

International Nuclear Information System (INIS)

Harari, Paul M.

1995-01-01

Purpose/Objective: This refresher course reviews current research activity and treatment results in the field of radiation therapy fractionation. The presentation emphasizes worldwide studies of altered fractionation, highlighting head and neck cancer as the primary teaching model. Basic radiobiological principles guiding the development of altered fractionation regimens, and advancing the understanding of fractionation effects on normal and tumor tissue are reviewed. A 'standard' prescription of 2 Gy x 35 fractions = 70 Gy may not provide the optimal balance between primary tumor control and late normal tissue effects for all patients with squamous cell carcinoma of the head and neck. The last decade has witnessed the treatment of thousands of head and neck cancer patients with curative radiotherapy using altered fractination schedules designed to improve overall treatment results. Although the number of different fractionation regimens currently being investigated continues to increase, the common guiding principles behind their design are relatively simple. Common fractionation terminology (i.e., accelerated hyperfractionation) will be reviewed, as well as a brief summary of radiobiological concepts pertaining to tumor potential doubling time, tumor proliferation kinetics, overall treatment time and fraction size-dependence of acute and late tissue effects. Several well known head and neck fractionation schedules from around the world (Manchester Christie Hospital-United Kingdom, Princess Margaret Hospital-Canada, Massachusetts General Hospital-USA, MD Anderson Hospital-USA, University of Florida-USA, Mount Vernon Hospital CHART-United Kingdom, RTOG and EORTC trials-USA and Europe) will be summarized with regard to design-rationale, treatment technique and results. The design of several current cooperative group trials investigating altered head and neck fractionation will be presented, as well as concepts prompting the pilot evaluation of several brand new

A comprehensive analysis of the IMRT dose delivery process using statistical process control (SPC)

Energy Technology Data Exchange (ETDEWEB)

Gerard, Karine; Grandhaye, Jean-Pierre; Marchesi, Vincent; Kafrouni, Hanna; Husson, Francois; Aletti, Pierre [Research Center for Automatic Control (CRAN), Nancy University, CNRS, 54516 Vandoeuvre-les-Nancy (France); Department of Medical Physics, Alexis Vautrin Cancer Center, 54511 Vandoeuvre-les-Nancy Cedex (France) and DOSIsoft SA, 94230 Cachan (France); Research Laboratory for Innovative Processes (ERPI), Nancy University, EA 3767, 5400 Nancy Cedex (France); Department of Medical Physics, Alexis Vautrin Cancer Center, 54511 Vandoeuvre-les-Nancy Cedex (France); DOSIsoft SA, 94230 Cachan (France); Research Center for Automatic Control (CRAN), Nancy University, CNRS, 54516 Vandoeuvre-les-Nancy, France and Department of Medical Physics, Alexis Vautrin Cancer Center, 54511 Vandoeuvre-les-Nancy Cedex (France)

2009-04-15

The aim of this study is to introduce tools to improve the security of each IMRT patient treatment by determining action levels for the dose delivery process. To achieve this, the patient-specific quality control results performed with an ionization chamber--and which characterize the dose delivery process--have been retrospectively analyzed using a method borrowed from industry: Statistical process control (SPC). The latter consisted in fulfilling four principal well-structured steps. The authors first quantified the short term variability of ionization chamber measurements regarding the clinical tolerances used in the cancer center ({+-}4% of deviation between the calculated and measured doses) by calculating a control process capability (C{sub pc}) index. The C{sub pc} index was found superior to 4, which implies that the observed variability of the dose delivery process is not biased by the short term variability of the measurement. Then, the authors demonstrated using a normality test that the quality control results could be approximated by a normal distribution with two parameters (mean and standard deviation). Finally, the authors used two complementary tools--control charts and performance indices--to thoroughly analyze the IMRT dose delivery process. Control charts aim at monitoring the process over time using statistical control limits to distinguish random (natural) variations from significant changes in the process, whereas performance indices aim at quantifying the ability of the process to produce data that are within the clinical tolerances, at a precise moment. The authors retrospectively showed that the analysis of three selected control charts (individual value, moving-range, and EWMA control charts) allowed efficient drift detection of the dose delivery process for prostate and head-and-neck treatments before the quality controls were outside the clinical tolerances. Therefore, when analyzed in real time, during quality controls, they should

A comprehensive analysis of the IMRT dose delivery process using statistical process control (SPC).

