18F-FDG-PET/CT in fever of unknown origin

DEFF Research Database (Denmark)

Middelbo Buch-Olsen, Karen; Andersen, Rikke V; Hess, Søren

2014-01-01

OBJECTIVE: Fever of unknown origin continues to be a diagnostic challenge for clinicians. The aim of this study was to confirm whether (18)F-fluorodeoxyglucose ((18)F-FDG)-PET/computed tomography (CT) is a helpful tool in patients suffering from this condition. PATIENTS AND METHODS: Fifty......-seven patients with fever of unknown origin were examined with (18)F-FDG-PET/CT as part of their diagnostic workup at the clinicians' discretion. The medical records were read retrospectively to establish the final diagnosis and evaluate the degree to which PET/CT contributed to the diagnosis. RESULTS......-FDG-PET/CT is a useful tool in the investigation of fever of unknown origin; it can reduce patient inconvenience and possibly costs to society if used earlier in the diagnostic process....

Melanoma of unknown origin: a case series.

LENUS (Irish Health Repository)

Kelly, J

2010-12-01

The natural history of metastatic melanoma involving lymph nodes, in the absence of a known primary site (cutaneous, ocular or mucosal) has, to date, been poorly defined; and the optimal management of this rare subtype of disease is therefore unclear. Melanomas of unknown primary site (MUP) are estimated to comprise between 3.7 and 6% of all melanomas (Anbari et al. in Cancer 79:1861-1821, 1997).

Renal disease masquerading as pyrexia of unknown origin

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D Korivi

2013-01-01

Full Text Available Pyrexia of unknown origin is a challenging clinical problem. Infections, malignancies, and connective tissue diseases form the major etiologies for this condition. We report a case of a 57-year-old diabetic male who presented with fever of unknown origin for several months. The course of investigations led to a kidney biopsy which clinched the cause of his fever as well as the underlying diagnosis. The light microscopy findings of expansile storiform fibrosis with a dense inflammatory infiltrate suggested the diagnosis which was confirmed by positive staining of Immunoglobulin G4, the dense lympho-plasmacytic infiltrate and elevated serum IgG4 concentrations. A course of steroids followed by mycophenolate mofetil as maintenance immunosuppression rendered the patient afebrile with improvement of renal function.

Value of Bone marrow Examination in Pyrexia of unknown origin

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A Jha

2013-10-01

Full Text Available Background: Pyrexia of unknown origin is a common diagnostic dilemma. Series of diagnostic modalities are required to arrive at diagnosis. Bone marrow examination is one of the common tests implicated in the diagnosis in combination with other diagnostic modalities. Present study has attempted to explore the causes of pyrexia of unknown origin based on bone marrow morphological study. Materials and Methods: In a one year prospective study conducted at Manipal Teaching Hospital, Pokhara, Nepal; bone marrow aspiration and biopsy was performed and evaluated morphologically, in 57 patients fulfilling the criteria of classic pyrexia of unknown origin. Results: In 42% cases; specific diagnosis could be made and hematological neoplasm was the most common finding followed by megaloblastic anemia, hypoplastic anemia and one case each of hemophagocytosis, malaria and tuberculosis. Acute leukemia was the most frequently encountered hematological malignancy followed by multiple myeloma, chronic myeloid leukemia, essential thrombocythemia and myelodysplastic syndrome. Conclusion: Morphological examination of bone marrow has important role in diagnosis of pyrexia of unknown origin. However, yield of diagnosis can be increased if it is combined with other diagnostic modalities including radiological, microbiological and serological tests. DOI: http://dx.doi.org/10.3126/jpn.v3i6.8991 Journal of Pathology of Nepal (2013 Vol. 3, 447-451

Quality of Life of Patients with Spinal Metastasis from Cancer of Unknown Primary Origin: A Longitudinal Study of Surgical Management Combined with Postoperative Radiation Therapy.

Science.gov (United States)

Ma, Yifei; He, Shaohui; Liu, Tielong; Yang, Xinghai; Zhao, Jian; Yu, Hongyu; Feng, Jiaojiao; Xu, Wei; Xiao, Jianru

2017-10-04

Patients with spinal metastasis from cancer of unknown primary origin have limited life expectancy and poor quality of life. Surgery and radiation therapy remain the main treatment options, but, to our knowledge, there are limited data concerning quality-of-life improvement after surgery and radiation therapy and even fewer data on whether surgical intervention would affect quality of life. Patients were enrolled between January 2009 and January 2014 at the Changzheng Hospital, Shanghai, People's Republic of China. The quality of life of 2 patient groups (one group that underwent surgery followed by postoperative radiation therapy and one group that underwent radiation therapy only) was assessed by the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire during a 6-month period. A subgroup analysis of quality of life was performed to compare different surgical strategies in the surgical group. A total of 287 patients, including 191 patients in the group that underwent surgery and 96 patients in the group that underwent radiation therapy only, were enrolled in the prospective study; 177 patients completed all 5 checkpoints and 110 patients had died by the final checkpoint. The surgery group had significantly higher adjusted quality-of-life scores than the radiation therapy group in each domain of the FACT-G questionnaire (all p quality of life in patients with spinal metastasis from cancer of unknown primary origin in the 6-month assessment. In terms of surgical strategies, circumferential decompression seems better than laminectomy alone in quality-of-life improvement. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

The role of PET in initial work-up and evaluation after therapy in patients with carcinoma of unknown primary

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Ryoo, Baek Yeol; Kang, Yoon Koo

1998-12-01

The carcinoma of unknown primary occupied 5 - 10 % of all malignancies. It is heterogenous in origin and has poor prognosis. The indentification of primary site and definition of involved area are more helpful in the management. The efficacy of positron emission tomography (PET) with fluorine-18- fluorodeoxyglucose (F18-FDG) positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (F18-FDG) was evaluated in several tumors such as breast, pancreas and head and neck cancers. In carcinoma of unknown primary, it was reported that the concentration of FDG was increased in tumor tissues, and that PET with F18-FDG may be much helpful in identifying primary site and defining involved area. The authors evaluated the usefulness of PET with F18-FDG in initial work-up and in evaluation after radical therapy for the patients with carcinoma of unknown primary. The visual analysis of FDG-PET would be helpful in identifying primary site and defining involved area. In detecting recurrent of residual lesions, FDG-PET seemed to be less helpful than conventional diagnostic work-up. But more studies with larger number of cases and longer follow-up were required. The results of this study can be bases for the direction of future studies for the usefulness of PET in carcinoma of unknown primary.

The role of PET in initial work-up and evaluation after therapy in patients with carcinoma of unknown primary

International Nuclear Information System (INIS)

Ryoo, Baek Yeol; Kang, Yoon Koo

1998-12-01

The carcinoma of unknown primary occupied 5 - 10 % of all malignancies. It is heterogenous in origin and has poor prognosis. The indentification of primary site and definition of involved area are more helpful in the management. The efficacy of positron emission tomography (PET) with fluorine-18- fluorodeoxyglucose (F18-FDG) positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (F18-FDG) was evaluated in several tumors such as breast, pancreas and head and neck cancers. In carcinoma of unknown primary, it was reported that the concentration of FDG was increased in tumor tissues, and that PET with F18-FDG may be much helpful in identifying primary site and defining involved area. The authors evaluated the usefulness of PET with F18-FDG in initial work-up and in evaluation after radical therapy for the patients with carcinoma of unknown primary. The visual analysis of FDG-PET would be helpful in identifying primary site and defining involved area. In detecting recurrent of residual lesions, FDG-PET seemed to be less helpful than conventional diagnostic work-up. But more studies with larger number of cases and longer follow-up were required. The results of this study can be bases for the direction of future studies for the usefulness of PET in carcinoma of unknown primary

A case of hemophagocytic lymphohistiocytosis presenting as pyrexia of unknown origin

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Indira Madhavan

2015-01-01

Full Text Available Hemophagocytic lymphohistiocytosis (HLH is a potentially fatal hyper inflammatory condition, which occurs as either primary (genetic or secondary (acquired due to impaired or absent function of natural killer cells and cytotoxic cells. Common secondary causes include viral and bacterial infections, autoimmune diseases, and hematological malignancies. Extensive phagocytosis of blood cells by histiocytes in bone marrow, spleen, liver and lymphnodes result in peripheral blood cytopenias, hepatosplenomegaly, and lymphadenopathy. We evaluated a case of pyrexia of unknown origin and found out that he fulfilled the criteria for diagnosing HLH. He was started on immunochemotherapy with etoposide, cyclosporine and steroids, but he succumbed to illness within 2 weeks of treatment. High index of suspicion is needed to diagnose HLH and prompt treatment on diagnosis can be lifesaving.

Time trends in incidence and prognosis of primary liver cancer and liver metastases of unknown origin in a Danish region, 1985-2004

DEFF Research Database (Denmark)

Erichsen, Rune; Jepsen, Peter; Jacobsen, Jacob

2008-01-01

OBJECTIVES: Changes, over the last 20 years, in the diagnostic procedures and treatment of primary liver cancer (PLC) and liver metastases of unknown origin (LMUO) may have affected the clinical course of both cancers. Few longitudinal studies examined this issue. In a population-based setting, we...... studied changes in the incidence and prognosis of PLC and LMUO over time. METHODS: Between 1985 and 2004, we identified 2675 patients with PLC and LMUO in three Danish counties, with a population of 1.4 million. We computed the standardized incidence rate (SIR), ratio of PLC to LMUO diagnoses, median...... survival, and estimated mortality rate ratio adjusted for age, sex, and comorbidity. RESULTS: The SIR of PLC increased from 3.2 in 1985 to 5.0 in 2003, and the SIR of LMUO increased from 3.7 to 6.4. No increase was noted in the PLC-to-LMUO ratio over time (P=0.1 for trend). From 1985 to 2004, the median...

Comparison of survival of patients with metastases from known versus unknown primaries: survival in metastatic cancer

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Riihimäki Matias

2013-01-01

Full Text Available Abstract Background Cancer of unknown primary site (CUP is considered an aggressive metastatic disease but whether the prognosis differs from metastatic cancers of known primary site is not known. Such data may give insight into the biology of CUP and the metastatic process in general. Methods 6,745 cancer patients, with primary metastatic cancer at diagnosis, were identified from the Swedish Cancer Registry, and were compared with 2,881 patients with CUP. Patients were diagnosed and died between 2002 and 2008. The influence of the primary site, known or unknown, on survival in patients with metastases at specific locations was investigated. Hazard ratios (HRs of death were estimated for several sites of metastasis, where patients with known primary sites were compared with CUP patients. Results Overall, patients with metastatic cancers with known primary sites had decreased hazards of death compared to CUP patients (HR = 0.69 [95% CI = 0.66–0.72]. The exceptions were cancer of the pancreas (1.71 [1.54–1.90], liver (1.58 [1.36–1.85], and stomach (1.16 [1.02–1.31]. For individual metastatic sites, patients with liver or bone metastases of known origin had better survival than those with CUP of the liver and bone. Patients with liver metastases of pancreatic origin had an increased risk of death compared with patients with CUP of the liver (1.25 [1.06–1.46]. The median survival time of CUP patients was three months. Conclusions Patients with CUP have poorer survival than patients with known primaries, except those with brain and respiratory system metastases. Of CUP sites, liver metastases had the worst prognosis. Survival in CUP was comparable to that in metastatic lung cancer. The aggressive behavior of CUP may be due to initial immunosuppression and immunoediting which may allow accumulation of mutations. Upon escape from the suppressed state an unstoppable tumor spread ensues. These novel data on the epidemiology of the

Carcinoma of Unknown Primary Treatment (PDQ®)—Health Professional Version

Science.gov (United States)

Carcinoma of unknown primary (CUP) treatment depends on the best determination of the primary site, if possible. Treatment options may include surgery, radiation therapy, and systemic treatment. Get detailed information about diagnosis and treatment of CUP in this summary for clinicians.

Carcinoma of Unknown Primary Treatment (PDQ®)—Patient Version

Science.gov (United States)

Carcinoma of unknown primary (CUP), treatment can include surgery, radiation therapy, chemotherapy, or hormone therapy. Get detailed information about the diagnosis and treatment of CUP in this expert-reviewed summary.

Fever of Unknown Origin: the Value of FDG-PET/CT

NARCIS (Netherlands)

Kouijzer, I.J.E.; Mulders-Manders, C.M.; Bleeker-Rovers, C.P.; Oyen, W.J.G.

2018-01-01

Fever of unknown origin (FUO) is commonly defined as fever higher than 38.3 degrees C on several occasions during at least 3 weeks with uncertain diagnosis after a number of obligatory investigations. The differential diagnosis of FUO can be subdivided in four categories: infections, malignancies,

Role of {sup 18}F-FDG PET/CT in the evaluation of primary tumours of unknown origin; experience of the Hospital Angeles del Pedregal; Papel del 18F-FDG PET/CT en la evaluacion de tumores primarios de origen desconocido; experiencia del Hospital Angeles del Pedregal

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Sanchez, N; Serna, J A; Quiroz, O; Valenzuela, J; Romo, C; Ramirez, J L [Hospital Angeles del Pedregal, Mexico D.F. (Mexico)

2007-07-01

It was in 1994 when published studies appear that evaluate the utility of the {sup 18}F-FDG PET in the patients with primary tumors of unknown origin (TOD); starting from then diverse studies that support the clinical utility of the study arise with {sup 18}F-FDG PET in the detection of the primary tumor. It is as well as it has been calculated that the study with {sup 18}F-FDG PET is able to detect the primary tumor in around 40% of the patients with negative results in the conventional diagnostic procedures. Until the moment, most of the studies published in relation to the primary tumors of unknown origin only evaluate the paper of the study with {sup 18}F-FDG PET, without including the image fusion technique PET/CT, which has demonstrated in diverse studies; in oncological scenarios different from the TOD, a superior diagnosis certainty. (Author)

Role of 18F-FDG PET-CT in detection of primary tumors in patients with cervical/extra cervical metastases of unknown origin

International Nuclear Information System (INIS)

Soundararajan, Ramya; Naswa, Niraj; Nazar, Aftab Hasan; Kumar, Rakesh; Bal, Chandrasekhar; Bandopadhyaya, Guru; Malhotra, Arun

2011-01-01

Carcinoma of unknown primary (CUP) is a heterogeneous group of histologically proven metastatic malignancies for which the primary tumor could not be detected despite thorough diagnostic evaluation. CUP accounts for 2.3-4.2% of cancer in both sexes and follows an aggressive behavior with a median survival less than 1 year. Identification of a primary tumor has an impact on therapy and life expectancy and it is often detected only in 10-35% of all cases by conventional imaging modalities. Hence there is clearly a need of whole body, non invasive imaging modality with a high diagnostic yield

Metastasis to neck from unknown primary tumor

International Nuclear Information System (INIS)

Jose, B.; Bosch, A.; Caldwell, W.L.; Frias, Z.

1979-01-01

The records of 54 consecutive patients who were irradiated for metastatic disease in the neck from an unknown primary tumor were reviewed. The overall survival results are comparable to those of other reported series. Patients with high or posterior cervical lymph node involvement were irradiated with fields including the nasopharynx and oropharynx. Patients with high neck nodes had a better survival rate than those with low neck nodes. The size of the neck tumors and the local control after treatment also have prognostic significance. (Auth.)

An Evidence-Based Review Literature About Risk Indicators and Management of Unknown-Origin Xerostomia

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Farzaneh Agha-hosseini

2013-01-01

Full Text Available Objective: This evidence-based article reviews risk indicators and management of unknown-origin xerostomia. Xerostomia and hyposalivation refer to different aspects of dry mouth. Xerostomia is a subjective sensation of dry mouth, whilst hyposalivation is defined as an objective assessment of reduced salivary flow rate. About 30% of the elderly (65 years and older experience xerostomia and hyposalivation. Structural and functional factors, or both may lead to salivary gland dysfunction.Study Selection: The EBM literature search was conducted by using the medical literature database MEDLINE via PubMed and OvidMedline search engines. Results were limited to English language articles (1965 to present including clinical trials (CT, randomized controlled trials (RCT, systematic reviews and review articles. Case control or cohort studies were included for the etiology.Results: Neuropathic etiology such as localized oral alteration of thermal sensations, saliva composition change (for example higher levels of K, Cl, Ca, IgA, amylase, calcium, PTH and cortisol, lower levels of estrogen and progesterone, smaller salivary gland size, and illnesses such as lichen planus, are risk indicators for unknown-origin xerostomia. The management is palliative and preventative. Management of symptoms includes drug administration (systemic secretogogues, saliva substitutes and bile secretion-stimulator, night guard, diet and habit modifications. Other managements may be indicated to treat adverse effects.Conclusion: Neuropathic etiology, saliva composition change, smaller salivary gland size, and illnesses such as oral lichen planus can be suggestive causes for unknown-origin xerostomia. However, longitudinal studies will be important to elucidate the causes of unknown-origin xerostomia.

Metastatic meningioma presenting as cancer of unknown primary

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Vinay Gupta

2013-12-01

Full Text Available We describe a case of anaplastic meningioma presenting in an extracranial osseous location, initially diagnosed as cancer of unknown primary. Although anaplastic meningioma comprise 3% of all meningiomas, this subtype is more likely to be associated with metastases. The increased degree of dedifferentiation in anaplastic meningioma makes diagnosis difficult, especially if characteristic imaging findings of meningioma are not identified. Adequate tissue for diagnostic purposes and appropriate imaging studies may help in establishing a definitive diagnosis.

Whole body 18F-deoxyglucose positron emission tomography in detecting the primary focus of metastatic cancer with an unknown primary

International Nuclear Information System (INIS)

Chen Yingrui; Li Weixiong; Gu Meixin; Zhan Zhiguang; Zeng Zijun

2002-01-01

Objective: To evaluate the value of 18 F-deoxyglucose (FDG) positron emission tomography (PET) in detecting the primary focus of metastatic cancer with an unknown primary. Methods: Twenty-nine patients with various histological types of metastases from an unknown primary after extensive conventional diagnostic work-up were studied. After intravenous 370 MBq FDG, whole body scan was made 50 minutes after injection. The results of FDG PET were compared with those of CT or MRI. Results: With FDG PET, the primary tumors were identified in 13 patients and confirmed by pathology. The corresponding detection rate was 44.8% (13/29) as compared with 27.6% (8/29) by CT or MRI. In addition, 26 metastases were discovered by FDG PET whole body imaging but only 13 were found by CT or MRI. During 2-13 months' follow-up, the mortality rates were 15.4%(2/13) and 42.9%(6/14) for patients with the primary tumor identified or unidentified. Conclusions: FDG PET is valuable in staging, selecting appropriate treatment protocol and predicting prognosis for patients suffering from metastatic cancers with an unknown primary

Carcinoma escamoso metastásico primario de origen desconocido. Presentación de un caso Primary Metastatic Squamous Cell Carcinoma of Unknown Origin. A Case Report

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Miguel Ángel Serra Valdés

2012-12-01

Full Text Available El cáncer primario oculto representa según varias series del 0,5 al 7 % de todos los cánceres que se diagnostican y la edad media de presentación es 60 años. Se presenta un caso de metástasis ganglionar de carcinoma primario de células escamosas no identificado, de una paciente de 58 años de edad, de color de piel blanca, con antecedentes de salud, ama de casa, que fumaba desde joven e ingería alcohol frecuentemente. Ingresó con aumento de volumen de los ganglios del cuello. Se diagnosticó por biopsia metástasis de carcinoma escamoso. No pudo identificarse el primario en vida ni en la necropsia. El cáncer metastásico primario de origen desconocido sigue siendo un reto para la práctica clínica.Occult primary cancer represents, according to several series, from 0,5 % to 7 % of all diagnosed cancers, the average onset age being 60 years old. We report the case of nodal metastasis of unidentified primary squamous cell carcinoma in a 58 years old patient with white skin and a history of good health. The patient was a housekeeper who smoked from early age and frequently consumed alcohol. She was admitted with an enlargement of the neck glands. Metastases of squamous cell carcinoma were diagnosed through biopsy. Primary cancer was not identified neither while still alive or at necropsy. Primary metastatic cancers of unknown origin remain a challenge for clinical practice.

STUDY OF SPECTRUM OF PYREXIA OF UNKNOWN ORIGIN PATIENTS IN A TERTIARY CARE HOSPITAL IN COASTAL ANDHRA PRADESH

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Suryaprakasa Rao Salla

2017-09-01

Full Text Available BACKGROUND Pyrexia of Unknown Origin (PUO/Fever of Unknown Origin (FUO was defined in 1961 by Petersdorf RG and Beeson PB2 as the following- A temperature greater than 38.3°C (101°F on several occasions; more than 3 weeks' duration of illness; and failure to reach a diagnosis despite 1 week of inpatient investigation. The aim of the study is to study the spectrum of cases of Pyrexia of Unknown Origin (PUO/Fever of Unknown Origin (FUO in a tertiary care hospital in coastal Andhra Pradesh. MATERIALS AND METHODS All patients with PUO admitted under the Department of General Medicine in the NRI Institute of Medical Sciences (Anil Neerukonda Hospital Sangivalasa, Visakhapatnam, during the period from 1st September, 2016, to 31st August, 2017, and who fulfil inclusion and exclusion criteria of classic PUO defined by Durrack and AC street1 were selected for the study. RESULTS The present study included 34 patients with pyrexia of unknown origin in which the patients’ age ranged from 15 years to 77 years. Most of the cases, 41.2% were in the age group 21 to 40 years and 35.3% in the age group 41 to 60 yrs. This indicates PUO is common in middle age group in our study. CONCLUSION Noninfectious causes like collagen vascular disease and neoplasms are becoming important differential diagnosis. But, in India, infections like tuberculosis, enteric fever are still the most common cause of FUO.

Cosmic-ray antimatter - A primary origin hypothesis

Science.gov (United States)

Stecker, F. W.; Protheroe, R. J.; Kazanas, D.

1983-01-01

The present investigation is concerned with the possibility that the observed cosmic-ray protons are of primary extragalactic origin, taking into account the significance of the current antiproton data. Attention is given to questions regarding primary antiprotons, antihelium fluxes, and the propagation of extragalactic cosmic rays. It is concluded that the primary origin hypothesis should be considered as a serious alternative explanation for the cosmic-ray antiproton fluxes. Such extragalactic primary origin can be considered in the context of a baryon symmetric domain cosmology. The fluxes and propagation characteristics suggested are found to be in rough agreement with the present antiproton data.

Metastatic Carcinoma of Unknown Primary Presenting as Jugular Venous Thrombosis

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Prince Cheriyan Modayil

2009-01-01

Full Text Available Jugular venous thrombosis is unusual and is associated with central venous catheterisation, intravenous drug abuse and head and neck sepsis. It is rarely associated with malignancy. We report a case of metastatic carcinoma of unknown primary in a forty year old female which presented with jugular venous thrombosis. The discussion includes investigation and treatment options for this condition.

Diagnostic and prognostic yield of tumor markers in cancer of unknown primary site

International Nuclear Information System (INIS)

Pervez, T.; Ibraheim, M.I.

2006-01-01

A case of metastatic carcinoma of unknown primary is reported that had widely disseminated disease from the very outset. Every effort was made to find out the primary by integrating all results and specially tumor markers. It was assumed that lung was the most possible site for primary. Tumor markers did not show their diagnostic value even in combined panel, they only showed their prognostic value. (author)

Membranoproliferative glomerulonephritis in a carcinoma with unknown primary: An autopsy study

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Gupta Kirti

2008-04-01

Full Text Available Kidney disease frequently complicates malignancy and its treatment. Although many solid and hematologic cancers may involve the renal parenchyma, clinical sequelae are usually not prominent. Published reports cite membranous nephropathy as the most common malignancy-associated glomerulopathy, occurring with many carcinomas and occasionally with leukemia and lymphoma followed by minimal change disease. Rarely membranoproliferative glomerulonephritis (MPGN has been reported in patients with malignancy. The mechanism by which malignancy induces disease remains unproved, but may involve deposition of tumor antigen in the subepithelial space with in situ immune complex formation and subsequent complement activation. Treatment of the underlying malignancy may lead to resolution of nephrotic syndrome, lending indirect support to this theory. We report a rare autopsy case of a patient with metastatic carcinoma (with unknown primary associated with MPGN. The association between MPGN and metastatic carcinoma with unknown primary is uncommon and has not been previously reported in the literature.

The added value of 18F-fluorodeoxyglucose positron emission tomography computed tomography in patients with neck lymph node metastases from an unknown primary malignancy.

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Prowse, S J B; Shaw, R; Ganeshan, D; Prowse, P M; Hanlon, R; Lewis-Jones, H; Wieshmann, H

2013-08-01

The search for a primary malignancy in patients with a metastatic cervical lymph node is challenging yet ultimately of utmost clinical importance. This study evaluated the efficacy of positron emission tomography computed tomography in detecting the occult primary, within the context of a tertiary referral centre head and neck cancer multidisciplinary team tumour board meeting. Thirty-two patients (23 men and 9 women; mean and median age, 61 years) with a metastatic cervical lymph node of unknown primary origin, after clinical examination and magnetic resonance imaging, underwent positron emission tomography computed tomography. The primary tumour detection rate was 50 per cent (16/32). Positron emission tomography computed tomography had a sensitivity of 94 per cent (16/17) and a specificity of 67 per cent (10/15). Combining these results with those of 10 earlier studies of similar patients gave an overall detection rate of 37 per cent. Positron emission tomography computed tomography has become an important imaging modality. To date, it has the highest primary tumour detection rate, for head and neck cancer patients presenting with cervical lymph node metastases from an unknown primary.

Frequency of different causes of pyrexia of unknown origin on bone marrow examination in a tertiary care hospital

Energy Technology Data Exchange (ETDEWEB)

Noor, A.; Ayyub, M.; Shafiq, M. [National Univ. of Science and Technology, Islamabad (Pakistan)

2014-09-15

To determine the frequency of underlying causes of pyrexia of unknown origin on bone marrow examination. Study Design: Descriptive study. Place and Duration of Study: The study was carried out at Hematology department (pathology) of Army Medical College, National University of Sciences and Technology (NUST) and Military Hospital Rawalpindi (during the period of one year) from Jan 2012-Dec 2012. Material and Methods: Total of 94 patients reporting with pyrexia of unknown origin at MH Rawalpindi underwent bone marrow examination. Bone marrow aspiration procedure was done from posterior superioriliac spine in patients older than one year while tibial tuberosity was used in patients less than one year of age. Lumbar puncture needle of 16 Gwas used for bone narrow aspiration and trephine biopsy was done by using 11 Gtrephine biopsy needle. Results: In children, commonest causes observed were acute lymphoblastic leukaemia in 7 (23.3%), marked haemophagocytosis in 4 (13.3%) and visceral leishmaniasis in 4 (13.3%) patients. In adults, commonest causes included megaloblastic anaemia in 13 (20.3%), lymphoproliferative disorders in 8 (12.5%) and hypersplenism in 5(7.8%) patients. Conclusion: This study concludes that causes of pyrexia of unknown origin vary with age of the patient. The most frequent causes of pyrexia of unknown origin observed in children were acute lymphoblastic leukaemia, marked haemophagocytosis, and visceral leishmaniasis where in adults main causes were megaloblastic anaemia, lymphoproliferative disorders and hypersplenism. (author)

Lung Lesions During Fever of Unknown Origin.

Science.gov (United States)

Krupa, Renata; Zielonka, Tadeusz M; Hadzik-Blaszczyk, Malgorzata; Wardyn, Kazimierz A; Zycinska, Katarzyna

2017-01-01

Fever of unknown origin (FUO) remains one of the most difficult diagnostic challenges. The causes of FUO can be various diseases located in different organs. The aim of the study was to determine the prevalence and nature of pulmonary lesions during FUO. One hundred and sixty one patients with FUO participated in this prospective study. We performed a detailed comprehensive history, physical examination, and a wide spectrum of tests. The most common causes of FUO were infections (39%), autoimmune conditions (28%), and neoplasms (17%). Lung lesions were found in 30% of patients. In this group 35% were infections, 30% autoimmune diseases, and 4% cancer. Among patients with respiratory infections, there were cases of tuberculosis, atypical pneumonia, lung abscess, and bronchiectases. Autoimmune pulmonary lesions were observed during vasculitis and systemic lupus. The causes of FUO in the group of patients with lung lesions were also pulmonary embolism, sarcoidosis, and pulmonary fibrosis. Chest CT played an important role in the diagnosis of the causes of FUO with pulmonary manifestations. Pulmonary lesions are a common cause of FUO. Most FUO with pulmonary lesions are recognized during infections and autoimmune diseases. An important part of diagnosing FUO is a detailed evaluation of the respiratory system.

Clinical applications of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in carcinoma of unknown primary

Institute of Scientific and Technical Information of China (English)

HU Man; YU Jin-ming; ZHAO Wei; ZHANG Pin-liang; JU Gui-fang; FU Zheng; ZHANG Guo-li; KONG Li; YANG Yan-qin; MA Yi-dong

2011-01-01

Background Carcinoma of unknown primary (CUP) encompasses a heterogeneous group of tumors with varying clinical features. The management of patients of CUP remains a clinical challenge. The purpose of this study was to evaluate the clinical applications of integrated 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) information in patients with CUP,including detecting the occult primary tumor and effecting on disease therapy.Methods One hundred and forty-nine patients with histologically-proven metastases of CUP were included. For all patients,the conventional diagnostic work-up was unsuccessful in localizing the primary site. Whole-body PET/CT images were obtained approximately 60 minutes after intravenous injection of 350-425 MBq of 18F-FDG.Results In 24.8% of patients,FDG PET/CT detected primary tumors that were not apparent after conventional workup.In this group of patients,the overall sensitivity,specificity,and accuracy rates of FDG PET/CT in detecting unknown primary tumors were 86.0%,87.7%,and 87.2%,respectively. FDG PET/CT imaging also led to the detection of previously unrecognized metastases in 29.5% of patients. Forty-seven (31.5%,47 of 149) patients underwent a change in therapeutic management.Conclusions FDG PET/CT is a valuable tool in patients with CUP,because it assisted in detecting unknown primary tumors and previously unrecognized distant metastases,and optimized the mangement of these patients.

Nuclear imaging of neuroendocrine tumors with unknown primary: why, when and how?

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Santhanam, Prasanna; Chandramahanti, Sangeeta [Marshall University, Section of Endocrinology, Department of Internal Medicine, Joan C Edwards School of Medicine, Huntington, WV (United States); Kroiss, Alexander [Medical University Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); Yu, Run [Cedars-Sinai Medical Center, Division of Endocrinology and Carcinoid and Neuroendocrine Tumor Center, Los Angeles, CA (United States); Ruszniewski, Philippe [Beaujon Hospital and Paris-Diderot University, Department of Gastroenterology-Pancreatology, Paris (France); Kumar, Rakesh [All India Institute of Medical Sciences, Diagnostic Nuclear Medicine Division, Department of Nuclear Medicine, New Delhi (India); Taieb, David [Aix-Marseille University, Department of Nuclear Medicine, La Timone University Hospital, Marseille (France); Institut Paoli-Calmettes, Inserm UMR1068 Marseille Cancerology Research Center, Marseille (France); Aix-Marseille University, European Center for Research in Medical Imaging, Marseille (France)

2015-03-13

Neuroendocrine tumors (NETs) with unknown primary (CUP-NET) are associated with a poor prognosis (10-year survival 22 %), grade 1 and 2 NETs having a more favorable outcome than grade 3 (also called carcinoma). There is evidence that an effort should be made to localize the primary tumor even in the presence of metastasis because resection of the primary tumor(s) may improve disease-free and overall survival, and because the choice of chemotherapeutic agent depends on the location of the primary tumor. Localization of the tumors remains challenging and often relies on a combination of radiological, endoscopic and functional imaging. The functional imaging protocol for evaluation of these patients has historically relied on somatostatin receptor scintigraphy (SRS). However, the sensitivity and specificity of SRS may be unsatisfactory, especially for NETs of midgut origin. Newer PET radiotracers such as {sup 68}Ga-labeled somatostatin analogs ({sup 68}Ga-DOTA-SSTa) and {sup 18}F-DOPA have shown promise. In direct comparisons between {sup 68}Ga-DOTA-SSTa PET/CT and {sup 99m}Tc-HYNIC-octreotide/{sup 111}In-pentetreotide SPECT(/CT), {sup 68}Ga-DOTA-SSTa performed better than other techniques, giving a compelling reason for switching from SPECT/CT to PET/CT imaging. {sup 18}F-DOPA performs better than SRS and CT in well-differentiated NETs of the small intestine. For detecting pancreatic NETs, the high background uptake of {sup 18}F-DOPA by the normal exocrine pancreas can be somewhat overcome by pretreatment with carbidopa. We have suggested a protocol in which SRS is replaced by one of the two agents (preferably with {sup 68}Ga-DOTA-SSTa, alternatively {sup 18}F-DOPA) as first-line nuclear tracer for detection of CUP-NET in patients with well-differentiated NETs and {sup 18}F-FDG PET/CT may be an additional diagnostic test for poorly differentiated tumors and for prognostication. In the near future, it is expected that patients with CUP-NET will benefit from newly

Nuclear imaging of neuroendocrine tumors with unknown primary: why, when and how?

International Nuclear Information System (INIS)

Santhanam, Prasanna; Chandramahanti, Sangeeta; Kroiss, Alexander; Yu, Run; Ruszniewski, Philippe; Kumar, Rakesh; Taieb, David

2015-01-01

Neuroendocrine tumors (NETs) with unknown primary (CUP-NET) are associated with a poor prognosis (10-year survival 22 %), grade 1 and 2 NETs having a more favorable outcome than grade 3 (also called carcinoma). There is evidence that an effort should be made to localize the primary tumor even in the presence of metastasis because resection of the primary tumor(s) may improve disease-free and overall survival, and because the choice of chemotherapeutic agent depends on the location of the primary tumor. Localization of the tumors remains challenging and often relies on a combination of radiological, endoscopic and functional imaging. The functional imaging protocol for evaluation of these patients has historically relied on somatostatin receptor scintigraphy (SRS). However, the sensitivity and specificity of SRS may be unsatisfactory, especially for NETs of midgut origin. Newer PET radiotracers such as 68 Ga-labeled somatostatin analogs ( 68 Ga-DOTA-SSTa) and 18 F-DOPA have shown promise. In direct comparisons between 68 Ga-DOTA-SSTa PET/CT and 99m Tc-HYNIC-octreotide/ 111 In-pentetreotide SPECT(/CT), 68 Ga-DOTA-SSTa performed better than other techniques, giving a compelling reason for switching from SPECT/CT to PET/CT imaging. 18 F-DOPA performs better than SRS and CT in well-differentiated NETs of the small intestine. For detecting pancreatic NETs, the high background uptake of 18 F-DOPA by the normal exocrine pancreas can be somewhat overcome by pretreatment with carbidopa. We have suggested a protocol in which SRS is replaced by one of the two agents (preferably with 68 Ga-DOTA-SSTa, alternatively 18 F-DOPA) as first-line nuclear tracer for detection of CUP-NET in patients with well-differentiated NETs and 18 F-FDG PET/CT may be an additional diagnostic test for poorly differentiated tumors and for prognostication. In the near future, it is expected that patients with CUP-NET will benefit from newly developed PET approaches (radiopharmaceuticals) and

Unintentional drinking-water contamination events of unknown origin: surrogate for terrorism preparedness.

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Winston, Gary; Leventhal, Alex

2008-01-01

Drinking-water is a direct conduit to many human receptors. An intentional attack (e.g. terrorism) on drinking-water systems can shock and disrupt elements of national infrastructures. We report on an unintentional drinking-water contamination event that occurred in Tel Aviv, Israel in July, 2001. Initially of unknown origin, this event involved risk management strategies used by the Ministry of Health for abating a potential public health crisis as might be envisaged of water contamination due to terrorism. In an abrupt event of unknown origin, public health officials need to be responsible for the same level of preparedness and risk communication. This is emphasized by comparison of management strategies between the Tel Aviv event and one of dire consequences that occurred in Camelford, England in 1988. From the onset of the Tel Aviv incident, the public health strategy was to employ the precautionary principle by warning residents of the affected region to not drink tap water, even if boiled. This strategy was in contrast to an earlier crisis that occurred in Camelford, England in 1988. An outcome of this event was heightened awareness that a water crisis can occur in peacetime and not only in association with terrorism. No matter how minor the contamination event or short-term the disruption of delivery of safe drinking-water, psychological, medical and public health impact could be significant.

Angiogenesis in cancer of unknown primary: clinicopathological study of CD34, VEGF and TSP-1

International Nuclear Information System (INIS)

Karavasilis, Vasilis; Malamou-Mitsi, Vasiliki; Briasoulis, Evangelos; Tsanou, Elena; Kitsou, Evangelia; Kalofonos, Haralambos; Fountzilas, George; Fotsis, Theodore; Pavlidis, Nicholas

2005-01-01

Cancer of unknown primary remains a mallignancy of elusive biology and grim prognosis that lacks effective therapeutic options. We investigated angiogenesis in cancer of unknown primary to expand our knowledge on the biology of these tumors and identify potential therapeutic targets. Paraffin embedded archival material from 81 patients diagnosed with CUP was used. Tumor histology was adenocarcinoma (77%), undifferentiated carcinoma (18%) and squamous cell carcinoma (5%). The tissue expression of CD34, VEGF and TSP-1 was assessed immunohistochemically by use of specific monoclonal antibodies and was analyzed against clinicopathological data. VEGF expression was detected in all cases and was strong in 83%. Stromal expression of TSP-1 was seen in 80% of cases and was strong in 20%. The expression of both proteins was not associated with any clinical or pathological parameters. Tumor MVD was higher in tumors classified as unfavorable compared to more favorable and was positively associated with VEGF and negatively with TSP-1. Angiogenesis is very active and expression of VEGF is almost universal in cancers of unknown primary. These findings support the clinical investigation of VEGF targeted therapy in this clinical setting

F-18-FDG PET/CT in inflammation of unknown origin : a cost-effectiveness pilot-study

NARCIS (Netherlands)

Balink, H.; Tan, S. S.; Veeger, N. J. G. M.; Holleman, F.; van Eck-Smit, B. L. F.; Bennink, R. J.; Verberne, H. J.

Purpose Patients with increased inflammatory parameters, nonspecific signs and symptoms without fever and without a diagnosis after a variety of diagnostic procedures are a diagnostic dilemma and are referred to as having inflammation of unknown origin (IUO). The objective of this pilot study was to

Marked improvement of vulvovaginitis of unknown origin in a pediatric patient--case report.

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Check, J H; Cohen, R

2014-01-01

To present a novel therapy for pediatric vulvovaginitis. An eight-year-old girl with persistent severe vulvovaginitis of unknown origin also complained of unexplained weight gain and sudden academic difficulties. She was treated with dextroamphetamine sulfate. She not only showed very quick and excellent relief from her vulvovaginitis but she also lost weight and improved her mentality. Sympathomimetic amine therapy may benefit pediatric vulvovaginitis when an infectious cause cannot be ascertained.

Fever of unknown origin (FUO): CMV infectious mononucleosis or lymphoma?

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Cunha, Burke A; Chawla, Karishma

2018-04-20

Fever of unknown origin (FUO) refers to fevers of > 101 °F that persist for > 3 weeks and remain undiagnosed after a focused inpatient or outpatient workup. FUO may be due to infectious, malignant/neoplastic, rheumatic/inflammatory, or miscellaneous disorders. The FUO category determines the focus of the diagnostic workup. In the case presented of an FUO in a young woman, there were clinical findings of both CMV infectious mononucleosis or a lymphoma, e.g., highly elevated ESR, elevated ferritin levels, and elevated ACE level, β-2 microglobulins. The indium scan showed intense splenic uptake. Lymph node biopsy, PET scan, and flow cytometry were negative for lymphoma. CMV infectious mononucleosis was the diagnosis, and she made a slow recovery.

Post-operative therapy following transoral robotic surgery for unknown primary cancers of the head and neck.

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Patel, Sapna A; Parvathaneni, Aarthi; Parvathaneni, Upendra; Houlton, Jeffrey J; Karni, Ron J; Liao, Jay J; Futran, Neal D; Méndez, Eduardo

2017-09-01

Our primary objective is to describe the post- operative management in patients with an unknown primary squamous cell carcinoma of the head and neck (HNSCC) treated with trans-oral robotic surgery (TORS). We conducted a retrospective multi-institutional case series including all patients diagnosed with an unknown primary HNSCC who underwent TORS to identify the primary site from January 1, 2010 to June 30, 2016. We excluded those with recurrent disease, ≤6months of follow up from TORS, previous history of radiation therapy (RT) to the head and neck, or evidence of primary tumor site based on previous biopsies. Our main outcome measure was receipt of post-operative therapy. The tumor was identified in 26/35 (74.3%) subjects. Post-TORS, 2 subjects did not receive adjuvant therapy due to favorable pathology. Volume reduction of RT mucosal site coverage was achieved in 12/26 (46.1%) subjects who had lateralizing tumors, ie. those confined to the palatine tonsil or glossotonsillar sulcus. In addition, for 8/26 (30.1%), the contralateral neck RT was also avoided. In 9 subjects, no primary was identified (pT0); four of these received RT to the involved ipsilateral neck nodal basin only without pharyngeal mucosal irradiation. Surgical management of an unknown primary with TORS can lead to deintensification of adjuvant therapy including avoidance of chemotherapy and reduction in RT doses and volume. There was no increase in short term treatment failures. Treatment after TORS can vary significantly, thus we advocate adherence to NCCN guideline therapy post-TORS to avoid treatment-associated variability. Published by Elsevier Ltd.

Significance of serum tumor markers monitoring in carcinomas of unknown primary site

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Pejčić Ivica

2010-01-01

Full Text Available Background/Aim. Unknown primary tumors represent a heterogeneous group of malignancies that are indicative of ominous prognosis. Cancer of unknown primary site (CUP is defined as the lack of any detectable primary site after full evaluation, and accounts for approximately 3-5% of all newly diagnosed patients with malignancies. The aim of this report was to present the prognostic and predictive value of 8 serum tumor markers in this group of patients. Methods. The study involved 63 patients. On histological examination, all the patients were presented with metastatic tumors whose primary site (origin could not be detected with noninvasive diagnostic techniques. Following the routine light microscopy, all histological findings were classified into one of the following three groups: plano-cellular carcinoma - 8 patients; adenocarcinoma - 33 patients; unclassifiable (undifferentiated carcinoma - 22 patients. In all the cases we evaluated 8 serum tumor markers: alpha-fetoproteins (AFP, chronic gonadotrophin beta submit, human (beta-HCG, neuron specific enolase (NSE, marker of malignant ovarian tumors (CA 125, prostate-specific antigene (PSA, marker of malignant brest tumor (CA 15-3, marker of malignant pancreas tumor and gastrointestinal tumor (Ca 19-9, carcinoembryonic antigen (CEA at the time of diagnosis. The patients on chemotherapy had the markers determined after the third and sixth chemocycle, i.e. at the time of illness progression observation, if present. The patients responding to chemotherapy with complete response (CR, partial response (PR or stable disease (SD had the markers determined after three-month periods until the time of relapse or progression. Chemotherapy was applied in 32 patients (20 females and 12 males, aged 29-70 years, who met the inclusion criteria. The following chemotherapy regimen was used: doxorubicin 50mg/m2 (day 1, cisplatin 60mg/m2 (day 1, and etoposide 120 mg/m2 (days 1-3. The period between two chemotherapy

Combined FDG-PET/CT for the detection of unknown primary tumors: systematic review and meta-analysis

International Nuclear Information System (INIS)

Kwee, Thomas C.; Kwee, Robert M.

2009-01-01

The aim of this study was to systematically review and meta-analyze published data on the diagnostic performance of combined 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the detection of primary tumors in patients with cancer of unknown primary (CUP). A systematic search for relevant studies was performed of the PubMed/MEDLINE and Embase databases. Methodological quality of the included studies was assessed. Reported detection rates, sensitivities and specificities were meta-analyzed. Subgroup analyses were performed if results of individual studies were heterogeneous. The 11 included studies, comprising a total sample size of 433 patients with CUP, had moderate methodological quality. Overall primary tumor detection rate, pooled sensitivity and specificity of FDG-PET/CT were 37%, 84% (95% CI 78-88%) and 84% (95% CI 78-89%), respectively. Sensitivity was heterogeneous across studies (P = 0.0001), whereas specificity was homogeneous across studies (P = 0.2114). Completeness of diagnostic workup before FDG-PET/CT, location of metastases of unknown primary, administration of CT contrast agents, type of FDG-PET/CT images evaluated and way of FDG-PET/CT review did not significantly influence diagnostic performance. In conclusion, FDG-PET/CT can be a useful method for unknown primary tumor detection. Future studies are required to prove the assumed advantage of FDG-PET/CT over FDG-PET alone and to further explore causes of heterogeneity. (orig.)

CUP Syndrome-Metastatic Malignancy with Unknown Primary Tumor.

Science.gov (United States)

Zaun, Gregor; Schuler, Martin; Herrmann, Ken; Tannapfel, Andrea

2018-03-09

2-4% of newly diagnosed cases of malignant disease involve cancer of unknown primary (CUP). This mixed entity is one of the 6 most common types of malignant disease in Germany. Highly refined treatment strategies can now be offered to patients with CUP. This review is based on pertinent publications retrieved by a selective search in PubMed with an emphasis on articles from the past decade. The current guidelines and recommendations of specialty societies were also considered in the evaluation. CUP most commonly manifests itself as metastases to the lymph nodes, lungs, liver, or bones. With the aid of imaging studies, including functional hybrid imaging and further medical examination, a primary tumor can be discovered in up to 40% of patients initially diagnosed with CUP. Immunohistochemistry guided by histomorphology often enables precise characterization of the lesion and can be supplemented, in selected cases, by molecular-genetic diagnostic evaluation. The most commonly detected types of primary tumor are cancers of the lung, pancreas, liver, and biliary system. For patients with local metastases, surgical resection or radiotherapy with curative intent is usually indicated, sometimes in the framework of a multimodal treatment concept. The median 2-year survival of patients with disseminated CUP is only 20%. For such patients, specific types of systemic therapy are recommended on the basis of the diagnostic characterization of the disease. Immune-modulatory antibodies can be effective, particularly in the treatment of CUP that has been characterized with biomarkers, but should still be considered experimental at present. A combination of conventional and innovative diagnostic methods enables the provision of highly refined therapeutic strategies to patients with CUP who are undergoing treatment in interdisciplinary cancer centers.

Disseminated hydatid disease presenting as fever of unknown origin: A case report and review of literature

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Nikhil Gupta

2015-01-01

Full Text Available Human hydatid disease occurs due to infection with larval form of Echinococcus granulosus. The disseminated hydatid disease is a very rare finding. Disseminated hydatid disease presenting as a cause of fever of unknown origin is a rare phenomenon. We present to you such a rare case.