Science.gov (United States)

Gérard, Karine; Grandhaye, Jean-Pierre; Marchesi, Vincent; Kafrouni, Hanna; Husson, François; Aletti, Pierre

2009-04-01

The aim of this study is to introduce tools to improve the security of each IMRT patient treatment by determining action levels for the dose delivery process. To achieve this, the patient-specific quality control results performed with an ionization chamber--and which characterize the dose delivery process--have been retrospectively analyzed using a method borrowed from industry: Statistical process control (SPC). The latter consisted in fulfilling four principal well-structured steps. The authors first quantified the short-term variability of ionization chamber measurements regarding the clinical tolerances used in the cancer center (+/- 4% of deviation between the calculated and measured doses) by calculating a control process capability (C(pc)) index. The C(pc) index was found superior to 4, which implies that the observed variability of the dose delivery process is not biased by the short-term variability of the measurement. Then, the authors demonstrated using a normality test that the quality control results could be approximated by a normal distribution with two parameters (mean and standard deviation). Finally, the authors used two complementary tools--control charts and performance indices--to thoroughly analyze the IMRT dose delivery process. Control charts aim at monitoring the process over time using statistical control limits to distinguish random (natural) variations from significant changes in the process, whereas performance indices aim at quantifying the ability of the process to produce data that are within the clinical tolerances, at a precise moment. The authors retrospectively showed that the analysis of three selected control charts (individual value, moving-range, and EWMA control charts) allowed efficient drift detection of the dose delivery process for prostate and head-and-neck treatments before the quality controls were outside the clinical tolerances. Therefore, when analyzed in real time, during quality controls, they should improve the

Indices of slowness of information processing in head injury patients : Tests for selective attention related to ERP latencies

NARCIS (Netherlands)

Spikman, Jacoba M.; Naalt, van der Joukje; Weerden , van Tiemen; Zomeren , van Adriaan H.

2004-01-01

We explored the relation between neuropsychological (attention tests involving time constraints) and neurophysiological (N2 and P3 event-related potential (ERP) latencies) indices of slowness of information processing after closed head injury (CHI). A group of 44 CHI patients performed worse than

Automatic tissue segmentation of head and neck MR images for hyperthermia treatment planning

International Nuclear Information System (INIS)

Fortunati, Valerio; Niessen, Wiro J; Veenland, Jifke F; Van Walsum, Theo; Verhaart, René F; Paulides, Margarethus M

2015-01-01

A hyperthermia treatment requires accurate, patient-specific treatment planning. This planning is based on 3D anatomical models which are generally derived from computed tomography. Because of its superior soft tissue contrast, magnetic resonance imaging (MRI) information can be introduced to improve the quality of these 3D patient models and therefore the treatment planning itself. Thus, we present here an automatic atlas-based segmentation algorithm for MR images of the head and neck.Our method combines multiatlas local weighting fusion with intensity modelling. The accuracy of the method was evaluated using a leave-one-out cross validation experiment over a set of 11 patients for which manual delineation were available.The accuracy of the proposed method was high both in terms of the Dice similarity coefficient (DSC) and the 95th percentile Hausdorff surface distance (HSD) with median DSC higher than 0.8 for all tissues except sclera. For all tissues, except the spine tissues, the accuracy was approaching the interobserver agreement/variability both in terms of DSC and HSD. The positive effect of adding the intensity modelling to the multiatlas fusion decreased when a more accurate atlas fusion method was used.Using the proposed approach we improved the performance of the approach previously presented for H and N hyperthermia treatment planning, making the method suitable for clinical application. (paper)

Automatic tissue segmentation of head and neck MR images for hyperthermia treatment planning

Science.gov (United States)

Fortunati, Valerio; Verhaart, René F.; Niessen, Wiro J.; Veenland, Jifke F.; Paulides, Margarethus M.; van Walsum, Theo

2015-08-01

A hyperthermia treatment requires accurate, patient-specific treatment planning. This planning is based on 3D anatomical models which are generally derived from computed tomography. Because of its superior soft tissue contrast, magnetic resonance imaging (MRI) information can be introduced to improve the quality of these 3D patient models and therefore the treatment planning itself. Thus, we present here an automatic atlas-based segmentation algorithm for MR images of the head and neck. Our method combines multiatlas local weighting fusion with intensity modelling. The accuracy of the method was evaluated using a leave-one-out cross validation experiment over a set of 11 patients for which manual delineation were available. The accuracy of the proposed method was high both in terms of the Dice similarity coefficient (DSC) and the 95th percentile Hausdorff surface distance (HSD) with median DSC higher than 0.8 for all tissues except sclera. For all tissues, except the spine tissues, the accuracy was approaching the interobserver agreement/variability both in terms of DSC and HSD. The positive effect of adding the intensity modelling to the multiatlas fusion decreased when a more accurate atlas fusion method was used. Using the proposed approach we improved the performance of the approach previously presented for H&N hyperthermia treatment planning, making the method suitable for clinical application.

[The role of core decompression for the treatment of femoral head avascular necrosis in renal transplant recipients].

Science.gov (United States)

Zivcić-Cosić, Stela; Stalekar, Hrvoje; Mamula, Mihaela; Miletić, Damir; Orlić, Lidija; Racki, Sanjin; Cicvarić, Tedi

2012-10-01

Avascular bone necrosis is a relatively rare but significant complication in renal transplant recipients because it causes progressive pain and invalidity. It can be the consequence of the action of numerous causative factors, but it is mostly connected to corticosteroid treatment.The underlying pathophysiologic mechanism is a diminished blood flow to the bone leading to necrosis and bone destruction. During the past 25-years period, 570 renal transplantations and five combined kidney and pancreas transplantations were performed in our centre. A part of the patients was lost to follow-up due to the separation of Croatia from the former Republic of Yugoslavia. After transplantation, we revealed aseptic necrosis of the femoral head in five female patients. All patients had a history of treatment with pulse doses of corticosteroids. At transplantation the average age of the patients was 52.2 yrs (range 46 to 62 yrs), and dialytic treatment before transplantation lasted in average 9.2 yrs (range 2.5 to 21.2 yrs). The period between renal transplantation and the development of clinical signs of avascular bone necrosis lasted in average 1.2 yrs (range 0.3 to 2.3 yrs). We will demonstrate our 62-year old female patient with terminal renal failure caused by post-streptococcal glomerulonephritis, who was treated with peritoneal dialysis 2.5 years before renal transplantation. Twenty months before renal transplantation the patient received pulse doses of corticosteroids, together with immunoglobulins and plasmapheresis, for the treatment of an acute polyradiculoneuritis Guillaine Barré. After transplantation a standard immunosuppressive protocol was applied which included tacrolimus, mycophenolate mofetil, corticosteroids and induction with basiliximab. Four months after transplantation the patient started to feel pain in the right hip after longer standing, in addition to the earlier long-lasting problems caused by bilateral coxarthrosis. The pelvic radiograph showed

A customized head and neck support system

International Nuclear Information System (INIS)

Bentel, Gunilla C.; Marks, Lawrence B.; Sherouse, George W.; Spencer, David P.

1995-01-01

Purpose: To describe a customized head and neck immobilization system for patients receiving radiotherapy including a head support that conforms to the posterior contour of the head and neck. Methods: The system includes a customized headrest to support the posterior head and neck. This is fixed to a thermoplastic face mask that molds to the anterior head/face contours. The shape of these customized head and neck supports were compared to 'standard' supports. Results: This system is comfortable for the patients and appears to be effective in reproducing the setup of the treatment. Conclusions: The variability in the size and shape of the customized posterior supports exceeded that of 'standard' headrests. It is our clinical impression that the customized supports improve reproducibility and are now a standard part of our immobilization system. The quantitative analysis of the customized headrests and some commonly used 'standard' headrests suggests that the customized supports are better able to address variabilities in patient shape

Ulnar nerve entrapment complicating radial head excision

Directory of Open Access Journals (Sweden)

Kevin Parfait Bienvenu Bouhelo-Pam

Full Text Available Introduction: Several mechanisms are involved in ischemia or mechanical compression of ulnar nerve at the elbow. Presentation of case: We hereby present the case of a road accident victim, who received a radial head excision for an isolated fracture of the radial head and complicated by onset of cubital tunnel syndrome. This outcome could be the consequence of an iatrogenic valgus of the elbow due to excision of the radial head. Hitherto the surgical treatment of choice it is gradually been abandoned due to development of radial head implant arthroplasty. However, this management option is still being performed in some rural centers with low resources. Discussion: The radial head plays an important role in the stability of the elbow and his iatrogenic deformity can be complicated by cubital tunnel syndrome. Conclusion: An ulnar nerve release was performed with favorable outcome. Keywords: Cubital tunnel syndrome, Peripheral nerve palsy, Radial head excision, Elbow valgus

[Skull cult. Trophy heads and tzantzas in pre-Columbian America].