Neuroendocrine Cell Carcinoma of Unknown Primary Arising in Long Standing History of Multiple Sclerosis

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Stergios Boussios

2015-01-01

Full Text Available Multiple sclerosis (MS is a chronic autoimmune disease that targets myelinated axons in the central nervous system (CNS. Cancer of unknown primary site (CUP is a well-recognised clinical disorder, accounting for 3–5% of all malignant epithelial tumors. CUP is clinically characterised as an aggressive disease with early dissemination. Studies of cancer risk in MS patients have shown inconsistent findings. An increased risk of malignancy in patients with MS has been suggested, but recently serious questions have been raised regarding this association. Use of disease-modifying therapies might contribute to an increased cancer risk in selected MS patients. The concurrence of MS and CUP is exceptionally rare. Here we describe the case of a neuroendocrine carcinoma of unknown primary diagnosed in a male patient with a nine-year history of MS. The discussion includes data from all available population-based register studies with estimates of certain malignancies in patients with MS.

Impact of CT in patients with sepsis of unknown origin

International Nuclear Information System (INIS)

Barkhausen, J.; Stoeblen, F.; Mueller, R.D.

1999-01-01

Purpose: To evaluate the diagnostic relevance of CT in patients with sepsis of unknown origin. Material and Methods: Sixty-three consecutive intensive care patients with suspicion of an abscess and negative or inconclusive previous radiological examinations were included. CT was performed using the helical technique. A total of 45 abdominal and 38 chest examinations were evaluated. Results: 5/38 examinations of the chest revealed the source of sepsis (pleural empyema 2, lung abscess 1, mediastinitis 1, retrosternal abscess 1). 7/45 abdominal CT examinations showed the source of sepsis (intraabdominal abscess 2, hepatic abscess 3, intestinal perforation 1, gangrenous colitis 1). Conclusion: CT is useful for the evaluation of patients with fever or sepsis without a known source. Due to the detection of a spetic focus by CT, 19% of the patients in our study could be immediately referred to causal therapy as percutaneous drainage or surgery. (orig.)

Impact of CT in patients with sepsis of unknown origin

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Barkhausen, J.; Stoeblen, F.; Mueller, R.D. [University Hospital Essen (Germany). Dept. of Radiology; Dominguez-Fernandez, E. [University Hospital Essen (Germany). Dept. of General Surgery; Henseke, P. [Nycomed-Amersham Arzneimittel GmbH, Muenchen (Germany)

1999-09-01

Purpose: To evaluate the diagnostic relevance of CT in patients with sepsis of unknown origin. Material and Methods: Sixty-three consecutive intensive care patients with suspicion of an abscess and negative or inconclusive previous radiological examinations were included. CT was performed using the helical technique. A total of 45 abdominal and 38 chest examinations were evaluated. Results: 5/38 examinations of the chest revealed the source of sepsis (pleural empyema 2, lung abscess 1, mediastinitis 1, retrosternal abscess 1). 7/45 abdominal CT examinations showed the source of sepsis (intraabdominal abscess 2, hepatic abscess 3, intestinal perforation 1, gangrenous colitis 1). Conclusion: CT is useful for the evaluation of patients with fever or sepsis without a known source. Due to the detection of a spetic focus by CT, 19% of the patients in our study could be immediately referred to causal therapy as percutaneous drainage or surgery. (orig.)

Inferior petrosal sinus sampling in the diagnosis of adrenocorticotropin dependent Cushing syndrome with unknown origin

International Nuclear Information System (INIS)

Shen Xuefeng; Yuan Dequan; Yue Ming; Feng Juanjuan

2011-01-01

Objective: To evaluate the value of inferior petrosal sinus sampling (IPSS) in the diagnosis of adrenocorticotropic hormone (ACTH) dependent Cushing syndrome (CS) with unknown origin. Methods: IPSS was carried out for the diagnosis of 16 cases with ACTH dependent CS who had not been identified after a series of dexamethasone suppression tests and radiological examinations. The ratio of inferior petrosal sinus/peripheral ACTH was assayed. The sensitivity and specificity of diagnosis of the Cushing disease were estimated. Results: The inferior petrosal sinus/peripheral ACTH ratio was over 2.0 in 13 cases. Twelve cases underwent surgery with pathological diagnosis of pituitary ACTH adenoma, 1 patient relieved after γ knife treatment. The ratio was < 2.0 in 3 cases including 2 pulmonary carcinoid and one pituitary ACTH adenoma. The sensitivity and specify of IPSS for the diagnosis of Cushing disease were 13/14 and 2/2 respectively. Conclusion: IPSS was a safe technique with high sensitivity, specify and infrequent complications in the diagnosis of ACTH dependent Cushing disease. It had great clinical value in the differential diagnosis of ACTH dependent Cushing disease with unknown origin. (authors)

[Standard of care of carcinomas on cancer of unknown primary site in 2016].

Science.gov (United States)

Benderra, Marc-Antoine; Ilié, Marius; Hofman, Paul; Massard, Christophe

2016-01-01

Patients with Cancer of unknown primary (cup) represent 2-10%, and have disseminated cancers for which we cannot find the primary site despite the clinical, pathological and radiological exams at our disposal. Diagnosis is based on a thorough clinical and histopathologic examination as well as new imaging techniques. Several clinicopathologic entities requiring specific treatment can be identified. Genome sequencing and liquid biopsy (circulating tumor cells and tumor free DNA) could allow further advances in the diagnosis. Therapeutically, in addition to surgery, radiotherapy and chemotherapy, precision medicine provides new therapeutic approaches. Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Radiotherapeutic concepts in cancer of unknown primary site

International Nuclear Information System (INIS)

Krug, D.; Debus, J.; Sterzing, F.

2014-01-01

The term cancer of unknown primary (CUP) encompasses a group of entities which differ to a great extent regarding etiology, prognosis and therapeutic management. The aim of the study was an elaboration of the role of radiotherapy in CUP syndrome. Systematic literature search and specification of the available treatment options. Radiotherapy is an integral part of interdisciplinary management approaches for patients with CUP in both curative and palliative situations. Radio-oncological techniques, such as intensity-modulated radiotherapy and stereotactic body radiotherapy increase the therapeutic window. Modern diagnostic modalities from radiology and nuclear medicine are the cornerstone of radiotherapeutic interventions, especially in terms of target volume definition and pretherapeutic staging. In the interdisciplinary setting radiation oncology offers the possibility of curative and often organ preserving approaches in patients with axillary and cervical CUP. In addition, improvement and preservation of quality of life can be achieved in patients with metastatic disease. Radiation oncology is a crucial component of the interdisciplinary management of patients with CUP. Therapeutic decisions in patients with CUP should be made in an interdisciplinary setting. (orig.) [de

Squamous cell carcinoma presenting with trigeminal anesthesia: An uncommon presentation of head & neck cancer with unknown primary.

Science.gov (United States)

Shah, Ameer T; Dagher, Walid I; O'Leary, Miriam A; Wein, Richard O

The differential diagnosis of facial anesthesia is vast. This may be secondary to trauma, neoplasm, both intracranial and extracranial, infection, and neurologic disease. When evaluating a patient with isolated facial anesthesia, the head and neck surgeon often thinks of adenoid cystic carcinoma, which has a propensity for perineural invasion and spread. When one thinks of head and neck squamous cell carcinoma with or without unknown primary, the typical presentation involves dysphagia, odynophagia, weight loss, hoarseness, or more commonly, a neck mass. Squamous cell carcinoma presenting as facial anesthesia and perineural spread, with no primary site is quite rare. Case presentations and review of the literature. Trigeminal anesthesia is an uncommon presentation of head and neck squamous cell carcinoma with unknown primary. We present two interesting cases of invasive squamous cell carcinoma of the trigeminal nerve, with no primary site identified. We will also review the literature of head and neck malignancies with perineural spread and the management techniques for the two different cases presented. Copyright © 2016 Elsevier Inc. All rights reserved.

Efficient Identification of miRNAs for Classification of Tumor Origin

DEFF Research Database (Denmark)

Søkilde, Rolf; Vincent, Martin; Møller, Anne K

2014-01-01

Carcinomas of unknown primary origin constitute 3% to 5% of all newly diagnosed metastatic cancers, with the primary source difficult to classify with current histological methods. Effective cancer treatment depends on early and accurate identification of the tumor; patients with metastases...... of unknown origin have poor prognosis and short survival. Because miRNA expression is highly tissue specific, the miRNA profile of a metastasis may be used to identify its origin. We therefore evaluated the potential of miRNA profiling to identify the primary tumor of known metastases. Two hundred eight...... formalin-fixed, paraffin-embedded samples, representing 15 different histologies, were profiled on a locked nucleic acid-enhanced microarray platform, which allows for highly sensitive and specific detection of miRNA. On the basis of these data, we developed and cross-validated a novel classification...

Nonbacterial thrombotic endocarditis associated with cancer of unknown origin complicated with thrombus in the left auricular appendage: case report

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Morinaga Yukiko

2011-02-01

Full Text Available Abstract A 63-year-old man was admitted to our hospital with a complaint of right lateroabdominal pain. He was diagnosed with metastatic colon cancer, and then developed multiple brain embolic infarctions 7 days after admission. Transesophageal echocardiography showed that mobile, echo-dense masses were attached to the anterior and posterior mitral valve leaflet. Furthermore, there was a thrombus in the left auricular appendage despite sinus rhythm. These findings led to a diagnosis of suspected infectious endocarditis with subsequent multiple brain infarctions. The patient's general condition worsened and he died 13 days after admission. An autopsy was performed, and, while poorly differentiated cancer was observed in multiple organs, no primary tumor could be identified. Histological analysis showed that the masses of the mitral valve consisted mainly of fibrin without bacteria or oncocytes. This patient was therefore diagnosed with nonbacterial thrombotic endocarditis associated with cancer of unknown origin complicated with thrombus in the left auricular appendage.

Investigation of cervical lymph node metastasis from primary unknown carcinoma

International Nuclear Information System (INIS)

Sagawa, Kosuke; Terada, Tomonori; Saeki, Nobuo; Uwa, Nobuhiro; Mohri, Takeshi; Sakagami, Masafumi

2012-01-01

We retrospectively evaluated 41 patients with metastatic cervical tumors from unknown primary sites at the Hyogo College of Medicine between 1997 and 2007. The N stage classification of cervical lymph nodes was: N1 in 3 cases, N2a in 10 cases, N2b in 10 cases, N2c in 4 cases, and N3 in 14 cases. The histopathological diagnoses of cervical lymph node were: squamous cell carcinoma in 33 cases, adenocarcinoma in 5 cases, undifferentiated carcinoma in 2 cases, and papillary carcinoma in 1 cases. Primary tumor sites were: tonsil in 5 cases, esophaguses in 2 cases, hypopharynxies in 2 cases, and thyroid, oral floor, submandibular gland, lung, gastric and colon in 1 case each. The useful tests were gastric endoscope, positron emission tomography-computed tomography (PET-CT), and blind biopsy of tonsil. We treated 24 of the 41 patients. Therapies were: neck dissection with postoperative radiation therapy in 11 cases, neck dissection alone in 1 case, only radiation or chemoradiation therapy alone in 8 cases, and chemotherapy alone in 4 cases. The 5-year survival rate was 40.1% in all cases and 81.5% in cases who underwent neck dissection. (author)

Cervical Lymph Node Metastases From Unknown Primary Cancer: A Single-Institution Experience With Intensity-Modulated Radiotherapy

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Villeneuve, Hugo, E-mail: hugo.villeneuve@umontreal.ca [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Despres, Philippe; Fortin, Bernard; Filion, Edith; Donath, David [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Soulieres, Denis [Department of Medical Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Guertin, Louis; Ayad, Tarek; Christopoulos, Apostolos [Department of Head and Neck Surgery, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Nguyen-Tan, Phuc Felix [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada)

2012-04-01

Purpose: To determine the effectiveness and rate of complications of intensity-modulated radiotherapy (IMRT) in the treatment of cervical lymph node metastases from unknown primary cancer. Methods and Materials: Between February 2005 and November 2008, 25 patients with an unknown primary cancer underwent IMRT, with a median radiation dose of 70 Gy. The bilateral neck and ipsilateral putative pharyngeal mucosa were included in the target volume. All patients had squamous cell carcinoma, except for 1 patient who had adenosquamous differentiation. They were all treated with curative intent. Of the 25 included patients, 20 were men and 5 were women, with a median age of 54 years. Of these patients, 3 had Stage III, 18 had Stage IVa, and 4 had Stage IVb. Of the 25 patients, 18 (72%) received platinum-based chemotherapy in a combined-modality setting. Neck dissection was reserved for residual disease after definitive IMRT. Overall survival, disease-free survival, and locoregional control were calculated using the Kaplan-Meier method. Results: With a median follow-up of 38 months, the overall survival, disease-free survival, and locoregional control rates were all 100% at 3 years. No occurrence of primary cancer was observed during the follow-up period. The reported rates of xerostomia reduced with the interval from the completion of treatment. Nine patients (36%) reported Grade 2 or greater xerostomia at 6 months, and only 2 (8%) of them reported the same grade of salivary function toxicity after 24 months of follow-up. Conclusion: In our institution, IMRT for unknown primary cancer has provided good overall and disease-free survival in all the patients with an acceptable rate of complications. IMRT allowed us to address the bilateral neck and ipsilateral putative pharyngeal mucosa with minimal late salivary function toxicity. The use of concurrent chemotherapy and IMRT for more advanced disease led to good clinical results with reasonable toxicities.

Cancer of unknown primary

DEFF Research Database (Denmark)

Dyrvig, Anne-Kirstine; Yderstræde, Knud Bonnet; Gerke, Oke

2017-01-01

210 (38.7%) had a CUP diagnosis confirmed. Within the cohort, 347 patients (64.0%) had a registration in CR matching with the NPR registration. Exposure to diagnostic procedures included biopsy (n = 439, 81.0%) and image modalities (n = 532, 98.2%). Survival was poor with 67 (12.4%) individuals alive...... after 4 years.The validity of a CUP diagnosis in NPR was low when using data from CR as reference. More than half the suspected CUP patients had a previous cancer diagnosis with CUP being the most frequent. Patients were diagnosed in compliance with guidelines indicating high external validity, but less...... than 1 quarter had their primary identified and the 1-year survival was approximately 20%. Research is needed to develop efficacious methods for primary detection....

Pretreatment costs of care and time to initial treatment for patients with cancer of unknown primary.

Science.gov (United States)

Walker, Mark S; Weinstein, Laura; Luo, Roger; Marino, Ingrid

2018-06-01

Time to treatment and pretreatment costs may be affected by unknown primary tumor site. This retrospective study used electronic medical record data from patients in ten US community oncology practices. Eligible patients were ≥18 years, diagnosed with cancer of unknown primary (CUP) or known metastatic solid tumor, and presented between 1 January 2012 and 30 June 2014. Patients with CUP (n = 294) had a longer interval than non-CUP patients (n = 92) from presentation to treatment initiation (1.18 vs 0.49 months, p < 0.0001), and had higher pretreatment costs (US$27,882 vs US$20,449, p = 0.0075). When analyzed as monthly cost, the difference between groups in log-cost per month was nonsignificant. Higher pretreatment costs in CUP patients appeared attributable to significantly longer time to initiation of therapy.

Cervical lymph node metastases from unknown primary tumours. Results from a national survey by the Danish Society for Head and Neck Oncology

DEFF Research Database (Denmark)

Grau, Cai; Johansen, L V; Jakobsen, J

2000-01-01

The management of patients with cervical lymph node metastases from unknown primary tumours is a major challenge in oncology. This study presents data collected from all five oncology centres in Denmark.......The management of patients with cervical lymph node metastases from unknown primary tumours is a major challenge in oncology. This study presents data collected from all five oncology centres in Denmark....

Fever of unknown origin: A value of 18F-FDG-PET/CT with integrated full diagnostic isotropic CT imaging

International Nuclear Information System (INIS)

Ferda, Jiri; Ferdova, Eva; Zahlava, Jan; Matejovic, Martin; Kreuzberg, Boris

2010-01-01

Aim: The aim of presented work is to evaluate the clinical value of 18 F-FDG-PET/CT in patients with fever of unknown origin (FUO) and to compare PET/CT finding with the results of the following investigation. Material and method: 48 patients (24 men, 24 women, mean age 57.6 years with range 15-89 years) underwent 18 F-FDG-PET/CT due to the fever of unknown origin. All examinations were performed using complex PET/CT protocol combined PET and whole diagnostic contrast enhanced CT with sub-millimeter spatial resolution (except patient with history of iodine hypersensitivity or sever renal impairment). CT data contained diagnostic images reconstructed with soft tissue and high-resolution algorithm. PET/CT finding were compared with results of biopsies, immunology, microbiology or autopsy. Results: The cause of FUO was explained according to the PET/CT findings and followed investigations in 44 of 48 cases-18 cases of microbial infections, nine cases of autoimmune inflammations, four cases of non-infectious granulomatous diseases, eight cases of malignancies and five cases of proved immunity disorders were found. In 46 cases, the PET/CT interpretation was correct. Only in one case, the cause was overlooked and the uptake in atherosclerotic changes of arteries was misinterpreted as vasculitis in the other. The reached sensitivity was 97% (43/44), and specificity 75% (3/4) respectively. Conclusion: In patients with fever of unknown origin, 18 F-FDG-PET/CT might enable the detection of its cause.

Early-Onset Oligohydramnios Complicated with Hypertension, Hyperthyroidism and Coexisting Elevated Urine Vanillylmandelic Acid of Unknown Origin, Mimicking a Pheochromocytoma

Directory of Open Access Journals (Sweden)

Joung-Liang Wu

2004-12-01

Conclusion: A combination of hypertension, oligohydramnios and hyperthyroidism is rare. An elevated 24- hour urine vanillylmandelic acid of unknown origin is a previously unreported finding, to the best of our knowledge, associated with hyperthyroidism and pregnancy-induced hypertension.

Detection of unknown primary tumours in patients with cerebral metastases using whole-body 18F-flouorodeoxyglucose positron emission tomography

DEFF Research Database (Denmark)

Klee, B; Law, I; Højgaard, L

2002-01-01

Identification of the unknown primary tumours in patients presenting with cerebral metastasis is a continued diagnostic challenge. Despite extensive and lengthy diagnostic work-up, the primary tumours will remain obscure in a significant proportion of the patients. The aim of this study was to ev...

A recommended procedure for establishing the source level relationships between heroin case samples of unknown origins

Directory of Open Access Journals (Sweden)

Kar-Weng Chan

2014-06-01

Full Text Available A recent concern of how to reliably establish the source level relationships of heroin case samples is addressed in this paper. Twenty-two trafficking heroin case samples of unknown origins seized from two major regions (Kuala Lumpur and Penang in Malaysia were studied. A procedure containing six major steps was followed to analyze and classify these samples. Subsequently, with the aid of statistical control samples, reliability of the clustering result was assessed. The final outcome reveals that the samples seized from the two regions in 2013 had highly likely originated from two different sources. Hence, the six-step procedure is sufficient for any chemist who attempts to assess the relative source level relationships of heroin samples.

Diagnostic value of (111)In-granulocyte scintigraphy in patients with fever of unknown origin

DEFF Research Database (Denmark)

Kjaer, Andreas; Lebech, Anne-Mette

2002-01-01

111In-granulocyte scintigraphy is often used as a diagnostic tool in patients with fever of unknown origin (FUO). However, its diagnostic performance has been studied in only a limited number of investigations, with most having been published more than 10 y ago; in addition, a broad range...... and specificity in cases of FUO, when one takes into account that (111)In-granulocyte scintigraphy is not a first-line test. The high predictive value of a scintigram showing negative findings may be especially valuable for ruling out an infectious cause of FUO. Neither peripheral leukocyte count nor CRP levels...

Febrile syndrome of unknown origin: Indications for 18F-FDG PET/CT in inflammatory and infectious processes.

Science.gov (United States)

García, J R

Fever of unknown origin is defined as a body temperature greater than 38.3°C lasting more than three weeks for which the cause could not be found within one week of hospital admission. More than 200 causes have been reported, and these can be classified into four categories: infections, inflammatory diseases, oncologic processes, and miscellaneous conditions. Noninvasive diagnostic techniques are used in 69.2% of cases and invasive techniques in 30.8%. Structural imaging techniques show the morphological changes from infectious, inflammatory, and tumor-related processes, but they do not allow the detection of the early changes brought about by these processes. The metabolic information provided by 18 F-FDG PET/CT has a promising role in these patients. 18 F-FDG uptake is based on the cells' use of glucose as a source of energy, so it can be observed in infectious, inflammatory, and tumor-related processes. The established non-oncologic indications for 18 F-FDG PET/CT are sarcoidosis, osteomyelitis, spondylodiscitis, fever of unknown origin, and vasculitis, which together account for more than 85% of studies. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Detection of unknown primary neuroendocrine tumours (CUP-NET) using 68Ga-DOTA-NOC receptor PET/CT

International Nuclear Information System (INIS)

Prasad, Vikas; Baum, Richard P.; Ambrosini, Valentina; Fanti, Stefano; Hommann, Merten; Hoersch, Dieter

2010-01-01

This bi-centric study aimed to determine the role of receptor PET/CT using 68 Ga-DOTA-NOC in the detection of undiagnosed primary sites of neuroendocrine tumours (NETs) and to understand the molecular behaviour of the primarily undiagnosed tumours. Overall 59 patients (33 men and 26 women, age: 65 ± 9 years) with documented NET and unknown primary were enrolled. PET/CT was performed after injection of approximately 100 MBq (46-260 MBq) of 68 Ga-DOTA-NOC. The maximum standardised uptake values (SUV max ) were calculated and compared with SUV max in known pancreatic NET (pNET) and ileum/jejunum/duodenum (SI-NET). The results of PET/CT were also correlated with CT alone. In 35 of 59 patients (59%), 68 Ga-DOTA-NOC PET/CT localised the site of the primary: ileum/jejunum (14), pancreas (16), rectum/colon (2), lungs (2) and paraganglioma (1). CT alone (on retrospective analyses) confirmed the findings in 12 of 59 patients (20%). The mean SUV max of identified previously unknown pNET and SI-NET were 18.6 ± 9.8 (range: 7.8-34.8) and 9.1 ± 6.0 (range: 4.2-27.8), respectively. SUV max in patients with previously known pNET and SI-NET were 26.1 ± 14.5 (range: 8.7-42.4) and 11.3 ± 3.7 (range: 5.6-17.9). The SUV max of the unknown pNET and SI-NET were significantly lower (p 68 Ga-DOTA-NOC receptor PET/CT, 6 of 59 patients were operated and the primary was removed (4 pancreatic, 1 ileal and 1 rectal tumour) resulting in a management change in approximately 10% of the patients. In the remaining 29 patients, because of the far advanced stage of the disease (due to distant metastases), the primary tumours were not operated. Additional histopathological sampling was available from one patient with bronchial carcinoid (through bronchoscopy). Our data indicate that 68 Ga-DOTA-NOC PET/CT is highly superior to 111 In-OctreoScan (39% detection rate for CUP according to the literature) and can play a major role in the management of patients with CUP-NET. (orig.)

Severe Unresponsive Hypoglycemia Associated with Neuroendocrine Tumor of Unknown Primary Site - 18 Years after Rectal Cancer Surgery. Case Report.

Science.gov (United States)

Rusu, Octavia Cristina; Costea, Radu Virgil; Popa, Cristian Constantin; Iliesiu, Andreea; Dumitru, Adrian; Becheanu, Gabriel; Neagu, Stefan Ilie

2015-09-01

Neuroendocrine tumors are derived from cells that have the unique ability to synthesize, store and secrete a variety of metabolically active substances, peptides and amines, characteristic of the tissue of origin, which can cause distinct clinical syndromes. We present the case of a 58-year-old patient diagnosed and surgically treated in January 1996 for stage III inferior rectal cancer, who was readmitted after 18 years presenting persistent diarrheic syndrome and asthenia. Investigations performed (abdominal CT) showed multiple liver metastases, initially suspected as being related to the rectal cancer. Biopsy of liver metastases and pathological and immunohistochemical analysis demonstrated the neuroendocrine origin (moderately differentiated neuroendocrine tumor). Seven months after the identification of liver metastases and after initiation of oncological therapy with Interferon and Somatostatin, the patient presented severe hypoglycemia (serum glucose 13-70 mg/dl) proved to be due to insulin-like factors (serum insulin level 64.9 ìU/ml) secreted by metastases. Due to the aggressive evolution of neuroendocrine tumor, with multiple episodes of severe hypoglycemia, resistant to treatment, the patient died approximately one month after the occurrence of hypoglycemic episodes. Despite comprehensive tests (abdominal CT scan, colonoscopy, bone scintigraphy and PET/CT), the primary site of the neuroendocrine tumors remained unknown.

Two similar cases of elderly women with moderate abdominal pain and pneumoperitoneum of unknown origin: a surgeon's successful conservative management.

Science.gov (United States)

Vinzens, Fabrizio; Zumstein, Valentin; Bieg, Christian; Ackermann, Christoph

2016-05-26

Patients presenting with abdominal pain and pneumoperitoneum in radiological examination usually require emergency explorative laparoscopy or laparotomy. Pneumoperitoneum mostly associates with gastrointestinal perforation. There are very few cases where surgery can be avoided. We present 2 cases of pneumoperitoneum with unknown origin and successful conservative treatment. Both patients were elderly women presenting to our emergency unit, with moderate abdominal pain. There was neither medical intervention nor trauma in their medical history. Physical examination revealed mild abdominal tenderness, but no clinical sign of peritonitis. Cardiopulmonary examination remained unremarkable. Blood studies showed only slight abnormalities, in particular, inflammation parameters were not significantly increased. Finally, obtained CTs showed free abdominal gas of unknown origin in both cases. We performed conservative management with nil per os, nasogastric tube, total parenteral nutrition and prophylactic antibiotics. After 2 weeks, both were discharged home. 2016 BMJ Publishing Group Ltd.

Histogram Analysis of Apparent Diffusion Coefficients for Occult Tonsil Cancer in Patients with Cervical Nodal Metastasis from an Unknown Primary Site at Presentation.

Science.gov (United States)

Choi, Young Jun; Lee, Jeong Hyun; Kim, Hye Ok; Kim, Dae Yoon; Yoon, Ra Gyoung; Cho, So Hyun; Koh, Myeong Ju; Kim, Namkug; Kim, Sang Yoon; Baek, Jung Hwan

2016-01-01

To explore the added value of histogram analysis of apparent diffusion coefficient (ADC) values over magnetic resonance (MR) imaging and fluorine 18 ((18)F) fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) for the detection of occult palatine tonsil squamous cell carcinoma (SCC) in patients with cervical nodal metastasis from a cancer of an unknown primary site. The institutional review board approved this retrospective study, and the requirement for informed consent was waived. Differences in the bimodal histogram parameters of the ADC values were assessed among occult palatine tonsil SCC (n = 19), overt palatine tonsil SCC (n = 20), and normal palatine tonsils (n = 20). One-way analysis of variance was used to analyze differences among the three groups. Receiver operating characteristic curve analysis was used to determine the best differentiating parameters. The increased sensitivity of histogram analysis over MR imaging and (18)F-FDG PET/CT for the detection of occult palatine tonsil SCC was evaluated as added value. Histogram analysis showed statistically significant differences in the mean, standard deviation, and 50th and 90th percentile ADC values among the three groups (P histogram analysis was 52.6% over MR imaging alone and 15.8% over combined conventional MR imaging and (18)F-FDG PET/CT. Adding ADC histogram analysis to conventional MR imaging can improve the detection sensitivity for occult palatine tonsil SCC in patients with a cervical nodal metastasis originating from a cancer of an unknown primary site. © RSNA, 2015.

Melanoma Patients with Unknown Primary Site or Nodal Recurrence after Initial Diagnosis Have a Favourable Survival Compared to Those with Synchronous Lymph Node Metastasis and Primary Tumour

OpenAIRE

Weide, Benjamin; Faller, Christine; Els?sser, Margrit; B?ttner, Petra; Pflugfelder, Annette; Leiter, Ulrike; Eigentler, Thomas Kurt; Bauer, J?rgen; Meier, Friedegund; Garbe, Claus

2013-01-01

BACKGROUND: A direct comparison of prognosis between patients with regional lymph node metastases (LNM) detected synchronously with the primary melanoma (primary LNM), patients who developed their first LNM subsequently (secondary LNM) and those with initial LNM in melanoma with unknown primary site (MUP) is missing thus far. PATIENTS AND METHODS: Survival of 498 patients was calculated from the time point of the first macroscopic LNM using Kaplan Meier and multivariate Cox hazard regression ...

Fever of unknown origin: A value of {sup 18}F-FDG-PET/CT with integrated full diagnostic isotropic CT imaging

Energy Technology Data Exchange (ETDEWEB)

Ferda, Jiri [Department of Nuclear Medicine, Charles University Medical School and Teaching Hospital, Plzen (Czech Republic); Radiodiagnostic Clinic, Charles University Medical School and Teaching Hospital, Plzen (Czech Republic)], E-mail: ferda@fnplzen.cz; Ferdova, Eva [Department of Nuclear Medicine, Charles University Medical School and Teaching Hospital, Plzen (Czech Republic); Radiodiagnostic Clinic, Charles University Medical School and Teaching Hospital, Plzen (Czech Republic); Zahlava, Jan [Department of Nuclear Medicine, Charles University Medical School and Teaching Hospital, Plzen (Czech Republic); Matejovic, Martin [Ist Internal Department, Charles University Medical School and Teaching Hospital, Plzen (Czech Republic); Kreuzberg, Boris [Radiodiagnostic Clinic, Charles University Medical School and Teaching Hospital, Plzen (Czech Republic)

2010-03-15

Aim: The aim of presented work is to evaluate the clinical value of {sup 18}F-FDG-PET/CT in patients with fever of unknown origin (FUO) and to compare PET/CT finding with the results of the following investigation. Material and method: 48 patients (24 men, 24 women, mean age 57.6 years with range 15-89 years) underwent {sup 18}F-FDG-PET/CT due to the fever of unknown origin. All examinations were performed using complex PET/CT protocol combined PET and whole diagnostic contrast enhanced CT with sub-millimeter spatial resolution (except patient with history of iodine hypersensitivity or sever renal impairment). CT data contained diagnostic images reconstructed with soft tissue and high-resolution algorithm. PET/CT finding were compared with results of biopsies, immunology, microbiology or autopsy. Results: The cause of FUO was explained according to the PET/CT findings and followed investigations in 44 of 48 cases-18 cases of microbial infections, nine cases of autoimmune inflammations, four cases of non-infectious granulomatous diseases, eight cases of malignancies and five cases of proved immunity disorders were found. In 46 cases, the PET/CT interpretation was correct. Only in one case, the cause was overlooked and the uptake in atherosclerotic changes of arteries was misinterpreted as vasculitis in the other. The reached sensitivity was 97% (43/44), and specificity 75% (3/4) respectively. Conclusion: In patients with fever of unknown origin, {sup 18}F-FDG-PET/CT might enable the detection of its cause.

Diagnostic Performance of F-18 FDG PET/CT in Patients with Cancer of Unknown Primary: Additional Benefit over CT-Based Conventional Work up

Directory of Open Access Journals (Sweden)

Mehrdad Bakhshayeshkaram

2016-01-01

Full Text Available Background: In the era of well-developed site-specific treatment strategies in cancer, identification of occult primary is of paramount importance in CUP patients. Furthermore, exact determination of the extent of the disease may help in optimizing treatment planning. The aim of the present study was to investigate additional value of F-18 FDG PET/CT in patients with cancer of unknown primary (CUP as an appropriate imaging tool in early phase of initial standard work up.Materials and Methods: Sixty-two newly diagnosed CUP patients with inconclusive diagnostic CT scan of chest, abdomen and pelvis referring for F-18 FDG PET/CT were enrolled in this study. Standard of reference was defined as histopathology, other diagnostic procedures and a 3-month formal clinical follow up. The results of PET/CT were categorized as suggestion for primary site and additional metastasis and classified as true positive, false positive, false negative and true negative. The impact of additional metastasis revealed by F-18 FDG PET/CT on treatment planning and the time contribution of F-18 FDG PET/CT in diagnostic pathway was investigated.Results: Sixty-two patients with mean age of 62 (30 men, 32 women, PET/CT correctly identified primary origin in 32% with false positive rate of 14.8%. No primary lesion was detected after negative PET/CT according to standard of reference. Sensitivity, Specificity and accuracy were 100%, 78% and 85%, respectively. Additional metastatic site was found in 56% with 22% impact on treatment planning. Time contribution for PET/CT was 10% of total diagnostic pathway.Conclusion: Providing higher detection rate of primary origin with excellent diagnostic performance, shortening the diagnostic pathway and improving treatment planning, F-18 FDG PET/CT may play a major role in diagnostic work up of CUP patients and may be recommended as an alternative imaging tool in early phase of investigation.

Fever of unknown origin; Re-evaluation of sup 67 Ga scintigraphy in detecting causes of fever

Energy Technology Data Exchange (ETDEWEB)

Misaki, Takashi; Matsui, Akira; Tanaka, Fumiko; Okuno, Yoshishige; Mitsumori, Michihide; Torizuka, Tatsurou; Dokoh, Shigeharu; Hayakawa, Katsumi; Shimbo, Shin-ichirou (Kyoto City Hospital (Japan))

1990-06-01

Gallium-67 scintigraphy is a commonly performed imaging modality in deteting pyrogenic lesions in cases of long-standing inexplainable fever. To re-evaluate the significance of gallium imaging in such cases, a retrospective review was made of 56 scans performed in febrile patients in whom sufficient clinical and laboratory findings were obtained. Gallium scans were true positive in 30 patients, false positive in 3, true negative in 19, and false negative in 4. In the group of true positive, local inflammatory lesions were detected in 23 patients with a final diagnosis of lung tuberculosis, urinary tract infection, and inflammatory joint disease. Abnormal gallium accumulation, as shown in the other 7 patients, provided clues to the diagnosis of generalized disorders, such as hematological malignancies (n=3), systemic autoimmune diseases (n=3), and severe infectious mononucleosis (n=one). In the group of false positive, gallium imaging revealed intestinal excretion of gallium in 2 patients and physiological pulmonary hilar accumulation in one. In the true negative group of 19 patients, fever of unknown origin was resolved spontaneously in 12 patients, and with antibiotics and corticosteroids in 2 and 5 patients, respectively. Four patients having false negative scans were finally diagnosed as having urinary tract infection (n=2), bacterial meningitis (n=one), and polyarteritis (n=one). Gallium imaging would remain the technique of choice in searching for origin of unknown fever. It may also be useful for early diagnosis of systemic disease, as well as focal inflammation. (N.K.).

Detection of unknown primary neuroendocrine tumours (CUP-NET) using {sup 68}Ga-DOTA-NOC receptor PET/CT

Energy Technology Data Exchange (ETDEWEB)

Prasad, Vikas; Baum, Richard P. [Zentralklinik Bad Berka, Department of Nuclear Medicine and Centre for PET/CT, Bad Berka (Germany); Ambrosini, Valentina; Fanti, Stefano [University of Bologna, Nuclear Medicine Unit, Policlinico S. Orsola-Malpighi, Bologna (Italy); Hommann, Merten [Zentralklinik Bad Berka, Department of General and Visceral Surgery, Bad Berka (Germany); Hoersch, Dieter [Zentralklinik Bad Berka, Department of Internal Medicine/Gastroenterology, Oncology and Endocrinology, Bad Berka (Germany)

2010-01-15

This bi-centric study aimed to determine the role of receptor PET/CT using {sup 68}Ga-DOTA-NOC in the detection of undiagnosed primary sites of neuroendocrine tumours (NETs) and to understand the molecular behaviour of the primarily undiagnosed tumours. Overall 59 patients (33 men and 26 women, age: 65 {+-} 9 years) with documented NET and unknown primary were enrolled. PET/CT was performed after injection of approximately 100 MBq (46-260 MBq) of {sup 68}Ga-DOTA-NOC. The maximum standardised uptake values (SUV{sub max}) were calculated and compared with SUV{sub max} in known pancreatic NET (pNET) and ileum/jejunum/duodenum (SI-NET). The results of PET/CT were also correlated with CT alone. In 35 of 59 patients (59%), {sup 68}Ga-DOTA-NOC PET/CT localised the site of the primary: ileum/jejunum (14), pancreas (16), rectum/colon (2), lungs (2) and paraganglioma (1). CT alone (on retrospective analyses) confirmed the findings in 12 of 59 patients (20%). The mean SUV{sub max} of identified previously unknown pNET and SI-NET were 18.6 {+-} 9.8 (range: 7.8-34.8) and 9.1 {+-} 6.0 (range: 4.2-27.8), respectively. SUV{sub max} in patients with previously known pNET and SI-NET were 26.1 {+-} 14.5 (range: 8.7-42.4) and 11.3 {+-} 3.7 (range: 5.6-17.9). The SUV{sub max} of the unknown pNET and SI-NET were significantly lower (p < 0.05) as compared to the ones with known primary tumour sites; 19% of the patients had high-grade and 81% low-grade NET. Based on {sup 68}Ga-DOTA-NOC receptor PET/CT, 6 of 59 patients were operated and the primary was removed (4 pancreatic, 1 ileal and 1 rectal tumour) resulting in a management change in approximately 10% of the patients. In the remaining 29 patients, because of the far advanced stage of the disease (due to distant metastases), the primary tumours were not operated. Additional histopathological sampling was available from one patient with bronchial carcinoid (through bronchoscopy). Our data indicate that {sup 68}Ga-DOTA-NOC PET/CT is

Magnetic resonance imaging (MRI) of liver and brain in haematologic-organic patients with fever of unknown origin

International Nuclear Information System (INIS)

Heussel, C.P.; Kauczor, H.U.; Poguntke, M.; Schadmand-Fischer, S.; Mildenberger, P.; Thelen, M.; Heussel, G.

1998-01-01

To examine the advantage of liver and brain MRI in clinically anomalous haematological patients with fever of unknown origin. Material and Methods: Twenty liver MRI (T 2 -TSE, T 2 -HASTE, T 1 -FLASH±Gd dynamic) and 16 brain MRI (T 2 -TSE, FLAIR, T 1 -TSE±Gd) were performed searching for a focus of fever with a suspected organ system. Comparison with clinical follow-up. Results: suspected organ system. Comparison with clinical follow-up. Results: A focus was detected in 11/20 liver MRI. Candidiasis (n=3), mycobacteriosis (n=2), relapse of haematological disease (n=3), graft versus host disease (n=1), non-clarified (n=2). The remaining 9 cases with normal MRI were not suspicious of infectious hepatic disease during follo-wup. In brain MRI, 3/16 showed a focus (toxoplasmosis, aspergillosis, mastoiditis). Clinical indication for an infectious involvement of the brain was found in 4/16 cases 2--5 months after initially normal brain MRI. No suspicion of an infectious involvement of brain was present in the remaining 9/16 cases. Conclusion: In case of fever of unknown origin and suspicion of liver involvement, MRI of the liver should be performed due to data given in literature and its sensitivity of 100%. Because of the delayed detectability of cerebral manifestations, in cases of persisting suspicion even a previously normal MRI of the brain should be repeated. (orig.) [de

Prevalence of scrub typhus in pyrexia of unknown origin and assessment of interleukin-8, tumor necrosis factor-alpha, and interferon-gamma levels in scrub typhus-positive patients.

Science.gov (United States)

Rizvi, Meher; Sultan, Asfia; Chowdhry, Madhav; Azam, Mohd; Khan, Fatima; Shukla, Indu; Khan, Haris M

2018-01-01

Scrub typhus is lesser known cause of fever of unknown origin in India. Even if there have been reports documenting the prevalence of scrub typhus in different parts of India, it is still an unknown entity, and clinicians usually do not consider it as differential diagnosis. The present study was performed to document the prevalence of scrub typhus among febrile patients in western part of Uttar Pradesh and to assess the clinical profile of infected patients on the one hand and knowledge, attitude, and practices among clinicians on the other. A total of 357 adult patients with fever of more than 5-day duration were recruited. All patients underwent complete physical examination, and detailed clinical history was elicited as per predesigned pro forma. After primary screening to rule out malaria, enteric fever, and leptospirosis infection, secondary screening for scrub typhus was done by rapid screen test and IgM ELISA. Scrub typhus infection was positive in 91 (25.5%) cases. The most common symptoms among the patients were fever (100%), pain in abdomen (79.1%), pedal edema 56 (61.5%), rash 44 (48.3%), headache 44 (48.3%), vomiting 42 (46.1%), constipation 33 (36.2%), cough 28 (30.7%), and lymphadenopathy 20 (21.9%). The median values of interleukin-8, interferon-gamma, and tumor necrosis factor-alpha in healthy controls were 15.54 pg/ml, 7.77 pg/ml, and 54.1 pg/ml, respectively, while the median values of these cytokines in scrub typhus-positive patients were 21.04 pg/ml, 8.74 pg/ml, and 73.8 pg/ml, respectively. Our results highlight that scrub typhus infection is an important cause of pyrexia of unknown origin, and active surveillance is necessary to assess the exact magnitude and distribution of the disease.

Chasing ghosts: allopolyploid origin of Oxyria sinensis (Polygonaceae) from its only diploid congener and an unknown ancestor.

Science.gov (United States)

Luo, Xin; Hu, Quanjun; Zhou, Pingping; Zhang, Dan; Wang, Qian; Abbott, Richard J; Liu, Jianquan

2017-06-01

Reconstructing the origin of a polyploid species is particularly challenging when an ancestor has become extinct. Under such circumstances, the extinct donor of a genome found in the polyploid may be treated as a 'ghost' species in that its prior existence is recognized through the presence of its genome in the polyploid. In this study, we aimed to determine the polyploid origin of Oxyria sinensis (2n = 40) for which only one congeneric species is known, that is diploid O. digyna (2n = 14). Genomic in situ hybridization (GISH), transcriptome, phylogenetic and demographic analyses, and ecological niche modelling were conducted for this purpose. GISH revealed that O. sinensis comprised 14 chromosomes from O. digyna and 26 chromosomes from an unknown ancestor. Transcriptome analysis indicated that following divergence from O. digyna, involving genome duplication around 12 million years ago (Ma), a second genome duplication occurred approximately 6 Ma to give rise to O. sinensis. Oxyria sinensis was shown to contain homologous gene sequences divergent from those present in O. digyna in addition to a set that clustered with those in O. digyna. Coalescent simulations indicated that O. sinensis expanded its distribution approximately 6-7 Ma, possibly following the second polyploidization event, whereas O. digyna expanded its range much later. It was also indicated that the distributions of both species contracted and re-expanded during the Pleistocene climatic oscillations. Ecological niche modelling similarly suggested that both species experienced changes in their distributional ranges in response to Quaternary climatic changes. The extinction of the unknown 'ghost' tetraploid species implicated in the origin of O. sinensis could have resulted from superior adaptation of O. sinensis to repeated climatic changes in the region where it now occurs. © 2017 John Wiley & Sons Ltd.

Radiotherapy for squamous cell carcinoma metastatic to cervical lymph nodes from an unknown primary site

International Nuclear Information System (INIS)

Colletier, Philip J.; Garden, Adam S.; Morrison, William H.; Geara, Fady B.; Kian Ang, K.

1996-01-01

PURPOSE/OBJECTIVE: To evaluate the outcome of patients treated with radiotherapy for carcinoma metastatic to cervical lymph nodes from an unknown primary site. This large retrospective series updates the results of our treatment policy in which patients receive radiation both to the involved neck(s) at risk as well as putative mucosal primary sites along the pharyngeal axis. MATERIALS/METHODS: Between July 1968 and December 1992, 196 patients with carcinoma metastatic to cervical lymph nodes from an unknown primary site were treated with curative intent using megavoltage external beam radiotherapy. One hundred thirty-nine patients received adjuvant radiation following either an excisional biopsy or neck dissection (S+XRT), and 57 received radiation to gross disease following either a diagnostic biopsy or incomplete resection (XRT). A neck dissection was performed following radiation in patients in the XRT group who were medically and technically operable if there were residual masses following radiation. Nodal stage distribution was as follows: N1 - 32 patients, N2a - 65, N2b - 35, N2c - 15, N3 - 36, and NX - 13. Thirty percent of patients in the XRT group had N3 disease vs. 14% in the S+XRT group (p = .008). Similarly, 33% of patients in the XRT group presented with low jugular or supraclavicular adenopathy compared with 16% in the S+XRT group (p = .006). Radiation was delivered to putative mucosal sites in 173 patients. Of these, 172 were treated to the oropharynx, 167 to the nasopharynx, 124 to the larynx and hypopharynx, and 5 to the oral cavity. All but one patient received bilateral treatment when covering putative mucosal primary sites. Treatment was limited to the ipsilateral neck only in 23 patients. Doses ranged from 24 to 90 Gy. The median doses to the sites of nodal involvement were 63 Gy and 68.1 Gy for the S+XRT and XRT groups, respectively. RESULTS: The range of follow-up was 1-267 months with a median follow-up in surviving patients of 87 months

18F-FDG whole body positron emission tomography (PET) in patients with unknown primary tumours (UPT)

DEFF Research Database (Denmark)

Lassen, U; Daugaard, G; Eigtved, A

1999-01-01

adenocarcinomas and 1 poorly differentiated carcinoma). The remaining patients had metastases located in bone (3), bone marrow (1), brain (1), pericardium (1), skin (1), pleura (1) and chest wall (1). All metastatic lesions were visible with PET. In 13 patients PET suggested the site for the primary tumour...... by the PET result. The rest received either radical radiotherapy to the head and neck region (7), palliative radiotherapy to the metastatic lesion (8), chemotherapy based on signet ring cell carcinoma in bone marrow (1) or no therapy (1). These results indicates that PET is useful in UPT preceding expensive......The management of patients with unknown primary tumours (UPT) often includes a large number of radiographical studies and invasive procedures, but the occult primary tumour is detected in less than 25%. In this prospective study we explored whether non-invasive whole body PET scans using FDG (18-F...

18F-FDG whole body positron emission tomography (PET) in patients with unknown primary tumours (UPT)

DEFF Research Database (Denmark)

Lassen, U; Daugaard, G; Eigtved, A

1999-01-01

-fluorodeoxyglucose) are of clinical value in detection of UPT. Whole-body FDG-PET scans were performed in 20 patients following standard staging procedures according to histology. PET results were verified either histologically or by the clinical course of the disease. 11 patients had neck metastases (5 squamous cell, 5......The management of patients with unknown primary tumours (UPT) often includes a large number of radiographical studies and invasive procedures, but the occult primary tumour is detected in less than 25%. In this prospective study we explored whether non-invasive whole body PET scans using FDG (18-F...... and this was verified in 9 (45%), either histologically or by the clinical course of disease. 8 of these had primary lung cancer and 1 had carcinoma at the basis of the tongue. In most patients PET had no treatment related implications. 3 patients with non-small cell lung cancer (NSCLC) received chemotherapy prompted...