Science.gov (United States)

Carod-Artal, F J

2012-07-16

The skull cult is a cultural tradition that dates back to at least Neolithic times. Its main manifestations are trophy heads, skull masks, moulded skulls and shrunken heads. The article reviews the skull cult in both pre-Columbian America and the ethnographic present from a neuro-anthropological perspective. The tradition of shaping and painting the skulls of ancestors goes back to the Indo-European Neolithic period (Natufian culture and Gobekli Tepe). In Mesoamerica, post-mortem decapitation was the first step of a mortuary treatment that resulted in a trophy head, a skull for the tzompantli or a skull mask. The lithic technology utilised by the Mesoamerican cultures meant that disarticulation had to be performed in several stages. Tzompantli is a term that refers both to a construction where the heads of victims were kept and to the actual skulls themselves. Skull masks are skulls that have been artificially modified in order to separate and decorate the facial part; they have been found in the Templo Mayor of Tenochtitlan. The existence of trophy heads is well documented by means of iconographic representations on ceramic ware and textiles belonging to the Paraca, Nazca and Huari cultures of Peru. The Mundurucu Indians of Brazil and the Shuar or Jivaroan peoples of Amazonian Ecuador have maintained this custom down to the present day. The Shuar also shrink heads (tzantzas) in a ritual process. Spanish chroniclers such as Fray Toribio de Benavente 'Motolinia' and Gaspar de Carvajal spoke of these practices. In pre-Columbian America, the tradition of decapitating warriors in order to obtain trophy heads was a wide-spread and highly developed practice.

Study of radiation dose attenuation by skull bone in head during radiotherapy treatment using MCNP

Energy Technology Data Exchange (ETDEWEB)

Menezes, Artur F.; Boia, Leonardo S.; Trombetta, Debora M.; Martins, Maximiano C.; Reis Junior, Juraci P.; Silva, Ademir X., E-mail: ademir@con.ufrj.b [Coordenacao dos Programas de Pos-Graduacao de Engenharia (PEN/COPPE/UFRJ), RJ (Brazil). Programa de Engenharia Nuclear; Batista, Delano V.S., E-mail: delano@inca.gov.b [Instituto Nacional do Cancer (INCa), Rio de Janeiro, RJ (Brazil). Dept. de Fisica Medica

2011-07-01

In this study the MCNPX code was used to investigate possible influences of the attenuation beam by the surface bone during radiotherapy treatments of the skull. The computer simulation was performed on topographic image obtained from the National Cancer Institute, in Rio de Janeiro, database of patients treated with radiotherapy. The image segmentation process were performed using the SAPDI program developed to this purpose. The segmented image conversion for the input file recognized by MCNPX code was performed by SCAN2MCNP Software. The simulation was done using 10MeV Clinac 2300C spectrum considering two opposite parallel beams, with field size 2x2 and 4x4 cm{sup 2}, incident on a slice located above the eyes, containing two row of detectors positioned on the central region with a radius of 0.03 cm and arranged perpendicular to the radiation beams. After analyze the results, the relative error values in the range of 2 at 4% for the high dose region, and 26 at 37% for the low dose area were found, respectively. These differences were attributed to the radiation field attenuation on the bone surface at the entrance of the beam. It was observed that most situations on the high dose region the beam profile, from more realistic scenarios, became smaller than the one obtained when the tomography image was considered consisting of water. However for the low dose area the profile, obtained of the realistic situation, became higher than the one which was obtained when the tomography image was considered consisting of water. The results showed significant differences between both analyzed cases which show the need to use a correction factor by the treatment planning system used in radiotherapy services when the real chemical composition of patient head is unconsidered during the patient treatment planning. (author)

Study of radiation dose attenuation by skull bone in head during radiotherapy treatment using MCNP

International Nuclear Information System (INIS)

Menezes, Artur F.; Boia, Leonardo S.; Trombetta, Debora M.; Martins, Maximiano C.; Reis Junior, Juraci P.; Silva, Ademir X.; Batista, Delano V.S.

2011-01-01

In this study the MCNPX code was used to investigate possible influences of the attenuation beam by the surface bone during radiotherapy treatments of the skull. The computer simulation was performed on topographic image obtained from the National Cancer Institute, in Rio de Janeiro, database of patients treated with radiotherapy. The image segmentation process were performed using the SAPDI program developed to this purpose. The segmented image conversion for the input file recognized by MCNPX code was performed by SCAN2MCNP Software. The simulation was done using 10MeV Clinac 2300C spectrum considering two opposite parallel beams, with field size 2x2 and 4x4 cm 2 , incident on a slice located above the eyes, containing two row of detectors positioned on the central region with a radius of 0.03 cm and arranged perpendicular to the radiation beams. After analyze the results, the relative error values in the range of 2 at 4% for the high dose region, and 26 at 37% for the low dose area were found, respectively. These differences were attributed to the radiation field attenuation on the bone surface at the entrance of the beam. It was observed that most situations on the high dose region the beam profile, from more realistic scenarios, became smaller than the one obtained when the tomography image was considered consisting of water. However for the low dose area the profile, obtained of the realistic situation, became higher than the one which was obtained when the tomography image was considered consisting of water. The results showed significant differences between both analyzed cases which show the need to use a correction factor by the treatment planning system used in radiotherapy services when the real chemical composition of patient head is unconsidered during the patient treatment planning. (author)