Diagnostic value of (111)In-granulocyte scintigraphy in patients with fever of unknown origin

DEFF Research Database (Denmark)

Kjaer, Andreas; Lebech, Anne-Mette

2002-01-01

111In-granulocyte scintigraphy is often used as a diagnostic tool in patients with fever of unknown origin (FUO). However, its diagnostic performance has been studied in only a limited number of investigations, with most having been published more than 10 y ago; in addition, a broad range...... of sensitivities and specificities has been reported. Therefore, the aim of this study was to investigate the diagnostic value of granulocyte scintigraphy in patients fulfilling the criteria of FUO. Also studied was whether increased peripheral leukocyte count or C-reactive protein (CRP) level could be used...... to select patients for scintigraphy to raise the diagnostic value. METHODS: For 31 patients with true FUO who underwent granulocyte scintigraphy at a third-line referral hospital between 1995 and 2000, the files and scintigraphy findings were reviewed retrospectively to test the ability of scintigraphy...

Capecitabine and oxaliplatin as second-line treatment in patients with carcinoma of unknown primary site

DEFF Research Database (Denmark)

Møller, Anne Kirstine Hundahl; Pedersen, Karen Damgaard; Abildgaard, Julie Rafn

2010-01-01

tumours may be overrepresented. These patients could be candidates for GI tract-directed therapy. We here report the results obtained with oxaliplatin and capecitabine as second-line therapy in 25 recurrent/refractory CUP patients following first-line treatment with paclitaxel, cisplatin and gemcitabine.......Treatment of patients with carcinoma of unknown primary site (CUP) remains a challenge, and no effective second-line treatment has been identified. In CUP patients who are non-responsive or relapse early after first-line platinum/taxane-based regimens, it is likely that gastrointestinal (GI) tract...

Contemporary management of lymph node metastases from an unknown primary to the neck : II. A review of therapeutic options

NARCIS (Netherlands)

Strojan, Primoz; Ferlito, Alfio; Langendijk, Johannes A.; Corry, June; Woolgar, Julia A.; Rinaldo, Alessandra; Silver, Carl E.; Paleri, Vinidh; Fagan, Johannes J.; Pellitteri, Phillip K.; Haigentz, Missak; Suarez, Carlos; Robbins, K. Thomas; Rodrigo, Juan P.; Olsen, Kerry D.; Hinni, Michael L.; Werner, Jochen A.; Mondin, Vanni; Kowalski, Luiz P.; Devaney, Kenneth O.; de Bree, Remco; Takes, Robert P.; Wolf, Gregory T.; Shaha, Ashok R.; Genden, Eric M.; Barnes, Leon

Although uncommon, cancer of an unknown primary (CUP) metastatic to cervical lymph nodes poses a range of dilemmas relating to optimal treatment. The ideal resolution would be a properly designed prospective randomized trial, but it is unlikely that this will ever be conducted in this group of

Contemporary management of lymph node metastases from an unknown primary to the neck: II. a review of therapeutic options

NARCIS (Netherlands)

Strojan, P.; Ferlito, A.; Langendijk, J.A.; Corry, J.; Woolgar, J.A.; Rinaldo, A.; Silver, C.E.; Paleri, V.; Fagan, J.J.; Pellitteri, P.K.; Haigentz Jr., M.; Suarez, C.; Robbins, K.T.; Rodrigo, J.P.; Olsen, K.D.; Hinni, M.L.; Werner, J.A.; Mondin, V.; Kowalski, L.P.; Devaney, K.O.; Bree, R. de; Takes, R.P.; Wolf, G.T.; Shaha, A.R.; Genden, E.M.; Barnes, L.

2013-01-01

Although uncommon, cancer of an unknown primary (CUP) metastatic to cervical lymph nodes poses a range of dilemmas relating to optimal treatment. The ideal resolution would be a properly designed prospective randomized trial, but it is unlikely that this will ever be conducted in this group of

Zoonotic and vector borne agents causing disease in adult patients hospitalized due to fever of unknown origin in Thailand

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Soawapak Hinjoy

2017-10-01

Full Text Available Objective: To determine the etiologic agents of fever of unknown origin among populations in agricultural communities and to assess the possible risk factors for zoonotic infections. Methods: Hospitalized patients with fever of unknown origin under physician care were asked to participate and provide blood samples for laboratory tests and screening for endemic diseases at the hospitals. Samples were stored at –80 °C until they were tested at Chulalongkorn University to identify additional pathogens. Results: We were able to identify the etiologic agents in 24.6% of the 463 enrolled patients. Zoonotic and vector borne agents were confirmed in 59 cases (12.7%. Dengue virus (7.3% was the most frequently detected disease followed by scrub typhus (3.2%. There were two cases of comorbidities of scrub typhus and dengue fever. The other six cases of zoonoses were leptospirosis, melioidosis, and Streptococcus suis infections. Patients with zoonotic/vector borne agents noticed rats in their houses and reported having contact with livestock feces more frequently than those patients without zoonotic/vector borne agents. Conclusions: Dengue virus and scrub typhus were mostly detected in the rainy season. During this specific season, clinicians should raise awareness of those diseases when any patients are admitted to the hospital with fever of an unidentified source.

Use of immunoscintigraphy in the diagnosis of fever of unknown origin

International Nuclear Information System (INIS)

Doelkemeyer, U.; Gramatzki, M.; Schneider, M.U.; Scheele, J.; Wolf, F.

1993-01-01

Fever of unknown origin (FUO) has been defined as an elevation in temperature (38 C) for at least 2-3 weeks despite intensive investigation. The value of immunoscintigraphy with technetium-99m-labelled anti-granulocyte antibody anti-NCA-95 (BW 250/183, IgGl) was studied retrospectively in 34 consecutive patients with FUO. Every effort was made to confirm a diagnosis, including methods such as ultrasonography, computed tomography, magnetic resonance imaging, bacteriological tests, surgical intervention and clinical follow-up. In 58,8% of the patients, an infectious cause for the fever was found. In 30.2% of the patients, a benign or malignant haematological disease, pancreatitis or thyrotoxicosis was found. No cause for fever could be found in 11%. The overall diagnostic sensitivity and specificity of immunoscintigraphy for infection were 40% and 92% respectively. The positive predictive value was calculated to be 88% and the negative predictive value was calculated to be 52%. False-negative scans were especially noted in patients with endocarditis, pneumonia and small brain abscesses, where the lesions did not exceed a diameter of 0.5 cm. If patients with endocarditis were excluded, the imaging sensitivity and specificity were increased to 57% and 95%. This study demonstrates that 99mTc-anti-NCA-95 scanning is able to localize infectious causes of FUO, other than endocarditis. (orig.)

Use of immunoscintigraphy in the diagnosis of fever of unknown origin

Energy Technology Data Exchange (ETDEWEB)

Doelkemeyer, U [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Nuclear Medicine; Gramatzki, M [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Medicine 3; Schneider, M U [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Medicine 1; Scheele, J [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Surgery; Wolf, F [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Nuclear Medicine

1993-11-01

Fever of unknown origin (FUO) has been defined as an elevation in temperature (38 C) for at least 2-3 weeks despite intensive investigation. The value of immunoscintigraphy with technetium-99m-labelled anti-granulocyte antibody anti-NCA-95 (BW 250/183, IgGl) was studied retrospectively in 34 consecutive patients with FUO. Every effort was made to confirm a diagnosis, including methods such as ultrasonography, computed tomography, magnetic resonance imaging, bacteriological tests, surgical intervention and clinical follow-up. In 58,8% of the patients, an infectious cause for the fever was found. In 30.2% of the patients, a benign or malignant haematological disease, pancreatitis or thyrotoxicosis was found. No cause for fever could be found in 11%. The overall diagnostic sensitivity and specificity of immunoscintigraphy for infection were 40% and 92% respectively. The positive predictive value was calculated to be 88% and the negative predictive value was calculated to be 52%. False-negative scans were especially noted in patients with endocarditis, pneumonia and small brain abscesses, where the lesions did not exceed a diameter of 0.5 cm. If patients with endocarditis were excluded, the imaging sensitivity and specificity were increased to 57% and 95%. This study demonstrates that 99mTc-anti-NCA-95 scanning is able to localize infectious causes of FUO, other than endocarditis. (orig.)

Radiotherapeutic concepts in cancer of unknown primary site; Strahlentherapeutische Konzepte beim CUP-Syndrom

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Krug, D.; Debus, J.; Sterzing, F. [Universitaetsklinikum Heidelberg, Klinik fuer Radioonkologie und Strahlentherapie, Heidelberg (Germany)

2014-02-15

The term cancer of unknown primary (CUP) encompasses a group of entities which differ to a great extent regarding etiology, prognosis and therapeutic management. The aim of the study was an elaboration of the role of radiotherapy in CUP syndrome. Systematic literature search and specification of the available treatment options. Radiotherapy is an integral part of interdisciplinary management approaches for patients with CUP in both curative and palliative situations. Radio-oncological techniques, such as intensity-modulated radiotherapy and stereotactic body radiotherapy increase the therapeutic window. Modern diagnostic modalities from radiology and nuclear medicine are the cornerstone of radiotherapeutic interventions, especially in terms of target volume definition and pretherapeutic staging. In the interdisciplinary setting radiation oncology offers the possibility of curative and often organ preserving approaches in patients with axillary and cervical CUP. In addition, improvement and preservation of quality of life can be achieved in patients with metastatic disease. Radiation oncology is a crucial component of the interdisciplinary management of patients with CUP. Therapeutic decisions in patients with CUP should be made in an interdisciplinary setting. (orig.) [German] Das Cancer-of-unknown-primary(CUP)-Syndrom fasst eine Gruppe von Erkrankungen zusammen, die durch eine ausgepraegte Heterogenitaet hinsichtlich Aetiologie, Therapie und Prognose gepraegt sind. Darstellung der Rolle der Strahlentherapie beim CUP-Syndrom. Systematische Literaturrecherche und Erlaeuterung der Behandlungsoptionen. Die Strahlentherapie ist beim CUP-Syndrom sowohl in adjuvanten und definitiven Therapiekonzepten wie auch in palliativer Intention etabliert. Technisch innovative Verfahren wie die intensitaetsmodulierte Radiotherapie und die stereotaktische Bestrahlung im Koerperstammbereich ermoeglichen eine Vergroesserung der therapeutischen Breite. Eine leistungsfaehige und moderne

Coma of unknown origin in the emergency department: implementation of an in-house management routine.

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Braun, Mischa; Schmidt, Wolf Ulrich; Möckel, Martin; Römer, Michael; Ploner, Christoph J; Lindner, Tobias

2016-04-27

Coma of unknown origin is an emergency caused by a variety of possibly life-threatening pathologies. Although lethality is high, there are currently no generally accepted management guidelines. We implemented a new interdisciplinary standard operating procedure (SOP) for patients presenting with non-traumatic coma of unknown origin. It includes a new in-house triage process, a new alert call, a new composition of the clinical response team and a new management algorithm (altogether termed "coma alarm"). It is triggered by two simple criteria to be checked with out-of-hospital emergency response teams before the patient arrives. A neurologist in collaboration with an internal specialist leads the in-hospital team. Collaboration with anaesthesiology, trauma surgery and neurosurgery is organised along structured pathways that include standardised laboratory tests and imaging. Patients were prospectively enrolled. We calculated response times as well as sensitivity and false positive rates, thus proportions of over- and undertriaged patients, as quality measures for the implementation in the SOP. During 24 months after implementation, we identified 325 eligible patients. Sensitivity was 60 % initially (months 1-4), then fluctuated between 84 and 94 % (months 5-24). Overtriage never exceeded 15 % and undertriage could be kept low at a maximum of 11 % after a learning period. We achieved a median door-to-CT time of 20 minutes. 85 % of patients needed subsequent ICU treatment, 40 % of which required specialised neuro-ICUs. Our results indicate that our new simple in-house triage criteria may be sufficient to identify eligible patients before arrival. We aimed at ensuring the fastest possible proceedings given high portions of underlying time-sensitive neurological and medical pathologies while using all available resources as purposefully as possible. Our SOP may provide an appropriate tool for efficient management of patients with non-traumatic coma. Our results

Intensity-Modulated Radiotherapy for Cervical Lymph Node Metastases From Unknown Primary Cancer

International Nuclear Information System (INIS)

Madani, Indira; Vakaet, Luc; Bonte, Katrien; Boterberg, Tom; Neve, Wilfried de

2008-01-01

Purpose: To compare the effectiveness of intensity-modulated radiotherapy (IMRT) and conventional (two-dimensional) radiotherapy in the treatment of cervical lymph node metastases from unknown primary cancer (UPC). Methods and Materials: Between February 2003 and September 2006, 23 patients with UPC of squamous cell carcinoma were treated with IMRT. Extended putative mucosal and bilateral nodal sites were irradiated to a median dose of 66 Gy. In 19 patients, IMRT was performed after lymph node dissection, and in 4 patients primary radiotherapy was given. The conventional radiotherapy group (historical control group) comprised 18 patients treated to a median dose of 66 Gy between August 1994 and October 2003. Results: Twenty patients completed treatment. As compared with conventional radiotherapy, the incidence of Grade 3 acute dysphagia was significantly lower in the IMRT group (4.5% vs. 50%, p = 0.003). By 6 months, Grade 3 xerostomia was detected in 11.8% patients in the IMRT group vs. 53.4% in the historical control group (p = 0.03). No Grade 3 dysphagia or skin fibrosis was observed after IMRT but these were noted after conventional radiotherapy (26.7%, p = 0.01) and 26.7%, p = 0.03) respectively). With median follow-up of living patients of 17 months, there was no emergence of primary cancer. One patient had persistent nodal disease and another had nodal relapse at 5 months. Distant metastases were detected in 4 patients. The 2-year overall survival and distant disease-free probability after IMRT did not differ significantly from those for conventional radiotherapy (74.8% vs. 61.1% and 76.3% vs. 68.4%, respectively). Conclusions: Use of IMRT for UPC resulted in lower toxicity than conventional radiotherapy, and was similar in efficacy

The role of 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography in the management of patients with carcinoma of unknown primary.

Science.gov (United States)

Deonarine, P; Han, S; Poon, F W; de Wet, C

2013-08-01

Carcinoma of unknown primary is one of the ten most frequent cancers worldwide. Its median survival time is less than 10 months. Detecting primary tumour locations and/or occult metastatic lesions may inform definitive treatment and improve patients' prognosis. We aimed to determine: (1) the sensitivity, specificity and accuracy of (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography; (2) its detection rate of primary tumour locations and occult metastases and (3) factors associated with improved survival times. We retrospectively reviewed all cases in the West of Scotland for the period 1 December 2007 to 31 May 2011 that met all our selection criteria: (1) diagnosis of carcinoma of unknown primary; (2) a thorough but negative 'work-up' and (3) (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography report. Statistical methods included frequencies, Kaplan-Meier graphs and log-rank tests to compare survival times. (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography detected primary tumour sites in 19/51 (37.3%) and occult metastases in 28/51 (54.9%) of eligible patients. Its sensitivity, specificity and accuracy were 79.2%, 70.4% and 74.5%, respectively; 20/51 (39.2%) patients died during the study period with a median survival of 8.4 months (range 21.4, SD ± 6.2). The number of metastatic locations was strongly associated with survival (p = 0.002), but detection of a primary tumour site (p = 0.174) or histopathology (p = 0.301) was not. (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography detected occult metastatic sites in the majority and a primary cancer location in a substantial minority of patients. Our results were comparable with international literature and may indicate that (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography have an early role to improve the accuracy of cancer staging and to optimise carcinoma of unknown

Primary and secondary organic aerosol origin by combined gas-particle phase source apportionment

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M. Crippa

2013-08-01

Full Text Available Secondary organic aerosol (SOA, a prominent fraction of particulate organic mass (OA, remains poorly constrained. Its formation involves several unknown precursors, formation and evolution pathways and multiple natural and anthropogenic sources. Here a combined gas-particle phase source apportionment is applied to wintertime and summertime data collected in the megacity of Paris in order to investigate SOA origin during both seasons. This was possible by combining the information provided by an aerosol mass spectrometer (AMS and a proton transfer reaction mass spectrometer (PTR-MS. A better constrained apportionment of primary OA (POA sources is also achieved using this methodology, making use of gas-phase tracers. These tracers made possible the discrimination between biogenic and continental/anthropogenic sources of SOA. We found that continental SOA was dominant during both seasons (24–50% of total OA, while contributions from photochemistry-driven SOA (9% of total OA and marine emissions (13% of total OA were also observed during summertime. A semi-volatile nighttime component was also identified (up to 18% of total OA during wintertime. This approach was successfully applied here and implemented in a new source apportionment toolkit.

Role of whole body positron emission tomography/computed tomography scan with 18F-fluorodeoxyglucose in patients with biopsy proven tumor metastases from unknown primary site

International Nuclear Information System (INIS)

Pelosi, E.; Pennone, M.; Deandreis, D.; Bisi, G.

2006-01-01

Aim: The aim of this study was to evaluate the role of whole body PET/CT scan with 1 8F -fluorodeoxyglucose (FDG) in the detection of the primary tumor in patients with metastatic cancer from unknown primary origin (CUP syndrome). Methods: Sixty-eight consecutive patients, with CUP syndrome (39 lymph nodes, 29 visceral biopsy proven tumor metastases), underwent a whole-body FDG-PET/CT study. All enrolled patients were unsuccessfully studied, within the previous month, with physical examination, laboratory tests and conventional diagnostic procedures. All the pathological findings identified at PET/CT scan and suspected for primaries, were further investigated. After PET study, the minimum follow-up period for the inclusion in the studied population was 3 months. Results: The primary tumor site was correctly identified by FDG-PET/CT in 24 patients (24/68, 35.3%): long (0-9). rino/oro-pharynx (n=6), pancreas (n=5), colon (n=2). uterus (n=2). In 5 cases, FDG-PET scan did not identify a primary pathological focus, which was subsequently detected by other diagnostic methods within 3 months. In 39 patients (39168, 57.4%), the primary tumor site was not localized. However, in 9 of them, FDG-PET/CT scan identified further unexpected metastases, modifying the stage of disease. Overall, the following oncological treatment was influenced by the PET scan, in a total of 33 patients (33/68, 48.5%). Conclusion: Our data strongly support the diagnostic contribution of whole body FDG-PET/CT scan in the evaluation of patients with CUP syndrome and suggest its use in an early phase of the diagnostic iter to optimize patient management

Multifocal, chronic osteomyelitis of unknown etiology

International Nuclear Information System (INIS)

Kozlowski, K.; Beluffi, G.; Feltham, C.; James, M.; Nespoli, L.; Tamaela, L.; Pavia Univ.; Municipal Hospital, Nelson; Medical School, Jakarta

1985-01-01

Four cases of multifocal osteomyelitis of unknown origin in childhood are reported. The variable clinical and radiographic appearances of the disease are illustrated and the diagnostic difficulties in the early stages of the disease are stressed. (orig.) [de

Cost-effectiveness of using a gene expression profiling test to aid in identifying the primary tumour in patients with cancer of unknown primary.

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Hannouf, M B; Winquist, E; Mahmud, S M; Brackstone, M; Sarma, S; Rodrigues, G; Rogan, P; Hoch, J S; Zaric, G S

2017-06-01

We aimed to investigate the cost-effectiveness of a 2000-gene-expression profiling (GEP) test to help identify the primary tumor site when clinicopathological diagnostic evaluation was inconclusive in patients with cancer of unknown primary (CUP). We built a decision-analytic-model to project the lifetime clinical and economic consequences of different clinical management strategies for CUP. The model was parameterized using follow-up data from the Manitoba Cancer Registry, cost data from Manitoba Health administrative databases and secondary sources. The 2000-GEP-based strategy compared to current clinical practice resulted in an incremental cost-effectiveness ratio (ICER) of $44,151 per quality-adjusted life years (QALY) gained. The total annual-budget impact was $36.2 million per year. A value-of-information analysis revealed that the expected value of perfect information about the test's clinical impact was $4.2 million per year. The 2000-GEP test should be considered for adoption in CUP. Field evaluations of the test are associated with a large societal benefit.

Head and neck squamous cell carcinoma of unknown primary: Outcomes of a pre-defined institutional treatment policy in a region with a high prevalence of skin cancer.

Science.gov (United States)

Huo, Michael; Panizza, Benedict; Bernard, Anne; Porceddu, Sandro V

2018-02-01

To determine the rate of subsequent primary site failure in patients with head and neck squamous cell carcinoma of unknown primary (UKP HNSCC) in a region with a high prevalence of cutaneous squamous cell carcinoma, according to a pre-determined institutional policy. Secondary aims included regional and distant control, and overall survival. Patients presenting between April 2005 and June 2016 to the Princess Alexandra Hospital Head and Neck Multidisciplinary Meeting with UKP HNSCC from either presumed mucosal or cutaneous sites treated with curative intent were eligible. Patients with presumed mucosal origin were treated with radiation therapy (RT) with or without chemotherapy, while patients with presumed cutaneous SCC were treated with surgery and post-operative RT with or without chemotherapy. A total of 63 patients met the inclusion criteria. Median follow up duration was 3.9 years (IQR 2.07-5.14). There were no subsequent primary site failures. The rate of nodal failure among presumed mucosal patients was 11.5%, and 8.1% among presumed cutaneous patients. The rate of distant metastatic failure was 11.1% among all patients. The estimated 5 year overall survival was 71.2% (95% CI 59.2-85.7%). Treatment according to our pre-defined institutional policy for UKP HNSCC in a region with a high prevalence of cutaneous SCC appears to be safe and effective with low rates of mucosal primary emergence and nodal failure. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Different Chondrogenic Potential among Human Induced Pluripotent Stem Cells from Diverse Origin Primary Cells

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Yeri Alice Rim

2018-01-01

Full Text Available Scientists have tried to reprogram various origins of primary cells into human induced pluripotent stem cells (hiPSCs. Every somatic cell can theoretically become a hiPSC and give rise to targeted cells of the human body. However, there have been debates on the controversy about the differentiation propensity according to the origin of primary cells. We reprogrammed hiPSCs from four different types of primary cells such as dermal fibroblasts (DF, n=3, peripheral blood mononuclear cells (PBMC, n=3, cord blood mononuclear cells (CBMC, n=3, and osteoarthritis fibroblast-like synoviocytes (OAFLS, n=3. Established hiPSCs were differentiated into chondrogenic pellets. All told, cartilage-specific markers tended to express more by the order of CBMC > DF > PBMC > FLS. Origin of primary cells may influence the reprogramming and differentiation thereafter. In the context of chondrogenic propensity, CBMC-derived hiPSCs can be a fairly good candidate cell source for cartilage regeneration. The differentiation of hiPSCs into chondrocytes may help develop “cartilage in a dish” in the future. Also, the ideal cell source of hiPSC for chondrogenesis may contribute to future application as well.

Fever of unknown origin: A retrospective study of 52 cases with evaluation of the diagnostic utility of FDG-PET/CT

DEFF Research Database (Denmark)

Pedersen, Thomas Ingemann; Roed, Casper; Knudsen, Lene Surland

2012-01-01

Abstract Objectives: Fever of unknown origin (FUO) is dynamic in its origin and will be an ongoing challenge to the clinician because of shifting disease epidemiology. Here we present a series of patients with classical FUO admitted to an infectious diseases department during a 5-y period......, with an emphasis on the diagnostic utility of (18)F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) in present-day cases of FUO. Methods: Patient records were reviewed retrospectively. Results: A final diagnosis was achieved for 31 of the 52 cases (60%). The final diagnoses...... of these 31 cases and their distribution in the respective diagnostic categories were: infections 32% (10/31), non-infectious inflammatory disease 55% (17/31), and malignancy 13% (4/31). In our study PET/CT successfully identified an infectious, inflammatory, or neoplastic cause of fever in 10 of the 22...

High dose intensity of cisplatin and etoposide in adenocarcinoma of unknown primary.

Science.gov (United States)

Gill, I; Guaglianone, P; Grunberg, S M; Scholz, M; Muggia, F M

1991-01-01

Adenocarcinoma of unknown primary (AUP) has generally a poor prognosis. Previous studies have suggested that Cisplatin and Etoposide have activity in AUP. The aim of this study was to determine if dose intensification of this combination would result in increased efficacy. Each 28 day cycle consisted of Cisplatin 100 mg/m2 given on Day 1 and 8 with Etoposide 80 mg/m2 given on day 1, 2, 8 and 9. Sixteen patients (Pts) with no prior chemotherapy were accrued to this study. Predominant sites of disease were lung, liver, and bone. BHCG and AFP were not elevated. One complete remission was seen in a patient with a mediastinal mass (duration of remission = 59 weeks). Two other patients had a partial response. Overall response rate was 19%. Moderate to severe renal toxicity was recorded in 8 patients, with neuro- and ototoxicities in 2 patients each. Severe granulocytopenia occurred in 8 patients, and one patient died of congestive heart failure on day 1 of cycle 2. This excessive toxicity, without enhanced efficacy does not encourage a more extensive empiric trial by this dose schedule in the treatment of AUP.

Neck lymph node metastases from an unknown primary tumor. Retrospective study and review of literature

International Nuclear Information System (INIS)

Christiansen, H.; Hermann, R.M.; Nitsche, M.; Schmidberger, H.; Pradier, O.; Martin, A.

2005-01-01

Background and purpose: up to 10% of all neck lymph node metastases present without a known primary site. The optimal treatment strategy for these patients is still undefined. The purpose of this retrospective analysis is to assess the outcome in patients with neck metastases from an unknown primary tumor (CUP). Furthermore, prognostic factors and treatment modalities are discussed. Patients and methods: from 1984 to 2003, 28 patients with squamous cell neck metastases from a CUP were treated at the authors' institution. In 17 patients, neck dissection (twelve radical, five modified radical) was performed. In that case, adjuvant radiotherapy was carried out with a mean of 56.7 Gy. In eleven patients, only biopsies were done. These patients received definitive radiotherapy with a mean of 66.8 Gy. In summary, 25 patients received extended radiotherapy including both sides of the neck and potential mucosal primary sites. Additional chemotherapy was administered to five patients. Results: the duration of follow-up was 4.1-189.5 months (median 45.1 months). After this period of time, ten patients (36%) remained alive. 5-year overall survival was 40.1%, neck control rate 72.7%. No subsequent primary could be detected. Extracapsular extension and surgery had significant influence on prognosis. Grade 3 toxicity (mucositis or skin reactions) was seen in three patients; no hematologic toxicity > grade 2 was observed. 19 patients suffered from grade 2 xerostomia. Conclusion: with radical surgery followed by radiotherapy good survival rates in patients with neck metastases from a CUP can be obtained. Whether limited radiotherapy might be equal to extended irradiation and can reduce side effects, must be shown in ongoing clinical trials. (orig.)

Ancient Origin of the CARD–Coiled Coil/Bcl10/MALT1-Like Paracaspase Signaling Complex Indicates Unknown Critical Functions

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Jens Staal

2018-05-01

Full Text Available The CARD–coiled coil (CC/Bcl10/MALT1-like paracaspase (CBM signaling complexes composed of a CARD–CC family member (CARD-9, -10, -11, or -14, Bcl10, and the type 1 paracaspase MALT1 (PCASP1 play a pivotal role in immunity, inflammation, and cancer. Targeting MALT1 proteolytic activity is of potential therapeutic interest. However, little is known about the evolutionary origin and the original functions of the CBM complex. Type 1 paracaspases originated before the last common ancestor of planulozoa (bilaterians and cnidarians. Notably in bilaterians, Ecdysozoa (e.g., nematodes and insects lacks Bcl10, whereas other lineages have a Bcl10 homolog. A survey of invertebrate CARD–CC homologs revealed such homologs only in species with Bcl10, indicating an ancient common origin of the entire CBM complex. Furthermore, vertebrate-like Syk/Zap70 tyrosine kinase homologs with the ITAM-binding SH2 domain were only found in invertebrate organisms with CARD–CC/Bcl10, indicating that this pathway might be related to the original function of the CBM complex. Moreover, the type 1 paracaspase sequences from invertebrate organisms that have CARD–CC/Bcl10 are more similar to vertebrate paracaspases. Functional analysis of protein–protein interactions, NF-κB signaling, and CYLD cleavage for selected invertebrate type 1 paracaspase and Bcl10 homologs supports this scenario and indicates an ancient origin of the CARD–CC/Bcl10/paracaspase signaling complex. By contrast, many of the known MALT1-associated activities evolved fairly recently, indicating that unknown functions are at the basis of the protein conservation. As a proof-of-concept, we provide initial evidence for a CBM- and NF-κB-independent neuronal function of the Caenorhabditis elegans type 1 paracaspase malt-1. In conclusion, this study shows how evolutionary insights may point at alternative functions of MALT1.

Unusual Origin and Rare Presentation of Primary Cardiac Lymphoma

Science.gov (United States)

Mohamed, Amir; Cherian, Sanjay; El-Ashmawy, Ahmed; Abdelmoneim, Salah Eldin; Soliman, Maher; Abu-Rayan, Mohamed; Kalangos, Afksendyios

2011-01-01

Non-Hodgkin lymphoblastic lymphomas are very uncommon tumors that rarely involve the heart; however, when they do, they typically cause cardiac symptoms. Herein, we describe the case of a young woman who presented with respiratory symptoms. These were caused by a high-grade lymphoblastic lymphoma, which originated in the left inferior pulmonary vein and extended into the left atrium. The tumor was surgically debulked, but it recurred in 1 month, and the patient underwent chemotherapy. Six months later, she had recurrent respiratory symptoms, and echocardiography revealed a persistent mass in the left lower lobar vein. A modified chemotherapy regimen led to complete resolution of the tumor within 2 months. We are unaware of other reports of a primary cardiac non-Hodgkin lymphoblastic lymphoma with this unusual site of origin and rare manifestation of symptoms. PMID:21841872

An Unusual Presentation of Isolated Leptomeningeal Disease in Carcinoma of Unknown Primary With Pancreatic Features

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Madhurima Anne MD

2013-06-01

Full Text Available Leptomeningeal disease (LMD can occur in a small percentage of patients with active metastatic cancer. However, we report a case of LMD occurring during disease remission in a patient with carcinoma of unknown primary with panreaticobiliary features. A 45-year-old woman was found with mediastinal and abdominal lymphadenopathy with lymph node biopsy consistent with adenocarcinoma, expressing immunomarkers CK7, CK20, and Ca19-9 along with markedly elevated serum Ca19-9 level. The patient was started on a pancreatic cancer directed chemotherapy regimen of Folfirinox (5-fluorouracil, leucovorin, oxaliplatin, irinotecan and achieved complete response. She was then noted to have slowly rising Ca19-9 level that did not correlate with her lack of evidence of systemic disease progression. Eventually, she presented with neurologic symptoms and was found on imaging to have isolated LMD.

Melanoma patients with unknown primary site or nodal recurrence after initial diagnosis have a favourable survival compared to those with synchronous lymph node metastasis and primary tumour.

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Benjamin Weide

Full Text Available BACKGROUND: A direct comparison of prognosis between patients with regional lymph node metastases (LNM detected synchronously with the primary melanoma (primary LNM, patients who developed their first LNM subsequently (secondary LNM and those with initial LNM in melanoma with unknown primary site (MUP is missing thus far. PATIENTS AND METHODS: Survival of 498 patients was calculated from the time point of the first macroscopic LNM using Kaplan Meier and multivariate Cox hazard regression analysis. RESULTS: Patients with secondary LNM (HR = 0.67; p = 0.009 and those with initial LNM in MUP (HR = 0.45; p = 0.008 had a better prognosis compared to patients with primary LNM (median survival time 52 and 65 vs. 24 months, respectively. A high number of involved nodes, the presence of in-transit/satellite metastases and male gender had an additional independent unfavourable effect. CONCLUSIONS: Survival of patients with LNM in MUP and with secondary LNM is similar and considerably more favourable compared to those with primary LNM. This difference needs to be considered during patient counselling and for stratification purposes in clinical trials. The assumption of an immune privilege of patients with MUP which is responsible for rejection of the primary melanoma, and results in a favourable prognosis is not supported by our data.

Gemcitabine and irinotecan as first-line therapy for carcinoma of unknown primary: results of a multicenter phase II trial.

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Shernan G Holtan

Full Text Available Metastatic carcinoma of unknown primary (CUP has a very poor prognosis, and no standard first-line therapy currently exists. Here, we report the results of a phase II study utilizing a combination of gemcitabine and irinotecan as first-line therapy. Treatment was with gemcitabine 1000 mg/m(2 and irinotecan 75 mg/m(2 weekly times four on a six week cycle (Cohort I. Due to excessive toxicity, the dose and schedule were modified as follows: gemcitabine 750 mg/m(2 and irinotecan 75 mg/m(2 given weekly times three on a four week cycle (Cohort II. The primary endpoint was the confirmed response rate (CR + PR. Secondary endpoints consisted of adverse events based upon the presence or absence of the UDP glucuronosyltransferase 1 family, polypeptide A1*28 (UGT1A1*28 polymorphism, time to progression, and overall survival. Thirty-one patients were enrolled with a median age of 63 (range: 38-94, and 26 patients were evaluable for efficacy. Significant toxicity was observed in Cohort 1, characterized by 50% (7/14 patients experiencing a grade 4+ adverse event, but not in cohort II. The confirmed response rate including patients from both cohorts was 12% (95% CI: 2-30%, which did not meet the criteria for continued enrollment. Overall median survival was 7.2 months (95% CI: 4.0 to 11.6 for the entire cohort but notably longer in cohort II than in cohort I (9.3 months (95% CI: 4.1 to 12.1 versus 4.0 months (95% CI: 2.2 to 15.6. Gemcitabine and irinotecan is not an active combination when used as first line therapy in patients with metastatic carcinoma of unknown primary. Efforts into developing novel diagnostic and therapeutic approaches remain important for improving the outlook for this heterogeneous group of patients.ClinicalTrials.gov NCT00066781.

Odontogenic facial swelling of unknown origin.

Science.gov (United States)

Ranjitkar, S; Cheung, W; Yong, R; Deverell, J; Packianathan, M; Hall, C

2015-12-01

Current radiography techniques have limitations in detecting subtle odontogenic anomalies or defects that can lead to dentoalveolar and facial infections. This report examines the application of micro-CT imaging on two extracted teeth to enable detailed visualization of subtle odontogenic defects that had given rise to facial swelling. Two extracted non-carious mandibular left primary canine teeth (73) associated with odontogenic infections were selected from two patients, and an intact contralateral tooth (83) from one of the patients was used as a control. All three teeth were subjected to three-dimensional micro-CT imaging at a resolution of 20 μm. Tooth 73 from the first case displayed dentine pores (channels) that established communication between the pulp chamber and the exposed dentine surface. In comparison, tooth 73 from the second case had a major vertical crack extending from the external enamel surface into the pulp chamber. The control tooth did not display any anomalies or major cracks. The scope of micro-CT imaging can be extended from current in vitro applications to establish post-extraction diagnosis of subtle odontogenic defects, in a manner similar to deriving histopathological diagnoses in extracted teeth. Ongoing technological advancements hold the promise for more widespread translatory applications. © 2015 Australian Dental Association.

Human papillomavirus and p53 expression in cancer of unknown primary in the head and neck region in relation to clinical outcome

International Nuclear Information System (INIS)

Sivars, Lars; Näsman, Anders; Tertipis, Nikolaos; Vlastos, Andrea; Ramqvist, Torbjörn; Dalianis, Tina; Munck-Wikland, Eva; Nordemar, Sushma

2014-01-01

Patients with cancer of unknown primary (CUP) in the head neck region are generally treated with neck dissection followed by radiotherapy at times combined with chemotherapy, a treatment associated with considerable side effects. Some of these tumors may originate as human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OSCC), with better clinical outcome than head neck squamous cell cancer (HNSCC) in general, and could potentially do well with less treatment. Here, we therefore investigated whether HPV status and p53-expression correlated to clinical outcome in patients with CUP in the head neck region. Fifty metastases were analyzed for presence of HPV DNA, and expression of p16 INK4A and p53 and the data were correlated to clinical outcome. Patients with HPV DNA-positive (HPV DNA+ ) metastases had significantly better 5-year overall survival (OS) compared to those with HPV DNA− metastases (80.0% vs. 36.7%, respectively; P = 0.004), with a similar tendency for disease-free survival (DFS). These survival rates showed excellent concordance with those of HPV DNA+ and HPV DNA− OSCC in Sweden during the same time period, strengthening the hypothesis that HPV DNA+ head and neck CUP may originate from HPV DNA+ OSCC. In addition, having absent/intermediary-low as compared to high expression of p53 correlated to a better prognosis with a 69% as compared to 14% 5-year OS, respectively (P < 0.001), and for DFS the tendency was analogous. In conclusion, both HPV status and p53 expression are valuable prognostic factors in patients with CUP in the head and neck region and should be further explored for clinical use

Monitoring residue in animals and primary products of animal origin

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Janković Saša

2008-01-01

Full Text Available The objective of control and systematic monitoring of residue is to secure, by the examination of a corresponding number of samples, the efficient monitoring of the residue level in tissues and organs of animals, as well as in primary products of animal origin. This creates possibilities for the timely taking of measures toward the securing of food hygiene of animal origin and the protection of public health. Residue can be a consequence of the inadequate use of medicines in veterinary medicine and pesticides in agriculture and veterinary medicine, as well as the polluting of the environment with toxic elements, dioxins, polychlorinated biphenyls, and others. Residue is being monitored in Serbia since 1972, and in 2004, national monitoring was brought to the level of EU countries through significant investments by the Ministry of Agriculture, Forestry and Water Management. This is also evident in the EU directives which permit exports of all kinds of meat and primary products of animal origin, covered by the Residue Monitoring Program. The program of systematic examinations of residue has been coordinated with the requirements of the European Union, both according to the type of examined substance, as well as according to the number of samples and the applied analytical techniques. In addition to the development of methods and the including of new harmful substances into the monitoring programme, it is also necessary to coordinate the national regulations that define the maximum permitted quantities of certain medicines and contaminants with the EU regulations, in order to protect the health of consumers as efficiently as possible, and for the country to take equal part in international trade.

Biological characterization of two xenografts derived from human CUPs (carcinomas of unknown primary

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Bernheim Alain

2007-12-01

Full Text Available Abstract Background Carcinomas of unknown primary site (CUP are epithelial malignancies revealed by metastatic lesions in the absence of any detectable primary tumor. Although they often adopt an aggressive clinical pattern, their basic biology remains poorly understood. Laboratory research on their biology have been hampered so far by the absence of cell lines representative of CUPs. Methods We attempted xenografts of CUP clinical specimens in immunodeficient mice and subsequent in vitro culture of transplanted malignant cells. Whenever possible, malignant xenografted or cultured cells were characterized by microsatellite genotyping, immunohistology, electron microscopy, multifish chromosome analysis and search of TP 53 gene mutations. Results Successful xenografts were achieved in 2 cases out of 4. One of them (Capi1 was lost after 3 passages whereas the other one (Capi3 has been adapted to in vitro culture and is currently available to the scientific community with reliable identification based on microsatellite genotyping. Both Capi1 and Capi3 have histological characteristics of adenocarcinomas and display intense expression of EMA, CEA and cytokeratin 7. Multifish chromosome analysis demonstrated a translocation involving chromosomes 4 and 21 in both specimens. Distinct rare missense mutations of the TP53 gene were detected in Capi1 (codon 312 and Capi3 (codon 181; the codon 181 mutation is consistent with a previously reported similar finding in a small series of CUP specimens. Finally, intense membrane expression of c-kit was recorded in Capi3. Conclusion Our data suggest that xenografted tumors can be obtained from a substantial fraction of CUP clinical specimens. The hypothesis of a preferential association of CUPs with TP 53 mutations of codon 181 deserves further investigations. The Capi3 cell line will be a useful tool for assessment of novel c-kit inhibitors.

(18F) FDG PET/CT in patients with fever of unknown origin: AIIMS experience

International Nuclear Information System (INIS)

Nazar, A.H.; Naswa, N.; Ramya, S.; Patnecha, M.; Bangkim, Chandra K.H.; Kumar, R.; Bandopadhyay, G.P.; Bal, C.S.; Malhotra, A.

2010-01-01

Full text: The aim of this study was to assess the value of ( 18 F) FDG PET/CT in evaluation of patients with Fever of Unknown Origin (FUO). We retrospectively analysed clinical data and ( 18 F) FDG PET scan of 48 patients over a period of 1 year. These patients met the revised definition criteria of FUO (febrile illness of greater than 3 weeks duration, temperature greater than 38.3 C and no diagnosis after appropriate in-patient or out-patient evaluation). Most of the patients recruited in this study had normal clinical and radiological examination. ( 18 F) FDG PET was helpful in making a diagnosis in 24 patients. An infective/inflammatory cause of FUO was found in thirteen (27%) patients, a neoplasm in six (12.5%) patients, autoimmune cause in five (10.4%) patients. A definitive diagnosis could not be made in twenty four (50%) patients. Out of these 24 patients, 15 had normal PET/CT study, 9 had positive PET/CT findings but they lost in follow up and 2 died within 1 month of PET/CT study without any diagnosis. ( 18 F) FDG PET/CT is a useful tool for evaluation of patients with FUO. It provides important diagnostic clues not suggested by other conventional imaging modalities. Patients with positive PET/CT findings but no definitive diagnosis should be followed up further to improve utility of PET/CT

Results of a multidisciplinary program for patients with fibromyalgia implemented in the primary care

NARCIS (Netherlands)

van Wilgen, C.P.; Bloten, H.; Oeseburg, B.

2007-01-01

Purpose. Fibromyalgia is a syndrome of unknown origin with a high prevalence. Multimodal approaches seem to be the treatment of choice in fibromyalgia. A multidisciplinary program was developed and implemented for patients with fibromyalgia in the primary care setting. The program included education

Clinical study of 18F-FDG PET/CT whole-body imaging in disseminated carcinoma of unknown primary site

International Nuclear Information System (INIS)

Wang Guohui; Liang Peiyan; Cai Yanjun; Zhang Weiguang; Xie Chuanmiao; Wu Peihong

2008-01-01

Objective: Carcinoma of unknown primary (CUP) is not uncommon in usual clinical settings. They are, by definition, those cases with clinically suspected primary malignancy but not revealed by conventional investigation. The aim of this study was to investigate the efficacy of whole-body 18 F-fluoro- deoxyglucose (FDG) PET/CT in detecting a primary neoplasm for these patients. Methods: A totle of 150 patients with retrievable records from 169 CUP patients were selected within a group of consecutive 2589 patients from Jan. 2006 to Jun. 2007. All cases underwent whole-body FDG PET/CT scan. The final diagnoses were confirmed by pathologic results, other imaging modalities or clinical follow-up. Results: Among 150 patients, primary tumor sites were successfully detected by whole-body 18 F-FDG PET/CT scan in 70 cases (46.7%), of which 52 were pathologically confirmed and 18 by clinical follow-up. And 38 cases (54.3%) were lung cancer, 8 (11.4%) were nasopharyngeal carcinoma, 13 (18.6%) in digestive sys- tem, and 11 (15.7%) in other systems. Three clinically suspected CUP cases with negative 18 F-FDG PET/ CT were subsequently confirmed of benign processes by clinical follow-up. Six patients were wrongly diagnosed by 18 F-FDG PET/CT, and 15 patients did not have a confirmed diagnosis by the end of research. The primary cause of malignancy after 18 F-FDG PET/CT remained obscure in 56 patients, only 3 of whom be- came known during the course of clinical follow-up (nasopharyngeal bladder and esophageal carcinoma). Conclusion: 18 F-FDG PET/CT whole-body imaging plays an important role in patients with metastatic CUP. (authors)

Diagnostic utility of fluorodeoxyglucose positron emission tomography/computed tomography in pyrexia of unknown origin

International Nuclear Information System (INIS)

Singh, Nidhi; Kumar, Rakesh; Malhotra, Arun; Bhalla, Ashu Seith; Kumar, Uma; Sood, Rita

2005-01-01

The present study was undertaken to evaluate the diagnostic utility of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) in patients presenting as pyrexia of unknown origin (PUO). Forty-seven patients (31 males and 16 females; mean age of 42.7 ± 19.96 years) presenting as PUO to the Department of Medicine at the All India Institute of Medical Sciences, New Delhi over a period of 2 years underwent F-18 FDG PET/CT. PET ⁄ CT was considered supportive when its results correlated with the final definitive diagnosis. Final diagnosis was made on the basis of combined evaluation of history, clinical findings, investigations, and response to treatment. Thirty-five PET/CT studies (74.5%) were positive. However, only 18 (38.3%) were supportive of the final diagnosis. In three patients (6.4%), PET/CT was considered diagnostic as none of the other investigations including contrast-enhanced computed tomography of chest and abdomen, and directed tissue sampling could lead to the final diagnosis. All these three patients were diagnosed as aortoarteritis. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography is an important emerging modality in the workup of PUO. It supported the final diagnosis in 38% of our patients and was diagnostic in 6.4% of patients. Thus, PET/CT should only be considered as second-line investigation for the diagnostic evaluation of PUO; especially in suspected noninfectious inflammatory disorders

Fever of unknown origin: prospective comparison of diagnostic value of 18F-FDG PET and 111In-granulocyte scintigraphy

DEFF Research Database (Denmark)

Kjaer, Andreas; Lebech, Anne-Mette; Eigtved, Annika

2004-01-01

The diagnostic work-up in patients with fever of unknown origin (FUO) is often challenging and frequently includes nuclear medicine procedures. Whereas a role for leucocyte or granulocyte scintigraphy in FUO is generally accepted, a possible role of fluorine-18 fluorodeoxyglucose (FDG) positron...... emission tomography (PET) in these patients remains to be established. To study this, we compared prospectively, on a head-to-head basis, the diagnostic value of FDG-PET and indium-111 granulocyte scintigraphy in patients with FUO. Nineteen patients with FUO underwent both FDG-PET and (111)In......-granulocyte scintigraphy within 1 week. FDG-PET scans and granulocyte scintigrams were reviewed by different doctors who were blinded to the result of the other investigation. The diagnostic values of FDG-PET and granulocyte scintigraphy were evaluated with regard to identification of a focal infectious...

Detection of primary tumor by 18F-FDG-TEP in patients with cup syndrome

International Nuclear Information System (INIS)

Alberini, J.L.; Belhocine, T.; Daenen, F.; Hustinx, R.; Rigo, P.

2000-01-01

To study the performance of whole body 18 F-FDG-PET in the detection of the primary tumor in patients with unknown primary carcinoma in comparison with conventional imaging. Patients and methods: Forty-one patients, without previous history of known cancer, (18 women and 23 men; average age 64,1 years) with bone, brain, lymph node, liver, cutaneous, pleural and epidural metastases were included in a retrospective study. Results of PET (UGM Penn PET 240 H) were compared with those of techniques used in the current conventional procedure. There were 26 true positives, 2 false negatives (1 renal carcinoma and 1 myeloma) and one false positive results. Origins were lung [16], gut [6], breast [3] and head and neck [1] but stayed undetermined in 8 patients. Results of PET were superior to conventional diagnostic procedure in 12 patients and led to modify the therapy management in 11 patients. All known metastatic lesions were detected by PET. FDG-PET can be useful to determine the origin of metastasis. It allows detection of the primary tumor (26/33 patients) and allows evaluation of the spread of the disease. These results have to be confirmed and particularly in patients with highly treatable unknown primary carcinoma. (author)

Metastatic carcinoma in the cervical lymph nodes from an unknown primary site: results of bilateral neck plus mucosal irradiation vs. ipsilateral neck irradiation

International Nuclear Information System (INIS)

Reddy, Sarada P.; Marks, James E.

1997-01-01

Purpose: To compare the outcome for patients with squamous cell carcinoma of cervical lymph nodes metastatic from an unknown primary site who were irradiated to both sides of the neck and potential mucosal sites with opposed photon beams, and for those irradiated to the ipsilateral side of the neck alone with an electron beam. Methods and Materials: Fifty-two patients with squamous cell carcinoma metastatic to cervical lymph nodes from an unknown primary site were irradiated by two different methods. Thirty-six were irradiated with a bilateral technique (BT), i.e., to both sides of the neck, including the naso-oro-hypopharyngeal mucosa, and 16 were irradiated with an electron beam (EB) to the ipsilateral side of the neck alone. Twenty patients of the BT group and 11 of the EB group had cervical lymph node dissections, and the remaining 21 patients had lymph node biopsies, prior to radiotherapy. Results: Tumor control in the ipsilateral side of the neck did not differ for either radiation technique, but was significantly higher after lymph node dissection than after biopsy (90 vs. 48%; p = 0.0004). Control of subclinical metastases in the contralateral cervical lymph nodes was higher for patients irradiated with BT than for patients irradiated with EB (86 vs. 56%; p 0.03). The occult primary was later discovered in 8% of the patients in the BT group and 44% of the EB group (p = 0.0005). The disease-free survival rate at 5 years for patients who had lymph node dissection prior to irradiation was 61%, and was 37% for those who had biopsy (p = 0.05). Only 20% of patients who subsequently developed an occult primary were salvaged and survived for 5 years after salvage treatment. Conclusion: Bilateral neck and mucosal irradiation is superior to ipsilateral neck irradiation in preventing contralateral cervical lymph node metastases and the subsequent appearance of an occult primary cancer. Both techniques combined with cervical lymph node dissection were equally effective

A Case of Squamous Cell Carcinoma of Unknown Primary that Responded to the Multi-Tyrosine Kinase Inhibitor Lenvatinib

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Reiko Kimura-Tsuchiya

2018-02-01

Full Text Available Lenvatinib is an oral tyrosine kinase inhibitor of vascular endothelial growth factor receptors 1, 2, and 3, fibroblast growth factor receptors 1 through 4, as well as platelet-derived growth factor receptor α, RET, and KIT. At present, lenvatinib is used in the treatment of thyroid cancer and renal cell carcinoma. We herein report a case of a 67-year-old patient with squamous cell carcinoma of unknown primary who was effectively treated with lenvatinib. The patient was initially diagnosed as having undifferentiated thyroid cancer, and after total thyroidectomy and bilateral lymph node dissection, lenvatinib was administered for the treatment of residual lymph node metastasis. A computed tomography scan after 1 month of lenvatinib administration showed marked regression of the lymph nodes, but interstitial pneumonia was also detected. Because the drug lymphocyte stimulation test for lenvatinib was strongly positive, we concluded that the interstitial pneumonia was induced by lenvatinib. The interstitial pneumonia only improved by the withdrawal of lenvatinib. Finally, his thyroid tumor was diagnosed as a metastasis of squamous cell carcinoma; however, we were unable to identify the primary lesion. This is the first reported case of interstitial pneumonia induced by lenvatinib.

CARCINOMA OF UNKNOWN PRIMARY WITH SECONDARY METASTASIS TO NECKANALYSIS OF PATIENT AND DISEASE RELATED FACTORS PREDICTING SUPERIOR PATIENT OUTCOMES IN CUPS NECK

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Preeti Singh

2017-11-01

Full Text Available BACKGROUND Carcinoma of unknown primary with secondary metastasis to neck (CUPS Neck is involvement of cervical nodes with squamous cell carcinoma without identifiable primary lesion in oral cavity, oropharynx and upper aerodigestive tract. Most commonly affects older male with history of tobacco and alcohol abuse. Commonly involved neck nodes are level II and III. Metastasis to these nodes usually comes from head and neck tumours. The aims of this study are to evaluate the factors (relating to patient and disease associated with improved outcomes following treatment in patients with metastatic squamous cell carcinoma of neck with unknown primary site. MATERIALS AND METHODS Study was done in ENT and Head Neck Centre, Base Hospital, Delhi Cantt. The investigation and treatment of such cases aim to detect a primary lesion, if possible in the upper aerodigestive tract (UADT and in any case to institute the optimal management protocol. Many factors impact the outcomes of treatment in terms of survival and quality of life. RESULTS After followup of 0.5 to 2 years data were compared among various groups, various disease related factors like volume of disease, staging of neck node, extracapsular spread in final HPE report and various patient related factors like age and sex of patient, performance status of patient, and presence of comorbidities were compared with final outcome in terms of recurrence or disease free survival with less complications. CONCLUSION 1. Most prominent tumour related prognostic factors were low volume nodal disease in the neck and absence of extracapsular spread. Patients with TNM stage I (T0N1M0 were associated with lower recurrence and less complication postoperatively as compared to advanced stage disease (T0N2M0 and T0N3M0. 2. In our study, patient related variables associated with superior patient outcomes in terms of locoregional recurrence or disease free survival were good performance status, females, young age

Gene expression profiles help identify the Tissue of Origin for metastatic brain cancers

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VandenBerg Scott R

2010-04-01

Full Text Available Abstract Background Metastatic brain cancers are the most common intracranial tumor and occur in about 15% of all cancer patients. In up to 10% of these patients, the primary tumor tissue remains unknown, even after a time consuming and costly workup. The Pathwork® Tissue of Origin Test (Pathwork Diagnostics, Redwood City, CA, USA is a gene expression test to aid in the diagnosis of metastatic, poorly differentiated and undifferentiated tumors. It measures the expression pattern of 1,550 genes in these tumors and compares it to the expression pattern of a panel of 15 known tumor types. The purpose of this study was to evaluate the performance of the Tissue of Origin Test in the diagnosis of primary sites for metastatic brain cancer patients. Methods Fifteen fresh-frozen metastatic brain tumor specimens of known origins met specimen requirements. These specimens were entered into the study and processed using the Tissue of Origin Test. Results were compared to the known primary site and the agreement between the two results was assessed. Results Fourteen of the fifteen specimens produced microarray data files that passed all quality metrics. One originated from a tissue type that was off-panel. Among the remaining 13 cases, the Tissue of Origin Test accurately predicted the available diagnosis in 12/13 (92.3% cases. Discussion This study demonstrates the accuracy of the Tissue of Origin Test when applied to predict the tissue of origin of metastatic brain tumors. This test could be a very useful tool for pathologists as they classify metastatic brain cancers.

Primary mucosa-associated lymphoid tissue thyroid lymphoma: a rare thyroid neoplasm of extrathyroid origin

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Dimitrios Hadjidakis

2012-01-01

Full Text Available Primary thyroid lymphoma is a rare malignancy, representing 2-8% of all thyroid malignancies and 1-2% of all extranodal lymphomas. The majority of cases concern non-Hodgkin`s lymphoma of B cell origin, following by Hodgkin’s disease, T cell lymphomas and rarely marginal zone B-cell mucosa-associated lymphoid tissue (MALT lymphomas. MALT lymphomas have been associated with long-standing autoimmune Hashimoto`s thyroiditis. We present the case of a 44-years-old woman with thyroid MALT lymphoma in the background of multinodular goiter of autoimmune origin.

Mass-forming cholangiocarcinoma and adenocarcinoma of unknown primary: can they be distinguished on liver MRI?

Science.gov (United States)

Al Ansari, Najwa; Kim, Bong Soo; Srirattanapong, Saowanee; Semelka, Charles T A; Ramalho, Miguel; Altun, Ersan; Woosley, John T; Calvo, Benjamin; Semelka, Richard C

2014-12-01

To determine MR features suggestive of mass-forming cholangiocarcinoma (CCA) or liver metastases of adenocarcinoma of unknown primary (AUP), and to compare the ability of two experienced radiologists to establish the correct diagnosis. 61 patients with CCA or AUP, with MRIs were placed into two groups: population 1, 28 patients with certain diagnosis of either CCA or AUP; and population 2, 33 patients with uncertain diagnosis. Using population 1 with known diagnosis, two investigators formulated imaging criteria for CCA or AUP, which represented phase 1 of the study. In phase 2, two independent radiologists categorized the patients in populations 1 and 2 as CCA or AUP using the formulated criteria. This categorization was compared with the patient medical records and pathologist review. Findings were tested for statistical significance. In phase 1, solitary lesion, multifocal lesions with dominant lesion, capsule retraction, and porta hepatis lymphadenopathy were features of CCA; multifocal lesions with similar size, and ring enhancement were features of AUP. The number of lesions, capsule retraction, and early tumor enhancement pattern were observed to be significant features (P AUP are identifiable on MRI images, which may aid the radiologist to establish the correct diagnosis.

Malignant priapism: Penile metastasis originating on a primary prostate adenocarcinoma

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Sandro Roberto da Silva Gaspar

2015-01-01

Full Text Available Malignant priapism is a definition invented in 1938 by Peacock, defined as a persistent erection, not related with sexual activity, caused by cavernous sinus and associated venous systems invasion with malignant cells. Penile secondary lesions are rare entities. Primary locations are usually the pelvic cavity organs, namely the prostate and the bladder as the most common ones. Priapism as a first manifestation of these kinds of lesions is even rarer. The aim was to present a 52-year-old patient harboring a penile metastasis that originated in the primary prostate adenocarcinoma, manifesting itself as a "common" priapism. The patient referred to the emergency room presenting with a priapism and nodules at the coronal sulcus, without previous similar episodes. His evolution until properly diagnosed was catastrophic with multiple lymph nodes, bone and organ involvement, and with his demise soon after from serious bleeding and congestive heart failure, almost 2 months after he first came to the emergency room. We review the literature concerning malignant priapism, diagnosis, and current treatment and survival perspectives.

Diagnostic value of F18-FDG PET/CT in patients with the revised definition of fever of unknown origin

DEFF Research Database (Denmark)

Prakash, Vineet; Ketharanathan, Nagulabaskaran; Lorenz, Eleanor

2009-01-01

Objectives: Fever of unknown origin (FUO) is an increasingly accepted indication for PET/CT where it has a relatively high diagnostic yield. This study assesses its diagnostic value for the revised definition of FUO. Methods: The revised definition of FUO is fever of greater than 38.3C for more...... than 3 weeks duration and an uncertain diagnosis after comprehensive evaluation as an inpatient or outpatient for a minimum of 3 days or 3 outpatient visits, having excluded immunocompromised states. 59 patients (pts) (F=35, age 18-92) with this definition underwent PET with full diagnostic contrast......), neoplasm (6 pts) and drug fever (1 pt). Before ordering a PET/CT, conventional CT or MRI was performed in 43 pts. We considered that a PET/CT was essential to establish the final diagnosis in 15/43 pts (35%) with inconclusive CT or MRI. Conclusions: 18F-FDG PET/CT contributed to establishing a final...

Compound odontoma associated with an unerupted mandibular primary canine: A case report

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Seraj B

2007-06-01

Full Text Available Odontomas are benign tumors of odontogenic origin characterized by their slow growth. They are considered to be a common type of odontogenic tumor, but rarely occur in the primary dentition.The etiology of odontomas is unknown, although local trauma, infection and genetic factors have been suggested. Odontomas often cause disturbances in the eruption of teeth such as, impaction or delayed eruption, and retention of primary teeth and abnormalities in the position of teeth such as tipping or displacement of adjacent teeth. In this paper, a case of unerupted right mandibular primary cuspid in a 5 years old girl due to the presence of a compound odontoma is presented.

Metastasis in the subcarinal lymph node with unknown primary tumor

DEFF Research Database (Denmark)

Eckardt, J.; Olsen, K. E.; Petersen, H.

2011-01-01

-differentiated squamous cell carcinoma but no primary tumor was visible on PET-computed tomography. Because of his previous lymphoma the patient was scheduled for mediastinoscopy where the diagnosis was confirmed. Subsequent gastroscopy was normal and a right-sided thoracotomy showed no evidence of cancer elsewhere, only...... an inoperable metastasis in a subcarinal lymph node which infiltrated the trachea, esophagus and aorta. Such isolated squamous cell carcinoma in a subcarinal lymph node without a primary tumor despite invasive work-up has not been reported before....

The value of CT in localizing primary and stomach-originated masses in the lesser sac

International Nuclear Information System (INIS)

Dong Peng; Wang Bin; Zhang Shizhuang; Chang Guanghui; Sun Xihe; Cheng Xin

2007-01-01

Objective: To investigate the normal CT manifestation of the vascular arch of the gastric lesser curvature, and to further probe the value of CT in the localization diagnosis of the primary and stomach-originated masses in the lesser sac. Methods: Contrast-enhanced CT scanning was performed in 51 normal individuals. Emphasis of image observation was focused on the CT manifestations of vascular arch of the gastric lesser curvature and the relation between the vascular arch and the gastric wall. Also contrast- enhanced CT scan was performed for seventeen cases of primary and stomach-originated masses in the lesser sac subsequently proved by surgery and pathology. Image analysis was focused on the relation between the mass and the vascular arch and its branches of the gastric lesser curvature, the shape of the mass, and the relation between the mass and the gastric wall. Results: The vascular arch of the gastric lesser curvature was clearly visualized in the fifty normal individuals. The tributaries of the vascular arch near the cardiac part, gastric corpus, and pyloric part were revealed in 42, 10 and 7 cases respectively. The vascular arch was in close contact with the gastric wall in 38 cases. Among the 17 patients, 13 cases demonstrated the obliteration of the transparent fat plane between the mass and the gastric wall. In 6 patients with stomach- originated masses, 5 patients showed the stretching of vascular arch tributaries adjacent to the masses, and no vascular arch and its tributaries could be not visualized between the masses and the stomach. In 11 patients with primary masses in the lesser sac, vascular arch were showed between the masses and the stomach in 10 cases, and no stretching of vascular arch tributaries adjacent to the masses could be showed. Conclusions: CT scan can clearly depict the normal vascular arch and its branches of the gastric lesser curvature. Based on the relation between the vascular arch and the gastric wall, the presence of fat

Prospective Study of 68Ga-DOTATATE Positron Emission Tomography/Computed Tomography for Detecting Gastro-Entero-Pancreatic Neuroendocrine Tumors and Unknown Primary Sites.

Science.gov (United States)

Sadowski, Samira M; Neychev, Vladimir; Millo, Corina; Shih, Joanna; Nilubol, Naris; Herscovitch, Peter; Pacak, Karel; Marx, Stephen J; Kebebew, Electron

2016-02-20

Gastro-entero-pancreatic neuroendocrine tumors (GEPNETs) are increasing in incidence, and accurate staging is important for selecting the appropriate treatment. (68)Ga-DOTATATE imaging is a promising approach for detecting GEPNETs and could help in selecting optimal therapeutic strategies. The aim of this study was to prospectively determine the clinical utility of (68)Ga-DOTATATE positron emission tomography (PET)/computed tomography (CT) in detecting unknown primary and metastatic GEPNETs. One hundred thirty-one patients were enrolled in a prospective study of patients undergoing (68)Ga-DOTATATE PET/CT, (111)In-pentetreotide single-photon emission computed tomography (SPECT)/CT and multiphasic CT scan, and/or magnetic resonance imaging in a blinded fashion with comprehensive biochemical testing. The primary outcome measure was the detection of lesions by each imaging study. (68)Ga-DOTATATE PET/CT imaging detected 95.1% of lesions (95% CI, 92.4% to 96.8%) with an average maximum standardized uptake value of 65.4 ± 47 (range, 6.9 to 244), anatomic imaging detected 45.3% of lesions (95% CI, 37.9% to 52.9%), and (111)In-pentetreotide SPECT/CT detected 30.9% of lesions (95% CI, 25.0% to 37.5%), with a significant difference between imaging modalities (P < .001). In four of 14 patients (28.6%), (68)Ga-DOTATATE PET/CT found a previously unknown primary tumor, and detected primary GEPNET, lymph node, and distant metastases correctly in 72 of 113 lesions (63.7%) when compared with histopathology, with 22.1% and 38.9% detected by using (111)In-pentetreotide SPECT/CT and anatomic imaging, respectively. On the basis of findings with (68)Ga-DOTATATE PET/CT, 43 of 131 patients (32.8%) had a change in management recommendation. In patients with carcinoid symptoms but negative biochemical testing, (68)Ga-DOTATATE PET/CT detected lesions in 65.2% of patients, 40% of which were detected neither by anatomic imaging nor by (111)In-pentetreotide SPECT/CT. (68)Ga-DOTATATE PET

A Multidisciplinary Investigation of a Polycythemia Vera Cancer Cluster of Unknown Origin

Science.gov (United States)

Seaman, Vincent; Dearwent, Steve M; Gable, Debra; Lewis, Brian; Metcalf, Susan; Orloff, Ken; Tierney, Bruce; Zhu, Jane; Logue, James; Marchetto, David; Ostroff, Stephen; Hoffman, Ronald; Xu, Mingjiang; Carey, David; Erlich, Porat; Gerhard, Glenn; Roda, Paul; Iannuzzo, Joseph; Lewis, Robert; Mellow, John; Mulvihill, Linda; Myles, Zachary; Wu, Manxia; Frank, Arthur; Gross-Davis, Carol Ann; Klotz, Judith; Lynch, Adam; Weissfeld, Joel; Weinberg, Rona; Cole, Henry

2010-01-01

Cancer cluster investigations rarely receive significant public health resource allocations due to numerous inherent challenges and the limited success of past efforts. In 2008, a cluster of polycythemia vera, a rare blood cancer with unknown etiology, was identified in northeast Pennsylvania. A multidisciplinary group of federal and state agencies, academic institutions, and local healthcare providers subsequently developed a multifaceted research portfolio designed to better understand the cause of the cluster. This research agenda represents a unique and important opportunity to demonstrate that cancer cluster investigations can produce desirable public health and scientific outcomes when necessary resources are available. PMID:20617023

Case Report: Intramammary lymph node metastasis of an unknown primary, probably occult breast, undifferentiated carcinoma [version 1; referees: 2 approved, 1 approved with reservations

Directory of Open Access Journals (Sweden)

Zacharoula Sidiropoulou

2017-03-01

Full Text Available Little is known about the clinical importance of intramammary lymph node metastasis of breast cancer, even though it is not rare. In the present paper, the authors present an unusual, rare case of an intramammary lymph node metastasis of an unknown primary, probably occult breast cancer, and its management. The patient was submitted to various staging exams and surgical procedures and a definitive diagnosis was not established. From a multidisciplinary context, it was assumed that the patient had a breast triple negative primary with axillary involvement. This decision lead to adjuvant chemo and radiotherapy. Challenging cases like the one described here, should always be managed within the multidisciplinary team context and recorded in the institution’s database.

Paclitaxel/carboplatin with or without belinostat as empiric first-line treatment for patients with carcinoma of unknown primary site

DEFF Research Database (Denmark)

Hainsworth, John D; Daugaard, Gedske; Lesimple, Thierry

2015-01-01

: The addition of belinostat to paclitaxel/carboplatin did not improve the PFS of patients with CUP who were receiving first-line therapy, although the patients who received belinostat had a higher investigator-assessed response rate. Future trials in CUP should focus on specific subsets, defined either......BACKGROUND: The objective of this study was to evaluate the efficacy of belinostat, a histone deacetylase inhibitor, when added to paclitaxel/carboplatin in the empiric first-line treatment of patients with carcinoma of unknown primary site (CUP). METHODS: In this randomized phase 2 trial......, previously untreated patients with CUP were randomized to receive belinostat plus paclitaxel/carboplatin (group A) or paclitaxel/carboplatin alone (group B) repeated every 21 days. Patients were re-evaluated every 2 cycles, and those without disease progression continued treatment for 6 cycles. Patients...

Efficacy and Toxicity of Chemoradiotherapy Using Intensity-Modulated Radiotherapy for Unknown Primary of Head and Neck

International Nuclear Information System (INIS)

Sher, David J.; Balboni, Tracy A.; Haddad, Robert I.; Norris, Charles M.; Posner, Marshall R.; Wirth, Lori J.; Goguen, Laura A.; Annino, Donald; Tishler, Roy B.

2011-01-01

Purpose: No single standard treatment paradigm is available for head-and-neck squamous cell carcinoma of an unknown primary (HNCUP). Bilateral neck radiotherapy with mucosal axis irradiation is widely used, with or without chemotherapy and/or surgical resection. Intensity-modulated radiotherapy (IMRT) is a highly conformal method for delivering radiation that is becoming the standard of care and might reduce the long-term treatment-related sequelae. We report the Dana-Farber Cancer Institute experience with IMRT-based treatment for HNCUP. Patients and Materials: A retrospective study of all patients treated at the Dana-Farber Cancer Institute for HNCUP with IMRT between August 2004 and January 2009. The primary endpoint was overall survival; the secondary endpoints were locoregional and distant control, and acute and chronic toxicity. Results: A total of 24 patients with HNCUP were included. Of these patients, 22 had Stage N2 disease or greater. All patients underwent neck computed tomography, positron emission tomography-computed tomography, and examination under anesthesia with directed biopsies. Of the 24 patients, 22 received concurrent chemotherapy, and 7 (29%) also underwent induction chemotherapy. The median involved nodal dose was 70 Gy, and the median mucosal dose was 60 Gy. With a median follow-up of 2.1 years, the 2-year actuarial overall survival and locoregional control rate was 92% and 100%, respectively. Only 25% of the patients had Grade 2 xerostomia, although 11 patients (46%) required esophageal dilation for stricture. Conclusion: In a single-institution series, IMRT-based chemoradiotherapy for HNCUP was associated with superb overall survival and locoregional control. The xerostomia rates were promising, but the aggressive therapy was associated with significant rates of esophageal stenosis.

Fiebre de origen desconocido, una forma de presentarse la tuberculosis Fever of unknown origin as a form of presentation of tuberculosis

Directory of Open Access Journals (Sweden)

Lázaro Arturo Vidal Tallet

2012-12-01

Full Text Available La tuberculosis es una causa importante de fiebre de origen desconocido. Dentro de los factores de riesgo para estar infectado por el bacilo tuberculoso se encuentra la edad, la presencia de comorbilidades, la competencia inmunológica y la alta prevalencia de la enfermedad en el área geográfica. Los hallazgos clínicos, radiológicos, epidemiológicos y la respuesta a la terapéutica antimicrobiana, pueden orientar en el diagnóstico de esta enfermedad infecciosa. Se presenta un caso en el que los elementos clínicos y epidemiológicos (padre con diagnóstico de tuberculosis llevaron finalmente a la sospecha diagnóstica de tuberculosis extra pulmonar, que no pudo ser demostrada por cultivo, pero la respuesta terapéutica resultó concluyente, ya que, una vez iniciada esta, hubo total remisión del cuadro clínico y recuperación nutricional. La terapia antituberculosa con carácter terapéutico y diagnóstico debe ser considerada en todo paciente con fiebre de origen desconocido, que, además, presente elementos clínicos y epidemiológicos que justifiquen la posibilidad de infección por el bacilo.Tuberculosis is an important cause of fever of unknown origin. Among the risk factors of getting infected by the tuberculosis bacillus are age, presence of comorbidities, immunological competence and high prevalence of the disease in a geographical area. The clinical, radiological and epidemiological findings along with the response to antimicrobial treatment can guide the physician to the correct diagnosis of this infectious disease. Here is a case in which the clinical and epidemiological elements (the father of the patient diagnosed with tuberculosis led to diagnostic suspicion of extrapulmonary tuberculosis. It was not possible to demonstrate it by culturing, but the response to therapy was conclusive, since once the treatment began, there were total remission of the clinical picture and nutritional recovery. The therapeutically and

Iron overload patients with unknown etiology from national survey in Japan.

Science.gov (United States)

Ikuta, Katsuya; Hatayama, Mayumi; Addo, Lynda; Toki, Yasumichi; Sasaki, Katsunori; Tatsumi, Yasuaki; Hattori, Ai; Kato, Ayako; Kato, Koichi; Hayashi, Hisao; Suzuki, Takahiro; Kobune, Masayoshi; Tsutsui, Miyuki; Gotoh, Akihiko; Aota, Yasuo; Matsuura, Motoo; Hamada, Yuzuru; Tokuda, Takahiro; Komatsu, Norio; Kohgo, Yutaka

2017-03-01

Transfusion is believed to be the main cause of iron overload in Japan. A nationwide survey on post-transfusional iron overload subsequently led to the establishment of guidelines for iron chelation therapy in this country. To date, however, detailed clinical information on the entire iron overload population in Japan has not been fully investigated. In the present study, we obtained and studied detailed clinical information on the iron overload patient population in Japan. Of 1109 iron overload cases, 93.1% were considered to have occurred post-transfusion. There were, however, 76 cases of iron overload of unknown origin, which suggest that many clinicians in Japan may encounter some difficulty in correctly diagnosing and treating iron overload. Further clinical data were obtained for 32 cases of iron overload of unknown origin; median of serum ferritin was 1860.5 ng/mL. As occurs in post-transfusional iron overload, liver dysfunction was found to be as high as 95.7% when serum ferritin levels exceeded 1000 ng/mL in these patients. Gene mutation analysis of the iron metabolism-related genes in 27 cases of iron overload with unknown etiology revealed mutations in the gene coding hemojuvelin, transferrin receptor 2, and ferroportin; this indicates that although rare, hereditary hemochromatosis does occur in Japan.

Overview of measles and mumps vaccine: origin, present, and future of vaccine production.

Science.gov (United States)

Betáková, T; Svetlíková, D; Gocník, M

2013-01-01

Measles and mumps are common viral childhood diseases that can cause serious complications. Vaccination remains the most efficient way to control the spread of these viruses. The manufacturing capability for viral vaccines produced in embryonated hen eggs and conventional/classical cell substrates, such as chicken embryo fibroblast or primary dog kidney cell substrates, is no longer sufficient. This limitation can be overcome by utilizing other recognized cell substrates such as Madin Darby Canine Kidney (MDCK), Chinese Hamster Ovary (CHO), Vero (monkey origin) cells, MRC-5 (human diploid) or as an alternative, introducing new cell substrates of human or avian origin. A very important factor in vaccine production is the safety and immunogenicity of the final vaccine, where the proper choice of cell substrate used for virus propagation is made. All substrates used in vaccine production must be fully characterized to avoid the contamination of hidden unknown pathogens which is difficult to achieve in primary cell substrates.

[Usefulness of (18)FDG PET-CT scan as a diagnostic tool of fever of unknown origin].

Science.gov (United States)

García-Gómez, Francisco Javier; Acevedo-Báñez, Irene; Martínez-Castillo, Rubén; García-Gutiérrez, Manuel; Tirado-Hospital, Juan Luis; Borrego-Dorado, Isabel

2015-07-20

Classic fever of unknown origin (FUO) is defined as the presence of fever greater than 38.3°C of at least 3 weeks with an uncertain diagnosis. Identification of the etiology is crucial in guiding further diagnostic procedures and subsequent patient management. The aim of this study was to evaluate the role of fluorine-18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography combined with computed tomography (PET/CT) in the diagnostic orientation of FUO. An observational retrospective study was performed, including 30 consecutive patients who had been studied between March 2010 and September 2013. Twenty-six out of 30 patients (86.67%) had a definitive diagnosis after pathologic confirmation in 15 cases, microbiological findings in one patient and clinical and radiological follow-up in 10 patients (mean: 16.38 months). Among the positive scans, malignancy (n=10), inflammatory (n=8), infectious (n=4) and miscellaneous causes (n=1) were identified. (18)F-FDG PET/CT had a diagnostic accuracy of 90.00%, sensitivity of 88.46% (95% confidence interval [95% CI] 76-101), specificity of 100.00% (95% CI 100-100), positive predictive values of 100.00% (95% CI100-100) and negative predictive value of 57.14% (95% CI 20-91). (18)F-FDG PET/CT provided useful for the etiologic diagnosis of FUO, with high sensitivity and specificity. (18)F-FDG PET/CT has an incremental morphological and functional value, especially indicating the best biopsy site. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Importance of immunohistochemistry and application of TTF-1 and napsin A in differential diagnosis of primary pulmonary adenocarcinomas and pulmonary metastases of extrapulmonary origins

International Nuclear Information System (INIS)

Mikulakova, A.; Hribikova, Z.

2017-01-01

The differential diagnosis between primary and secondary pulmonary adenocarcinomas is daily requisition for pathologist. Lungs are the most common site of metastases from various primary and primary pulmonary adenocarcinomas are one of the most common worldwide malignancies. Immunohistochemistry is useful method to determine the origin of tumor in case when histomorphology alone is insufficient in poor differentiated carcinomas. Accordingly, presence of enteric, clear cell, spindle cell and signet-ring cell features complicates determining of origin of adenocarcinomas. The most common and long-used lung specific immunohistochemical marker is TTF-1, but specificity and sensitivity is not 100%. Use of TTF-1 has pitfalls that complicate its routine use. TTF-1 alone is insufficient marker for determining of origin of adenocarcinoma in the lung. Newly used immunohistochemical marker is napsin A. According to many authors is sensitivity and specificity for napsin A higher than TTF-1. Use of TTF-1 and napsin A simultaneously increases sensitivity up to 85% for primary lung adenocarcinomas. Both immunohistochemical l markers can be expressed in various tumours of extrapulmonary origin that can metastasize to lung, thus specificity is not 100%. In cases of surgical resection of tumor wider panels of immunohistochemical antibodies are used. Small biopsies and cytological material is quantitative restricted and sometimes qualitatively deficient. It is sometimes complicated and even impossible for pathologist to determine primary origin of tumor. (author)

Electricity of nuclear origin and primary and end-use energy consumption; Electricite nucleaire et consommation d'energie primaire et finale

Energy Technology Data Exchange (ETDEWEB)

NONE

2008-07-01

In France, the electricity of nuclear origin corresponds to about 40% of the primary energy consumption, while electricity as a whole represents about 23% of the end-use energy. This apparent paradox can be explained by 2 methodological points: 1 - the primary energy consumption, in the case of electricity, includes only the energy of nuclear, hydraulic, wind, photovoltaic and geothermal origin. On the other hand, the end-use energy consumption includes all forms of electricity consumed, i.e. the electricity of both primary and secondary origin. 2 - By international convention, the coefficients used to convert MWth into tpe (ton of petroleum equivalent) can change according to two factors: the power generation source and the type of kWh considered, either produced or consumed. The coexistence of different concepts and definitions is justified by the different usages made with them. Therefore, calculations referring to different definitions or equivalence coefficients are not immediately comparable. (J.S.)

Comparison of a gene expression profiling strategy to standard clinical work-up for determination of tumour origin in cancer of unknown primary (CUP)

DEFF Research Database (Denmark)

Ades, Felipe; de Azambuja, Evandro; Daugaard, Gedske

2013-01-01

CupPrint® is a genomic signature able to identify 47 different cancer types. The aim of our study was to compare the accuracy of this genomic signature to that of a full clinical work-up in diagnosing the primary tumour site. Patients with newly diagnosed, untreated metastatic tumours were eligible...

Treatment of cervical lymph node metastasis from an unknown primary tumor, with a review of the literature

International Nuclear Information System (INIS)

Planken, H.J.M. van der; Tiwari, R.M.; Karim, A.B.M.F.

1997-01-01

Background: The results of treatment at the Free University Hospital of 44 patients with cervical lymph node metastasis of an unknown primary tumor were reviewed in order to establish an optimal treatment policy and to look for prognostic parameters. These results were compared with results of other treatment policies known from the literature. Patients and Method: Thirty-three out of the 44 patients received a treatment with curative intent; 22 cases received a unilateral neck dissection and postoperative radiotherapy, 7 were irradiated after an excisional biopsy and 4 received radical radiotherapy alone. Results: For the whole group 5- and 10-year overall survival was 50% and 44%, respectively, and for the group treated with curative intent 68% and 56%, respectively. Disease-free survival at 5 and 10 years after treatment for the whole group was 48% and 32%, respectively, and for the group treated with curative intent 63% and 37%, respectively. Conclusions: Multivariate analysis showed only treatment with intent and histology as significant independent prognostic factors for the whole group. For the patients treated with curative intent no significant influences of variables were found. (orig.) [de

Impact of Primary and Secondary Social Origin Factors on the Transition to University in the Czech Republic

Czech Academy of Sciences Publication Activity Database

Simonová, Natalie; Soukup, P.

2015-01-01

Roč. 36, č. 5 (2015), s. 707-728 ISSN 0142-5692 Institutional support: RVO:68378025 Keywords : educational inequality * social origin * primary and secondary effects Subject RIV: AO - Sociology, Demography Impact factor: 1.220, year: 2015 http://dx.doi.org/10.1080/01425692.2013.854690

A sensitivity analysis approach to control of manipulators with unknown load

International Nuclear Information System (INIS)

Tzes, A.; Yurkovich, S.

1987-01-01

This paper presents a straightforward control strategy applied to an N-link manipulator holding an unknown load and driving its end effector along a prespecified trajectory. The control is constituted into two primary components. The non-adaptive component is derived from the inverse problem technique while the adaptive component is computed via the application of sensitivity analysis applied to the complete, centralized dynamic model of the manipulator. The result is a robust adaptive controller which tunes its parameters at specified time instants and can withstand all expected variations of the payload. The control synthesis is illustrated by simulations in a 2-link planar manipulator holding an unknown load

18F-FDG PET/CT in inflammation of unknown origin: a cost-effectiveness pilot-study

International Nuclear Information System (INIS)

Balink, H.; Tan, S.S.; Veeger, N.J.G.M.; Holleman, F.; Eck-Smit, B.L.F. van; Bennink, R.J.; Verberne, H.J.

2015-01-01

Patients with increased inflammatory parameters, nonspecific signs and symptoms without fever and without a diagnosis after a variety of diagnostic procedures are a diagnostic dilemma and are referred to as having inflammation of unknown origin (IUO). The objective of this pilot study was to compare the cost-effectiveness of a diagnostic work-up/strategy with and without 18 F-FDG PET/CT in patients with IUO using a published dataset as a reference. IUO patients without 18 F-FDG PET/CT (group A, 46 patients) and IUO patients referred for 18 F-FDG PET/CT (group B, 46 patients) were selected. IUO was defined as the combination of nonspecific signs and symptoms and a prolonged erythrocyte sedimentation rate (ESR), defined as ≥age/2 in men and ≥(age + 10)/2 in women (ESR in millimetres per hour and age in years), and/or C-reactive protein (CRP) ≥15 mg/l. The costs of all tests and procedures and the number of hospitalization days in each patient to reach a diagnosis were calculated using current Dutch tariffs. In group A a diagnosis was reached in 14 of the 46 patients. The mean cost per patient of all the diagnostic procedures was EUR2,051, and including the cost of hospitalization was EUR12,614. In group B a diagnosis was reached in 32 of the 46 patients. The mean cost per patient of all the diagnostic procedures was EUR1,821, significantly lower than in group A (p < 0.0002), and including the cost of hospitalization was EUR5,298. In IUO 18 F-FDG PET/CT has the potential to become a cost-effective routine imaging technique indicating the direction for further diagnostic decisions thereby allowing unnecessary, invasive and expensive diagnostic investigations to be avoided and possibly the duration of hospitalization to be reduced. However, a prospective multicentre ''bottom-up microcosting'' cost-effectiveness study is warranted before these preliminary data can be extrapolated to clinical practice. (orig.)

Non-alcoholic beverages, unknown influence on cell proliferation - an in vitro study.

Science.gov (United States)

Nowacki, Maciej; Adamowicz, Jan; Olkowska, Joanna; Pietkun, Katarzyna; Kloskowski, Tomasz; Bajek, Anna; Drewa, Tomasz

2014-01-01

The aim of the presented study was to check differences between 'Diet' and 'non-Diet' soft drinks on cell proliferation. Coca Cola and Pepsi Cola of different origin and their dietetic versions were examined at concentrations of 2% and 4%. Fructose and glucose as well as medium alone (control) were examined. Cell number was higher in media supplemented with soft drinks, compared to control. Proliferation depended on the soft drink concentration and its origin, but not on sugar and calorific content. An unknown factor is responsible for the increase in proliferation.

Detection of viral sequence fragments of HIV-1 subfamilies yet unknown

Directory of Open Access Journals (Sweden)

Stanke Mario

2011-04-01

Full Text Available Abstract Background Methods of determining whether or not any particular HIV-1 sequence stems - completely or in part - from some unknown HIV-1 subtype are important for the design of vaccines and molecular detection systems, as well as for epidemiological monitoring. Nevertheless, a single algorithm only, the Branching Index (BI, has been developed for this task so far. Moving along the genome of a query sequence in a sliding window, the BI computes a ratio quantifying how closely the query sequence clusters with a subtype clade. In its current version, however, the BI does not provide predicted boundaries of unknown fragments. Results We have developed Unknown Subtype Finder (USF, an algorithm based on a probabilistic model, which automatically determines which parts of an input sequence originate from a subtype yet unknown. The underlying model is based on a simple profile hidden Markov model (pHMM for each known subtype and an additional pHMM for an unknown subtype. The emission probabilities of the latter are estimated using the emission frequencies of the known subtypes by means of a (position-wise probabilistic model for the emergence of new subtypes. We have applied USF to SIV and HIV-1 sequences formerly classified as having emerged from an unknown subtype. Moreover, we have evaluated its performance on artificial HIV-1 recombinants and non-recombinant HIV-1 sequences. The results have been compared with the corresponding results of the BI. Conclusions Our results demonstrate that USF is suitable for detecting segments in HIV-1 sequences stemming from yet unknown subtypes. Comparing USF with the BI shows that our algorithm performs as good as the BI or better.

TumorTracer: a method to identify the tissue of origin from the somatic mutations of a tumor specimen

DEFF Research Database (Denmark)

Marquard, Andrea Marion; Birkbak, Nicolai Juul; Thomas, Cecilia Engel

2015-01-01

A substantial proportion of cancer cases present with a metastatic tumor and require further testing to determine the primary site; many of these are never fully diagnosed and remain cancer of unknown primary origin (CUP). It has been previously demonstrated that the somatic point mutations......-copy-number classifier on three independent data sets: 1669 newly available public tumors of various types, a cohort of 91 breast metastases, and a set of 24 specimens from 9 lung cancer patients subjected to multiregion sequencing. The cross-validation accuracy was highest when all three types of information were used...... detected in a tumor can be used to identify its site of origin with limited accuracy. We hypothesized that higher accuracy could be achieved by a classification algorithm based on the following feature sets: 1) the number of nonsynonymous point mutations in a set of 232 specific cancer-associated genes, 2...

New component of cosmic rays of unknown origin at a few MeV per nucleon

International Nuclear Information System (INIS)

Gloecker, G.

1974-04-01

Recently discovered anomalies in the abundances and energy spectra of quiet time, extraterrestrial hydrogen, helium, carbon, nitrogen, and oxygen require serious revisions of origin theories to account for this new component of cosmic radiation. Abnormally large O/C and N/C ratios, long term intensity variations with time, and radial gradient measurements indicate a nonsolar origin for these 2 to 30 MeV/nucleon particles. Ideas suggested to explain these measurements range from acceleration of galactic source material having an unusual composition to local acceleration of particles within the solar cavity. Observations are at present insufficient to choose between these alternate origin models. (U.S.)

Original Researc Original Research

African Journals Online (AJOL)

RAGHAVENDRA

Practices. Problems. Supervision. Primary School. *Corresponding Author: Asrat Dagnew. E-mail: asratboza@yahoo.com tructional support. The relevant and ... vision is one of indispensable system pment. Supervision is a system of that directly concerned on the aff members in a school or other. Original Research ...

Unknown quantum states: The quantum de Finetti representation

International Nuclear Information System (INIS)

Caves, Carlton M.; Fuchs, Christopher A.; Schack, Ruediger

2002-01-01

We present an elementary proof of the quantum de Finetti representation theorem, a quantum analog of de Finetti's classical theorem on exchangeable probability assignments. This contrasts with the original proof of Hudson and Moody [Z. Wahrschein. verw. Geb. 33, 343 (1976)], which relies on advanced mathematics and does not share the same potential for generalization. The classical de Finetti theorem provides an operational definition of the concept of an unknown probability in Bayesian probability theory, where probabilities are taken to be degrees of belief instead of objective states of nature. The quantum de Finetti theorem, in a closely analogous fashion, deals with exchangeable density-operator assignments and provides an operational definition of the concept of an ''unknown quantum state'' in quantum-state tomography. This result is especially important for information-based interpretations of quantum mechanics, where quantum states, like probabilities, are taken to be states of knowledge rather than states of nature. We further demonstrate that the theorem fails for real Hilbert spaces and discuss the significance of this point

Intraabdominal abscessus of unknown etiology

Directory of Open Access Journals (Sweden)

Čolović Radoje

2012-01-01

Full Text Available Introduction. Intraabdominal abscesses are in 98-99% cases the result of secondary and only in 1-2% of primary peritonitis. They are easy and successfully diagnosed. Abdominal abscesses of unknown cause are extremely rare. Case Outline. The authors present a 68-year-old man, without significant data in past history, who suddenly developed epigastric pain, nausea, vomiting and leukocytosis which was treated with antibiotics resulting in the alleviation of complaints and reduction of white blood cells count. After five days ultrasonography showed incapsulated collection of dense fluid in the epigastrium confirmed by CT scan two days later. Upper endoscopy excluded ulcer and/or perforation of the stomach and duodenum. Under local anesthesia, through the upper part of the left rectal muscle, puncture followed by incision was done, and about 50 ml of dense pus was removed. Finger exploration of the cavity showed no foreign body within the cavity. Using drainage, the recovery was quick and uneventful. By preoperative and postoperative abdominal investigations no cause of the abscess was found. Two and a half years after surgery the patient remained symptom-free with normal clinical, laboratory and ultrasonographic findings. Conclusion. The authors presented an intraabdominal abscess of unknown cause that was successfully treated with antibiotics, percutaneous puncture and drainage under local anaesthesia. In spite of all diagnostic methods the cause of the abscess could not be found. Thus, such a possibility, although being rare, should be taken into account.

Prognostic factors for carcinoma of unknown primary localized to the neck only (CUP Syndrome) and the role of F-18-FDG PET for diagnosis and therapeutic management

International Nuclear Information System (INIS)

Baum, R.P.; Schmuecking, M.; Niesen, A.; Bank, P.; Lopatta, E.C.; Wendt, T.G.; Koscielny, S.; Beleites, E.

2002-01-01

Aim: Treatment of patients with carcinoma of unknown primary localized to the neck only is still controversial. To determine both patient related prognostic factors and the influence of treatment parameters the records of 99 patients were analyzed retrospectively, to evaluate the role of F-18-FDG PET for diagnostics and therapy management 33 patients were analyzed prospectively. Material and Methods: Retrospectively: Out of 99 patients with carcinoma of unknown primary, 51 received surgery as a sole treatment. 48 were treated with a combination of surgery and radiation therapy. 8/99 patients received a F-18-FDG PET. Statistical analyses: Kaplan-Meier, log-rank-test, chi-square-test. Prospectively: All PET studies were carried out after conventional diagnostic procedures failed to detect the primary tumor. PET findings were correlated with histology and/or clinical course of the patients. Results: Retrospectively: Disease specific survival (DSS) was significant longer for patients with N1/N2 vs. N3 (p=0.03), for upper nodal involvement vs. lower and/or supraclavicular nodal involvement (p=0.031) and for absence of extracapsular spread (p=0.041). No influence of DSS was noted for grading (p=0.469), treatment volume (p=0.82) and applied dose (>50Gy vs. <50Gy). In 2/8 patients, PET detected the primary tumor, in 1/8 bone metastases. Prospectively: Detection of the primary tumor by PET was successful in 21%, mostly in patients with lower and/or supraclavicular nodal involvement. In these patients the primary tumor was located extracervically in 72%, e.g. lung or gastric cancer. Distant metastases were detected in 33%. Conclusion: The presence of ECS, the extend and localization of nodal involvement are prognostic factors in patients suffering from CUP localized to the neck only. Patients with upper nodal involvement should be treated with curative intention. The irradiation fields should cover the whole neck including the potential region of the primary tumor with doses

Primary intraosseous smooth muscle tumor of uncertain malignant potential: original report and molecular characterization

Directory of Open Access Journals (Sweden)

Lauren Kropp

2016-11-01

Full Text Available We report the first case of primary intraosseous smooth muscle tumor of uncertain malignant potential (STUMP which is analogous to borderline malignant uterine smooth muscle tumors so designated. The tumor presented in the femur of an otherwise healthy 30-year-old woman. Over a 3-year period, the patient underwent 11 biopsies or resections and 2 cytologic procedures. Multiple pathologists reviewed the histologic material including musculoskeletal pathologists but could not reach a definitive diagnosis. However, metastases eventually developed and were rapidly progressive and responsive to gemcitabine and docetaxel. Molecular characterization and ultrastructural analysis was consistent with smooth muscle origin, and amplification of unmutated chromosome 12p and 12q segments appears to be the major genomic driver of this tumor. Primary intraosseous STUMP is thought to be genetically related to leiomyosarcoma of bone, but likely representing an earlier stage of carcinogenesis. Wide excision and aggressive followup is warranted for this potentially life-threatening neoplasm.

Primary Intraosseous Smooth Muscle Tumor of Uncertain Malignant Potential: Original Report and Molecular Characterization.

Science.gov (United States)

Kropp, Lauren; Siegal, Gene P; Frampton, Garrett M; Rodriguez, Michael G; McKee, Svetlana; Conry, Robert M

2016-11-17

We report the first case of primary intraosseous smooth muscle tumor of uncertain malignant potential (STUMP) which is analogous to borderline malignant uterine smooth muscle tumors so designated. The tumor presented in the femur of an otherwise healthy 30-year-old woman. Over a 3-year period, the patient underwent 11 biopsies or resections and 2 cytologic procedures. Multiple pathologists reviewed the histologic material including musculoskeletal pathologists but could not reach a definitive diagnosis. However, metastases eventually developed and were rapidly progressive and responsive to gemcitabine and docetaxel. Molecular characterization and ultrastructural analysis was consistent with smooth muscle origin, and amplification of unmutated chromosome 12p and 12q segments appears to be the major genomic driver of this tumor. Primary intraosseous STUMP is thought to be genetically related to leiomyosarcoma of bone, but likely representing an earlier stage of carcinogenesis. Wide excision and aggressive follow-up is warranted for this potentially life-threatening neoplasm.

[Focal myositis: An unknown disease].