Study the Effect of Intermittent and Continuous Ponding Depths by Using Different Heads to Leach Water

Directory of Open Access Journals (Sweden)

Nesrin J. AL-Mansori

2018-03-01

Full Text Available As results of using water for irrigated lands in a random manner in a time of shortage main water resources, Experimental work carried out to study the effect of continuous and intermittent ponding depth on the leaching processes. Sandy soil used, sourced from Hilla / Al-Jameeya, at Hilla city. Sieve analysis and hydrometer testing used to identify the properties of the soil. A model used with dimensions of 30, 30 and, 70 cm, with two different heads of water. Shatt-Al-Hilla River samples used in the leaching process.   Chemical tests carried out before the leaching process to identify changes in the proprieties in both water and soil. Leachate collected from two soil columns drained into boxes and tests carried out every 30 minutes. After the leaching process was complete, the soil was re-tested. Chemical tests on soil samples and the collected water applied after leaching for 47.5 cm and 52.5cm heads. From the results،, it can be notice that electrical conductivity for the outlet discharge from soil samples decreased faster with time, then slowing down until the end of leaching process.  The same pattern can be seen for all soil properties. In continuous leaching, a large quantity of water is required over a short leaching period, the inverse true for intermittent leaching. All parameters reduce with time in continuous leaching in comparison to intermittent leaching but when the water level in the soil column compared, it can inferred that increasing the head will reduce all the parameters for soil.

Intercomparison of two dynamic treatment techniques, ring scan and spot scan, for head and neck tumors with the Piotron

International Nuclear Information System (INIS)

Takai, M.; Blattmann, H.; Pedroni, E.

1988-01-01

An evaluation of the ring scan and the spot scan was made for the pion irradiation of head and neck tumors with the Piotron. For the geometry of the Piotron, with its 60 radially converging beams, two scanning techniques have been developed, ring scan and spot scan. They have different characteristics concerning achievable dose distributions and sensitivity to tissue inhomogenities. The optimized 3-dimensional dose distributions for the treatment with ring scan and spot scan techniques were calculated for two examples of the target volume. The comparison of the dose distributions has shown that the ring scan is better in sparing normal tissues than the spot scan for a simple shape target volume but not for an irregular shape target volume with the present status of the technique. The irradiation time needed for the ring scan is longer, for the present examples three times, than for the spot scan. From the practical view point the spot scan is preferable to the ring scan for the treatment of head and neck tumors with the Piotron

Investigation on Effect of Material Hardness in High Speed CNC End Milling Process

Directory of Open Access Journals (Sweden)

N. V. Dhandapani

2015-01-01

Full Text Available This research paper analyzes the effects of material properties on surface roughness, material removal rate, and tool wear on high speed CNC end milling process with various ferrous and nonferrous materials. The challenge of material specific decision on the process parameters of spindle speed, feed rate, depth of cut, coolant flow rate, cutting tool material, and type of coating for the cutting tool for required quality and quantity of production is addressed. Generally, decision made by the operator on floor is based on suggested values of the tool manufacturer or by trial and error method. This paper describes effect of various parameters on the surface roughness characteristics of the precision machining part. The prediction method suggested is based on various experimental analysis of parameters in different compositions of input conditions which would benefit the industry on standardization of high speed CNC end milling processes. The results show a basis for selection of parameters to get better results of surface roughness values as predicted by the case study results.

Investigation on Effect of Material Hardness in High Speed CNC End Milling Process.

Science.gov (United States)

Dhandapani, N V; Thangarasu, V S; Sureshkannan, G

2015-01-01

This research paper analyzes the effects of material properties on surface roughness, material removal rate, and tool wear on high speed CNC end milling process with various ferrous and nonferrous materials. The challenge of material specific decision on the process parameters of spindle speed, feed rate, depth of cut, coolant flow rate, cutting tool material, and type of coating for the cutting tool for required quality and quantity of production is addressed. Generally, decision made by the operator on floor is based on suggested values of the tool manufacturer or by trial and error method. This paper describes effect of various parameters on the surface roughness characteristics of the precision machining part. The prediction method suggested is based on various experimental analysis of parameters in different compositions of input conditions which would benefit the industry on standardization of high speed CNC end milling processes. The results show a basis for selection of parameters to get better results of surface roughness values as predicted by the case study results.

Neural networks in front-end processing and control

International Nuclear Information System (INIS)

Lister, J.B.; Schnurrenberger, H.; Staeheli, N.; Stockhammer, N.; Duperrex, P.A.; Moret, J.M.

1992-01-01

Research into neural networks has gained a large following in recent years. In spite of the long term timescale of this Artificial Intelligence research, the tools which the community is developing can already find useful applications to real practical problems in experimental research. One of the main advantages of the parallel algorithms being developed in AI is the structural simplicity of the required hardware implementation, and the simple nature of the calculations involved. This makes these techniques ideal for problems in which both speed and data volume reduction are important, the case for most front-end processing tasks. In this paper the authors illustrate the use of a particular neural network known as the Multi-Layer Perceptron as a method for solving several different tasks, all drawn from the field of Tokamak research. The authors also briefly discuss the use of the Multi-Layer Perceptron as a non-linear controller in a feedback loop. The authors outline the type of problem which can be usefully addressed by these techniques, even before the large-scale parallel processing hardware currently under development becomes cheaply available. The authors also present some of the difficulties encountered in applying these networks

Neural networks in front-end processing and control

International Nuclear Information System (INIS)

Lister, J.B.; Schnurrenberger, H.; Staeheli, N.; Stockhammer, N.; Duperrex, P.A.; Moret, J.M.

1991-07-01

Research into neural networks has gained a large following in recent years. In spite of the long term timescale of this Artificial Intelligence research, the tools which the community is developing can already find useful applications to real practical problems in experimental research. One of the main advantages of the parallel algorithms being developed in AI is the structural simplicity of the required hardware implementation, and the simple nature of the calculations involved. This makes these techniques ideal for problems in which both speed and data volume reduction are important, the case for most front-end processing tasks. In this paper we illustrate the use of a particular neural network known as the Multi-Layer Perceptron as a method for solving several different tasks, all drawn from the field of Tokamak research. We also briefly discuss the use of the Multi-Layer Perceptron as a non-linear controller in a feedback loop. We outline the type of problem which can be usefully addressed by these techniques, even before the large-scale parallel processing hardware currently under development becomes cheaply available. We also present some of the difficulties encountered in applying these networks. (author) 13 figs., 9 refs

Ultralow field emission from thinned, open-ended, and defected carbon nanotubes by using microwave hydrogen plasma processing

Energy Technology Data Exchange (ETDEWEB)

Deng, Jian-Hua, E-mail: jhdeng1983@163.com [College of Physics and Materials Science, Tianjin Normal University, Tianjin 300387 (China); Cheng, Lin; Wang, Fan-Jie; Yu, Bin; Li, Guo-Zheng; Li, De-Jun [College of Physics and Materials Science, Tianjin Normal University, Tianjin 300387 (China); Cheng, Guo-An [Key Laboratory of Beam Technology and Material Modification of Ministry of Education, Beijing Normal University, Beijing 100875 (China)

2015-01-01

Graphical abstract: Thinned, open-ended, and defected carbon nanotubes were prepared by using hydrogen plasma processing. The processed carbon nanotubes have far better field emission performance than that of the pristine ones. - Highlights: • CVD prepared CNT arrays were processed by microwave hydrogen plasma. • Thinned, open-ended, and defected CNTs were obtained. • Processed CNTs have far better field emission performance than the pristine ones. • Processed CNTs have applicable emission stability after being perfectly aged. - Abstract: Ultralow field emission is achieved from carbon nanotubes (CNTs) by using microwave hydrogen plasma processing. After the processing, typical capped CNT tips are removed, with thinned, open-ended, and defected CNTs left. Structural analyses indicate that the processed CNTs have more SP{sup 3}-hybridized defects as compared to the pristine ones. The morphology of CNTs can be readily controlled by adjusting microwave powers, which change the shape of CNTs by means of hydrogen plasma etching. Processed CNTs with optimal morphology are found to have an ultralow turn-on field of 0.566 V/μm and threshold field of 0.896 V/μm, much better than 0.948 and 1.559 V/μm of the as-grown CNTs, respectively. This improved FE performance is ascribed to the structural changes of CNTs after the processing. The thinned and open-ended shape of CNTs can facilitate electron tunneling through barriers and additionally, the increased defects at tube walls can serve as new active emission sites. Furthermore, our plasma processed CNTs exhibit excellent field emission stability at a large emission current density of 10.36 mA/cm{sup 2} after being perfectly aged, showing promising prospects in applications as high-performance vacuum electron sources.