Science.gov (United States)

Gallay, L; Streichenberger, N; Benveniste, O; Allenbach, Y

2017-10-01

Focal myositis are inflammatory muscle diseases of unknown origin. At the opposite from the other idiopathic inflammatory myopathies, they are restricted to a single muscle or to a muscle group. They are not associated with extramuscular manifestations, and they have a good prognosis without any treatment. They are characterized by a localized swelling affecting mostly lower limbs. The pseudo-tumor can be painful, but is not associated with a muscle weakness. Creatine kinase level is normal. Muscle MRI shows an inflammation restricted to a muscle or a muscle group. Muscle biopsy and pathological analysis remain necessary for the diagnosis, showing inflammatory infiltrates composed by macrophages and lymphocytes without any specific distribution within the muscle. Focal overexpression of HLA-1 by the muscle fibers is frequently observed. The muscle biopsy permits to rule out differential diagnosis such a malignancy (sarcoma). Spontaneous remission occurs within weeks or months after the first symptoms, relapse is unusual. Copyright © 2017. Published by Elsevier SAS.

Clinical Pathology and Prognostic Analysis of Visceral Metastatic Carcinoma of Unknown Primary Site (VMCUP

Directory of Open Access Journals (Sweden)

Q Xu

2014-12-01

Full Text Available Objective: To analyse the clinicopathologic characteristics of visceral metastatic carcinoma of unknown primary site (VMCUP, discuss the relationship between its treatment and prognosis, and provide the basis for individualized clinical diagnosis and treatment. Methods: A retrospective analysis on clinical pathologic data was performed on 21 VMCUP cases from Fujian Union Hospital from January 2007 to January 2012. Follow-up visits on patients were made and analysis of their survival conditions and relevant influencing factors were collated. Results: The gender distribution of the 21 VMCUP cases was 1:1.1; the median age was 63 years and the pathology type was dominated by adenocarcinoma. The median survival time and survival rate in patients accepting treatment were evidently higher than those in patients not accepting treatment. The median survival time of those patients receiving more than one treatment procedure was higher than in those patients only receiving chemotherapy. Among those patients who received comprehensive therapy, the median survival time in those mainly receiving operative therapy was also higher than in those only receiving chemotherapy (p two cycles or > four cycles was evidently longer than those receiving chemotherapy ≤ two cycles or ≤ four cycles separately. For those choosing paclitaxel in combination with platinum as first-line chemotherapy, their median survival time was longer than those primarily taking fluorouracil (p 0.05 in the median survival times among groups receiving the same treatment but with different age, gender or pathological types. It was indicated by multiple-factor analysis that the chemotherapeutics, chemotherapy times and treatment methods were prognostic factors affecting the survival of VMCUP. Conclusion: The overall progression of VMCUP patients deteriorates quickly, with a poor prognosis and without a standard treatment pattern. Appropriate chemotherapy, surgery and radiotherapy, however

Contribution of 18F-FDG PET in the diagnostic assessment of fever of unknown origin (FUO): a stratification-based meta-analysis

International Nuclear Information System (INIS)

Besson, Florent L.; Chaumet-Riffaud, Philippe; Prigent, Alain; Durand, Emmanuel; Playe, Margot; Noel, Nicolas; Lambotte, Olivier; Goujard, Cecile

2016-01-01

The aim of this study was to quantify the contribution of FDG PET to the diagnostic assessment of fever of unknown origin (FUO), taking into account the diagnostic limitations resulting from the composite nature of this entity. The PubMed/MEDLINE database was searched from 2000 to September 2015. Original articles fulfilling the following criteria were included: (1) FUO as the initial diagnosis, (2) no immunosuppressed or nosocomial condition, (3) final diagnosis not based on PET, (4) a follow-up period specified, (5) adult population, and (6) availability of adapted data for calculation of odds ratios (ORs). ORs were computed for each study and then pooled using a random effects model. Stratification-based sensitivity analyses were finally performed using the following prespecified criteria: (a) study design, (b) PET device, (c) geographic area, and (d) follow-up period. A meta-analysis of the 14 included studies showed that normal PET findings led to an increase in the absolute final diagnostic rate of 36 % abnormal PET findings to an increase of 83 %, corresponding to a pooled OR of 8.94 (95 % CI 4.18 - 19.12, Z = 5.65; p < 0.00001). The design of the studies influenced the results (OR 2.92, 95 % CI 1.00 - 8.53 for prospective studies; OR 18,57, 95 % CI 7.57 - 45.59 for retrospective studies; p = 0.01), whereas devices (dedicated or hybrid), geographic area and follow-up period did not. Abnormal PET findings are associated with a substantially increased final diagnostic rate in FUO. Consequently, FDG PET could be considered for inclusion in the first-line diagnostic work-up of FUO. Further randomized prospective studies with standardized FDG PET procedures are warranted to confirm this first-line position. (orig.)

Role of Definitive Radiation Therapy in Carcinoma of Unknown Primary in the Abdomen and Pelvis

International Nuclear Information System (INIS)

Kelly, Patrick; Das, Prajnan; Varadhachary, Gauri R.; Fontanilla, Hiral P.; Krishnan, Sunil; Delclos, Marc E.; Jhingran, Anuja; Eifel, Patricia J.; Crane, Christopher H.

2012-01-01

Objectives: Carcinoma of unknown primary (CUP) in the abdomen and pelvis is a heterogeneous group of cancers with no standard treatment. Considered by many to be incurable, these patients are often treated with chemotherapy alone. In this study, we determined the effectiveness of radiation therapy in combination with chemotherapy in patients with CUP in the abdomen and pelvis. Patients and Methods: Medical records were reviewed for 37 patients with CUP treated with radiation therapy for disease located in the soft tissues and/or nodal basins of the abdomen and pelvis at University of Texas M.D. Anderson Cancer between 2002 and 2009. All patients underwent chemotherapy, either before or concurrent with radiation therapy. Patients were selected for radiation therapy on the basis of histologic type, disease extent, and prior therapy response. Twenty patients underwent definitive radiation therapy (defined as radiation therapy targeting all known disease sites with at least 45 Gy) and 17 patients underwent palliative radiation therapy. Only 6 patients had surgical resection of their disease. Patient and treatment characteristics were extracted and the endpoints of local disease control, progression-free survival (PFS), overall survival (OS), and treatment-related toxicity incidence were analyzed. Results: The 2-year PFS and OS rates for the entire cohort were 32% and 57%, respectively. However, in patients treated with definitive radiation therapy, the rates were 48% and 76%, and 7 patients lived more than 3 years after treatment with no evidence of disease progression. Nevertheless, radiation-associated toxicity was significant in this cohort, as 40% experienced Grade 2 or higher late toxicities. Conclusions: The use of definitive radiation therapy should be considered in selected patients with CUP in the soft tissues or nodal basins of the abdomen and pelvis.

{sup 18}F-FDG PET/CT in inflammation of unknown origin: a cost-effectiveness pilot-study

Energy Technology Data Exchange (ETDEWEB)

Balink, H. [Medical Center Leeuwarden, Department of Nuclear Medicine, Leeuwarden (Netherlands); Tan, S.S. [Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam (Netherlands); Veeger, N.J.G.M. [University Medical Center Groningen, Department of Epidemiology, Groningen (Netherlands); Holleman, F. [Academic Medical Center Amsterdam, Department of Internal Medicine, Amsterdam (Netherlands); Eck-Smit, B.L.F. van; Bennink, R.J.; Verberne, H.J. [Academic Medical Center, Department of Nuclear Medicine, Amsterdam (Netherlands)

2015-08-15

Patients with increased inflammatory parameters, nonspecific signs and symptoms without fever and without a diagnosis after a variety of diagnostic procedures are a diagnostic dilemma and are referred to as having inflammation of unknown origin (IUO). The objective of this pilot study was to compare the cost-effectiveness of a diagnostic work-up/strategy with and without {sup 18}F-FDG PET/CT in patients with IUO using a published dataset as a reference. IUO patients without {sup 18}F-FDG PET/CT (group A, 46 patients) and IUO patients referred for {sup 18}F-FDG PET/CT (group B, 46 patients) were selected. IUO was defined as the combination of nonspecific signs and symptoms and a prolonged erythrocyte sedimentation rate (ESR), defined as ≥age/2 in men and ≥(age + 10)/2 in women (ESR in millimetres per hour and age in years), and/or C-reactive protein (CRP) ≥15 mg/l. The costs of all tests and procedures and the number of hospitalization days in each patient to reach a diagnosis were calculated using current Dutch tariffs. In group A a diagnosis was reached in 14 of the 46 patients. The mean cost per patient of all the diagnostic procedures was EUR2,051, and including the cost of hospitalization was EUR12,614. In group B a diagnosis was reached in 32 of the 46 patients. The mean cost per patient of all the diagnostic procedures was EUR1,821, significantly lower than in group A (p < 0.0002), and including the cost of hospitalization was EUR5,298. In IUO {sup 18}F-FDG PET/CT has the potential to become a cost-effective routine imaging technique indicating the direction for further diagnostic decisions thereby allowing unnecessary, invasive and expensive diagnostic investigations to be avoided and possibly the duration of hospitalization to be reduced. However, a prospective multicentre ''bottom-up microcosting'' cost-effectiveness study is warranted before these preliminary data can be extrapolated to clinical practice. (orig.)

Algorithms for Rapidly Dispersing Robot Swarms in Unknown Environments

OpenAIRE

Hsiang, Tien-Ruey; Arkin, Esther M.; Bender, Michael; Fekete, Sandor P.; Mitchell, Joseph S. B.

2002-01-01

We develop and analyze algorithms for dispersing a swarm of primitive robots in an unknown environment, R. The primary objective is to minimize the makespan, that is, the time to fill the entire region. An environment is composed of pixels that form a connected subset of the integer grid. There is at most one robot per pixel and robots move horizontally or vertically at unit speed. Robots enter R by means of k>=1 door pixels Robots are primitive finite automata, only having local communicatio...

IGF-IEc expression is increased in secondary compared to primary foci in neuroendocrine neoplasms.

Science.gov (United States)

Alexandraki, Krystallenia I; Philippou, Anastassios; Boutzios, Georgios; Theohari, Irini; Koutsilieris, Michael; Delladetsima, Ioanna Kassiani; Kaltsas, Gregory A

2017-10-03

Different Insulin-like growth factor-I (IGF-I) mRNA transcripts are produced by alternative splicing and particularly the IGF-IEc isoform has been implicated in the development and/or progression of various types of cancer. In the present study, we examined the potential role of IGF-IEc expression as a new immunohistochemical marker of aggressiveness in neuroendocrine neoplasms (NENs). We utilized immunohistochemical analysis in tissue specimens of 47 patients with NENs, to evaluate the expression of IGF-IEc (%) and Ki-67 proliferation index (%). Specimens from patients with tumors of different tissue origin, of either primary or metastatic lesions and of different grade were examined. Cytoplasmic IGF-IEc staining was found in 23 specimens of NENs or NECs: 10 pancreatic, 4 small bowel, 3 gastric, 1 lung, 1 uterine and 4 poorly differentiated of unknown primary origin. Ki-67 and IGF-IEc expression was positively correlated in all the samples studied (r=0.31, p=0.03). IGF-1Ec expression was more prevalent in specimens originating from metastatic foci with high Ki-67 compared to primary sites with low Ki-67 expression (p=0.036). These findings suggest a possible role of IGF-IEc in NEN tumorigenesis and progression to metastases that could be used as an additional new marker of a more aggressive behavior and a potential drugable target.

Co-infection of scrub typhus and leptospirosis in patients with pyrexia of unknown origin in Longding district of Arunachal Pradesh in 2013.

Science.gov (United States)

Borkakoty, Biswajyoti; Jakharia, Aniruddha; Biswas, Dipankar; Mahanta, Jagadish

2016-01-01

Scrub typhus and leptospirosis are bacterial zoonotic disease causing high morbidity and mortality. The seasonal outbreak of pyrexia is common in Arunachal Pradesh (AP); many times the disease remains undiagnosed. An outbreak of pyrexia of unknown origin (PUO) occurred in Longding district of Arunachal Pradesh in 2013, with 108 deaths, which was investigated to elucidate the cause of illness. Blood samples from the affected region with acute pyrexia were collected, and screened for the malaria parasite, scrub typhus IgM and leptospira IgM. Scrub typhus IgM was reactive in 97% (30/31), and 25% (8/31) cases were co-infected with leptospira. Incidentally, scrub typhus reactive (67%) and leptospira co-infection (62.7%) were higher in females. Record of previous 3 years (2011-2013) from Longding, Community Health Centre showed an increase in indoor pyrexia cases by 2-fold or more during October and November. The present study is the first report of co-infection of scrub typhus with leptospirosis from Northeast India. Medical officers in this region should take scrub typhus and leptospirosis in their differential diagnosis of patients with PUO for early diagnosis and effective treatment.

Allocating monitoring effort in the face of unknown unknowns

Science.gov (United States)

Wintle, B.A.; Runge, M.C.; Bekessy, S.A.

2010-01-01

There is a growing view that to make efficient use of resources, ecological monitoring should be hypothesis-driven and targeted to address specific management questions. 'Targeted' monitoring has been contrasted with other approaches in which a range of quantities are monitored in case they exhibit an alarming trend or provide ad hoc ecological insights. The second form of monitoring, described as surveillance, has been criticized because it does not usually aim to discern between competing hypotheses, and its benefits are harder to identify a priori. The alternative view is that the existence of surveillance data may enable rapid corroboration of emerging hypotheses or help to detect important 'unknown unknowns' that, if undetected, could lead to catastrophic outcomes or missed opportunities. We derive a model to evaluate and compare the efficiency of investments in surveillance and targeted monitoring. We find that a decision to invest in surveillance monitoring may be defensible if: (1) the surveillance design is more likely to discover or corroborate previously unknown phenomena than a targeted design and (2) the expected benefits (or avoided costs) arising from discovery are substantially higher than those arising from a well-planned targeted design. Our examination highlights the importance of being explicit about the objectives, costs and expected benefits of monitoring in a decision analytic framework. ?? 2010 Blackwell Publishing Ltd/CNRS.

Sliding Mode Observer-Based Current Sensor Fault Reconstruction and Unknown Load Disturbance Estimation for PMSM Driven System.

Science.gov (United States)

Zhao, Kaihui; Li, Peng; Zhang, Changfan; Li, Xiangfei; He, Jing; Lin, Yuliang

2017-12-06

This paper proposes a new scheme of reconstructing current sensor faults and estimating unknown load disturbance for a permanent magnet synchronous motor (PMSM)-driven system. First, the original PMSM system is transformed into two subsystems; the first subsystem has unknown system load disturbances, which are unrelated to sensor faults, and the second subsystem has sensor faults, but is free from unknown load disturbances. Introducing a new state variable, the augmented subsystem that has sensor faults can be transformed into having actuator faults. Second, two sliding mode observers (SMOs) are designed: the unknown load disturbance is estimated by the first SMO in the subsystem, which has unknown load disturbance, and the sensor faults can be reconstructed using the second SMO in the augmented subsystem, which has sensor faults. The gains of the proposed SMOs and their stability analysis are developed via the solution of linear matrix inequality (LMI). Finally, the effectiveness of the proposed scheme was verified by simulations and experiments. The results demonstrate that the proposed scheme can reconstruct current sensor faults and estimate unknown load disturbance for the PMSM-driven system.

Financial Development and Economic Growth: Known Knowns, Known Unknowns, and Unknown Unknowns

OpenAIRE

Ugo Panizza

2014-01-01

This paper summarizes the main findings of the literature on the relationship between financial and economic development (the known knowns), points to directions for future research (the known unknowns), and then speculates on the third Rumsfeldian category. The known knowns section organizes the empirical literature on finance and growth into three strands: (i) the traditional literature which established the link between finance and growth; (ii) the new literature which qualified some of th...

Building a RAPPOR with the Unknown: Privacy-Preserving Learning of Associations and Data Dictionaries

Directory of Open Access Journals (Sweden)

Fanti Giulia

2016-07-01

Full Text Available Techniques based on randomized response enable the collection of potentially sensitive data from clients in a privacy-preserving manner with strong local differential privacy guarantees. A recent such technology, RAPPOR [12], enables estimation of the marginal frequencies of a set of strings via privacy-preserving crowdsourcing. However, this original estimation process relies on a known dictionary of possible strings; in practice, this dictionary can be extremely large and/or unknown. In this paper, we propose a novel decoding algorithm for the RAPPOR mechanism that enables the estimation of “unknown unknowns,” i.e., strings we do not know we should be estimating. To enable learning without explicit dictionary knowledge, we develop methodology for estimating the joint distribution of multiple variables collected with RAPPOR. Our contributions are not RAPPOR-specific, and can be generalized to other local differential privacy mechanisms for learning distributions of string-valued random variables.

Previously unknown species of Aspergillus.

Science.gov (United States)

Gautier, M; Normand, A-C; Ranque, S

2016-08-01

The use of multi-locus DNA sequence analysis has led to the description of previously unknown 'cryptic' Aspergillus species, whereas classical morphology-based identification of Aspergillus remains limited to the section or species-complex level. The current literature highlights two main features concerning these 'cryptic' Aspergillus species. First, the prevalence of such species in clinical samples is relatively high compared with emergent filamentous fungal taxa such as Mucorales, Scedosporium or Fusarium. Second, it is clearly important to identify these species in the clinical laboratory because of the high frequency of antifungal drug-resistant isolates of such Aspergillus species. Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) has recently been shown to enable the identification of filamentous fungi with an accuracy similar to that of DNA sequence-based methods. As MALDI-TOF MS is well suited to the routine clinical laboratory workflow, it facilitates the identification of these 'cryptic' Aspergillus species at the routine mycology bench. The rapid establishment of enhanced filamentous fungi identification facilities will lead to a better understanding of the epidemiology and clinical importance of these emerging Aspergillus species. Based on routine MALDI-TOF MS-based identification results, we provide original insights into the key interpretation issues of a positive Aspergillus culture from a clinical sample. Which ubiquitous species that are frequently isolated from air samples are rarely involved in human invasive disease? Can both the species and the type of biological sample indicate Aspergillus carriage, colonization or infection in a patient? Highly accurate routine filamentous fungi identification is central to enhance the understanding of these previously unknown Aspergillus species, with a vital impact on further improved patient care. Copyright © 2016 European Society of Clinical Microbiology and

Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression

Energy Technology Data Exchange (ETDEWEB)

Blokhuis, Gijsbert J.; Diender, Marije G.; Oyen, Wim J.G. [Radboud University Medical Center, Department of Nuclear Medicine, Nijmegen (Netherlands); Bleeker-Rovers, Chantal P. [Radboud University Medical Center, Division of Infectious Diseases, Department of Internal Medicine, Nijmegen (Netherlands); Draaisma, Jos M.T. [Radboud University Medical Center, Department of Paediatrics, Nijmegen (Netherlands); Geus-Oei, Lioe-Fee de [Radboud University Medical Center, Department of Nuclear Medicine, Nijmegen (Netherlands); University of Twente, MIRA Institute for Biomedical Technology and Technical Medicine, Biomedical Photonic Imaging Group, Enschede (Netherlands)

2014-10-15

Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed tomography (FDG-PET/CT) in children with FUO and in children with unexplained fever during immune suppression. All FDG-PET/(CT) scans performed in the Radboud university medical center for the evaluation of FUO or unexplained fever during immune suppression in the last 10 years were reviewed. Results were compared with the final clinical diagnosis. FDG-PET/(CT) scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52 %). Of the total number of scans, 32 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80 % and 78 %, respectively. FDG-PET/(CT) scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in nine patients (75 %). Of the total number of these scans, 58 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78 % and 67 %, respectively. FDG-PET/CT appears a valuable imaging technique in the evaluation of children with FUO and in the diagnostic process of children with unexplained fever during immune suppression. Prospective studies of FDG-PET/CT as part of a structured diagnostic protocol are warranted to assess the additional diagnostic value. (orig.)

Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression

International Nuclear Information System (INIS)

Blokhuis, Gijsbert J.; Diender, Marije G.; Oyen, Wim J.G.; Bleeker-Rovers, Chantal P.; Draaisma, Jos M.T.; Geus-Oei, Lioe-Fee de

2014-01-01

Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed tomography (FDG-PET/CT) in children with FUO and in children with unexplained fever during immune suppression. All FDG-PET/(CT) scans performed in the Radboud university medical center for the evaluation of FUO or unexplained fever during immune suppression in the last 10 years were reviewed. Results were compared with the final clinical diagnosis. FDG-PET/(CT) scans were performed in 31 children with FUO. A final diagnosis was established in 16 cases (52 %). Of the total number of scans, 32 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in these patients was 80 % and 78 %, respectively. FDG-PET/(CT) scans were performed in 12 children with unexplained fever during immune suppression. A final diagnosis was established in nine patients (75 %). Of the total number of these scans, 58 % were clinically helpful. The sensitivity and specificity of FDG-PET/CT in children with unexplained fever during immune suppression was 78 % and 67 %, respectively. FDG-PET/CT appears a valuable imaging technique in the evaluation of children with FUO and in the diagnostic process of children with unexplained fever during immune suppression. Prospective studies of FDG-PET/CT as part of a structured diagnostic protocol are warranted to assess the additional diagnostic value. (orig.)

Original analytic solution of a half-bridge modelled as a statically indeterminate system

Science.gov (United States)

Oanta, Emil M.; Panait, Cornel; Raicu, Alexandra; Barhalescu, Mihaela

2016-12-01

The paper presents an original computer based analytical model of a half-bridge belonging to a circular settling tank. The primary unknown is computed using the force method, the coefficients of the canonical equation being calculated using either the discretization of the bending moment diagram in trapezoids, or using the relations specific to the polygons. A second algorithm based on the method of initial parameters is also presented. Analyzing the new solution we came to the conclusion that most of the computer code developed for other model may be reused. The results are useful to evaluate the behavior of the structure and to compare with the results of the finite element models.

Designing towards the unknown

DEFF Research Database (Denmark)

Wilde, Danielle; Underwood, Jenny

2018-01-01

the research potential to far-ranging possibilities. In this article we unpack the motivations driving the PKI project. We present our mixed-methodology, which entangles textile crafts, design interactions and materiality to shape an embodied enquiry. Our research outcomes are procedural and methodological......New materials with new capabilities demand new ways of approaching design. Destabilising existing methods is crucial to develop new methods. Yet, radical destabilisation—where outcomes remain unknown long enough that new discoveries become possible—is not easy in technology design where complex......, to design towards unknown outcomes, using unknown materials. The impossibility of this task is proving as useful as it is disruptive. At its most potent, it is destabilising expectations, aesthetics and processes. Keeping the researchers, collaborators and participants in a state of unknowing, is opening...

Adenocarcinoma metastático cutâneo de origem desconhecida: Relato de um caso Metastatic cutaneous adenocarcinoma of unknown primary site: Case report

Directory of Open Access Journals (Sweden)

Caio Sergio Rizkallah Nahas

2004-06-01

Full Text Available RACIONAL: Metástases podem ser a primeira manifestação de adenocarcinoma. Cerca de 60% destas podem ser cutâneas e correspondem a casos de neoplasia em estágio avançado. A procura pelo sítio primário é onerosa, sendo necessário o emprego de diversos exames de imagem, endoscópicos e imunoistoquímicos. Apesar disto, o sítio primário é descoberto somente em 15% a 20% dos pacientes, sendo os demais casos reconhecidos nas autopsias. OBJETIVO: Relatar um caso de adenocarcinoma, moderadamente diferenciado metastático cutâneo, de sítio primário desconhecido. A região acometida foi a pele da fossa ilíaca esquerda. RESULTADOS: A lesão foi ressecada cirurgicamente. O sítio primário não foi identificado por nenhum exame de imagem ou endoscópico. O estudo imunoistoquímico revelou o seguinte padrão de imunoperoxidase: CEA negativo, CK7 positivo, CK20 negativo e PSA negativo. Com base nestes achados, foram afastados tumores primários do intestino grosso e da próstata (PSA, CK20 e CEA negativos. Os principais sítios primários aventados foram pâncreas e vias biliares. CONCLUSÃO: A procura pelo sítio primário de adenocarcinoma metastático continua sendo tarefa difícil, onerosa e com pouco impacto no tratamento dos pacientes acometidos.BACKGROUND: Metastases may be the first manifestation of adenocarcinoma. Up to 60% are cutaneous and present in advanced stage neoplasms. Research for the primary site is costly and requires endoscopy, imaging and immunohistochemical exams. The primary site becomes obvious in only 15% to 20% of live patients and is detected mainly at autopsy. AIM: To report a case of metastatic cutaneous moderately differentiated adenocarcinoma of unknown primary site, located in the lower left abdomen. RESULTS: The lesion was surgically resected. Primary site was not found by any imaging or endoscopy exams. The immunohistochemistry was negative for CEA, CK20, PSA and positive for CK7. Based on these exams

Recension: Mao - The Unknown Story

DEFF Research Database (Denmark)

Clausen, Søren

2005-01-01

Anmeldelse - kritisk! - til Sveriges førende Kinatidsskrift af Jung Chang & Jon Halliday's sensationelle "Mao - the Unknown Story".......Anmeldelse - kritisk! - til Sveriges førende Kinatidsskrift af Jung Chang & Jon Halliday's sensationelle "Mao - the Unknown Story"....

32 CFR 2001.21 - Original classification.

Science.gov (United States)

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Original classification. 2001.21 Section 2001.21... Markings § 2001.21 Original classification. (a) Primary markings. At the time of original classification... authority. The name and position, or personal identifier, of the original classification authority shall...

Health service utilisation and investigations before diagnosis of cancer of unknown primary (CUP): A population-based nested case-control study in Australian Government Department of Veterans' Affairs clients.

Science.gov (United States)

Vajdic, Claire M; Schaffer, Andrea L; Dobbins, Timothy A; Ward, Robyn L; Er, Chuang C; Pearson, Sallie-Anne

2015-08-01

Population-based data on the use of health services and diagnostic investigations for patients with cancer of unknown primary (CUP) is scarce. It is uncertain whether the pathways to diagnosis are different for CUP compared to other cancers. We performed a population-based nested matched case-control study using linked routinely collected records for Australian Government Department of Veterans' Affairs clients, 2004-2007. We compared health care consultations, hospitalisations, emergency department visits, and diagnostic procedures in the three months prior and the month of diagnosis for 281 clients registered with a diagnosis of CUP (C809) and 1102 controls randomly selected from clients registered with a first diagnosis of metastatic cancer of known primary. Overall, the median age at cancer diagnosis was 83 years. CUP patients were slightly older and had significantly more comorbidities prior to diagnosis than those with known primary. Compared to known primary, a diagnosis of CUP was significantly more likely after an emergency department visit, less specialist input, fewer invasive diagnostic procedures such as resection or endoscopy, and more non-invasive procedures such as magnetic resonance imaging. There were no differences in primary care or allied health consultations and hospitalisations. This health care pathway suggests delayed recognition of cancer and scope for improvement in the medical management of high-risk individuals presenting to primary care. The pattern of diagnostic investigations reveals under-investigation in some CUP patients but this is likely to reflect recognition of limited treatment options and poor prognosis and is consistent with clinical guidelines. Copyright © 2015 Commonwealth of Australia. Published by Elsevier Ltd.. All rights reserved.

A pilot randomised controlled trial in intensive care patients comparing 7 days' treatment with empirical antibiotics with 2 days' treatment for hospital-acquired infection of unknown origin.

Science.gov (United States)

Scawn, N; Saul, D; Pathak, D; Matata, B; Kemp, I; Stables, R; Lane, S; Haycox, A; Houten, R

2012-09-01

Management of cardiac intensive care unit (ICU) sepsis is complicated by the high incidence of systemic inflammatory response syndrome, which mimics sepsis but without an infective cause. This pilot randomised trial investigated whether or not, in the ICU, 48 hours of broad-spectrum antibiotic treatment was adequate to safely treat suspected sepsis of unknown and unproven origin and also the predictive power of newer biomarkers of sepsis. The main objective of this pilot study was to provide preliminary data on the likely safety and efficacy of a reduced course of antibiotics for the treatment of ICU infections of unknown origin. A pilot, single-centre, open-label randomised trial. This study was carried out in the ICU of a tertiary heart and chest hospital. Patients being treated within the ICU were recruited into the trial if the intensivist was planning to commence antibiotics because of evidence of systemic inflammatory response syndrome and a strong suspicion of infection but there was no actual known source for that infection. Broad-spectrum antibiotic treatment administered for 48 hours (experimental) compared with treatment for 7 days (control). The primary outcome was a composite outcome of the rate of death or initiation of antibiotic therapy after the completion of the treatment schedule allocated at randomisation. Secondary outcomes included the duration of mechanical ventilation and ICU and hospital stay; the incidence of infection with Clostridium difficile (B. S. Weeks & E. Alcamo) Jones & Bartlett International Publishers, 2008, or methicillin-resistant Staphylococcus aureus (MRSA) (B. S. Weeks & E. Alcamo) Jones & Bartlett International Publishers, 2008; resource utilisation and costs associated with each of the two pilot arms; the ratio of patients screened to patients eligible to patients randomised; the incidence of crossover between groups; and the significance of newer biomarkers for sepsis for predicting patients' need for further antibiotics

Role of Radiotherapy in the Treatment of Cervical Lymph Node Metastases From an Unknown Primary Site: Retrospective Analysis of 113 Patients

International Nuclear Information System (INIS)

Beldi, Debora; Jereczek-Fossa, Barbara A.; D'Onofrio, Alberto; Gambaro, Giuseppina; Fiore, Maria Rosaria; Pia, Francesco; Chiesa, Fausto; Orecchia, Roberto; Krengli, Marco

2007-01-01

Purpose: The management of patients with cervical lymph-node metastases from unknown primary site (UPS) remains a matter of discussion. This study aimed to analyze the results and prognostic factors in a series of patients treated with radiotherapy. Methods and Materials: Data from 113 patients who presented with cervical lymph nodes metastases from UPS treated from 1980 to 2004 were reviewed. Eighty-seven patients (77.0%) were squamous cell carcinoma (SCC). Ninety-one patients were treated with curative and 22 with palliative intent. Fifty-nine of 113 patients (52.2%) received surgery followed by radiotherapy and 54 of 113 (47.8%) received radiotherapy alone. Radiotherapy was delivered to the neck and pharyngeal mucosa in 67 patients and to the ipsilateral or bilateral neck in 45 patients. Twenty-one patients (18.5%) also received chemotherapy. Results: The 5-year overall survival rates were 40.7% for the entire group and 46.6% for the SCC subgroup. The occurrence of the occult primary was observed in 23 of 113 patients (20.3%), 19 (82.6%) within the head and neck region. At multivariate analysis, treatment with curative intent and extensive irradiation of bilateral neck and pharyngeal mucosa were favorable prognostic factors for the whole series, and treatment with curative intent, extensive irradiation of bilateral neck and pharyngeal mucosa, and absence of extracapsular spread were favorable prognostic factors for the SCC subgroup. Conclusions: Patients with cervical lymph node metastases from UPS have a similar prognosis to those affected by other head and neck malignancies. Curative treatment strategies including neck dissection and extensive irradiation by three-dimensional conformal radiation therapy resulted in significantly better outcomes

Hybrid imaging for detection of carcinoma of unknown primary: A preliminary comparison trial of whole-body PET/MRI versus PET/CT

International Nuclear Information System (INIS)

Ruhlmann, Verena; Ruhlmann, Marcus; Bellendorf, Alexander; Grueneisen, Johannes; Sawicki, Lino M.; Grafe, Hong; Forsting, Michael; Bockisch, Andreas; Umutlu, Lale

2016-01-01

Highlights: • Both 18F-FDG PET/CT and 18F-FDG PET/MRI provide a comparable diagnostic ability for detection of primary cancer and metastases in CUP-syndrome. • Both imaging methods showed comparably high lesion conspicuity and diagnostic confidence (superior assessment of cervical lesions in PET/MRI). • PET/MRI may serve as a powerful alternative, particularly for therapy monitoring or surveillance considering the long-term cumulative dose. - Abstract: Purpose: The aim of this study is to evaluate and compare the diagnostic potential of integrated whole-body [18F]FDG-PET/MRI to [18F]FDG-PET/CT for detection of a potential primary cancer and metastases in patients suspected for cancer of unknown primary (CUP). Methods: A total of 20 patients (15 male, 5 female, age 53 ± 13 years) suspect for CUP underwent a dedicated head and neck & whole-body [18F]FDG-PET/CT (Biograph mCT 128, Siemens Healthcare) and a subsequent simultaneous [18F]FDG-PET/MRI examination (Biograph mMR, Siemens Healthcare). Two readers rated the datasets (PET/CT; PET/MRI) regarding the detection of the primary cancer and metastases, lesion conspicuity (4-point ordinal scale) and diagnostic confidence (3-point ordinal scale). PET analysis comprised the assessment of maximum standardized uptake values (SUVmax) of all PET-positive lesions using volume of interest (VOI) analysis derived from the PET/CT and PET/MR datasets. All available data considering histology and imaging including prior and clinical follow-up examinations served as reference standard. Statistical analysis included comparison of mean values using Mann-Whitney U test and correlation of SUVmax using Pearson‘s correlation. Results: In 14 out of 20 patients 49 malignant lesions were present. The primary cancer could be correctly identified in 11/20 patients with both PET/CT and PET/MRI. PET/CT enabled the detection of a total 38 metastases, PET/MR respectively of 37 metastases (one lung metastasis <5mm was missed). PET/CT and

Hybrid imaging for detection of carcinoma of unknown primary: A preliminary comparison trial of whole-body PET/MRI versus PET/CT

Energy Technology Data Exchange (ETDEWEB)

Ruhlmann, Verena; Ruhlmann, Marcus; Bellendorf, Alexander [Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122 Essen (Germany); Grueneisen, Johannes [Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122 Essen (Germany); Sawicki, Lino M. [Department of Diagnostic and Interventional Radiology, University of Dusseldorf, Moorenstraße 5, 40225 Dusseldorf (Germany); Grafe, Hong [Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122 Essen (Germany); Forsting, Michael [Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122 Essen (Germany); Bockisch, Andreas [Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122 Essen (Germany); Umutlu, Lale, E-mail: verena.ruhlmann@uk-essen.de [Department of Nuclear Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45122 Essen (Germany)

2016-11-15

Highlights: • Both 18F-FDG PET/CT and 18F-FDG PET/MRI provide a comparable diagnostic ability for detection of primary cancer and metastases in CUP-syndrome. • Both imaging methods showed comparably high lesion conspicuity and diagnostic confidence (superior assessment of cervical lesions in PET/MRI). • PET/MRI may serve as a powerful alternative, particularly for therapy monitoring or surveillance considering the long-term cumulative dose. - Abstract: Purpose: The aim of this study is to evaluate and compare the diagnostic potential of integrated whole-body [18F]FDG-PET/MRI to [18F]FDG-PET/CT for detection of a potential primary cancer and metastases in patients suspected for cancer of unknown primary (CUP). Methods: A total of 20 patients (15 male, 5 female, age 53 ± 13 years) suspect for CUP underwent a dedicated head and neck & whole-body [18F]FDG-PET/CT (Biograph mCT 128, Siemens Healthcare) and a subsequent simultaneous [18F]FDG-PET/MRI examination (Biograph mMR, Siemens Healthcare). Two readers rated the datasets (PET/CT; PET/MRI) regarding the detection of the primary cancer and metastases, lesion conspicuity (4-point ordinal scale) and diagnostic confidence (3-point ordinal scale). PET analysis comprised the assessment of maximum standardized uptake values (SUVmax) of all PET-positive lesions using volume of interest (VOI) analysis derived from the PET/CT and PET/MR datasets. All available data considering histology and imaging including prior and clinical follow-up examinations served as reference standard. Statistical analysis included comparison of mean values using Mann-Whitney U test and correlation of SUVmax using Pearson‘s correlation. Results: In 14 out of 20 patients 49 malignant lesions were present. The primary cancer could be correctly identified in 11/20 patients with both PET/CT and PET/MRI. PET/CT enabled the detection of a total 38 metastases, PET/MR respectively of 37 metastases (one lung metastasis <5mm was missed). PET/CT and

Estimation of unknown nuclear masses by means of the generalized mass relations. Pt. 3

International Nuclear Information System (INIS)

Popa, S.M.

1980-01-01

A survey of the estimations of the unknown nuclear masses by means of the generalized mass relations is presented. One discusses the new hypotheses supplementing the original general Garvey-Kelson scheme, reviewing the generalized mass relations and formulae, according to the present status of this new formalism. A critical discussions is given of the reliability of these new Garvey-Kelson type extrapolation procedures. (author)

The Unknown Component Problem Theory and Applications

CERN Document Server

Villa, Tiziano; Brayton, Robert K; Mishchenko, Alan; Petrenko, Alexandre; Sangiovanni-Vincentelli, Alberto

2012-01-01

The Problem of the Unknown Component: Theory and Applications addresses the issue of designing a component that, combined with a known part of a system, conforms to an overall specification. The authors tackle this problem by solving abstract equations over a language. The most general solutions are studied when both synchronous and parallel composition operators are used. The abstract equations are specialized to languages associated with important classes of automata used for modeling systems. The book is a blend of theory and practice, which includes a description of a software package with applications to sequential synthesis of finite state machines. Specific topologies interconnecting the components, exact and heuristic techniques, and optimization scenarios are studied. Finally the scope is enlarged to domains like testing, supervisory control, game theory and synthesis for special omega languages. The authors present original results of the authors along with an overview of existing ones.

Diagnostic value of [18F]-FDG PET/CT in children with fever of unknown origin or unexplained signs of inflammation

International Nuclear Information System (INIS)

Jasper, Niklas; Daebritz, Jan; Frosch, Michael; Foell, Dirk; Loeffler, Markus; Weckesser, Matthias

2010-01-01

Fever of unknown origin (FUO) and unexplained signs of inflammation are challenging medical problems especially in children and predominantly caused by infections, malignancies or noninfectious inflammatory diseases. The aim of this study was to assess the diagnostic value of 18 F-FDG PET and PET/CT in the diagnostic work-up in paediatric patients. In this retrospective study, 47 FDG PET and 30 PET/CT scans from 69 children (median age 8.1 years, range 0.2-18.1 years, 36 male, 33 female) were analysed. The diagnostic value of PET investigations in paediatric patients presenting with FUO (44 scans) or unexplained signs of inflammation without fever (33 scans) was analysed. A diagnosis in paediatric patients with FUO or unexplained signs of inflammation could be established in 32 patients (54%). Of all scans, 63 (82%) were abnormal, and of the total number of 77 PET and PET/CT scans 35 (45%) were clinically helpful. In patients with a final diagnosis, scans were found to have contributed to the diagnosis in 73%. Laboratory, demographic or clinical parameters of the children did not predict the usefulness of FDG PET scans. This is the first larger study demonstrating that FDG PET and PET/CT may be valuable diagnostic tools for the evaluation of children with FUO and unexplained signs of inflammation. Depicting inflammation in the whole body, while not being traumatic, it is attractive for use especially in children. The combination of PET with CT seems to be superior, since the site of inflammation can be localized more accurately. (orig.)

ORIGINAL ARTICLE Primary School Teachers' Knowledge, Attitude ...

African Journals Online (AJOL)

user

Thus, it was recommended that teachers be given on-job training about CA ... 1Professor, Department of English, Faculty of Humanities, Bahir Dar University,. Ethiopia. .... psychomotor developments and uses variety of instruments ..... Table 3. Primary school teachers' responses about the advantages and disadvantages of.

The energy equation with three unknowns

International Nuclear Information System (INIS)

Schifano, Fabio; Moriconi, Daniele

2008-01-01

This article discusses the alarming situation of energy in Italy as this country depends at 82 per cent on its imports (oil, natural gas and electricity), a dependence which could even increase. The authors first propose overviews of the situation regarding oil, natural gas and electric power (origins of imports, role of Italian companies, status of infrastructures), and also briefly of renewable energies. They recall the history of the use of nuclear energy: Italy has been one of the first country to use nuclear energy to produce electric power, but a referendum organised after Chernobyl resulted in phasing out nuclear. Then, the authors discuss perspectives associated with three main strategic unknowns: an increase of energy dependence with respect to hydrocarbons and to foreign nuclear power, a supply insecurity due to a dependence concentrated on a small number of countries (notably as far as natural gas is concerned), and an increasing interdependence between economic growth and sustainable development (the reduction of greenhouse emissions is a prevailing parameter for future energetic choices)

A meta-analysis of the value of fluorodeoxyglucose-PET/PET-CT in the evaluation of fever of unknown origin

International Nuclear Information System (INIS)

Dong Mengjie; Zhao Kui; Liu Zhenfeng; Wang Guolin; Yang Shuye; Zhou Guojun

2011-01-01

Background and purpose: The diagnosis of patients with fever of unknown origin (FUO) remains a challenging medical problem for internal medicine. A reliable estimate of the diagnostic performance of FDG-PET and FDG-PET/CT in the assessment of FUO unidentified by conventional workup has never been systematically assessed, and present systematic review was aimed at this issue. Methods: A systematic search for relevant studies was performed of the PubMed, Embase, and Cochrane databases. Methodological quality of each study was assessed. Sensitivity, specificity and area under the curve (AUC) were meta-analyzed. Subgroup analyses were performed if results of individual studies were heterogeneous. Results: The inclusion criteria were met by nine studies. Overall, the studies had good methodological quality. Pooled sensitivity and specificity of FDG-PET for the detection of FUO were 0.826 (95% CI; 0.729–0.899) and 0.578 (95% CI; 0.488–0.665), respectively, and the AUC was 0.810. Heterogeneity among the results of FDG PET studies was present (QSE = 12.40, I 2 = 67.7%; QSp = 35.98, I 2 = 88.9%). Pooled sensitivity and specificity of FDG-PET/CT were 0.982 (95% CI; 0.936–0.998) and 0.859 (95% CI; 0.750–0.934), respectively, and the AUC was 0.947. We did not find any statistical differences in the AUC and Q* index between FDG-PET and FDG-PET/CT (Z = 0.566, p > 0.05). Conclusions: Although the FDG-PET studies that we examined were heterogeneous, FDG-PET appears to be a sensitive and promising diagnostic tool for the detection of the causes of FUO. FDG-PET/CT should be considered among the first diagnostic tools for patients with FUO in whom conventional diagnostics have been unsuccessful.

Patterns of care and survival after a cancer of unknown primary (CUP) diagnosis: A population-based nested cohort study in Australian Government Department of Veterans' Affairs clients.

Science.gov (United States)

Schaffer, Andrea L; Pearson, Sallie-Anne; Dobbins, Timothy A; Er, Chuang C; Ward, Robyn L; Vajdic, Claire M

2015-08-01

Little is known about patterns of care after a cancer of unknown primary (CUP) diagnosis. We performed a retrospective cohort study to describe and compare the treatment, health service use and survival of patients with CUP and metastatic cancer of known primary among 143,956 Australian Government Department of Veterans' Affairs clients, 2004-2007. We randomly matched clients with CUP (C809; n=252) with clients with a first diagnosis of metastatic solid cancer of known primary (n=980). We ascertained health services from the month of diagnosis up to 2 months post-diagnosis for consultations, hospitalizations and emergency department visits, and up to 1 year for treatment. We compared cancer treatments using conditional logistic regression; consultation rates using negative binomial regression; and survival using stratified Cox regression. 30% of CUP patients and 70% of patients with known primary received cancer treatment and the median survival was 37 days and 310 days respectively. CUP patients received fewer cancer medicines (odds ratio (OR)=0.54, 95% confidence interval (CI) 0.33-0.89) and less cancer-related surgery (OR=0.25, 95% CI 0.15-0.41); males with CUP received more radiation therapy (OR=2.88, 95% CI 1.69-4.91). CUP patients had more primary care consultations (incidence rate ratio (IRR)=1.25, 95% CI 1.11-1.41), emergency department visits (IRR=1.86, 95% CI 1.50-2.31) and hospitalizations (IRR=1.18, 95% CI 1.03-1.35), and a higher risk of death within 30 days (hazard ratio=3.30, 95% CI 1.69-6.44). Patients with CUP receive less treatment but use more health services, which may reflect underlying patient and disease characteristics. Copyright © 2015 Commonwealth of Australia. Published by Elsevier Ltd.. All rights reserved.

[Primary sclerosing cholangitis associated with Sjögren's syndrome, retroperitoneal fibrosis and chronic pancreatitis. Report of a case].

Science.gov (United States)

Barreda, F; Contardo, C; León, A; Navarrete, J; Figueroa, R; Attanasio, F

1989-01-01

Primary Sclerosing Cholangitis (PSC) is an unusual chronic, cholestatic disease of unknown etiology, more frequently seen in young adults in close relationship with Chronic Ulcerative Colitis. We report the case of a 30 year old woman, coming from the peruvian amazon with PSC associated with Sjögren Syndrome, Chronic Pancreatitis and Retroperitoneal Fibrosis, without colonic involvement. She was treated with external biliary drainage and controlled for 12 months. In this paper, clinical, biochemical, radiological, histological and therapeutic features are reviewed as well as its possible immunologie autoimmune origin.

Histone acetylation regulates the time of replication origin firing.

Science.gov (United States)

Vogelauer, Maria; Rubbi, Liudmilla; Lucas, Isabelle; Brewer, Bonita J; Grunstein, Michael

2002-11-01

The temporal firing of replication origins throughout S phase in yeast depends on unknown determinants within the adjacent chromosomal environment. We demonstrate here that the state of histone acetylation of surrounding chromatin is an important regulator of temporal firing. Deletion of RPD3 histone deacetylase causes earlier origin firing and concurrent binding of the replication factor Cdc45p to origins. In addition, increased acetylation of histones in the vicinity of the late origin ARS1412 by recruitment of the histone acetyltransferase Gcn5p causes ARS1412 alone to fire earlier. These data indicate that histone acetylation is a direct determinant of the timing of origin firing.

"A Marriage on the Rocks": An Unknown Letter by William H. Kilpatrick about His Project Method

Science.gov (United States)

Knoll, Michael

2010-01-01

William H. Kilpatrick is worldwide known as "Mr. Project Method." But the origin of his celebrated paper of 1918 has never been explored. The discovery of a hitherto unknown letter reveals that Kilpatrick was an educational entrepreneur who, without regard for language and tradition, adopted the term "project" and used it in a provocative new way…

Non-alcoholic beverages, unknown influence on cell proliferation – an [i]in vitro[/i] study

Directory of Open Access Journals (Sweden)

Maciej Nowacki

2014-03-01

Full Text Available Introduction and objective. The aim of the presented study was to check differences between ‘Diet’ and ‘non-Diet’ soft drinks on cell proliferation. Materials and methods. Coca Cola and Pepsi Cola of different origin and their dietetic versions were examined at concentrations of 2% and 4%. Fructose and glucose as well as medium alone (control were examined. Results. Cell number was higher in media supplemented with soft drinks, compared to control. Proliferation depended on the soft drink concentration and its origin, but not on sugar and calorific content. Conclusions. An unknown factor is responsible for the increase in proliferation.

Adaptively locating unknown steady states: Formalism and basin of attraction

International Nuclear Information System (INIS)

Wu, Yu; Lin, Wei

2011-01-01

The adaptive technique, which includes both dynamical estimators and coupling gains, has been recently verified to be practical for locating the unknown steady states numerically. This Letter, in the light of the center manifold theory for dynamical systems and the matrix spectrum principle, establishes an analytical formalism of this adaptive technique and reveals a connection between this technique and the original adaptive controller which includes only the dynamical estimator. More interestingly, in study of the well-known Lorenz system, the selections of the estimator parameters and initial values are found to be crucial to the successful application of the adaptive technique. Some Milnor-like basins of attraction with fractal structures are found quantitatively. All the results obtained in the Letter can be further extended to more general dynamical systems of higher dimensions. -- Highlights: → Establishing a new and rigorous formalism for the adaptive stabilization technique. → Showing a close connection between the adaptive technique and the original controller. → Providing feasible algorithms for simultaneous stabilization of multiple steady states. → Finding Milnor-like basins of attraction with fractal structures in adaptive control.

The Etiology of Primary Hyperhidrosis

DEFF Research Database (Denmark)

Hashmonai, Moshe; Cameron, Alan E.P.; Connery, Cliff P.

2017-01-01

of patients with hyperhidrosis has been reported. Conclusions: Despite these accumulated data, the etiology of primary hyperhidrosis remains obscure. Nevertheless, three main lines for future research seem to be delineated: genetics, histological observations, and enzymatic studies.......Purpose: Primary hyperhidrosis is a pathological disorder of unknown etiology, affecting 0.6-5% of the population, and causing severe functional and social handicaps. As the etiology is unknown, it is not possible to treat the root cause. Recently some differences between affected and non......-affected people have been reported. The aim of this review is to summarize these new etiological data. Methods: Search of the literature was performed in the PubMed/Medline Database and pertinent articles were retrieved and reviewed. Additional publications were obtained from the references of these articles...

The added value of 68Ga-DOTA-TATE-PET to contrast-enhanced CT for primary site detection in CUP of neuroendocrine origin.

Science.gov (United States)

Kazmierczak, Philipp M; Rominger, Axel; Wenter, Vera; Spitzweg, Christine; Auernhammer, Christoph; Angele, Martin K; Rist, Carsten; Cyran, Clemens C

2017-04-01

To quantify the additional value of 68 Ga-DOTA-TATE PET/CT in comparison with contrast-enhanced CT alone for primary tumour detection in neuroendocrine cancer of unknown primary (CUP-NET). In total, 38 consecutive patients (27 men, 11 women; mean age 62 years) with histologically proven CUP-NET who underwent a contrast-enhanced 68 Ga-DOTA-TATE PET/CT scan for primary tumour detection and staging between 2010 and 2014 were included in this IRB-approved retrospective study. Two blinded readers independently analysed the contrast-enhanced CT and 68 Ga-DOTA-TATE PET datasets separately and noted from which modality they suspected a primary tumour. Consensus was reached if the results were divergent. Postoperative histopathology (24 patients) and follow-up 68 Ga-DOTA-TATE PET/CT imaging (14 patients) served as the reference standards and statistical measures of diagnostic accuracy were calculated accordingly. The majority of confirmed primary tumours were located in the abdomen (ileum in 19 patients, pancreas in 12, lung in 2, small pelvis in 1). High interobserver agreement was noted regarding the suspected primary tumour site (Cohen's k 0.90, p DOTA-TATE PET demonstrated a significantly higher sensitivity (94 % vs. 63 %, p = 0.005) and a significantly higher accuracy (87 % vs. 68 %, p = 0.003) than contrast-enhanced CT. Ga-DOTA-TATE PET/CT compared with contrast-enhanced CT alone provides an improvement in sensitivity of 50 % and an improvement in accuracy of 30 % in primary tumour detection in CUP-NET. • 68 Ga-DOTA-TATE PET augments the sensitivity of contrast-enhanced CT by 50 % • 68 Ga-DOTA-TATE PET augments the accuracy of contrast-enhanced CT by 30 % • Somatostatin receptor-targeted hybrid imaging optimizes primary tumour detection in CUP-NET.

Axillary node metastatic carcinoma without definitive primary: a case report

Directory of Open Access Journals (Sweden)

Spencer R. Anderson

2016-01-01

Full Text Available Cancer of unknown primary (CUP is the finding of a metastatic cancerous lesion without an established primary source localized within the body. CUP can be of any cancer cell type, however, adenocarcinoma is most often identified by histology. Up to 5% of all malignant diagnoses are classified as CUP. PET is an imaging modality often utilized to distinguish a primary source in the setting of CUP, yet often a primary is never identified. CUP can be further stratified using specific qualifiers as favorable and unfavorable, indicating the potential therapeutic response to treatment regimens. Treatment approach to CUP relies heavily on the cell type identified by histology, the location of the lesion, and the amount of spread within the body. In the typical setting and presentation, per current literature, CUP arises in the 7th decade of life in patients with multiple comorbidities, and often has a poor prognostic value. This case report identifies an atypical presentation of CUP, a 38-year-old Caucasian female with an axillary mobile mass, and no associated systemic symptoms. Biopsy of the node and immunohistochemical staining showed histology consistent with metastatic carcinoma. Mammography, MRI, and PET scan found no evidence of tumor primary or distant metastasis. Further staining confirmed metastatic carcinoma consistent with breast origin, without an established breast primary. As in this case, CUP may present in an atypical manner, warranting a thorough investigation aiming to identify the tumor primary to aid in identification of a proper treatment regimen and approach.

The added value of {sup 68}Ga-DOTA-TATE-PET to contrast-enhanced CT for primary site detection in CUP of neuroendocrine origin

Energy Technology Data Exchange (ETDEWEB)

Kazmierczak, Philipp M. [Klinikum der Universitaet Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany); Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Muenchen (Germany); Rominger, Axel; Wenter, Vera [Ludwig-Maximilians-University Hospital Munich, Department of Nuclear Medicine, Muenchen (Germany); Spitzweg, Christine; Auernhammer, Christoph [Ludwig-Maximilians-University Hospital Munich, Department of Internal Medicine II, Muenchen (Germany); Angele, Martin K. [Ludwig-Maximilians-University Hospital Munich, Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Muenchen (Germany); Rist, Carsten; Cyran, Clemens C. [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Muenchen (Germany)

2017-04-15

To quantify the additional value of {sup 68}Ga-DOTA-TATE PET/CT in comparison with contrast-enhanced CT alone for primary tumour detection in neuroendocrine cancer of unknown primary (CUP-NET). In total, 38 consecutive patients (27 men, 11 women; mean age 62 years) with histologically proven CUP-NET who underwent a contrast-enhanced {sup 68}Ga-DOTA-TATE PET/CT scan for primary tumour detection and staging between 2010 and 2014 were included in this IRB-approved retrospective study. Two blinded readers independently analysed the contrast-enhanced CT and {sup 68}Ga-DOTA-TATE PET datasets separately and noted from which modality they suspected a primary tumour. Consensus was reached if the results were divergent. Postoperative histopathology (24 patients) and follow-up {sup 68}Ga-DOTA-TATE PET/CT imaging (14 patients) served as the reference standards and statistical measures of diagnostic accuracy were calculated accordingly. The majority of confirmed primary tumours were located in the abdomen (ileum in 19 patients, pancreas in 12, lung in 2, small pelvis in 1). High interobserver agreement was noted regarding the suspected primary tumour site (Cohen's k 0.90, p < 0.001). {sup 68}Ga-DOTA-TATE PET demonstrated a significantly higher sensitivity (94 % vs. 63 %, p = 0.005) and a significantly higher accuracy (87 % vs. 68 %, p = 0.003) than contrast-enhanced CT. Ga-DOTA-TATE PET/CT compared with contrast-enhanced CT alone provides an improvement in sensitivity of 50 % and an improvement in accuracy of 30 % in primary tumour detection in CUP-NET. (orig.)

Known knowns, known unknowns and unknown unknowns in prokaryotic transposition.

Science.gov (United States)

Siguier, Patricia; Gourbeyre, Edith; Chandler, Michael

2017-08-01

Although the phenomenon of transposition has been known for over 60 years, its overarching importance in modifying and streamlining genomes took some time to recognize. In spite of a robust understanding of transposition of some TE, there remain a number of important TE groups with potential high genome impact and unknown transposition mechanisms and yet others, only recently identified by bioinformatics, yet to be formally confirmed as mobile. Here, we point to some areas of limited understanding concerning well established important TE groups with DDE Tpases, to address central gaps in our knowledge of characterised Tn with other types of Tpases and finally, to highlight new potentially mobile DNA species. It is not exhaustive. Examples have been chosen to provide encouragement in the continued exploration of the considerable prokaryotic mobilome especially in light of the current threat to public health posed by the spread of multiple Ab R . Copyright © 2017 Elsevier Ltd. All rights reserved.

Quantum circuits cannot control unknown operations

International Nuclear Information System (INIS)

Araújo, Mateus; Feix, Adrien; Costa, Fabio; Brukner, Časlav

2014-01-01

One of the essential building blocks of classical computer programs is the ‘if’ clause, which executes a subroutine depending on the value of a control variable. Similarly, several quantum algorithms rely on applying a unitary operation conditioned on the state of a control system. Here we show that this control cannot be performed by a quantum circuit if the unitary is completely unknown. The task remains impossible even if we allow the control to be done modulo a global phase. However, this no-go theorem does not prevent implementing quantum control of unknown unitaries in practice, as any physical implementation of an unknown unitary provides additional information that makes the control possible. We then argue that one should extend the quantum circuit formalism to capture this possibility in a straightforward way. This is done by allowing unknown unitaries to be applied to subspaces and not only to subsystems. (paper)

Prospective evaluation of fever of unknown origin in patients infected with the human immunodeficiency virus. Grupo Andaluz para el Estudio de las Enfermedades Infecciosas.

Science.gov (United States)

Lozano, F; Torre-Cisneros, J; Bascuñana, A; Polo, J; Viciana, P; García-Ordóñez, M A; Hernández-Quero, J; Márquez, M; Vergara, A; Díez, F; Pujol, E; Torres-Tortosa, M; Pasquau, J; Hernández-Burruezo, J J; Suárez, I

1996-09-01

The aim of this study was to determine the frequency and aetiology of fever of unknown origin (FUO) in patients infected with the human immunodeficiency virus (HIV), to assess the value of the tests used in its diagnosis, and to evaluate possible models of diagnosis for the causes found most frequently. One hundred twenty-eight (3.5%) of 3603 hospitalised HIV-positive patients evaluated from October 1992 to December 1993 had FUO, defined by established criteria. Eighty-six percent of patients with FUO had previously progressed to AIDS. The median CD4+ cell count was 46/mm3. A definite diagnosis was made in 96 (75%) of the 128 patients and a possible diagnosis in 24 (18.7%). whilst no diagnosis was made in eight cases (6.2%). Tuberculosis (48.3%), visceral leishmaniasis (16%), and infection by Mycobacterium avium complex (6.9%) were the diseases found most frequently. The most useful diagnostic tests were liver biopsy (68.9%) and bone marrow aspirate/biopsy (39.7%). It is not possible to predict clinically the cases of FUO due to tuberculosis, whilst thrombocytopaenia < 100,000 cells/mm3 alone is useful for differentiating the cases of visceral leishmaniasis, with a negative predictive value of 95.2%.

Summarizing primary and secondary effects

DEFF Research Database (Denmark)

Karlson, Kristian Bernt

2013-01-01

Current methods for decomposing class differentials in educational decisions into primary and secondary effects produce many parameters, rendering them ill-equipped for parsimonious comparisons across countries or birth cohorts. This paper develops a parametric method that provides an optimal...... summary of primary and secondary effects across discrete class origins. Under the testable assumption that the pattern of effects of class origins on academic ability is proportional to the pattern of effects of class origins on educational choice net of academic ability, the method returns a single...

66 ORIGINAL ARTICLE

African Journals Online (AJOL)

boaz

ORIGINAL ARTICLE. AFRICAN JOURNAL OF CLINICAL AND EXPERIMENTAL MICROBIOLOGY JAN 2016 ISBN 1595-689X VOL 17 No.1 ..... WOMEN. Social characteristics. No. examined (n = 310). No. positive. (n=30) (%). Education. Illiterate. Primary. Secondary. Tertiary. Occupation. Civil servant. House wife. Students.

Functional outcome and survival after radiotherapy of metastatic spinal cord compression in patients with cancer of unknown primary

International Nuclear Information System (INIS)

Rades, Dirk; Fehlauer, Fabian; Veninga, Theo; Stalpers, Lukas J.A.; Basic, Hiba; Hoskin, Peter J.; Rudat, Volker; Karstens, Johann H.; Schild, Steven E.; Dunst, Juergen

2007-01-01

Purpose: Patients with cancer of unknown primary (CUP) account for about 10% of patients with metastatic spinal cord compression (MSCC). This study aims to define the appropriate radiation regimen for these patients. Methods and Materials: Data of 143 CUP patients irradiated for MSCC were retrospectively evaluated. Short-course radiotherapy (RT) (1x8 Gy, 5x4 Gy, n = 68) and long-course RT (10x3 Gy, 15x2.5 Gy, 20x2 Gy, n = 75) plus 8 further potential prognostic factors (age, gender, performance status, visceral metastases, other bone metastases, number of involved vertebrae, ambulatory status, time of developing motor deficits before RT) were compared for functional outcome and survival. Results: Improvement of motor function occurred in 10% of patients, no further progression of motor deficits in 57%, and deterioration in 33%. On multivariate analysis, functional outcome was positively associated with slower development of motor deficits (p < 0.001), absence of visceral metastases (p = 0.008) and other bone metastases (p = 0.027), and ambulatory status (p = 0.054), not with the radiation regimen (p = 0.74). Recurrence of MSCC in the irradiated region occurred in 7 patients after median 6 months. Median survival was 4 months. On multivariate analysis, better survival was significantly associated with absence of visceral metastases (p < 0.001), absence of other bone metastases (p = 0.005), ambulatory status (p = 0.001), and slower development of motor deficits (p = 0.030). Conclusions: For MSCC treatment in patients with CUP, no significant difference was observed between short-course and long-course RT regarding functional outcome and survival. Short-course RT appears preferable, at least for patients with a poor predicted survival, as it is more patient convenient and more cost-effective

Comparative study of methods for recognition of an unknown person's action from a video sequence

Science.gov (United States)

Hori, Takayuki; Ohya, Jun; Kurumisawa, Jun

2009-02-01

This paper proposes a Tensor Decomposition Based method that can recognize an unknown person's action from a video sequence, where the unknown person is not included in the database (tensor) used for the recognition. The tensor consists of persons, actions and time-series image features. For the observed unknown person's action, one of the actions stored in the tensor is assumed. Using the motion signature obtained from the assumption, the unknown person's actions are synthesized. The actions of one of the persons in the tensor are replaced by the synthesized actions. Then, the core tensor for the replaced tensor is computed. This process is repeated for the actions and persons. For each iteration, the difference between the replaced and original core tensors is computed. The assumption that gives the minimal difference is the action recognition result. For the time-series image features to be stored in the tensor and to be extracted from the observed video sequence, the human body silhouette's contour shape based feature is used. To show the validity of our proposed method, our proposed method is experimentally compared with Nearest Neighbor rule and Principal Component analysis based method. Experiments using 33 persons' seven kinds of action show that our proposed method achieves better recognition accuracies for the seven actions than the other methods.

Neurological Autoantibody Prevalence in Epilepsy of Unknown Etiology.

Science.gov (United States)

Dubey, Divyanshu; Alqallaf, Abdulradha; Hays, Ryan; Freeman, Matthew; Chen, Kevin; Ding, Kan; Agostini, Mark; Vernino, Steven

2017-04-01

Autoimmune epilepsy is an underrecognized condition, and its true incidence is unknown. Identifying patients with an underlying autoimmune origin is critical because these patients' condition may remain refractory to conventional antiseizure medications but may respond to immunotherapy. To determine the prevalence of neurological autoantibodies (Abs) among adult patients with epilepsy of unknown etiology. Consecutive patients presenting to neurology services with new-onset epilepsy or established epilepsy of unknown etiology were identified. Serum samples were tested for autoimmune encephalitis Abs as well as thyroperoxidase (TPO) and glutamic acid decarboxylase 65 (GAD65) Abs. An antibody prevalence in epilepsy (APE) score based on clinical characteristics was assigned prospectively. Data were collected from June 1, 2015, to June 1, 2016. Presence of neurological Abs. A score based on clinical characteristics was assigned to estimate the probability of seropositivity prior to antibody test results. Good seizure outcome was estimated on the basis of significant reduction of seizure frequency at the first follow-up or seizure freedom. Of the 127 patients (68 males and 59 females) enrolled in the study, 15 were subsequently excluded after identification of an alternative diagnosis. Serum Abs suggesting a potential autoimmune etiology were detected in 39 (34.8%) cases. More than 1 Ab was detected in 7 patients (6.3%): 3 (2.7%) had TPO-Ab and voltage-gated potassium channel complex (VGKCc) Ab, 2 (1.8%) had GAD65-Ab and VGKCc-Ab, 1 had TPO-Ab and GAD65-Ab, and 1 had anti-Hu Ab and GAD65-Ab. Thirty-two patients (28.6%) had a single Ab marker. Among 112 patients included in the study, 15 (13.4%) had TPO-Ab, 14 (12.5%) had GAD65-Ab, 12 (10.7%) had VGKCc (4 of whom were positive for leucine-rich glioma-inactivated protein 1 [LGI1] Ab), and 4 (3.6%) had N-methyl-D-aspartate receptor (NMDAR) Ab. Even after excluding TPO-Ab and low-titer GAD65-Ab, Abs strongly suggesting an

Accessory papillary muscles and papillary muscle hypertrophy are associated with sudden cardiac arrest of unknown cause.

Science.gov (United States)

Uhm, Jae-Sun; Youn, Jong-Chan; Lee, Hye-Jeong; Park, Junbeom; Park, Jin-Kyu; Shim, Chi Young; Hong, Geu-Ru; Joung, Boyoung; Pak, Hui-Nam; Lee, Moon-Hyoung

2015-10-15

The present study was performed for elucidating the associations between the morphology of the papillary muscles (PMs) and sudden cardiac arrest (SCA). We retrospectively reviewed history, laboratory data, electrocardiography, echocardiography, coronary angiography, and cardiac CT/MRI for 190 patients with SCA. The prevalence of accessory PMs and PM hypertrophy in patients with SCA of unknown cause was compared with that in patients with SCA of known causes and 98 age- and sex-matched patients without SCA. An accessory PM was defined as a PM with origins separated from the anterolateral and posteromedial PMs, or a PM that branched into two or three bellies at the base of the anterolateral or posteromedial PM. PM hypertrophy was defined as at least one of the two PMs having a diameter of ≥1.1cm. In 49 patients (age 49.9±15.9years; 38 men) the cause of SCA was unknown, whereas 141 (age 54.2±16.6years; 121 men) had a known cause. The prevalence of accessory PMs was significantly higher in the unknown-cause group than in the known-cause group (24.5% and 7.8%, respectively; p=0.002) or the no-SCA group (7.1%, p=0.003). The same was true for PM hypertrophy (unknown-cause 12.2%, known-cause 2.1%, p=0.010; no SCA group 1.0%, p=0.006). By logistic regression, accessory PM and PM hypertrophy were independently associated with sudden cardiac arrest of unknown cause. An accessory PM and PM hypertrophy are associated with SCA of unknown cause. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Chinese Unknown Word Recognition for PCFG-LA Parsing

Directory of Open Access Journals (Sweden)

Qiuping Huang

2014-01-01

Full Text Available This paper investigates the recognition of unknown words in Chinese parsing. Two methods are proposed to handle this problem. One is the modification of a character-based model. We model the emission probability of an unknown word using the first and last characters in the word. It aims to reduce the POS tag ambiguities of unknown words to improve the parsing performance. In addition, a novel method, using graph-based semisupervised learning (SSL, is proposed to improve the syntax parsing of unknown words. Its goal is to discover additional lexical knowledge from a large amount of unlabeled data to help the syntax parsing. The method is mainly to propagate lexical emission probabilities to unknown words by building the similarity graphs over the words of labeled and unlabeled data. The derived distributions are incorporated into the parsing process. The proposed methods are effective in dealing with the unknown words to improve the parsing. Empirical results for Penn Chinese Treebank and TCT Treebank revealed its effectiveness.

Characterization of unknown genetic modifications using high throughput sequencing and computational subtraction

Directory of Open Access Journals (Sweden)

Butenko Melinka A

2009-10-01

Full Text Available Abstract Background When generating a genetically modified organism (GMO, the primary goal is to give a target organism one or several novel traits by using biotechnology techniques. A GMO will differ from its parental strain in that its pool of transcripts will be altered. Currently, there are no methods that are reliably able to determine if an organism has been genetically altered if the nature of the modification is unknown. Results We show that the concept of computational subtraction can be used to identify transgenic cDNA sequences from genetically modified plants. Our datasets include 454-type sequences from a transgenic line of Arabidopsis thaliana and published EST datasets from commercially relevant species (rice and papaya. Conclusion We believe that computational subtraction represents a powerful new strategy for determining if an organism has been genetically modified as well as to define the nature of the modification. Fewer assumptions have to be made compared to methods currently in use and this is an advantage particularly when working with unknown GMOs.

Primary NK/T cell lymphoma nasal type of the colon

Directory of Open Access Journals (Sweden)

Ana María Chirife

2013-02-01

Full Text Available Since nasal NK/T-cell lymphoma and NK/T-cell lymphoma nasal type are rare diseases, colonic involvement has seldom been seen. We report a case of a patient with a primary NK/T-cell lymphoma nasal type of the colon. The patient had no history of malignant diseases and was diagnosed after exhaustive study in the context of fever of unknown origin. The first therapeutic approach followed the DAEPOCH-protocol: etoposide, prednisone, doxor-rubicin, vincristine and cyclophosphamide. The persistence of constitutional symptoms after the first treatment course motivated the switch to a second line following the SMILE-protocol: dexamethasone, metotrexate, ifosfamide, E.coli L-asparaginase, and etoposide. Despite intensive chemotherapy, the patient died 2 months after the diagnose of an extranodal NK/T-cell lymphoma of the colon and 4 months after the first symptomatic appearance of disease.

Taming the unknown a history of algebra from antiquity to the early twentieth century

CERN Document Server

Katz, Victor J

2014-01-01

What is algebra? For some, it is an abstract language of x's and y's. For mathematics majors and professional mathematicians, it is a world of axiomatically defined constructs like groups, rings, and fields. Taming the Unknown considers how these two seemingly different types of algebra evolved and how they relate. Victor Katz and Karen Parshall explore the history of algebra, from its roots in the ancient civilizations of Egypt, Mesopotamia, Greece, China, and India, through its development in the medieval Islamic world and medieval and early modern Europe, to its modern form in the early twentieth century. Defining algebra originally as a collection of techniques for determining unknowns, the authors trace the development of these techniques from geometric beginnings in ancient Egypt and Mesopotamia and classical Greece. They show how similar problems were tackled in Alexandrian Greece, in China, and in India, then look at how medieval Islamic scholars shifted to an algorithmic stage, which was further dev...

Ursodeoxycholic acid for primary biliary cirrhosis

DEFF Research Database (Denmark)

Gong, Y.; Huang, Z.B.; Christensen, Erik

2008-01-01

, and the references of identified studies. The last search was performed in January 2007. SELECTION CRITERIA: Randomised clinical trials evaluating UDCA versus placebo or no intervention in patients with primary biliary cirrhosis. DATA COLLECTION AND ANALYSIS: The primary outcomes were mortality and mortality......, trial duration, and patient's severity of primary biliary cirrhosis. We also used Bayesian meta-analytic approach to estimate the UDCA effect as sensitivity analysis. MAIN RESULTS: Sixteen randomised clinical trials evaluating UDCA against placebo or no intervention were identified. Data from three......BACKGROUND: Primary biliary cirrhosis is an uncommon autoimmune liver disease with unknown aetiology. Ursodeoxycholic acid (UDCA) has been used for primary biliary cirrhosis, but the effects remain controversial. OBJECTIVES: To evaluate the benefits and harms of UDCA on patients with primary...

Febrile rhabdomyolysis of unknown origin in refugees coming from West Africa through the Mediterranean.

Science.gov (United States)

Odolini, Silvia; Gobbi, Federico; Zammarchi, Lorenzo; Migliore, Simona; Mencarini, Paola; Vecchia, Marco; di Lauria, Nicoletta; Schivazappa, Simona; Sabatini, Tony; Chianura, Leonardo; Vanino, Elisa; Piacentini, Daniela; Zanotti, Paola; Bussi, Anna; Bartoloni, Alessandro; Bisoffi, Zeno; Castelli, Francesco

2017-09-01

Cases of undiagnosed severe febrile rhabdomyolysis in refugees coming from West Africa, mainly from Nigeria, has been observed since May 2014. The aim of this study was to describe this phenomenon. This was a multicentre retrospective observational study of cases of febrile rhabdomyolysis reported from May 2014 to December 2016 in 12 Italian centres. A total of 48 cases were observed, mainly in young males. The mean time interval between the day of departure from Libya and symptom onset was 26.2 days. An average 8.3 further days elapsed before medical care was sought. All patients were hospitalized with fever and very intense muscle aches. Creatine phosphokinase, aspartate aminotransferase, and lactate dehydrogenase values were abnormal in all cases. The rhabdomyolysis was ascribed to an infective agent in 16 (33.3%) cases. In the remaining cases, the aetiology was undefined. Four out of seven patients tested had sickle cell trait. No alcohol abuse or drug intake was reported, apart from a single reported case of khat ingestion. The long incubation period does not support a mechanical cause of rhabdomyolysis. Furthermore, viral infections such as those caused by coxsackievirus are rarely associated with such a severe clinical presentation. It is hypothesized that other predisposing conditions like genetic factors, unknown infections, or unreported non-conventional remedies may be involved. Targeted surveillance of rhabdomyolysis cases is warranted. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Thin-layer chromatography of polyphosphoinositides from platelet extracts: interference by an unknown phospholipid

International Nuclear Information System (INIS)

Tysnes, O.B.; Aarbakke, G.M.; Verhoeven, A.J.; Holmsen, H.

1985-01-01

Different ratios of radioactive polyphosphoinositides in platelets pulse-labelled with 32p-orthophosphate have been reported by various laboratories. We studied whether these differences originate from differences in methodology. Extracts of 32p-Pi labelled human platelets were prepared at various times after gel-filtration and phosphatidylinositol (PI)-, mono (PIP)- and bisphosphate (PIP2) were separated by thin-layer chromatography using four different solvent systems. The 32p-levels in PIP and PIP2 remained constant during one hour after gel-filtration, whereas 32p-PI increased continuously and more than doubled within the first h. In two of the systems PIP co-chromatographed with a radioactive compound which separated well from PIP in the two other systems. This unknown compound was also labelled with 3H-glycerol, 3H-inositol and 3H-arachidonic acid, but it was metabolically and functionally different from the polyphosphoinositides. Both the co-chromatography of this unknown phospholipid and the increase in 32p-PI in gel-filtered platelets can explain the difference in 32p-labelling in phosphoinositides reported in the literature

ORIGINAL ARTICLES Primary care morbidity in Eastern Cape ...

African Journals Online (AJOL)

Research Department of Primary Care and Population Health, Royal Free and Uni- .... S - Skin. 842. (12.28) 147 (17.78). 563. (15.04). 132. (5.78). A - General unspecified. 823. (12). 108 (13.6). 428. (11.43). 287. (12.56). N - Neurological. 801. (11.68). 90 (10.58) .... absence of longitudinal follow-up data to monitor trends in.

Known Unknowns in Judgment and Choice

OpenAIRE

Walters, Daniel

2017-01-01

This dissertation investigates how people make inferences about missing information. Whereas most prior literature focuses on how people process known information, I show that the extent to which people make inferences about missing information impacts judgments and choices. Specifically, I investigate how (1) awareness of known unknowns affects overconfidence in judgment in Chapter 1, (2) beliefs about the knowability of unknowns impacts investment strategies in Chapter 2, and (3) inferences...

Adaptive neural network output feedback control for stochastic nonlinear systems with unknown dead-zone and unmodeled dynamics.

Science.gov (United States)

Tong, Shaocheng; Wang, Tong; Li, Yongming; Zhang, Huaguang

2014-06-01

This paper discusses the problem of adaptive neural network output feedback control for a class of stochastic nonlinear strict-feedback systems. The concerned systems have certain characteristics, such as unknown nonlinear uncertainties, unknown dead-zones, unmodeled dynamics and without the direct measurements of state variables. In this paper, the neural networks (NNs) are employed to approximate the unknown nonlinear uncertainties, and then by representing the dead-zone as a time-varying system with a bounded disturbance. An NN state observer is designed to estimate the unmeasured states. Based on both backstepping design technique and a stochastic small-gain theorem, a robust adaptive NN output feedback control scheme is developed. It is proved that all the variables involved in the closed-loop system are input-state-practically stable in probability, and also have robustness to the unmodeled dynamics. Meanwhile, the observer errors and the output of the system can be regulated to a small neighborhood of the origin by selecting appropriate design parameters. Simulation examples are also provided to illustrate the effectiveness of the proposed approach.

Primary black holes

International Nuclear Information System (INIS)

Novikov, I.; Polnarev, A.

1981-01-01

Proves are searched for of the formation of the so-called primary black holes at the very origin of the universe. The black holes would weigh less than 10 13 kg. The formation of a primary black hole is conditional on strong fluctuations of the gravitational field corresponding roughly to a half of the fluctuation maximally permissible by the general relativity theory. Only big fluctuations of the gravitational field can overcome the forces of the hot gas pressure and compress the originally expanding matter into a black hole. Low-mass black holes have a temperature exceeding that of the black holes formed from stars. A quantum process of particle formation, the so-called evaporation takes place in the strong gravitational field of a black hole. The lower the mass of the black hole, the shorter the evaporation time. The analyses of processes taking place during the evaporation of low-mass primary black holes show that only a very small proportion of the total mass of the matter in the universe could turn into primary black holes. (M.D.)

Volume-based predictive biomarkers of sequential FDG-PET/CT for sunitinib in cancer of unknown primary: identification of the best benefited patients

International Nuclear Information System (INIS)

Ma, Yifei; Xu, Wei; Xiao, Jianru; Bai, Ruojing; Li, Yiming; Yu, Hongyu; Yang, Chunshan; Shi, Huazheng; Zhang, Jian; Li, Jidong; Wang, Chenguang

2017-01-01

To test the performance of sequential "1"8F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in predicting survival after sunitinib therapies in patients with cancer of unknown primary (CUP). CUP patients were enrolled for sequential PET/CT scanning for sunitinib and a control group. Univariate and multivariate analysis were applied to test the efficacy of sunitinib therapy in CUP patients. Next, sequential analyses involving PET/CT parameters were performed to identify and validate sensitive PET/CT biomarkers for sunitinib therapy. Finally, time-dependent receiver operating characteristic (TDROC) analyses were performed to compare the predictive accuracy. Multivariate analysis proved that sunitinib group had significantly improved survival (p < 0.01) as compared to control group. After cycle 2 of therapy, multivariate analysis identified volume-based PET/CT parameters as sensitive biomarkers for sunitinib (p < 0.01). TDROC curves demonstrated whole-body total lesion glycolysis reduction (Δ WTLG) and follow-up WTLG to have good accuracy for efficacy prediction. This evidence was validated after cycle 4 of therapy with the same method. Sunitinib therapy proved effective in treatment of CUP. PET/CT volume-based parameters may help predict outcome of sunitinib therapy, in which Δ WTLG and follow-up WTLG seem to be sensitive biomarkers for sunitinib efficacy. Patients with greater reduction and lower WTLG at follow-up seem to have better survival outcome. (orig.)

Volume-based predictive biomarkers of sequential FDG-PET/CT for sunitinib in cancer of unknown primary: identification of the best benefited patients

Energy Technology Data Exchange (ETDEWEB)

Ma, Yifei [Second Military Medical University, Department of Orthorpedic Oncology, Changzheng Hospital, Shanghai (China); Second Military Medical University, Department of Pathology, Changzheng Hospital, Shanghai (China); Xu, Wei; Xiao, Jianru [Second Military Medical University, Department of Orthorpedic Oncology, Changzheng Hospital, Shanghai (China); Bai, Ruojing [Geriatrics Institute, Department of Geriatrics, Tianjin Medical University General Hospital, Laboratory of Neuro-Trauma and Neurodegenerative Disorder, Tianjin (China); Li, Yiming [Neurosurgery Institute, Department of Neuro-oncology, Beijing (China); Yu, Hongyu [Second Military Medical University, Department of Pathology, Changzheng Hospital, Shanghai (China); Yang, Chunshan [Panorama Medical Imaging Center, Department of PET/CT Radiology, Shanghai (China); Department of PET/CT Radiology Center, Shanghai (China); Shi, Huazheng; Zhang, Jian [Department of PET/CT Radiology Center, Shanghai (China); Li, Jidong [The First People' s Hospital of Shangqiu, Department of Stomatology, Shangqiu, Henan Province (China); Wang, Chenguang [Second Military Medical University, Department of Radiology, Changzheng Hospital, Shanghai (China)

2017-02-15

To test the performance of sequential {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in predicting survival after sunitinib therapies in patients with cancer of unknown primary (CUP). CUP patients were enrolled for sequential PET/CT scanning for sunitinib and a control group. Univariate and multivariate analysis were applied to test the efficacy of sunitinib therapy in CUP patients. Next, sequential analyses involving PET/CT parameters were performed to identify and validate sensitive PET/CT biomarkers for sunitinib therapy. Finally, time-dependent receiver operating characteristic (TDROC) analyses were performed to compare the predictive accuracy. Multivariate analysis proved that sunitinib group had significantly improved survival (p < 0.01) as compared to control group. After cycle 2 of therapy, multivariate analysis identified volume-based PET/CT parameters as sensitive biomarkers for sunitinib (p < 0.01). TDROC curves demonstrated whole-body total lesion glycolysis reduction (Δ WTLG) and follow-up WTLG to have good accuracy for efficacy prediction. This evidence was validated after cycle 4 of therapy with the same method. Sunitinib therapy proved effective in treatment of CUP. PET/CT volume-based parameters may help predict outcome of sunitinib therapy, in which Δ WTLG and follow-up WTLG seem to be sensitive biomarkers for sunitinib efficacy. Patients with greater reduction and lower WTLG at follow-up seem to have better survival outcome. (orig.)

Adaptive neural control for dual-arm coordination of humanoid robot with unknown nonlinearities in output mechanism.

Science.gov (United States)

Liu, Zhi; Chen, Ci; Zhang, Yun; Chen, C L P

2015-03-01

To achieve an excellent dual-arm coordination of the humanoid robot, it is essential to deal with the nonlinearities existing in the system dynamics. The literatures so far on the humanoid robot control have a common assumption that the problem of output hysteresis could be ignored. However, in the practical applications, the output hysteresis is widely spread; and its existing limits the motion/force performances of the robotic system. In this paper, an adaptive neural control scheme, which takes the unknown output hysteresis and computational efficiency into account, is presented and investigated. In the controller design, the prior knowledge of system dynamics is assumed to be unknown. The motion error is guaranteed to converge to a small neighborhood of the origin by Lyapunov's stability theory. Simultaneously, the internal force is kept bounded and its error can be made arbitrarily small.

Role and interpretation of fluorodeoxyglucose-positron emission tomography/computed tomography in HIV-infected patients with fever of unknown origin: a prospective study.

Science.gov (United States)

Martin, C; Castaigne, C; Tondeur, M; Flamen, P; De Wit, S

2013-09-01

The aim of the study was to evaluate prospectively the usefulness of fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in investigation of fever of unknown origin (FUO) in HIV-positive patients and to determine whether HIV viraemia impacts on FDG-PET/CT performance. The FDG-PET/CT results of 20 HIV-infected patients with FUO were analysed and compared with the FDG-PET/CT results of 10 HIV-infected viraemic patients without FUO. The performance of FDG-PET/CT for identifying the aetiology of FUO was assessed. Final diagnosis for FUO was based on histopathology, microbiological assays, or clinical and imaging follow-up. FDG-PET/CT contributed to the diagnosis or exclusion of a focal aetiology of the febrile state in 80% of patients with FUO. The presence of increased FDG uptake in the central lymph node has 100% specificity for focal aetiology of fever, even in viraemic patients. The absence of hypermetabolic central lymph nodes in FUO patients has 100% negative predictive value for focal disease. Lymph node biopsy in central hypermetabolic areas allowed, in 100% of cases, identification of underlying disease in patients with FUO. Biopsy of peripheral lymph nodes should be performed in lymph nodes with maximum standardized uptake value (SUVmax) ≥ 6-8 (sensitivity 62.5%; specificity 75%) and avoided in lymph nodes with SUVmax = 0-4 (specificity 0%). High HIV viraemia does not prevent correct interpretation of FDG-PET/CT. As in HIV-negative patients, we confirm the usefulness of FDG-PET/CT in investigation of FUO in HIV-positive patients even if they are viraemic. © 2013 British HIV Association.

Prognostic factors for head and neck cancer of unknown primary including the impact of human papilloma virus infection.

Science.gov (United States)

Axelsson, Lars; Nyman, Jan; Haugen-Cange, Hedda; Bove, Mogens; Johansson, Leif; De Lara, Shahin; Kovács, Anikó; Hammerlid, Eva

2017-06-10

Head and neck cancer of unknown primary (HNCUP) is rare and prospective studies are lacking. The impact of different prognostic factors such as age and N stage is not completely known, the optimal treatment is not yet established, and the reported survival rates vary. In the last decade, human papilloma virus (HPV) has been identified as a common cause of and important prognostic factor in oropharyngeal cancer, and there is now growing interest in the importance of HPV for HNCUP. The aim of the present study on curatively treated HNCUP was to investigate the prognostic importance of different factors, including HPV status, treatment, and overall survival. A search for HNCUP was performed in the Swedish Cancer Registry, Western health district, between the years 1992-2009. The medical records were reviewed, and only patients with squamous cell carcinoma or undifferentiated carcinoma treated with curative intent were included. The tumor specimens were retrospectively analyzed for HPV with p16 immunostaining. Sixty-eight patients were included. The mean age was 59 years. The majority were males, and had N2 tumors. Sixty-nine percent of the tumors were HPV positive using p16 staining. Patients who were older than 70 years, patients with N3-stage tumors, and patients with tumors that were p16 negative had a significantly worse prognosis. The overall 5-year survival rate for patients with p16-positive tumors was 88% vs 61% for p16-negative tumors. Treatment with neck dissection and postoperative radiation or (chemo) radiation had 81 and 88% 5-year survival rates, respectively. The overall and disease-free 5-year survival rates for all patients in the study were 82 and 74%. Curatively treated HNCUP had good survival. HPV infection was common. Independent prognostic factors for survival were age over 70 years, HPV status and N3 stage. We recommend that HPV analysis should be performed routinely for HNCUP. Treatment with neck dissection and postoperative radiation or

The origin of Ceratocystis fagacearum, the oak wilt fungus

Science.gov (United States)

Jennifer Juzwik; Thomas C. Harrington; William L. MacDonald; David N. Appel

2008-01-01

The oak wilt pathogen, Ceratocystis fagacearum, may be another example of a damaging, exotic species in forest ecosystems in the United States. Though C. fagacearum has received much research attention, the origin of the fungus is unknown. The pathogen may have been endemic at a low incidence until increased disturbances, changes...

Mobile assistant for unknown caller identification

OpenAIRE

Hribernik, Andraž

2012-01-01

The main motivation of this diploma thesis is a development of Android application, which helps user of application to find out who is the owner of unknown phone number. Data source for finding unknown phone number are free available web sources. Through the development of prototype, data from different web sources were integrated. Result of this integration is shown in Android application. Data integration includes access to semi-structured data on web portal of Phone Directory of Slovenia, ...

Gravity, strings and particles a journey into the unknown

CERN Document Server

Gasperini, Maurizio

2014-01-01

New fundamental forces of Nature? New forms of "dark'' energy? Signals from epochs preceding the Big Bang? Is our space-time unique? Only a joint study of the three topics examined in this book – gravity, strings and particles – may provide answers to these questions. Such a study may also provide the key to solving one of the most fascinating mysteries of modern science, namely: Besides time and the three spatial dimensions, how many other dimensions exist in our universe? The book is primarily addressed to readers who do not necessarily have a specific background in physics but are nevertheless interested in discovering the originality and the possible implications of some of the amazing ideas in modern theoretical physics. The emphasis is on conveying ideas rather than explaining formulas, focusing not on what is known but -- mainly -- on what is still unknown. Many parts of the book are devoted to fundamental theoretical models and results which are potentially highly relevant for a deeper understand...

Metastatic Squamous Neck Cancer with Occult Primary Treatment (PDQ®)—Patient Version

Science.gov (United States)

Metastatic squamous neck cancer with occult primary (unknown primary) treatment options include surgery, radiation therapy, or a combination of both. Learn more about the diagnosis and treatment of these tumors in this expert-reviewed summary.

Direct LSC method for determination of bio-origin by C-14 measurement

International Nuclear Information System (INIS)

Kristof, Romana; Kozar Logar, Jasmina

2017-01-01

The aim of the research was to test the generalized direct liquid scintillation spectrometry (LSC) method for bio-origin determination by measurement of C-14. Examples of diversified items with known and unknown bio-origin were measured by liquid scintillation counting and analyzed by procedures, developed for fuel samples. Bio-origin of fuels, lubricants and monomer resins were successfully determined via direct LSC method after simple sample preparation with acceptable accuracy and trueness despite their diversity in color, viscosity, density or chemical composition. (author)

Tracing the origin of glomerular extracapillary lesions from parietal epithelial cells.

NARCIS (Netherlands)

Smeets, B.; Uhlig, S.; Fuss, A.; Mooren, F.; Wetzels, J.F.M.; Floege, J.; Moeller, M.J.

2009-01-01

Cellular lesions form in Bowman's space in both crescentic glomerulonephritis and collapsing glomerulopathy. The pathomechanism and origin of the proliferating cells in these lesions are unknown. In this study, we examined proliferating cells by lineage tracing of either podocytes or parietal

Depression and dementia of cerebrovascular origin

Directory of Open Access Journals (Sweden)

Marmorato Paulo Germano

2002-01-01

Full Text Available We report the case of a patient who presented various psychiatric syndromes at the time of evaluation - partial complex epileptic seizures, personality change, and severe depression, which eventually progressed to dementia - resulting from multiple cerebral infarctions of probable neuro-angiopathic origin, of unknown etiology. Aspects related to depression following cerebrovascular accidents, as well as how cerebrovascular accidents can result in different disorders depending on the variables, are discussed based on the data from current literature.

Smooth extrapolation of unknown anatomy via statistical shape models

Science.gov (United States)

Grupp, R. B.; Chiang, H.; Otake, Y.; Murphy, R. J.; Gordon, C. R.; Armand, M.; Taylor, R. H.

2015-03-01

Several methods to perform extrapolation of unknown anatomy were evaluated. The primary application is to enhance surgical procedures that may use partial medical images or medical images of incomplete anatomy. Le Fort-based, face-jaw-teeth transplant is one such procedure. From CT data of 36 skulls and 21 mandibles separate Statistical Shape Models of the anatomical surfaces were created. Using the Statistical Shape Models, incomplete surfaces were projected to obtain complete surface estimates. The surface estimates exhibit non-zero error in regions where the true surface is known; it is desirable to keep the true surface and seamlessly merge the estimated unknown surface. Existing extrapolation techniques produce non-smooth transitions from the true surface to the estimated surface, resulting in additional error and a less aesthetically pleasing result. The three extrapolation techniques evaluated were: copying and pasting of the surface estimate (non-smooth baseline), a feathering between the patient surface and surface estimate, and an estimate generated via a Thin Plate Spline trained from displacements between the surface estimate and corresponding vertices of the known patient surface. Feathering and Thin Plate Spline approaches both yielded smooth transitions. However, feathering corrupted known vertex values. Leave-one-out analyses were conducted, with 5% to 50% of known anatomy removed from the left-out patient and estimated via the proposed approaches. The Thin Plate Spline approach yielded smaller errors than the other two approaches, with an average vertex error improvement of 1.46 mm and 1.38 mm for the skull and mandible respectively, over the baseline approach.

Primary Adult Renal Ewing's Sarcoma: A Rare Entity

OpenAIRE

Ravindra Mukkunda; Ramachandran Venkitaraman; Khin Thway; Toon Min; Cyril Fisher; Alan Horwich; Ian Judson

2009-01-01

Background. Ewing's sarcoma of extraskeletal origin is uncommon and that is of primary renal origin in adults are rare. There is no consensus on the optimal management of Ewing's tumors of renal origin. Methods. A retrospective review of the clinical features, treatment, and outcome of adult patients with primary renal extra-skeletal Ewing's sarcoma who were treated at the Royal Marsden hospital from January 1993–December 2007 is reported. Results. Seven adult patien...

Effect of surgery on cardiac structure and function in mild primary hyperparathyroidism

DEFF Research Database (Denmark)

Persson, Anita; Bollerslev, Jens; Rosen, Thord

2011-01-01

The cardiovascular (CV) risk profile is worsened in primary hyperparathyroidism (PHPT), and CV mortality is related to serum calcium levels. It is unknown whether CV mortality is increased in the most common form of PHPT and whether the increased CV risk is reversible after surgery.......The cardiovascular (CV) risk profile is worsened in primary hyperparathyroidism (PHPT), and CV mortality is related to serum calcium levels. It is unknown whether CV mortality is increased in the most common form of PHPT and whether the increased CV risk is reversible after surgery....

MoCha: Molecular Characterization of Unknown Pathways.

Science.gov (United States)

Lobo, Daniel; Hammelman, Jennifer; Levin, Michael

2016-04-01

Automated methods for the reverse-engineering of complex regulatory networks are paving the way for the inference of mechanistic comprehensive models directly from experimental data. These novel methods can infer not only the relations and parameters of the known molecules defined in their input datasets, but also unknown components and pathways identified as necessary by the automated algorithms. Identifying the molecular nature of these unknown components is a crucial step for making testable predictions and experimentally validating the models, yet no specific and efficient tools exist to aid in this process. To this end, we present here MoCha (Molecular Characterization), a tool optimized for the search of unknown proteins and their pathways from a given set of known interacting proteins. MoCha uses the comprehensive dataset of protein-protein interactions provided by the STRING database, which currently includes more than a billion interactions from over 2,000 organisms. MoCha is highly optimized, performing typical searches within seconds. We demonstrate the use of MoCha with the characterization of unknown components from reverse-engineered models from the literature. MoCha is useful for working on network models by hand or as a downstream step of a model inference engine workflow and represents a valuable and efficient tool for the characterization of unknown pathways using known data from thousands of organisms. MoCha and its source code are freely available online under the GPLv3 license.

Fever of unknown origin in the elderly.