One stage functional end-to-end stapled intestinal anastomosis and resection performed by nonexpert surgeons for the treatment of small intestinal obstruction in 30 dogs.

Science.gov (United States)

Jardel, Nicolas; Hidalgo, Antoine; Leperlier, Dimitri; Manassero, Mathieu; Gomes, Aymeric; Bedu, Anne Sophie; Moissonnier, Pierre; Fayolle, Pascal; Begon, Dominique; Riquois, Elisabeth; Viateau, Véronique

2011-02-01

To describe stapled 1-stage functional end-to-end intestinal anastomosis for treatment of small intestinal obstruction in dogs and evaluate outcome when the technique is performed by nonexpert surgeons after limited training in the technique. Case series. Dogs (n=30) with intestinal lesions requiring an enterectomy. Stapled 1-stage functional end-to-end anastomosis and resection using a GIA-60 and a TA-55 stapling devices were performed under supervision of senior residents and faculty surgeons by junior surgeons previously trained in the technique on pigs. Procedure duration and technical problems were recorded. Short-term results were collected during hospitalization and at suture removal. Long-term outcome was established by clinical and ultrasonographic examinations at least 2 months after surgery and from written questionnaires, completed by owners. Mean±SD procedure duration was 15±12 minutes. Postoperative recovery was uneventful in 25 dogs. One dog had anastomotic leakage, 1 had a localized abscess at the transverse staple line, and 3 dogs developed an incisional abdominal wall abscess. No long-term complications occurred (follow-up, 2-32 months). Stapled 1-stage functional end-to-end anastomosis and resection is a fast and safe procedure in the hand of nonexpert but trained surgeons. © Copyright 2011 by The American College of Veterinary Surgeons.

[End-of-life care and end-of-life medical decisions: the ITAELD study].

Science.gov (United States)

Miccinesi, Guido; Puliti, Donella; Paci, Eugenio

2011-01-01

To describe the attitudes towards end of life care and the practice of end-of-life medical decisions with possible life-shortening effect among Italian physicians. Cross sectional study (last death among the assisted patients in the last 12 months was considered). In the year 2007, 5,710 GPs and 8,950 hospital physicians were invited all over Italy to participate in the ITAELDstudy through anonymous mail questionnaire. Proportion of agreement with statements on end-of-life care issues. Proportion of deaths with an end-of-life medical decision. The response rate was 19.2%. The 65% of respondents agreed with the duty to respect any non-treatment request of the competent patient, the 55% agreed with the same duty in case of advanced directives, the 39% in case of proxy's request. The 53% of respondents agreed with the ethical acceptability of active euthanasia in selected cases. Among 1,850 deaths the 57.7% did not receive any end-of-life medical decision. For a further 21.0% no decision was possible, being sudden and unexpected deaths. In the remaining 21.3% at least one end-of-life medical decision was reported: 0.8% was classified as physician assisted death, 20.5% as non-treatment decision. Among all deceased the 19.6% were reported to have been deeply sedated. Being favourable to the use of opioids in terminal patients was associated to non-treatment decisions with possible but non-intentional life shortening effect; agreeing with the duty to fully respect any actual non-treatment request of the competent patient was associated to end-of life medical decisions with intentional life-shortening effect (adjusted OR>10 in both cases). The life stance and ethical beliefs of physicians determine their behaviour at the end of life wherever specific statements of law are lacking. Therefore education and debate are needed on these issues.

Application of the pulsed magnetic welding process to nuclear breeder reactor fuel pin end closures

International Nuclear Information System (INIS)

Brown, W.F.

1984-01-01

The pulsed magnetic welding process is a solid state welding process in which metallurgical bonding is effected by impacting metal or alloy parts against each other at high velocity by use of controlled high frequency, high intensity pulsed magnetic fields. This process is similar to the explosive welding process except that magnetic energy is used for impacting the parts together instead of using explosive energy. The pulsed magnetic welding (PMW) process is readily applied to the welding of cylindrical plugs to small diameter tubes. Although breeder reactor fuel pin design may vary in size, the application described here consisted of cladding tubes approximately 6.4 mm in diameter by 244 cm long with a wall thickness of 0.38 mm. After the cladding tubes are filled with fuel pellets and associated metal hardware, tapered end plugs are inserted into the end of the tubes and welded. A typical setup for PMW is described

Endogenous System Microbes as Treatment Process ...