Science.gov (United States)

Wakefield, K M; Henderson, S T; Streit, J G

1989-06-01

Fever is a prominent sign of an acute-phase response induced by microbial invasion, tissue injury, immunologic reactions, or inflammatory processes. This generalized host response is produced by a multiplicity of localized or systemic diseases and characterized by acute, subacute, or chronic changes in metabolic, endocrinologic, neurologic, and immunologic functions. The fundamental event is an initiation of the acute-phase response by the production of a mediated molecule called IL-1. This polypeptide is produced primarily from phagocytic cells such as blood monocytes, phagocytic lining cells of the liver and spleen, and other tissue macrophages. IL-1 produces a local reaction but also enters the circulation, acting as a hormone to mediate distant organ system responses to infection, immunologic reaction, and inflammatory processes. Fever is the result when IL-1 initiates the synthesis of prostaglandins, notably prostaglandin E2 in the thermoregulatory center located in the anterior hypothalamus. The thermostatic set point is then raised and mechanisms to conserve heat (vasoconstriction) and to produce heat (shivering) are initiated. The result is a sudden rise in body temperature. The same basic mechanisms are involved in FUO. Many of the biologic and biochemical changes that are seen in FUO are also evidence of an acute-phase response. The elevated erythrocyte sedimentation rate is partly due to increased synthesis of hepatic proteins, including compliment components, ceruloplasmin, fibrinogen, and C-reactive protein. IL-1 acts directly on the bone marrow to increase absolute numbers and immaturity of circulating neutrophils. Anemia is produced by many mechanisms, including the reduction of circulating serum iron. Although fever production in the elderly maybe delayed or of less intensity, it is still a marker of significant disease.(ABSTRACT TRUNCATED AT 400 WORDS)

Primary Intradural Extraosseous Ewing's Sarcoma

OpenAIRE

Kim, Seok Won; Shin, Ho

2009-01-01

Ewing's sarcoma usually arises from skeletal bone, but rarely may have an extraskeletal origin. However, Ewing's sarcoma that originates around the spinal column, especially, the intradural extramedullary type is extremely rare. We report a rare case of primary intraspinal extraskeletal Ewing's sarcoma.

A significant abiotic pathway for the formation of unknown nitrogen in nature

Science.gov (United States)

Jokic, A.; Schulten, H.-R.; Cutler, J. N.; Schnitzer, M.; Huang, P. M.

2004-03-01

The global nitrogen cycle is of prime importance in natural ecosystems. However, the origin and nature of up to one-half of total soil N remains obscure despite all attempts at elucidation. Our data provide, for the first time, unequivocal evidence that the promoting action of Mn (IV) oxide on the Maillard reaction (sugar-amino acid condensation) under ambient conditions results in the abiotic formation of heterocyclic N compounds, which are often referred to as unknown nitrogen, and of amides which are apparently the dominant N moieties in nature. The information presented is of fundamental significance in understanding the role of mineral colloids in abiotic transformations of organic N moieties, the incorporation of N in the organic matrix of fossil fuels, and the global N cycle.

Whole-brain radiotherapy with 20 Gy in 5 fractions for brain metastases in patients with cancer of unknown primary (CUP)

International Nuclear Information System (INIS)

Rades, D.; Bohlen, G.; Dunst, J.; Lohynska, R.; Veninga, T.; Stalpers, L.J.A.; Schild, S.E.

2007-01-01

Background: Whole brain radiotherapy (WBRT) is the most common treatment for brain metastases. Survival of patients with cancer of unknown primary (CUP) presenting with brain metastases is extremely poor. A radiation program with a short overall treatment time (short-course RT) would be preferable to longer programs if it provides similar outcomes. This study compares short-course RT with 20 Gy in 5 fractions (5 x 4 Gy) given over 5 days to longer programs in CUP patients. Patients and Methods: Data regarding 101 CUP patients who received either short course WBRT (n = 34) with 5 x 4 Gy or long-course WBRT (n = 67) with 10 x 3 Gy given over 2 weeks or 20 x 2 Gy given over 4 weeks for brain metastases were analyzed retrospectively. Six additional potential prognostic factors were investigated: age, gender, Karnofsky performance score (KPS), number of brain metastases, extracranial metastases, RPA-(Recursive Partitioning Analysis-)class. Results: On univariate analysis, the radiation program was not associated with survival (p = 0.88) nor intracerebral control (p = 0.36). Improved survival was associated with KPS ≥ 70 (p < 0.001), absence of extracranial metastases (p < 0.001), and RPA-class 1 (p < 0.001). On multivariate analyses, KPS (risk ratio [RR]: 4.55; p < 0.001), extracranial metastases (RR: 1.70; p = 0.018), and RPA-class (RR: 2.86; p < 0.001) maintained significance. On univariate analysis, KPS (p < 0.001) and RPA-class (p < 0.001) were significantly associated with intracerebral control. On multivariate analyses, KPS (RR: 2.72; p < 0.001) and RPA-class (RR: 2.09; p < 0.001) remained significant. Conclusion: Short-course WBRT with 5 x 4 Gy provided similar intracerebral control and survival as longer programs for the treatment of brain metastases in CUP patients. 5 x 4 Gy appears preferable because it is more convenient for patients. (orig.)

The origins and processing of ultra fine anaphase DNA bridges

DEFF Research Database (Denmark)

Liu, Ying; Nielsen, Christian Thomas Friberg; Yao, Qi

2014-01-01

and BLM. UFBs become visible in the anaphase of mitosis, and can persist into telophase in rare cases. There are at least three different types of UFBs that can be distinguished according to the chromosomal loci from which they originate. However, it remains largely unknown how these UFBs are generated...

Function analysis of unknown genes

DEFF Research Database (Denmark)

Rogowska-Wrzesinska, A.

2002-01-01

  This thesis entitled "Function analysis of unknown genes" presents the use of proteome analysis for the characterisation of yeast (Saccharomyces cerevisiae) genes and their products (proteins especially those of unknown function). This study illustrates that proteome analysis can be used...... to describe different aspects of molecular biology of the cell, to study changes that occur in the cell due to overexpression or deletion of a gene and to identify various protein modifications. The biological questions and the results of the described studies show the diversity of the information that can...... genes and proteins. It reports the first global proteome database collecting 36 yeast single gene deletion mutants and selecting over 650 differences between analysed mutants and the wild type strain. The obtained results show that two-dimensional gel electrophoresis and mass spectrometry based proteome...

Disaster and primary health care utilization: a 4 year follow-up.

NARCIS (Netherlands)

Dorn, T.; Yzermans, J.; Kerssens, J.; Veen, P. ten

2005-01-01

Background: Although crucial for the management of the post-disaster phase, the impact of disasters on primary health care utilization is largely unknown. Often, pre-disaster base-line data is lacking. The current study quantified primary health care utilization after a major fire disaster in The

On the microstructural origin of primary creep in nickel-base superalloys

International Nuclear Information System (INIS)

Heilmaier, M.; Reppich, B.

1997-01-01

The nature of primary creep in nickel-base superalloys is strongly correlated to the different hardening species present in the material. In fine-grained single-phase material the classical assumption of a homogeneous dislocation distribution enables the prediction of the transition from normal via sigmoidal to inverse primary creep with decreasing applied stress σ. In coarse-grained material the back stress σ b of hard subgrain boundaries evolving during plastic deformation must be additionally taken into account. Second-phase particles influence creep in a 2-fold manner via reducing the effective stress σ eff , namely directly by the stress σ p * for particle overcoming, and indirectly by increasing the dislocation density ρ. The proposed approach accounts for the observed pronounced normal primary creep in particle-strengthened superalloys. (orig.)

Myxedema coma of both primary and secondary origin, with non-classic presentation and extremely elevated creatine kinase.

Science.gov (United States)

Benvenga, S; Squadrito, S; Saporito, F; Cimino, A; Arrigo, F; Trimarchi, F

2000-09-01

Myxedema coma is a rare, often fatal endocrine emergency that concerns elderly patients with long-standing primary hypothyroidism; myxedema coma of central origin is exceedingly rare. Here, we report a 37-year-old woman in whom classical symptoms of hypothyroidism had been absent. Six years earlier, she had severe obstetric hemorrhage and, shortly after, two subsequent episodes of pericardial effusion. On the day of admission, pericardiocentesis was performed for the third episode of pericardial effusion. Because of the subsequent grave arrhythmias and unconsciousness, she was transferred to our ICU. Prior to the endocrine consultation, a silent myocardial infarction had been suspected, based on the extremely high serum levels of creatine kinase (CK) and isoenzyme CK-MB. However, based on thyroid sonography, pituitary computed tomography, elevated titers of antithyroid antibodies and pituitary stimulation tests, the final diagnosis was myxedema coma of dual origin: an atrophic variant of Hashimoto's thyroiditis and post-necrotic pituitary atrophy (Sheehan syndrome). Substitutive therapy caused a prompt clinical amelioration and normalization of CK levels. Our patient is the first case of myxedema coma of double etiology, and illustrates how its presentation deviates markedly from the one endocrinologists and physicians at ICU are prepared to encounter. In addition, cardiac problems as those of our patient should not discourage from substitutive treatment (using L-thyroxine and the gastrointestinal route of absorption), if the age is relatively low.

Diverticular Disease in the Primary Care Setting.

Science.gov (United States)

Wensaas, Knut-Arne; Hungin, Amrit Pali

2016-10-01

Diverticular disease is a chronic and common condition, and yet the impact of diverticular disease in primary care is largely unknown. The diagnosis of diverticular disease relies on the demonstration of diverticula in the colon, and the necessary investigations are often not available in primary care. The specificity and sensitivity of symptoms, clinical signs and laboratory tests alone are generally low and consequently the diagnostic process will be characterized by uncertainty. Also, the criteria for symptomatic uncomplicated diverticular disease in the absence of macroscopic inflammation are not clearly defined. Therefore both the prevalence of diverticular disease and the incidence of diverticulitis in primary care are unknown. Current recommendations for treatment and follow-up of patients with acute diverticulitis are based on studies where the diagnosis has been verified by computerized tomography. The results cannot be directly transferred to primary care where the diagnosis has to rely on the interpretation of symptoms and signs. Therefore, one must allow for greater diagnostic uncertainty, and safety netting in the event of unexpected development of the condition is an important aspect of the management of diverticulitis in primary care. The highest prevalence of diverticular disease is found among older patients, where multimorbidity and polypharmacy is common. The challenge is to remember the possible contribution of diverticular disease to the patient's overall condition and to foresee its implications in terms of advice and treatment in relation to other diseases.

A prospective multi-centre study of the value of FDG-PET as part of a structured diagnostic protocol in patients with fever of unknown origin

International Nuclear Information System (INIS)

Bleeker-Rovers, Chantal P.; Vos, Fidel J.; Meer, Jos W.M. van der; Mudde, Aart H.; Dofferhoff, Anton S.M.; Geus-Oei, Lioe-Fee de; Rijnders, Anton J.; Krabbe, Paul F.M.; Corstens, Frans H.M.; Oyen, Wim J.G.

2007-01-01

Since 18 F-fluorodeoxyglucose (FDG) accumulates in neoplastic cells and in activated inflammatory cells, positron emission tomography (PET) with FDG could be valuable in diagnosing patients with fever of unknown origin (FUO). The aim of this study was to validate the use of FDG-PET as part of a structured diagnostic protocol in the general patient population with FUO. From December 2003 to July 2005, 70 patients with FUO were recruited from one university hospital (n=38) and five community hospitals (n=32). A structured diagnostic protocol including FDG-PET was used. A dedicated, full-ring PET scanner was used for data acquisition. FDG-PET scans were interpreted by two staff members of the department of nuclear medicine without further clinical information. The final clinical diagnosis was used for comparison with the FDG-PET results. Of all scans, 33% were clinically helpful. The contribution of FDG-PET to the final diagnosis did not differ significantly between patients diagnosed in the university hospital and patients diagnosed in the community hospitals. FDG-PET contributed significantly more often to the final diagnosis in patients with continuous fever than in patients with periodic fever. FDG-PET was not helpful in any of the patients with normal erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). FDG-PET is a valuable imaging technique as part of a diagnostic protocol in the general patient population with FUO and a raised ESR or CRP. (orig.)

The Primary Origin of Dose Rate Effects on Microstructural Evolution of Austenitic Alloys During Neutron Irradiation

International Nuclear Information System (INIS)

Okita, Taira; Sato, Toshihiko; Sekimura, Naoto; Garner, Francis A.; Greenwood, Lawrence R.

2002-01-01

The effect of dose rate on neutron-induced microstructural evolution was experimentally estimated. Solution-annealed austenitic model alloys were irradiated at approximately 400 degrees C with fast neutrons at seven different dose rates that vary more than two orders difference in magnitude, and two different doses were achieved at each dose rate. Both cavity nucleation and growth were found to be enhanced at lower dose rate. The net vacancy flux is calculated from the growth rate of cavities that had already nucleated during the first cycle of irradiation and grown during the second cycle. The net vacancy flux was found to be proportional to (dpa/sec) exp (1/2) up to 28.8 dpa and 8.4 x 10 exp (-7) dpa/sec. This implies that mutual recombination dominates point defect annihilation, in this experiment even though point defect sinks such as cavities and dislocations were well developed. Thus, mutual recombination is thought to be the primary origin of the effect of dose rate on microstructural evolution

Organizational Conditions for Dealing with The Unknown Unknown Illustrated by how a Dutch water management authority is preparing for climate change

NARCIS (Netherlands)

Termeer, Catrien J. A. M.; van den Brink, Margo A.

2013-01-01

The central question of this article is the extent to which organizations, governmental authorities in particular, are able to deal with the unknown unknown. Drawing on Weick's work on sensemaking, we introduce seven organizational conditions that can facilitate organizations to be reliable under

Origin of the matter-antimatter asymmetry

International Nuclear Information System (INIS)

Dine, Michael; Kusenko, Alexander

2004-01-01

Although the origin of matter-antimatter asymmetry remains unknown, continuing advances in theory and improved experimental limits have ruled out some scenarios for baryogenesis, for example, sphaleron baryogenesis at the electroweak phase transition in the Standard Model. At the same time, the success of cosmological inflation and the prospects for discovering supersymmetry at the Large Hadron Collider have put some other models in sharper focus. We review the current state of our understanding of baryogenesis with emphasis on those scenarios that we consider most plausible

Splenectomy as a treatment for adults with relapsed hemophagocytic lymphohistiocytosis of unknown cause.

Science.gov (United States)

Jing-Shi, Wang; Yi-Ni, Wang; Lin, Wu; Zhao, Wang

2015-05-01

Our aim was to evaluate the clinical value of splenectomy as a treatment for relapsed hemophagocytic lymphohistiocytosis (HLH) of unknown cause in adults. We retrospectively reviewed the clinical data from medical records of 19 adults with relapsed HLH of unknown cause treated with splenectomy in our institution from June 2007 to March 2014. To rule out possible underlying diseases, including infection, autoimmune disease, neoplasms, and primary HLH, the patients had undergone examinations including F18 fluoro-2-deoxyglucose positron emission tomography/computed tomography, HLH-associated gene defects, and lymph node biopsies. Twelve patients (63.2%) achieved partial responses (PR), whereas seven patients (36.8%) had no response (NR) prior to splenectomy. Infection and hemorrhage were the main complications of splenectomy. Eighteen cases were evaluable after follow-up. Seven cases with histopathologic diagnoses of lymphoma had received chemotherapy, four of whom had achieved complete responses (CR), one PR, and two NR. Maintenance treatment was ceased 2 or 3 months after splenectomy in the other 11 cases, five of whom had CR, four PR, and two NR. Eleven of 18 cases (61.1%) survived with a median follow-up of 25 months (range 3-79 months) for survivors. Twelve- and 36-month progression-free survival rates were 48 and 24%, respectively; 12- and 36-month overall survival rates were 57 and 25%, respectively. Median survival time was 22 months. Our results indicate splenectomy may be an effective means of diagnosis and treatment of relapsed HLH of unknown cause. Further study is required to establish the mechanism and value of splenectomy in this disease.

Unknown foundation determination for scour.

Science.gov (United States)

2012-04-01

Unknown foundations affect about 9,000 bridges in Texas. For bridges over rivers, this creates a problem : regarding scour decisions as the calculated scour depth cannot be compared to the foundation depth, and a : very conservative costly approach m...

Schwannoma Originating From the Periphereral Intercostal Nerves

Directory of Open Access Journals (Sweden)

Yunus Aksoy

2017-06-01

Full Text Available Schwannomas are usually solitary, encapsulated, and asymptomatic, benign neurogenic tumors originating from the nerve sheath. Schwannomas rarely show malignant transformation, however, require close monitoring. They are primarily located in the thorax in the costovertebral sulcus, may rarely originate from peripheral intercostal nerves. Less than 10% of primary thoracic neurogenic tumors originate from the peripheral intercostal nerves. The main treatment and diagnosis of schwannomas are complete surgical resection. We report a rare case of a 40-year-old male with asymptomatic schwannoma originating from an intercostal nerve which was found incidentally on his chest X-ray and was treated with surgery.

Organizational conditions for dealing with the unknown unknown : illustrated by how a Dutch water management authority is preparing for climate change

NARCIS (Netherlands)

Termeer, C.J.A.M.; Brink, van den M.A.

2013-01-01

The central question of this article is the extent to which organizations, governmental authorities in particular, are able to deal with the unknown unknown. Drawing on Weick’s work on sensemaking, we introduce seven organizational conditions that can facilitate organizations to be reliable under

PROSTATE-SPECIFIC ANTIGEN A Clue for the Prostatic Origin of Metastasis

OpenAIRE

MANABE, Toshiaki; TSUKAYAMA, Chotatsu; YAMAGUCHI, Masae; YAMASHITA, Koshi

1983-01-01

The prostate-specific antigen is a recently purified glycoprotein which is present only in the prostatic gland. In order to confirm the usefulness of this protein in isolating prostatic carcinomas from socalled metastatic carcinomas of unknown primary site, we immunohistochemically studied 19 non-neoplastic prostatic tissue, 18 primary carcinomas of the prostate, and 32 non-prostatic adenocarcinomas. From our study, we concluded that PSA is highly specific for the prostatic carcinomas. The ab...

Reduced TCA flux in diabetic myotubes: A governing influence on the diabetic phenotype?

DEFF Research Database (Denmark)

Gaster, Michael

2009-01-01

The diabetic phenotype is complex, requiring elucidation of key initiating defects. It is unknown whether the reduced tricarboxylic acid cycle (TCA) flux in skeletal muscle of obese and obese type 2 diabetic (T2D) subjects is of primary origin. Acetate oxidation (measurement of TCA-flux) was sign......The diabetic phenotype is complex, requiring elucidation of key initiating defects. It is unknown whether the reduced tricarboxylic acid cycle (TCA) flux in skeletal muscle of obese and obese type 2 diabetic (T2D) subjects is of primary origin. Acetate oxidation (measurement of TCA...

PET and PET/CT in tumour of undetermined origin

International Nuclear Information System (INIS)

Garcia O, J.R.

2007-01-01

In this presentation the following conclusions were obtained regarding the use of PET and PET/CT in patient with cancer of unknown primary: 1. Detection of the primary one in 1/3 at 1/2 of patient. 2. It detects metastases in other places in 50%. 3. It changes the initial therapy planned in 1/3 at 1/2 of patient. 4. Useful in initial phases of protocol study to limit the other procedures. After standard evaluation. Before advanced protocol. 5. PET/CT study increases the % of primary detection, although in a non significant way vs. PET. 6. They are required more studies to value their utility to a more objective manner. (Author)

Evolutionary reversion of editing sites of ndh genes suggests their origin in the Permian-Triassic, before the increase of atmospheric CO2

Directory of Open Access Journals (Sweden)

Mercedes eMartin

2015-07-01

Full Text Available The plastid ndh genes have hovered frequently on the edge of dispensability. They are absent in the plastid DNA of many algae and certain higher plants and present editing sites requiring C-to-U corrections of primary transcripts. The evolutionary origin of editing sites and their loss due to C-to-T reversions at the DNA level are unknown and must be related to the dispensability of the ndh genes in specific environments. In order to better understand the evolution of ndh gene editing sites, we have created expandable data banks with the 12 editing sites of the ndhB gene (600 GenBank sequences and both editing sites of the ndhF gene (1,600 GenBank sequences. Since their origin via T-to-C mutations that probably occurred between 300 and 200 Myr BP (Permian-Triassic, ndh editing sites have undergone independent and random C-to-T reversions in the different angiosperm lineages. Some of these reversions appear early in angiosperm diversification. Old C-to-T reversions can be traced back to radiation steps that gave origin to main classes, orders and some families.

Mobile robot navigation in unknown static environments using ANFIS controller

Directory of Open Access Journals (Sweden)

Anish Pandey

2016-09-01

Full Text Available Navigation and obstacle avoidance are the most important task for any mobile robots. This article presents the Adaptive Neuro-Fuzzy Inference System (ANFIS controller for mobile robot navigation and obstacle avoidance in the unknown static environments. The different sensors such as ultrasonic range finder sensor and sharp infrared range sensor are used to detect the forward obstacles in the environments. The inputs of the ANFIS controller are obstacle distances obtained from the sensors, and the controller output is a robot steering angle. The primary objective of the present work is to use ANFIS controller to guide the mobile robot in the given environments. Computer simulations are conducted through MATLAB software and implemented in real time by using C/C++ language running Arduino microcontroller based mobile robot. Moreover, the successful experimental results on the actual mobile robot demonstrate the effectiveness and efficiency of the proposed controller.

Radio(chemo)therapy in the management of squamous cell carcinoma of cervical lymph nodes from an unknown primary site. A retrospective analysis

Energy Technology Data Exchange (ETDEWEB)

Fakhrian, K.; Thamm, R.; Knapp, S.; Molls, M.; Pigorsch, S.; Geinitz, H. [Technische Univ. Muenchen (Germany). Dept. of Radiation Oncology; Haller, B. [Technische Univ. Muenchen (Germany). Inst. of Medical Statistics and Epidemiology

2012-01-15

The goal was to retrospectively review the outcome of patients with cervical lymph node metastases of squamuos cell carcinoma of unknown primary site (CUP) treated with radio(chemo)therapy. Patients and methods A total of 65 patients with CUP N1-3, M0, treated between 1988 and 2009 were evaluated: 61 patients underwent surgical resection followed by postoperative radio(chemo)therapy, 4 patients received definitive radiochemotherapy. Radiotherapy of bilateral neck nodes + the parapharyngeal region (COMP-RT) was performed in 48 patients (80%) and a unilateral radiotherapy of lymph nodes (UL-RT) in 17 patients (20%). Results After a median follow-up time of 64 months (range 3-219 months), the estimated 2- and 5-year overall survival (OS) rates were 71 {+-} 6% and 48 {+-} 7%, respectively. The recurrent free survival (RFS) rate at 2- and 5-years was 58 {+-} 6% and 48% {+-} 7%, respectively. Extracapsular spread, resection status (R0 vs. R1/R2), neck lymph node level (I-III vs. IV-V), and Karnofsky index (60-70 vs. 80-100) were significant prognostic factors for OS and RFS in the univariate analysis. Lower nodal stage (N1/N2a vs. N2b/N2c/N3) was significantly associated with a better OS. Resection status and involvement of lymph node level IV significantly affected the OS and RFS in the multivariate analysis. COMP-RT or concurrent chemotherapy was not associated with a better OS or RFS. Conclusion An advantage of comprehensive radiotherapy or radiochemotherapy compared with unilateral radiotherapy of lymph nodes was not observed. (orig.)

Origin and fate of organic matter in sandy soils along a primary vegetation succession

NARCIS (Netherlands)

Nierop, K.

1999-01-01

Until now little is known about the role vegetation plays in the organic matter formation, particularly at the molecular level. Most ecosystems have a long history, which is unknown or too complex to find distinct relations between vegetation and the chemical composition of soil organic

The diagnostic utility of Merkel cell polyomavirus immunohistochemistry in a fine needle aspirate of metastatic Merkel cell carcinoma of unknown primary to the pancreas.

Science.gov (United States)

Li, Long; Molberg, Kyle; Cheedella, Naga; Thibodeaux, Joel; Hinson, Stacy; Lucas, Elena

2018-01-01

Merkel cell carcinoma (MCC) is an aggressive skin tumor with a high tendency for metastases. We report a case of MCC initially presenting as axillary and pancreatic metastases. A 33-year-old HIV-positive Hispanic male presented with a history of a rapidly growing axillary mass. A needle core biopsy demonstrated an epithelioid neoplasm composed of small to medium-sized cells with high nuclear-cytoplasmic ratio, nuclear molding, and frequent mitotic figures. A subsequent PET scan revealed a 1.5 cm FDG avid mass in the pancreas. Endoscopic ultrasound-guided FNA of the pancreatic mass showed neoplastic cells with similar morphology to those of the axillary mass. The tumor cells were positive with pancytokeratin AE1/AE3, CK20, CD56, synatophysin, chromogranin, and Merkel cell polyomavirus (MCPyV). This case of MCC most likely originated from a resolved primary skin lesion drained by the involved axillary lymph node with subsequent metastases to the pancreas and distant lymph nodes. © 2017 Wiley Periodicals, Inc.

Origins of eponymous orthopaedic equipment.

Science.gov (United States)

Meals, Clifton; Wang, Jeffrey

2010-06-01

Orthopaedists make great use of eponymous equipment, however the origins of these tools are unknown to many users. This history enriches, enlightens, and enhances surgical education, and may inspire modern innovation. We explored the origins of common and eponymous orthopaedic equipment. We selected pieces of equipment named for their inventors and in the broadest use by modern orthopaedists. We do not describe specialized orthopaedic implants and instruments owing to the overwhelming number of these devices. The history of this equipment reflects the coevolution of orthopaedics and battlefield medicine. Additionally, these stories evidence the primacy of elegant design and suggest that innovation is often a process of revision and refinement rather than sudden inspiration. Their history exposes surgical innovators as brilliant, lucky, hardworking, and sometimes odd. These stories amuse, enlighten, and may inspire modern orthopaedists to develop creative solutions of their own. The rich history of the field's eponymous instruments informs an ongoing tradition of innovation in orthopaedics.

InSourcerer: a high-throughput method to search for unknown metabolite modifications by mass spectrometry.

Science.gov (United States)

Mrzic, Aida; Lermyte, Frederik; Vu, Trung Nghia; Valkenborg, Dirk; Laukens, Kris

2017-09-15

Using mass spectrometry, the analysis of known metabolite structures has become feasible in a systematic high-throughput fashion. Nevertheless, the identification of previously unknown structures remains challenging, partially because many unidentified variants originate from known molecules that underwent unexpected modifications. Here, we present a method for the discovery of unknown metabolite modifications and conjugate metabolite isoforms in a high-throughput fashion. The method is based on user-controlled in-source fragmentation which is used to induce loss of weakly bound modifications. This is followed by the comparison of product ions from in-source fragmentation and collision-induced dissociation (CID). Diagonal MS 2 -MS 3 matching allows the detection of unknown metabolite modifications, as well as substructure similarities. As the method relies heavily on the advantages of in-source fragmentation and its ability to 'magically' elucidate unknown modification, we have named it inSourcerer as a portmanteau of in-source and sorcerer. The method was evaluated using a set of 15 different cytokinin standards. Product ions from in-source fragmentation and CID were compared. Hierarchical clustering revealed that good matches are due to the presence of common substructures. Plant leaf extract, spiked with a mix of all 15 standards, was used to demonstrate the method's ability to detect these standards in a complex mixture, as well as confidently identify compounds already present in the plant material. Here we present a method that incorporates a classic liquid chromatography/mass spectrometry (LC/MS) workflow with fragmentation models and computational algorithms. The assumptions upon which the concept of the method was built were shown to be valid and the method showed that in-source fragmentation can be used to pinpoint structural similarities and indicate the occurrence of a modification. Copyright © 2017 John Wiley & Sons, Ltd.

Primary acalvaria: a case report

International Nuclear Information System (INIS)

Rios, Livia Teresa Moreira; Martins, Marilia da Gloria; Simoes, Vanda Maria Ferreira; Nunes, Marynea do Vale; Marques, Patricia Franco; Godoy, Silvia Helena Cavalcante de Souza

2010-01-01

Acalvaria is a rare congenital malformation of unknown pathogenesis characterized by the absence of the flat bones of the cranial vault, dura mater and associated muscles, while the central nervous system is usually preserved. The most accepted physiopathogenic theory suggests the presence of a post neurulation defect with normal placement the embryonic ectoderm. The present report describes neonatal imaging findings of primary acalvaria. (author)

Primary acalvaria: a case report

Energy Technology Data Exchange (ETDEWEB)

Rios, Livia Teresa Moreira, E-mail: ltlrios@terra.com.b [Universidade Federal do Maranhao (UFMA), Sao Luis, MA (Brazil). Hospital Universitario. Unidade de Diagnostico por Imagem; Martins, Marilia da Gloria [Universidade Federal do Maranhao (UFMA), Sao Luis, MA (Brazil). Hospital Universitario. Servico de Ginecologia e Obstetricia; Simoes, Vanda Maria Ferreira; Nunes, Marynea do Vale; Marques, Patricia Franco; Godoy, Silvia Helena Cavalcante de Souza [Universidade Federal do Maranhao (UFMA), Sao Luis, MA (Brazil). Hospital Universitario. Servico de Neonatologia

2010-07-15

Acalvaria is a rare congenital malformation of unknown pathogenesis characterized by the absence of the flat bones of the cranial vault, dura mater and associated muscles, while the central nervous system is usually preserved. The most accepted physiopathogenic theory suggests the presence of a post neurulation defect with normal placement the embryonic ectoderm. The present report describes neonatal imaging findings of primary acalvaria. (author)

A Prospective Comparison of 18F-FDG PET/CT and CT as Diagnostic Tools to Identify the Primary Tumor Site in Patients with Extracervical Carcinoma of Unknown Primary Site

DEFF Research Database (Denmark)

Moller, Anne Kirstine H; Loft, Annika; Berthelsen, Anne K

2012-01-01

that the same set of criteria were used for classification of patients, that is, either as CUP patients or patients with a suggested primary tumor site. The independently obtained suggestions of primary tumor sites using PET/CT and CT were correlated with the SR to reach a consensus regarding true-positive (TP......), true-negative, false-negative, and false-positive results.Results. SR identified a primary tumor site in 66 CUP patients (48.9%). PET/CT identified 38 TP primary tumor sites and CT identified 43 TP primary tumor sites. No statistically significant differences were observed between (18)F-FDG PET...

Transoral robotic surgery for the management of head and neck squamous cell carcinoma of unknown primary

DEFF Research Database (Denmark)

Channir, Hani Ibrahim; Rubek, Niclas; Nielsen, Hans Ulrik

2015-01-01

Scandinavian study could potentially minimize the radiation field to the pharyngeal axis in patients with identified primary tumours. OBJECTIVES: The aim of the study was to investigate whether bilateral lingual tonsillectomy performed with TORS is feasible, and whether it could improve the detection rates...

Stereotactic body radiotherapy (SBRT) for oligometastatic lung tumors from colorectal cancer and other primary cancers in comparison with primary lung cancer

International Nuclear Information System (INIS)

Takeda, Atsuya; Kunieda, Etsuo; Ohashi, Toshio; Aoki, Yousuke; Koike, Naoyoshi; Takeda, Toshiaki

2011-01-01

Purpose: To analyze local control of oligometastatic lung tumors (OLTs) compared with that of primary lung cancer after stereotactic body radiotherapy (SBRT). Materials and methods: Retrospective record review of patients with OLTs who received SBRT with 50 Gy in 5 fractions. Local control rates (LCRs), toxicities, and factors of prognostic significance were assessed. Results: Twenty-one colorectal OLTs, 23 OLTs from other origins, and 188 primary lung cancers were included. Multivariate analysis revealed only tumor origin was prognostically significant (p < 0.05). The 1-year/2-year LCRs in colorectal OLTs and OLTs from other origins were 80%/72% and 94%/94%, respectively. The LCR in colorectal OLTs was significantly worse than that in OLTs from the other origins and primary lung cancers with pathological and clinical diagnosis (p < 0.05, p < 0.0001 and p < 0.005). Among 44 OLT patients, Grades 2 and 3 radiation pneumonitis were identified in 2 and 1 patients, respectively. No other toxicities of more than Grade 3 occurred. Conclusion: SBRT for OLTs is tolerable. The LCR for OLTs from origins other than colorectal cancer is excellent. However, LCR for colorectal OLTs is worse than that from other origins. Therefore dose escalation should be considered to achieve good local control for colorectal OLTs.

Mechanisms of action of brief alcohol interventions remain largely unknown - a narrative review.

Science.gov (United States)

Gaume, Jacques; McCambridge, Jim; Bertholet, Nicolas; Daeppen, Jean-Bernard

2014-01-01

A growing body of evidence has shown the efficacy of brief intervention (BI) for hazardous and harmful alcohol use in primary health care settings. Evidence for efficacy in other settings and effectiveness when implemented at larger scale are disappointing. Indeed, BI comprises varying content; exploring BI content and mechanisms of action may be a promising way to enhance efficacy and effectiveness. Medline and PsychInfo, as well as references of retrieved publications were searched for original research or review on active ingredients (components or mechanisms) of face-to-face BIs [and its subtypes, including brief advice and brief motivational interviewing (BMI)] for alcohol. Overall, BI active ingredients have been scarcely investigated, almost only within BMI, and mostly among patients in the emergency room, young adults, and US college students. This body of research has shown that personalized feedback may be an effective component; specific MI techniques showed mixed findings; decisional balance findings tended to suggest a potential detrimental effect; while change plan exercises, advice to reduce or stop drinking, presenting alternative change options, and moderation strategies are promising but need further study. Client change talk is a potential mediator of BMI effects; change in norm perceptions and enhanced discrepancy between current behavior and broader life goals and values have received preliminary support; readiness to change was only partially supported as a mediator; while enhanced awareness of drinking, perceived risks/benefits of alcohol use, alcohol treatment seeking, and self-efficacy were seldom studied and have as yet found no significant support as such. Research is obviously limited and has provided no clear and consistent evidence on the mechanisms of alcohol BI. How BI achieves the effects seen in randomized trials remains mostly unknown and should be investigated to inform the development of more effective interventions.

Contrast-enhanced [18F] fluorodeoxyglucose-positron emission tomography-computed tomography as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin

International Nuclear Information System (INIS)

Jain, Avani; Srivastava, Madhur Kumar; Pawaskar, Alok Suresh; Shelley, Simon; Elangovan, Indirani; Jain, Hasmukh; Pandey, Somnath; Kalal, Shilpa; Amalachandran, Jaykanth

2005-01-01

To evaluate the advantages of contrast enhanced F-18-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-contrast enhanced CT [CECT]) when used as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin (MUO). A total of 243 patients with fine needle aspiration cytology/biopsy proven MUO were included in this prospective study. Patients who were thoroughly evaluated for primary or primary tumor was detected by any other investigation were excluded from the analysis. Totally, 163 patients with pathological diagnosis of malignancy but no apparent sites of the primary tumor were finally selected for analysis. The site of probable primary malignancy suggested by PET-CECT was confirmed by biopsy/follow-up. PET-CECT suggested probable site of primary in 128/163 (78.52%) patients. In 30/35 remaining patients, primary tumor was not detected even after extensive work-up. In 5 patients, where PET-CECT was negative, primary was found on further extensive investigations or follow-up. The sensitivity, specificity, positive predictive value and negative predictive value of the study were 95.76%, 66.67%, 88.28% and 85.71% respectively. F-18 FDG PET-CECT aptly serves the purpose of initial imaging modality owing to high sensitivity, negative and positive predictive value. PET-CECT not only surveys the whole body for the primary malignancy but also stages the disease accurately. Use of contrast improves the diagnostic utility of modality as well as help in staging of the primary tumor. Although benefits of using PET-CECT as initial diagnostic modality are obvious from this study, there is a need for a larger study comparing conventional methods for diagnosing primary in patients with MUO versus PET-CECT

Contrast-enhanced [18F] fluorodeoxyglucose-positron emission tomography-computed tomography as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin.

Science.gov (United States)

Jain, Avani; Srivastava, Madhur Kumar; Pawaskar, Alok Suresh; Shelley, Simon; Elangovan, Indirani; Jain, Hasmukh; Pandey, Somnath; Kalal, Shilpa; Amalachandran, Jaykanth

2015-01-01

To evaluate the advantages of contrast enhanced F-18-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-contrast enhanced CT [CECT]) when used as an initial imaging modality in patients presenting with metastatic malignancy of undefined primary origin (MUO). A total of 243 patients with fine needle aspiration cytology/biopsy proven MUO were included in this prospective study. Patients who were thoroughly evaluated for primary or primary tumor was detected by any other investigation were excluded from the analysis. Totally, 163 patients with pathological diagnosis of malignancy but no apparent sites of the primary tumor were finally selected for analysis. The site of probable primary malignancy suggested by PET-CECT was confirmed by biopsy/follow-up. PET-CECT suggested probable site of primary in 128/163 (78.52%) patients. In 30/35 remaining patients, primary tumor was not detected even after extensive work-up. In 5 patients, where PET-CECT was negative, primary was found on further extensive investigations or follow-up. The sensitivity, specificity, positive predictive value and negative predictive value of the study were 95.76%, 66.67%, 88.28% and 85.71% respectively. F-18 FDG PET-CECT aptly serves the purpose of initial imaging modality owing to high sensitivity, negative and positive predictive value. PET-CECT not only surveys the whole body for the primary malignancy but also stages the disease accurately. Use of contrast improves the diagnostic utility of modality as well as help in staging of the primary tumor. Although benefits of using PET-CECT as initial diagnostic modality are obvious from this study, there is a need for a larger study comparing conventional methods for diagnosing primary in patients with MUO versus PET-CECT.

Radio(chemo)therapy in the management of squamous cell carcinoma of cervical lymph nodes from an unknown primary site. A retrospective analysis

International Nuclear Information System (INIS)

Fakhrian, K.; Thamm, R.; Knapp, S.; Molls, M.; Pigorsch, S.; Geinitz, H.; Haller, B.

2012-01-01

The goal was to retrospectively review the outcome of patients with cervical lymph node metastases of squamuos cell carcinoma of unknown primary site (CUP) treated with radio(chemo)therapy. Patients and methods A total of 65 patients with CUP N1-3, M0, treated between 1988 and 2009 were evaluated: 61 patients underwent surgical resection followed by postoperative radio(chemo)therapy, 4 patients received definitive radiochemotherapy. Radiotherapy of bilateral neck nodes + the parapharyngeal region (COMP-RT) was performed in 48 patients (80%) and a unilateral radiotherapy of lymph nodes (UL-RT) in 17 patients (20%). Results After a median follow-up time of 64 months (range 3-219 months), the estimated 2- and 5-year overall survival (OS) rates were 71 ± 6% and 48 ± 7%, respectively. The recurrent free survival (RFS) rate at 2- and 5-years was 58 ± 6% and 48% ± 7%, respectively. Extracapsular spread, resection status (R0 vs. R1/R2), neck lymph node level (I-III vs. IV-V), and Karnofsky index (60-70 vs. 80-100) were significant prognostic factors for OS and RFS in the univariate analysis. Lower nodal stage (N1/N2a vs. N2b/N2c/N3) was significantly associated with a better OS. Resection status and involvement of lymph node level IV significantly affected the OS and RFS in the multivariate analysis. COMP-RT or concurrent chemotherapy was not associated with a better OS or RFS. Conclusion An advantage of comprehensive radiotherapy or radiochemotherapy compared with unilateral radiotherapy of lymph nodes was not observed. (orig.)

The occult head and neck primary: to treat or not to treat?

International Nuclear Information System (INIS)

Sinnathamby, K.; Peters, L.J.; Laidlaw, C.; Hughes, P.G.

1997-01-01

In patients with cervical node metastases from an unknown primary malignancy, there is unresolved controversy regarding the utility of elective irradiation of putative pharyngeal primary sites as part of the management plan. We analysed the experience of the Peter MacCallum Cancer Institute to assess the risk of withholding mucosal irradiation in relation to the diagnostic algorithm used to exclude a primary lesion at the time of initial presentation. (author)

Classification of Unknown Thermocouple Types Using Similarity Factor Measurement

Directory of Open Access Journals (Sweden)

Seshu K. DAMARLA

2011-01-01

Full Text Available In contrast to classification using PCA method, a new methodology is proposed for type identification of unknown thermocouple. The new methodology is based on calculating the degree of similarity between two multivariate datasets using two types of similarity factors. One similarity factor is based on principle component analysis and the angles between the principle component subspaces while the other is based on the Mahalanobis distance between the datasets. Datasets containing thermo-emfs against given temperature ranges are formed for each type of thermocouple (e.g. J, K, S, T, R, E, B and N type by experimentation are considered as reference datasets. Datasets corresponding to unknown type are captured. Similarity factor between the datasets one of which being the unknown type and the other being each known type are compared. When maximum similarity factor occurs, then the class of unknown type is allocated to that of known type.

Switched-Observer-Based Adaptive Neural Control of MIMO Switched Nonlinear Systems With Unknown Control Gains.

Science.gov (United States)

Long, Lijun; Zhao, Jun

2017-07-01

In this paper, the problem of adaptive neural output-feedback control is addressed for a class of multi-input multioutput (MIMO) switched uncertain nonlinear systems with unknown control gains. Neural networks (NNs) are used to approximate unknown nonlinear functions. In order to avoid the conservativeness caused by adoption of a common observer for all subsystems, an MIMO NN switched observer is designed to estimate unmeasurable states. A new switched observer-based adaptive neural control technique for the problem studied is then provided by exploiting the classical average dwell time (ADT) method and the backstepping method and the Nussbaum gain technique. It effectively handles the obstacle about the coexistence of multiple Nussbaum-type function terms, and improves the classical ADT method, since the exponential decline property of Lyapunov functions for individual subsystems is no longer satisfied. It is shown that the technique proposed is able to guarantee semiglobal uniformly ultimately boundedness of all the signals in the closed-loop system under a class of switching signals with ADT, and the tracking errors converge to a small neighborhood of the origin. The effectiveness of the approach proposed is illustrated by its application to a two inverted pendulum system.

An approach to the selection of recommended cooling intervals for the activation analysis of unknown samples with Ge(Li) gamma-ray spectrometry

International Nuclear Information System (INIS)

Hirose, Akio; Ishii, Daido

1975-01-01

Estimation of the optimum cooling interval by the mathematic or graphic method for Ge(Li) γ-ray spectrometry performed in the presence of some Compton interferences, and the recommended cooling intervals available for activation analysis of unknown samples have been proposed, and applied to the non-destructive activation analysis of gold in pure copper. In the presence of Compton interferences, two kinds of optimum cooling intervals were discussed. One maximizes the S/N ratio of a desired photo-peak. This interval had been originated by Isenhour, et al. Using the computer technique, this work is abbreviated as tsub( s/ n). The other, which minimizes the relative standard deviation (delta s/S) of a net photo-peak counting rate of interest (S) was originated by Tomov, et al. and Quittner, et al., this work is abbreviated as tsub(opt) or t'sub(opt). All equations derived by the above authors, however, have the practical disadvantage of including a term relating to the intensity of the desired photo-peak, thus making it difficult to predict the optimum cooling interval before irradiation. Since in chemical analysis, the concentration of the desired element, or the intensity of the photo-peak of interest, should be considered as ''unknown''. In the present work, an approach to the selection of recommended cooling interval applicable to the unknown sample has been discussed, and the interval, tsub(opt), which minimizes the lower limit of detection of a desired element under given irradiation and counting conditions has been proposed. (Evans, J.)

Molecular diagnosis of Fragile X syndrome in subjects with intellectual disability of unknown origin: implications of its prevalence in regional Pakistan.

Directory of Open Access Journals (Sweden)

Madiha Kanwal

Full Text Available Fragile-X syndrome (FXS is the most common form of inherited intellectual disability (ID and affects 0.7-3.0% of intellectually compromised population of unknown etiology worldwide. It is mostly caused by repeat expansion mutations in the FMR1 at chromosome Xq27.3. The present study aimed to develop molecular diagnostic tools for a better detection of FXS, to assess implementation of diagnostic protocols in a developing country and to estimate the prevalence of FXS in a cohort of intellectually disabled subjects from Pakistan. From a large pool of individuals with below normal IQ range, 395 subjects with intellectual disability of unknown etiology belonging to different regions of the country were recruited. Conventional-PCR, modified-PCR and Southern blot analysis methods were employed for the detection of CGG repeat polymorphisms in the FMR1 gene. Initial screening with conventional-PCR identified 13 suspected patients. Subsequent investigations through modified PCR and Southern blot analyses confirmed the presence of the FMR1 mutation, suggesting a prevalence of 3.5% and 2.8% (mean 3.3% among the male and female ID patients, respectively. These diagnostic methods were further customized with the in-house conditions to offer robust screening of referral patients/families for diagnostics and genetic counseling. Prescreening and early diagnosis are crucial for designing a prudent strategy for the management of subjects with ID. Outcome of the study recommends health practitioners for implementation of molecular based FXS diagnosis in routine clinical practice to give a better care for patients similar to the ones included in the study.

Systemic amyloidosis due to unknown multiple myeloma in small bowel pseudo-obstruction: case report

Directory of Open Access Journals (Sweden)

Giuseppe Caparrotti

2016-03-01

Full Text Available Amyloidosis is a pathologic diagnosis characterized by extracellular deposition of insoluble protein fibrils in various organs and tissues. There are two main forms of amyloidosis, primary amyloidosis, and secondary amyloidosis. Gastrointestinal involvement is common in both amyloidosis forms. We describe the case of a 78-year-old woman taken to the operating room for small bowel obstruction, found to have pseudo-obstruction and enteritis. Exploratory laparotomy revealed gastric mass and histological examen showed extensive amyloid deposition consistent with amyloidosis. Hematological evaluation revealed unknown multiple myeloma. This case report and literature data suggest to perform a hematological examination in patients with amyloidosis diagnosis to exclude a multiple myeloma or other plasma cell disorders

Primary ventral or groin hernia in pregnancy

DEFF Research Database (Denmark)

Oma, E; Bay-Nielsen, M; Jensen, K K

2017-01-01

BACKGROUND: Prevalence, management, and risk of emergency operation for primary ventral or groin hernia in pregnancy are unknown. The objective of this study was to estimate the prevalences of primary ventral or groin hernia in pregnancy and the potential risks for elective and emergency repair...... was conducted to identify patients registered with a primary ventral or groin hernia in pregnancy. Follow-up was conducted by review of medical record notes within the Capital Region of Denmark supplemented with structured telephone interviews on indication. RESULTS: In total, 20,714 pregnant women were...... included in the study cohort. Seventeen (0.08%) and 25 (0.12%) women were registered with a primary ventral and groin hernia, respectively. None underwent elective or emergency repair in pregnancy, and all had uncomplicated childbirth. In 10 women, the groin bulge disappeared spontaneously after delivery...