Science.gov (United States)

Monitoring the efficacy of treatment strategies to remove pathogens in decentralized systems remains a challenge. Evaluating log reduction targets by measuring pathogen levels is hampered by their sporadic and low occurrence rates. Fecal indicator bacteria are used in centralized systems to indicate the presence of fecal pathogens, but are ineffective decentralized treatment process indicators as they generally occur at levels too low to assess log reduction targets. System challenge testing by spiking with high loads of fecal indicator organisms, like MS2 coliphage, has limitations, especially for large systems. Microbes that are endogenous to the decentralized system, occur in high abundances and mimic removal rates of bacterial, viral and/or parasitic protozoan pathogens during treatment could serve as alternative treatment process indicators to verify log reduction targets. To identify abundant microbes in wastewater, the bacterial and viral communities were examined using deep sequencing. Building infrastructure-associated bacteria, like Zoogloea, were observed as dominant members of the bacterial community in graywater. In blackwater, bacteriophage of the order Caudovirales constituted the majority of contiguous sequences from the viral community. This study identifies candidate treatment process indicators in decentralized systems that could be used to verify log removal during treatment. The association of the presence of treatment process indic

Initial clinical experience with an interactive, video-based patient-positioning system for head and neck treatment

International Nuclear Information System (INIS)

Johnson, L.; Hadley, Scott W.; Milliken, Barrett D.; Pelizzari, Charles A.; Haraf, Daniel J.; Nguyen, Ai; Chen, George T.Y.

1996-01-01

Objective: To evaluate an interactive, video-based system for positioning head and neck patients. Materials and Methods: System hardware includes two B and W CCD cameras (mounted to provide left-lateral and AP-inferior views), zoom lenses, and a PC equipped with a frame grabber. Custom software is used to acquire and archive video images, as well as to display real-time subtraction images revealing patient misalignment in multiple views. Live subtraction images are obtained by subtracting a reference image (i.e., an image of the patient in the correct position) from real-time video. As seen in the figure, darker regions of the subtraction image indicate where the patient is currently, while lighter regions indicate where the patient should be. Adjustments in the patient's position are updated and displayed in less than 0.07s, allowing the therapist to interactively detect and correct setup discrepancies. Patients selected for study are treated BID and immobilized with conventional litecast straps attached to a baseframe which is registered to the treatment couch. Morning setups are performed by aligning litecast marks and patient anatomy to treatment room lasers. Afternoon setups begin with the same procedure, and then live subtraction images are used to fine-tune the setup. At morning and afternoon setups, video images and verification films are taken after positioning is complete. These are visually registered offline to determine the distribution of setup errors per patient, with and without video assistance. Results: Without video assistance, the standard deviation of setup errors typically ranged from 5 to 7mm and was patient-dependent. With video assistance, standard deviations are reduced to 1 to 4mm, with the result depending on patient coopertiveness and the length of time spent fine-tuning the setups. At current levels of experience, 3 to 4mm accuracy is easily achieved in about 30s, while 1 to 3mm accuracy is achieved in about 1 to 2 minutes. Studies

The impact of oral rehabilitation on oral health-related quality of life in patients receiving radiotherapy for the treatment of head and neck cancer.

Science.gov (United States)

Schweyen, Ramona; Kuhnt, Thomas; Wienke, Andreas; Eckert, Alexander; Hey, Jeremias

2017-05-01

To analyze the influence of dental treatment on oral health-related quality of life (OHRQoL) in head and neck cancer patients. This study included the data of 116 patients who underwent radiotherapy (RT) because of head and neck cancer. For each patient, the variables age, sex, tumor site, irradiation technique, dose on the spared parotid gland, concomitant chemotherapy, and denture status were documented. OHRQoL was determined using the OHIP-G14 questionnaire. Patients were divided into subgroups according to denture status: none or fixed partial dentures (none/FPD), removable partial dentures (RPD), and full dentures (CD). OHIP summary scores were determined and tested for clinical relevant differences with respect to the different variables. The association between OHRQol and the variables was assessed using linear regression. No clinically relevant influence on OHRQoL was found for gender, irradiation technique, and chemotherapy. Patients with tumors located in the oral cavity had a significantly higher OHIP score than patients with other tumor sites (p < 0.001). None/FPD and RPD patients had higher values than those found in a normal population, but did not differ significantly from each other (p = 0.387). In contrast to tumor site, teeth and type of denture seem to have a limited effect on OHRQoL in head and neck cancer patients. Prosthetic treatment in head and neck cancer patients do not lead to the same improvement in OHRQoL as found in the normal population. This might be taken into account especially if extensive dental treatment is intended.