Protocol for counterfactually transporting an unknown qubit

Directory of Open Access Journals (Sweden)

Hatim eSalih

2016-01-01

Full Text Available Quantum teleportation circumvents the uncertainty principle using dual channels: a quantum one consisting of previously-shared entanglement, and a classical one, together allowing the disembodied transport of an unknown quantum state over distance. It has recently been shown that a classical bit can be counterfactually communicated between two parties in empty space, Alice and Bob. Here, by using our dual version of the chained quantum Zeno effect to achieve a counterfactual CNOT gate, we propose a protocol for transporting an unknown qubit counterfactually, that is without any physical particles travelling between Alice and Bob—no classical channel and no previously-shared entanglement.

Graves' disease presenting as pyrexia of unknown origin.

OpenAIRE

Shaked, Y.; Samra, Y.; Zwas, S. T.

1988-01-01

Fever is a common clinical manifestation of inflammatory processes of the thyroid and thyroid crisis. On the other hand, fever alone as a presenting symptom of thyrotoxicosis, without other manifestations, is extremely rare. A female patient is described in whom fever persisted for two months prior to hospitalization, but without clinical symptoms or signs to lead to suspicion of thyroid disease. After exhaustive investigation it was found that the patient was suffering from hyperthyroidism. ...

CGRP in human models of primary headaches

DEFF Research Database (Denmark)

Ashina, Håkan; Schytz, Henrik Winther; Ashina, Messoud

2018-01-01

experiments are likely due to assay variation; therefore, proper validation and standardization of an assay is needed. To what extent CGRP is involved in tension-type headache and cluster headache is unknown. CONCLUSION: Human models of primary headaches have elucidated the role of CGRP in headache...... pathophysiology and sparked great interest in developing new treatment strategies using CGRP antagonists and antibodies. Future studies applying more refined human experimental models should identify biomarkers of CGRP-induced primary headache and reveal whether CGRP provocation experiments could be used......OBJECTIVE: To review the role of CGRP in human models of primary headaches and to discuss methodological aspects and future directions. DISCUSSION: Provocation experiments demonstrated a heterogeneous CGRP migraine response in migraine patients. Conflicting CGRP plasma results in the provocation...

Multimodality management of primary diaphragmatic synovial sarcoma: First report

Directory of Open Access Journals (Sweden)

Preyas J Vaidya

2016-01-01

Full Text Available Synovial cell sarcoma is an extremely rare tumor of mesenchymal origin. It commonly affects the soft tissues of the extremities but could possibly origin from the head and neck, heart, lung, pleura, mediastinum, esophagus, abdominal wall and the mesentery, and retroperitoneum. Primary synovial sarcoma of pleura, mediastinum, and lung have been reported. Primary synovial sarcoma of the diaphragm has not been reported to the best of our knowledge. We report a case of primary synovial cell sarcoma of the diaphragm presenting as a recurrent pleural effusion and pain in the left hypochondrium managed with multimodality approach.

Origin of the low-level EMG during the silent period following transcranial magnetic stimulation

DEFF Research Database (Denmark)

Butler, Jane E; Petersen, Nicolas C; Herbert, Robert D

2012-01-01

OBJECTIVE: The cortical silent period refers to a period of near silence in the electromyogram (EMG) after transcranial magnetic stimulation (TMS) of the motor cortex during contraction. However, low-level EMG of unknown origin is often present. We hypothesised that it arises through spinal...

Embryonic origin of the Arabidopsis primary root and root meristem initials

NARCIS (Netherlands)

Scheres, B.J.G.; Wolkenfelt, H.; Willemsen, V.; Terlouw, M.; Lawson, E.; Dean, C.; Weisbeek, P.

1994-01-01

The embryonic origin of the Arabidopsis root and hypocotyl region has been investigated using histological techniques and clonal analysis. Our data reveal the pattern of cell division in the embryo giving rise to the various initials within the root promeristem. A small region of the root at its

JAK2V617F mutation in a patient with B-cell chronic lymphocytic leukemia and prefibrotic primary myelofibrosis

Directory of Open Access Journals (Sweden)

Ristić Slobodan

2015-01-01

Full Text Available Introduction. Secondary malignancies, particularly solid tumors, are common in patients with chronic lymphocytic leukemia (CLL, but association of myeloproliferative neoplasms and chronic lymphocytic leukemia in the same patient is very rare. Case Outline. We report of a 67-year-old man with B-cell chronic lymphoid leukemia (B-CLL who developed primary myelofibrosis (PMF nine years after initial diagnosis. Patient received alkylation agents and purine analogue, which can be a predisposing factor for the development of myeloproliferative neoplasms. JAK2V617F mutation was not present initially at the time of CLL diagnosis, but was found after nine years when PMF occurred, which indicates that B-CLL and PMF represent two separate clonal origin neoplasms. Conclusion. Pathogenic mechanisms for the development of myeloproliferative and lymphoproliferative neoplasms in the same patient are unknown. Further research is needed to determine whether these malignancies originate from two different cell clones or arise from the same pluripotent hematopoietic stem cell. [Projekat Ministarstva nauke Republike Srbije, br. III 41004

Mechanisms of action of brief alcohol interventions remain largely unknown – A narrative review

Directory of Open Access Journals (Sweden)

Jacques eGaume

2014-08-01

Full Text Available A growing body of evidence has shown efficacy of brief intervention (BI for hazardous and harmful alcohol use in primary health care settings. Evidence for efficacy in other settings, and effectiveness when implemented at larger scale is disappointing. Indeed, BI comprises varying content, and exploring BI content and mechanisms of action may be a promising way to enhance efficacy and effectiveness.We searched Medline and PsychInfo, as well as references of retrieved publications for original research or reviews on active ingredients (or components, or mechanisms of face-to-face BIs (and its subtypes, including brief advice and brief motivational interviewing [BMI] for alcohol. Overall, BI active ingredients have been scarcely investigated, almost only within BMI, and mostly among Emergency Room patients, young adults, and US college students. This body of research has shown that personalized feedback may be an effective component; specific MI techniques showed mixed findings; decisional balance findings tended to suggest a potential detrimental effect; while change plan exercises, advice to reduce or stop drinking, presenting alternative change options, and moderation strategies are promising but need further study. Client change talk is a potential mediator of BMI effects; change in norm perceptions and enhanced discrepancy between current behavior and broader life goals and values have received preliminary support; readiness to change was only partially supported as a mediator; while enhanced awareness of drinking, perceived risks/benefits of alcohol use, alcohol treatment seeking, and self-efficacy were seldom studied and have as yet found no significant support as such.Research is obviously limited and has provided no clear and consistent evidence on the mechanisms of alcohol BI. How BI achieves the effects seen in randomized trials remains mostly unknown and should be investigated to inform the development of more effective interventions.

DNA replication origins-where do we begin?

Science.gov (United States)

Prioleau, Marie-Noëlle; MacAlpine, David M

2016-08-01

For more than three decades, investigators have sought to identify the precise locations where DNA replication initiates in mammalian genomes. The development of molecular and biochemical approaches to identify start sites of DNA replication (origins) based on the presence of defining and characteristic replication intermediates at specific loci led to the identification of only a handful of mammalian replication origins. The limited number of identified origins prevented a comprehensive and exhaustive search for conserved genomic features that were capable of specifying origins of DNA replication. More recently, the adaptation of origin-mapping assays to genome-wide approaches has led to the identification of tens of thousands of replication origins throughout mammalian genomes, providing an unprecedented opportunity to identify both genetic and epigenetic features that define and regulate their distribution and utilization. Here we summarize recent advances in our understanding of how primary sequence, chromatin environment, and nuclear architecture contribute to the dynamic selection and activation of replication origins across diverse cell types and developmental stages. © 2016 Prioleau and MacAlpine; Published by Cold Spring Harbor Laboratory Press.

Preparation of esters of gallic acid with higher primary alcohols

NARCIS (Netherlands)

Kerk, G.J.M. van der; Verbeek, J.H.; Cleton, J.C.F.

1951-01-01

The esters of gallic acid and higher primary alcohols, especially fatty alcohols, have recently gained considerable interest as possible antioxidants for fats. Two independent methods for the preparation of these esters are described. In the first method the hitherto unknown compound galloyl

Surface ocean metabarcoding confirms limited diversity in planktonic foraminifera but reveals unknown hyper-abundant lineages.

Science.gov (United States)

Morard, Raphaël; Garet-Delmas, Marie-José; Mahé, Frédéric; Romac, Sarah; Poulain, Julie; Kucera, Michal; de Vargas, Colomban

2018-02-07

Since the advent of DNA metabarcoding surveys, the planktonic realm is considered a treasure trove of diversity, inhabited by a small number of abundant taxa, and a hugely diverse and taxonomically uncharacterized consortium of rare species. Here we assess if the apparent underestimation of plankton diversity applies universally. We target planktonic foraminifera, a group of protists whose known morphological diversity is limited, taxonomically resolved and linked to ribosomal DNA barcodes. We generated a pyrosequencing dataset of ~100,000 partial 18S rRNA foraminiferal sequences from 32 size fractioned photic-zone plankton samples collected at 8 stations in the Indian and Atlantic Oceans during the Tara Oceans expedition (2009-2012). We identified 69 genetic types belonging to 41 morphotaxa in our metabarcoding dataset. The diversity saturated at local and regional scale as well as in the three size fractions and the two depths sampled indicating that the diversity of foraminifera is modest and finite. The large majority of the newly discovered lineages occur in the small size fraction, neglected by classical taxonomy. These unknown lineages dominate the bulk [>0.8 µm] size fraction, implying that a considerable part of the planktonic foraminifera community biomass has its origin in unknown lineages.

Quantum jointly assisted cloning of an unknown three-dimensional equatorial state

Science.gov (United States)

Ma, Peng-Cheng; Chen, Gui-Bin; Li, Xiao-Wei; Zhan, You-Bang

2018-02-01

We present two schemes for perfectly cloning an unknown single-qutrit equatorial state with assistance from two and N state preparers, respectively. In the first scheme, the sender wishes to teleport an unknown single-qutrit equatorial state from two state preparers to a remote receiver, and then to create a perfect copy of the unknown state at her location. The scheme consists of two stages. The first stage of the scheme requires the usual teleportation. In the second stage, to help the sender realize the quantum cloning, two state preparers perform single-qutrit projective measurements on their own qutrits from the sender, then the sender can acquire a perfect copy of the unknown state. It is shown that, only if the two state preparers collaborate with each other, the sender can create a copy of the unknown state by means of some appropriate unitary operations. In the second scheme, we generalized the jointly assisted cloning in the first scheme to the case of N state prepares. In the present schemes, the total probability of success for assisted cloning of a perfect copy of the unknown state can reach 1.

Random neural Q-learning for obstacle avoidance of a mobile robot in unknown environments

Directory of Open Access Journals (Sweden)

Jing Yang

2016-07-01

Full Text Available The article presents a random neural Q-learning strategy for the obstacle avoidance problem of an autonomous mobile robot in unknown environments. In the proposed strategy, two independent modules, namely, avoidance without considering the target and goal-seeking without considering obstacles, are first trained using the proposed random neural Q-learning algorithm to obtain their best control policies. Then, the two trained modules are combined based on a switching function to realize the obstacle avoidance in unknown environments. For the proposed random neural Q-learning algorithm, a single-hidden layer feedforward network is used to approximate the Q-function to estimate the Q-value. The parameters of the single-hidden layer feedforward network are modified using the recently proposed neural algorithm named the online sequential version of extreme learning machine, where the parameters of the hidden nodes are assigned randomly and the sample data can come one by one. However, different from the original online sequential version of extreme learning machine algorithm, the initial output weights are estimated subjected to quadratic inequality constraint to improve the convergence speed. Finally, the simulation results demonstrate that the proposed random neural Q-learning strategy can successfully solve the obstacle avoidance problem. Also, the higher learning efficiency and better generalization ability are achieved by the proposed random neural Q-learning algorithm compared with the Q-learning based on the back-propagation method.

Treatment Option Overview (Carcinoma of Unknown Primary)

Science.gov (United States)

... Common Cancer Types Recurrent Cancer Common Cancer Types Bladder Cancer Breast Cancer Colorectal Cancer Kidney (Renal Cell) Cancer ... cancer cells have places where hormones can attach ( receptors ), drugs, surgery, or radiation therapy are used to ...

Cytokine responses in primary chicken embryo intestinal cells infected with Campylobacter jejuni strains of human and chicken origin and the expression of bacterial virulence-associated genes

DEFF Research Database (Denmark)

Li, Yiping; Ingmer, Hanne; Madsen, Mogens

2008-01-01

of the bacterial genes. We have investigated the invasiveness of primary chicken embryo intestinal cells (CEICs) by C. jejuni strains of human and chicken origins and the production of pro-inflammatory cytokines as well as the expression of the bacterial virulence-associated genes during co-cultivation. Results C......-free media from another co-cultivation experiment also increased the expression of the virulence-associated genes in the C. jejuni chicken isolate, indicating that the expression of bacterial genes is regulated by component(s) secreted upon co-cultivation of bacteria and CEICs. Conclusion We show that under...... in vitro culture condition C. jejuni strains of both human and chicken origins can invade avian host cells with a pro-inflammatory response and that the virulence-associated genes of C. jejuni may play a role in this process....

Iterative Selection of Unknown Weights in Direct Weight Optimization Identification

Directory of Open Access Journals (Sweden)

Xiao Xuan

2014-01-01

Full Text Available To the direct weight optimization identification of the nonlinear system, we add some linear terms about input sequences in the former linear affine function so as to approximate the nonlinear property. To choose the two classes of unknown weights in the more linear terms, this paper derives the detailed process on how to choose these unknown weights from theoretical analysis and engineering practice, respectively, and makes sure of their key roles between the unknown weights. From the theoretical analysis, the added unknown weights’ auxiliary role can be known in the whole process of approximating the nonlinear system. From the practical analysis, we learn how to transform one complex optimization problem to its corresponding common quadratic program problem. Then, the common quadratic program problem can be solved by the basic interior point method. Finally, the efficiency and possibility of the proposed strategies can be confirmed by the simulation results.

Which Are the Cells of Origin in Merkel Cell Carcinoma

International Nuclear Information System (INIS)

Tilling, T.; Moll, I.

2012-01-01

Merkel cell carcinoma (MCC), a highly aggressive skin tumour with increasing incidence, is associated with the newly discovered Merkel cell polyoma virus (MCPyV). Studies on MCC and MCPyV as well as other risk factors have significantly increased our knowledge of MCC pathogenesis, but the cells of origin, which could be important targets in future therapies, are still unknown. Merkel cells (MCs), the neuroendocrine cells of the skin, were believed to be at the origin of MCC due to their phenotypic similarities. However, for several reasons, for example, heterogeneous differentiation of MCCs and post mitotic character of MCs, it is not very likely that MCC develops from differentiated MCs. Skin stem cells, probably from the epidermal lineage, are more likely to be cells of origin in MCC. Future studies will have to address these questions more directly in order to identify the physiological cells which are transformed to MCC cells.

The plant pathogen Phytophthora andina emerged via hybridization of an unknown Phytophthora species and the Irish potato famine pathogen, P. infestans.

Directory of Open Access Journals (Sweden)

Erica M Goss

Full Text Available Emerging plant pathogens have largely been a consequence of the movement of pathogens to new geographic regions. Another documented mechanism for the emergence of plant pathogens is hybridization between individuals of different species or subspecies, which may allow rapid evolution and adaptation to new hosts or environments. Hybrid plant pathogens have traditionally been difficult to detect or confirm, but the increasing ease of cloning and sequencing PCR products now makes the identification of species that consistently have genes or alleles with phylogenetically divergent origins relatively straightforward. We investigated the genetic origin of Phytophthora andina, an increasingly common pathogen of Andean crops Solanum betaceum, S. muricatum, S. quitoense, and several wild Solanum spp. It has been hypothesized that P. andina is a hybrid between the potato late blight pathogen P. infestans and another Phytophthora species. We tested this hypothesis by cloning four nuclear loci to obtain haplotypes and using these loci to infer the phylogenetic relationships of P. andina to P. infestans and other related species. Sequencing of cloned PCR products in every case revealed two distinct haplotypes for each locus in P. andina, such that each isolate had one allele derived from a P. infestans parent and a second divergent allele derived from an unknown species that is closely related but distinct from P. infestans, P. mirabilis, and P. ipomoeae. To the best of our knowledge, the unknown parent has not yet been collected. We also observed sequence polymorphism among P. andina isolates at three of the four loci, many of which segregate between previously described P. andina clonal lineages. These results provide strong support that P. andina emerged via hybridization between P. infestans and another unknown Phytophthora species also belonging to Phytophthora clade 1c.

CE: Original Research: Primary Care Providers and Screening for Military Service and PTSD.

Science.gov (United States)

Mohler, Kristin Michelle; Sankey-Deemer, Cydnee

2017-11-01

: Background: Most veterans have the option of receiving their health care from the Veterans Health Administration or through primary care providers in the private sector. However, there is some evidence that fewer than half of community-based, private sector primary care and mental health providers screen their patients for military service, particularly in rural areas, leaving these veterans less likely to be screened for posttraumatic stress disorder (PTSD) and other military service-related conditions. To determine whether primary care providers in the private sector are screening patients for military service and subsequent PTSD. We designed and piloted a survey to determine whether primary care providers in a rural Pennsylvania region routinely screen for military service and service-related PTSD. We distributed the survey to a convenience sample of more than 250 primary care providers in central and western Pennsylvania through the U.S. Postal Service, via Facebook, and via work e-mails for those who worked in a local health system. Among 50 eligible respondents, only four (8%) said they screen all their patients for military service, and 20 (40%) reported screening none; only two respondents (4%) screened all their patients who have served in the military for PTSD, and 30 (60%) screened none. Veterans who rely on private sector providers may not receive evidence-based care for military service-related health problems, including PTSD. To improve care for these patients, providers in the private sector should be educated on why all patients should be screened for military service, how to conduct such screening properly, and veterans' general health concerns.

Chaos Synchronization Based on Unknown Input Proportional Multiple-Integral Fuzzy Observer

Directory of Open Access Journals (Sweden)

T. Youssef

2013-01-01

Full Text Available This paper presents an unknown input Proportional Multiple-Integral Observer (PIO for synchronization of chaotic systems based on Takagi-Sugeno (TS fuzzy chaotic models subject to unmeasurable decision variables and unknown input. In a secure communication configuration, this unknown input is regarded as a message encoded in the chaotic system and recovered by the proposed PIO. Both states and outputs of the fuzzy chaotic models are subject to polynomial unknown input with kth derivative zero. Using Lyapunov stability theory, sufficient design conditions for synchronization are proposed. The PIO gains matrices are obtained by resolving linear matrix inequalities (LMIs constraints. Simulation results show through two TS fuzzy chaotic models the validity of the proposed method.

Characterizing unknown systematics in large scale structure surveys

International Nuclear Information System (INIS)

Agarwal, Nishant; Ho, Shirley; Myers, Adam D.; Seo, Hee-Jong; Ross, Ashley J.; Bahcall, Neta; Brinkmann, Jonathan; Eisenstein, Daniel J.; Muna, Demitri; Palanque-Delabrouille, Nathalie; Yèche, Christophe; Pâris, Isabelle; Petitjean, Patrick; Schneider, Donald P.; Streblyanska, Alina; Weaver, Benjamin A.

2014-01-01

Photometric large scale structure (LSS) surveys probe the largest volumes in the Universe, but are inevitably limited by systematic uncertainties. Imperfect photometric calibration leads to biases in our measurements of the density fields of LSS tracers such as galaxies and quasars, and as a result in cosmological parameter estimation. Earlier studies have proposed using cross-correlations between different redshift slices or cross-correlations between different surveys to reduce the effects of such systematics. In this paper we develop a method to characterize unknown systematics. We demonstrate that while we do not have sufficient information to correct for unknown systematics in the data, we can obtain an estimate of their magnitude. We define a parameter to estimate contamination from unknown systematics using cross-correlations between different redshift slices and propose discarding bins in the angular power spectrum that lie outside a certain contamination tolerance level. We show that this method improves estimates of the bias using simulated data and further apply it to photometric luminous red galaxies in the Sloan Digital Sky Survey as a case study

Characterizing unknown systematics in large scale structure surveys

Energy Technology Data Exchange (ETDEWEB)

Agarwal, Nishant; Ho, Shirley [McWilliams Center for Cosmology, Department of Physics, Carnegie Mellon University, Pittsburgh, PA 15213 (United States); Myers, Adam D. [Department of Physics and Astronomy, University of Wyoming, Laramie, WY 82071 (United States); Seo, Hee-Jong [Berkeley Center for Cosmological Physics, LBL and Department of Physics, University of California, Berkeley, CA 94720 (United States); Ross, Ashley J. [Institute of Cosmology and Gravitation, University of Portsmouth, Portsmouth, PO1 3FX (United Kingdom); Bahcall, Neta [Princeton University Observatory, Peyton Hall, Princeton, NJ 08544 (United States); Brinkmann, Jonathan [Apache Point Observatory, P.O. Box 59, Sunspot, NM 88349 (United States); Eisenstein, Daniel J. [Harvard-Smithsonian Center for Astrophysics, 60 Garden St., Cambridge, MA 02138 (United States); Muna, Demitri [Department of Astronomy, Ohio State University, Columbus, OH 43210 (United States); Palanque-Delabrouille, Nathalie; Yèche, Christophe [CEA, Centre de Saclay, Irfu/SPP, F-91191 Gif-sur-Yvette (France); Pâris, Isabelle [Departamento de Astronomía, Universidad de Chile, Casilla 36-D, Santiago (Chile); Petitjean, Patrick [Université Paris 6 et CNRS, Institut d' Astrophysique de Paris, 98bis blvd. Arago, 75014 Paris (France); Schneider, Donald P. [Department of Astronomy and Astrophysics, Pennsylvania State University, University Park, PA 16802 (United States); Streblyanska, Alina [Instituto de Astrofisica de Canarias (IAC), E-38200 La Laguna, Tenerife (Spain); Weaver, Benjamin A., E-mail: nishanta@andrew.cmu.edu [Center for Cosmology and Particle Physics, New York University, New York, NY 10003 (United States)

2014-04-01

Photometric large scale structure (LSS) surveys probe the largest volumes in the Universe, but are inevitably limited by systematic uncertainties. Imperfect photometric calibration leads to biases in our measurements of the density fields of LSS tracers such as galaxies and quasars, and as a result in cosmological parameter estimation. Earlier studies have proposed using cross-correlations between different redshift slices or cross-correlations between different surveys to reduce the effects of such systematics. In this paper we develop a method to characterize unknown systematics. We demonstrate that while we do not have sufficient information to correct for unknown systematics in the data, we can obtain an estimate of their magnitude. We define a parameter to estimate contamination from unknown systematics using cross-correlations between different redshift slices and propose discarding bins in the angular power spectrum that lie outside a certain contamination tolerance level. We show that this method improves estimates of the bias using simulated data and further apply it to photometric luminous red galaxies in the Sloan Digital Sky Survey as a case study.

A definition of unknown parent groups based on bull usage patterns across herds.

Science.gov (United States)

Bouquet, A; Renand, G; Phocas, F

2011-03-01

In genetic evaluations, the definition of unknown parent groups (UPG) is usually based on time periods, selection path and flows of foreign founders. The definition of UPG may be more complex for populations presenting genetic heterogeneity due to both, large national expansion and coexistence of artificial insemination (AI) and natural service (NS). A UPG definition method accounting for beef bull flows was proposed and applied to the French Charolais cattle population. It assumed that, at a given time period, unknown parents belonged to the same UPG when their progeny were bred in herds that used bulls with similar origins (birth region and reproduction way). Thus, the birth period, region and AI rate of a herd were pointed out to be the three criteria reflecting genetic disparities at the national level in a beef cattle population. To deal with regional genetic disparities, 14 regions were identified using a factorial approach combining principal component analysis and Ward clustering. The selection nucleus of the French cattle population was dispersed over three main breeding areas. Flows of NS bulls were mainly carried out within each breeding area. On the contrary, the use and the selection of AI bulls were based on a national pool of candidates. Within a time period, herds of different regions were clustered together when they used bulls coming from the same origin and with an estimated difference of genetic level lower than 20% of genetic standard deviation (σg) for calf muscle and skeleton scores (SS) at weaning. This led to the definition of 16 UPG of sires, which were validated as robust and relevant in a sire model, meaning numerically stable and corresponding to distinct genetic subpopulations. The UPG genetic levels were estimated for muscle and SS under sire and animal models. Whatever the trait, differences between bull UPG estimates within a time period could reach 0.5 σg across regions. For a given time period, bull UPG estimates for muscle and

Primary clear cell sarcoma of bone: a unique site of origin

International Nuclear Information System (INIS)

Gelczer, R.K.; Wenger, D.E.; Wold, L.E.

1999-01-01

Clear cell sarcoma is a rare soft tissue neoplasm, accounting for less than 1% of soft tissue sarcomas. We are presenting a case of a clear cell sarcoma of bone which, to our knowledge, is the only report of a primary clear cell sarcoma of bone. (orig.)

Robust Fault Detection for Switched Fuzzy Systems With Unknown Input.

Science.gov (United States)

Han, Jian; Zhang, Huaguang; Wang, Yingchun; Sun, Xun

2017-10-03

This paper investigates the fault detection problem for a class of switched nonlinear systems in the T-S fuzzy framework. The unknown input is considered in the systems. A novel fault detection unknown input observer design method is proposed. Based on the proposed observer, the unknown input can be removed from the fault detection residual. The weighted H∞ performance level is considered to ensure the robustness. In addition, the weighted H₋ performance level is introduced, which can increase the sensibility of the proposed detection method. To verify the proposed scheme, a numerical simulation example and an electromechanical system simulation example are provided at the end of this paper.

Origin-based polyphenolic fingerprinting of Theobroma cacao in unfermented and fermented beans.

Science.gov (United States)

D'Souza, Roy N; Grimbs, Sergio; Behrends, Britta; Bernaert, Herwig; Ullrich, Matthias S; Kuhnert, Nikolai

2017-09-01

A comprehensive analysis of cocoa polyphenols from unfermented and fermented cocoa beans from a wide range of geographic origins was carried out to catalogue systematic differences based on their origin as well as fermentation status. This study identifies previously unknown compounds with the goal to ascertain, which of these are responsible for the largest differences between bean types. UHPLC coupled with ultra-high resolution time-of-flight mass spectrometry was employed to identify and relatively quantify various oligomeric proanthocyanidins and their glycosides amongst several other unreported compounds. A series of biomarkers allowing a clear distinction between unfermented and fermented cocoa beans and for beans of different origins were identified. The large sample set employed allowed comparison of statistically significant variations of key cocoa constituents. Copyright © 2017 Elsevier Ltd. All rights reserved.

Extra osseous primary Ewing's sarcoma.

Science.gov (United States)

Ali, Syed Asad; Muhammad, Agha Taj; Soomro, Abdul Ghani; Siddiqui, Akmal Jamal

2010-01-01

The case of 20 years old boy with an extra osseous Ewing's sarcoma is described. He was initially diagnosed as a case of infiltrative malignant tumour of left suprarenal gland on the basis of preoperative workup but postoperative biopsy of surgically excised specimen confirmed Extra-osseous Ewing's Sarcoma (EES) suprarenal gland with no evidence of malignancy on skeletal scintiscan, bone marrow aspirate and histopathology Suprarenal location of primary EES is unknown and probably has not been reported in literature. We report a unique case of EES.

Off-Policy Actor-Critic Structure for Optimal Control of Unknown Systems With Disturbances.

Science.gov (United States)

Song, Ruizhuo; Lewis, Frank L; Wei, Qinglai; Zhang, Huaguang

2016-05-01

An optimal control method is developed for unknown continuous-time systems with unknown disturbances in this paper. The integral reinforcement learning (IRL) algorithm is presented to obtain the iterative control. Off-policy learning is used to allow the dynamics to be completely unknown. Neural networks are used to construct critic and action networks. It is shown that if there are unknown disturbances, off-policy IRL may not converge or may be biased. For reducing the influence of unknown disturbances, a disturbances compensation controller is added. It is proven that the weight errors are uniformly ultimately bounded based on Lyapunov techniques. Convergence of the Hamiltonian function is also proven. The simulation study demonstrates the effectiveness of the proposed optimal control method for unknown systems with disturbances.

Magnetic resonance imaging (MRI) of liver and brain in haematologic-organic patients with fever of unknown origin; Magnetresonanztomographie (MRT) der Leber und des Gehirns bei haematologisch-onkologischen Patienten mit Fieber unbekannter Ursache

Energy Technology Data Exchange (ETDEWEB)

Heussel, C.P.; Kauczor, H.U.; Poguntke, M.; Schadmand-Fischer, S.; Mildenberger, P.; Thelen, M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Heussel, G. [Mainz Univ. (Germany). 3. Medizinische Klinik und Poliklinik

1998-08-01

To examine the advantage of liver and brain MRI in clinically anomalous haematological patients with fever of unknown origin. Material and Methods: Twenty liver MRI (T{sub 2}-TSE, T{sub 2}-HASTE, T{sub 1}-FLASH{+-}Gd dynamic) and 16 brain MRI (T{sub 2}-TSE, FLAIR, T{sub 1}-TSE{+-}Gd) were performed searching for a focus of fever with a suspected organ system. Comparison with clinical follow-up. Results: suspected organ system. Comparison with clinical follow-up. Results: A focus was detected in 11/20 liver MRI. Candidiasis (n=3), mycobacteriosis (n=2), relapse of haematological disease (n=3), graft versus host disease (n=1), non-clarified (n=2). The remaining 9 cases with normal MRI were not suspicious of infectious hepatic disease during follo-wup. In brain MRI, 3/16 showed a focus (toxoplasmosis, aspergillosis, mastoiditis). Clinical indication for an infectious involvement of the brain was found in 4/16 cases 2--5 months after initially normal brain MRI. No suspicion of an infectious involvement of brain was present in the remaining 9/16 cases. Conclusion: In case of fever of unknown origin and suspicion of liver involvement, MRI of the liver should be performed due to data given in literature and its sensitivity of 100%. Because of the delayed detectability of cerebral manifestations, in cases of persisting suspicion even a previously normal MRI of the brain should be repeated. (orig.) [Deutsch] Untersuchung des Nutzens der MRT der Leber und des Gehirns bei klinisch auffaelligen haematologischen Patienten mit Fieber unbekannter Ursache. Material und Methoden: Es wurden 20 MRT der Leber (T{sub 2}-TSE, T{sub 2}-HASTE, T{sub 1}-FLASH{+-}Gd dynamisch) und 16 MRT des Gehirns (T{sub 2}-TSE, FLAIR, T{sub 1}-TSE{+-}Gd) zur Fokussuche bei Infektionsverdacht und Organhinweisen durchgefuehrt. Es erfolgte der Abgleich mit dem weiteren klinischen Verlauf. Ergebnisse: 11/20 MRT-Untersuchungen der Leber zeigten einen Herdbefund: Candidiasis (n=3), Mykobakteriose (n=2

[Badminton--unknown sport].

Science.gov (United States)

Zekan-Petrinović, Lidija

2007-01-01

For a long time, badminton was considered to be only a slow and light game for children, a game that is played outdoors and is structurally undemanding.Today, it is not an unknown and unrecognised sport, especially after it was included into the Olympics Games in 1992. Badminton is one of the oldest sports in the world. It is suitable for all ages (for children and elderly equally), women and men and even handicapped persons. Beginners can start playing badminton matches early because the basics are learned quickly. As a recreational activity, badminton is very popular in Zagreb. In the last 10 years, a number of halls specialized for badminton or offering badminton as one of available sports activities have been opened in Zagreb. At present, there are over 70 professional playgrounds for training of top contestants but also for the citizens who can play recreational badminton.

Bivalirudin Started during Emergency Transport for Primary PCI

DEFF Research Database (Denmark)

Steg, Philippe Gabriel; van 't Hof, Arnoud; Hamm, Christian W

2013-01-01

Bivalirudin, as compared with heparin and glycoprotein IIb/IIIa inhibitors, has been shown to reduce rates of bleeding and death in patients undergoing primary percutaneous coronary intervention (PCI). Whether these benefits persist in contemporary practice characterized by prehospital initiation...... of treatment, optional use of glycoprotein IIb/IIIa inhibitors and novel P2Y12 inhibitors, and radial-artery PCI access use is unknown....

Improving Patient Safety Culture in Primary Care: A Systematic Review

NARCIS (Netherlands)

Verbakel, Natasha J.; Langelaan, Maaike; Verheij, Theo J. M.; Wagner, Cordula; Zwart, Dorien L. M.

Background: Patient safety culture, described as shared values, attitudes and behavior of staff in a health-care organization, gained attention as a subject of study as it is believed to be related to the impact of patient safety improvements. However, in primary care, it is yet unknown, which

The Interactive Origin and the Aesthetic Modelling of Image-Schemas and Primary Metaphors.

Science.gov (United States)

Martínez, Isabel C; Español, Silvia A; Pérez, Diana I

2018-06-02

According to the theory of conceptual metaphor, image-schemas and primary metaphors are preconceptual structures configured in human cognition, based on sensory-motor environmental activity. Focusing on the way both non-conceptual structures are embedded in early social interaction, we provide empirical evidence for the interactive and intersubjective ontogenesis of image-schemas and primary metaphors. We present the results of a multimodal image-schematic microanalysis of three interactive infant-directed performances (the composition of movement, touch, speech, and vocalization that adults produce for-and-with the infants). The microanalyses show that adults aesthetically highlight the image-schematic structures embedded in the multimodal composition of the performance, and that primary metaphors are also lived as embedded in these inter-enactive experiences. The findings allow corroborating that the psychological domains of cognition and affection are not in rivalry or conflict but rather intertwined in meaningful experiences.

Supernovae and the origin of the solar system

International Nuclear Information System (INIS)

Clayton, D.D.

1979-01-01

This review concentrates on recent ideas involving a relationship between the early solar system and supernovae explosions. It summarizes briefly the data that has helped inspire those ideas. Because the true relationship is still unknown and generates controversy, the distinct ideas are introduced singly in the historical context of their origins, and the active sense of surprise and controversy is visible. Quotations from pivotal papers are used as part of the exposition. The subject involves equally the isotopic anomalies detected in meteorites and the dynamic events of galactic evolution, nucleosynthesis, and protosolar collapse. Whatever the correct situation is, new connections have been found between the origin of the elements and the formation of the solar system. The objective of this review is to enable interested space scientists to quickly identify the competing points of view and the experiments and theories that have led to them. (Auth.)

Psychological profile: the problem of modeling the unknown criminal personality

Directory of Open Access Journals (Sweden)

Г. М. Гетьман

2013-10-01

Full Text Available The article investigates the problem of modeling an unknown person in the preparation of criminal psychological profile. Some approaches to the concept of "psychological profile" and "psychological portrait", in particular the proposed delineation of these terms. We consider the system steps in the development of the psychological profile of an unknown perpetrator.

Multifocal chronic osteomyelitis of unknown etiology

International Nuclear Information System (INIS)

Kozlowski, K.; Masel, J.; Harbison, S.; Yu, J.; Royal Brisbane Children Hospital; Regional Hospital Bowral

1983-01-01

Five cases of chronic, inflammatory, multifocal bone lesions of unknown etiology are reported. Although bone biopsy confirmed osteomyelitis in each case in none of them were organisms found inspite of an extensive work up. Different clinical course of the disease reflects different aetiology in respective cases. These cases present changing aspects of osteomyelitis emerging since introduction of antibiotics. (orig.)

Bayesian source term determination with unknown covariance of measurements

Science.gov (United States)

Belal, Alkomiet; Tichý, Ondřej; Šmídl, Václav

2017-04-01

Determination of a source term of release of a hazardous material into the atmosphere is a very important task for emergency response. We are concerned with the problem of estimation of the source term in the conventional linear inverse problem, y = Mx, where the relationship between the vector of observations y is described using the source-receptor-sensitivity (SRS) matrix M and the unknown source term x. Since the system is typically ill-conditioned, the problem is recast as an optimization problem minR,B(y - Mx)TR-1(y - Mx) + xTB-1x. The first term minimizes the error of the measurements with covariance matrix R, and the second term is a regularization of the source term. There are different types of regularization arising for different choices of matrices R and B, for example, Tikhonov regularization assumes covariance matrix B as the identity matrix multiplied by scalar parameter. In this contribution, we adopt a Bayesian approach to make inference on the unknown source term x as well as unknown R and B. We assume prior on x to be a Gaussian with zero mean and unknown diagonal covariance matrix B. The covariance matrix of the likelihood R is also unknown. We consider two potential choices of the structure of the matrix R. First is the diagonal matrix and the second is a locally correlated structure using information on topology of the measuring network. Since the inference of the model is intractable, iterative variational Bayes algorithm is used for simultaneous estimation of all model parameters. The practical usefulness of our contribution is demonstrated on an application of the resulting algorithm to real data from the European Tracer Experiment (ETEX). This research is supported by EEA/Norwegian Financial Mechanism under project MSMT-28477/2014 Source-Term Determination of Radionuclide Releases by Inverse Atmospheric Dispersion Modelling (STRADI).

Fast grasping of unknown objects using principal component analysis

Science.gov (United States)

Lei, Qujiang; Chen, Guangming; Wisse, Martijn

2017-09-01

Fast grasping of unknown objects has crucial impact on the efficiency of robot manipulation especially subjected to unfamiliar environments. In order to accelerate grasping speed of unknown objects, principal component analysis is utilized to direct the grasping process. In particular, a single-view partial point cloud is constructed and grasp candidates are allocated along the principal axis. Force balance optimization is employed to analyze possible graspable areas. The obtained graspable area with the minimal resultant force is the best zone for the final grasping execution. It is shown that an unknown object can be more quickly grasped provided that the component analysis principle axis is determined using single-view partial point cloud. To cope with the grasp uncertainty, robot motion is assisted to obtain a new viewpoint. Virtual exploration and experimental tests are carried out to verify this fast gasping algorithm. Both simulation and experimental tests demonstrated excellent performances based on the results of grasping a series of unknown objects. To minimize the grasping uncertainty, the merits of the robot hardware with two 3D cameras can be utilized to suffice the partial point cloud. As a result of utilizing the robot hardware, the grasping reliance is highly enhanced. Therefore, this research demonstrates practical significance for increasing grasping speed and thus increasing robot efficiency under unpredictable environments.

Do trained practice nurses apply motivational interviewing techniques in primary care consultations?

NARCIS (Netherlands)

Noordman, J.; Lee, I. van der; Nielen, M.; Vlek, H.; Weijden, T. van der; Dulmen, S. van

2012-01-01

Background: Reducing the prevalence of unhealthy lifestyle behaviour could positively influence health. Motivational interviewing (MI) is used to promote change in unhealthy lifestyle behaviour as part of primary or secondary prevention. Whether MI is actually applied as taught is unknown. Practice

The avian-origin H3N2 canine influenza virus has limited replication in swine

Science.gov (United States)

A genetically and antigenically distinct H3N2 canine influenza of avian-origin was detected in March of 2015 in Chicago, Illinois. A subsequent outbreak was reported with over 1,000 dogs in the Midwest affected. The potential for canine-to-swine transmission was unknown. Experimental infection in pi...

Quantum key distribution with an unknown and untrusted source

Science.gov (United States)

Zhao, Yi; Qi, Bing; Lo, Hoi-Kwong

2009-03-01

The security of a standard bi-directional ``plug & play'' quantum key distribution (QKD) system has been an open question for a long time. This is mainly because its source is equivalently controlled by an eavesdropper, which means the source is unknown and untrusted. Qualitative discussion on this subject has been made previously. In this paper, we present the first quantitative security analysis on a general class of QKD protocols whose sources are unknown and untrusted. The securities of standard BB84 protocol, weak+vacuum decoy state protocol, and one-decoy decoy state protocol, with unknown and untrusted sources are rigorously proved. We derive rigorous lower bounds to the secure key generation rates of the above three protocols. Our numerical simulation results show that QKD with an untrusted source gives a key generation rate that is close to that with a trusted source. Our work is published in [1]. [4pt] [1] Y. Zhao, B. Qi, and H.-K. Lo, Phys. Rev. A, 77:052327 (2008).

Grasping Unknown Objects in an Early Cognitive Vision System

DEFF Research Database (Denmark)

Popovic, Mila

2011-01-01

Grasping of unknown objects presents an important and challenging part of robot manipulation. The growing area of service robotics depends upon the ability of robots to autonomously grasp and manipulate a wide range of objects in everyday environments. Simple, non task-specific grasps of unknown ...... and comparing vision-based grasping methods, and the creation of algorithms for bootstrapping a process of acquiring world understanding for artificial cognitive agents....... presents a system for robotic grasping of unknown objects us- ing stereo vision. Grasps are defined based on contour and surface information provided by the Early Cognitive Vision System, that organizes visual informa- tion into a biologically motivated hierarchical representation. The contributions...... of the thesis are: the extension of the Early Cognitive Vision representation with a new type of feature hierarchy in the texture domain, the definition and evaluation of contour based grasping methods, the definition and evaluation of surface based grasping methods, the definition of a benchmark for testing...

Fresnel's original interpretation of complex numbers in 19th century optics

DEFF Research Database (Denmark)

Avelar Sotomaior Karam, Ricardo

2018-01-01

In 1823, Fresnel published an original (physical) interpretation of complex numbers in his investigations of refraction and reflection of polarized light. This is arguably the first time that complex numbers were given a physical interpretation, which led to a better understanding of elliptical a...... and circular polarizations. This rather unknown episode of the history of physics is described in this work, and some of the pedagogical lessons that can be extracted from it are discussed....

Fresnel's original interpretation of complex numbers in 19th century optics

Science.gov (United States)

Karam, Ricardo

2018-04-01

In 1823, Fresnel published an original (physical) interpretation of complex numbers in his investigations of refraction and reflection of polarized light. This is arguably the first time that complex numbers were given a physical interpretation, which led to a better understanding of elliptical and circular polarizations. This rather unknown episode of the history of physics is described in this work, and some of the pedagogical lessons that can be extracted from it are discussed.

Primary Adult Renal Ewing's Sarcoma: A Rare Entity

Science.gov (United States)

Mukkunda, Ravindra; Venkitaraman, Ramachandran; Thway, Khin; Min, Toon; Fisher, Cyril; Horwich, Alan; Judson, Ian

2009-01-01

Background. Ewing's sarcoma of extraskeletal origin is uncommon and that is of primary renal origin in adults are rare. There is no consensus on the optimal management of Ewing's tumors of renal origin. Methods. A retrospective review of the clinical features, treatment, and outcome of adult patients with primary renal extra-skeletal Ewing's sarcoma who were treated at the Royal Marsden hospital from January 1993–December 2007 is reported. Results. Seven adult patients with primary renal Ewing's sarcoma were identified. All four patients with nonmetastatic disease had radical nephrectomy and received adjuvant chemotherapy +/− radiotherapy. Two developed metastatic disease while on adjuvant chemotherapy, and one patient relapsed after 55 months. The three patients with metastatic disease at presentation did not have nephrectomy and were treated with chemotherapy. All three patients had disease progression with a dismal outcome. Only one patient in the whole group is alive and disease free. The median overall survival was 62.8 months, and the median disease-free survival in patients with nonmetastatic disease after combined modality treatment was 30.3 months. Conclusion. Primary adult renal Ewing's sarcoma is an aggressive tumor with a propensity for early metastasis. Radical nephrectomy with adjuvant combination chemotherapy produced the best results but the outlook remained poor with only one patient experiencing long disease-free survival. PMID:19478963

Primary Adult Renal Ewing's Sarcoma: A Rare Entity

Directory of Open Access Journals (Sweden)

Ravindra Mukkunda

2009-01-01

Full Text Available Background. Ewing's sarcoma of extraskeletal origin is uncommon and that is of primary renal origin in adults are rare. There is no consensus on the optimal management of Ewing's tumors of renal origin. Methods. A retrospective review of the clinical features, treatment, and outcome of adult patients with primary renal extra-skeletal Ewing's sarcoma who were treated at the Royal Marsden hospital from January 1993–December 2007 is reported. Results. Seven adult patients with primary renal Ewing's sarcoma were identified. All four patients with nonmetastatic disease had radical nephrectomy and received adjuvant chemotherapy +/− radiotherapy. Two developed metastatic disease while on adjuvant chemotherapy, and one patient relapsed after 55 months. The three patients with metastatic disease at presentation did not have nephrectomy and were treated with chemotherapy. All three patients had disease progression with a dismal outcome. Only one patient in the whole group is alive and disease free. The median overall survival was 62.8 months, and the median disease-free survival in patients with nonmetastatic disease after combined modality treatment was 30.3 months. Conclusion. Primary adult renal Ewing's sarcoma is an aggressive tumor with a propensity for early metastasis. Radical nephrectomy with adjuvant combination chemotherapy produced the best results but the outlook remained poor with only one patient experiencing long disease-free survival.

Primary hadron: origin of stars, galaxies and astronomical Universe

International Nuclear Information System (INIS)

Muradian, R.M.

1979-01-01

The relationship between mass and angular momentum for the known cosmic objects has been examined. It is shown that they are described by the generalized Regge-like dependence of the J=(m/msub(p))sup((1+1)/(n+h/2π)), which connects the maximal spin J, masses of heavy hadrons and the Planck constant h and where n=2 for galaxies, their clusters and superclusters and n=3 for asteroids, planets and stars. It offers the possibility, that Ambartsumyan's superdense protomatter has hadronic nature. This allows to give a realistic and quantitative explanation with a minimum number of arbitrary assumptions for the origin of cosmic angular momenta, cosmic magnetic fields and offers the framework for other cosmogonic implications. This approach incorporates in a natural way the fundamental quantum-mechanical parameters besides the classical parameters and allows to derive simple expressions for masses and spins of cosmic objects through fundamental constants, some of which coincide with Eddington-Dirac's ''Large Number'' relations

Common Genetic Determinants of Intraocular Pressure and Primary Open-Angle Glaucoma

NARCIS (Netherlands)

van Koolwijk, Leonieke M. E.; Ramdas, Wishal D.; Ikram, M. Kamran; Jansonius, Nomdo M.; Pasutto, Francesca; Hysi, Pirro G.; Macgregor, Stuart; Janssen, Sarah F.; Hewitt, Alex W.; Viswanathan, Ananth C.; ten Brink, Jacoline B.; Hosseini, S. Mohsen; Amin, Najaf; Despriet, Dominiek D. G.; Willemse-Assink, Jacqueline J. M.; Kramer, Rogier; Rivadeneira, Fernando; Struchalin, Maksim; Aulchenko, Yurii S.; Weisschuh, Nicole; Zenkel, Matthias; Mardin, Christian Y.; Gramer, Eugen; Welge-Luessen, Ulrich; Montgomery, Grant W.; Carbonaro, Francis; Young, Terri L.; Bellenguez, Celine; McGuffin, Peter; Foster, Paul J.; Topouzis, Fotis; Mitchell, Paul; Wang, Jie Jin; Wong, Tien Y.; Czudowska, Monika A.; Hofman, Albert; Uitterlinden, Andre G.; Wolfs, Roger C. W.; de Jong, Paulus T. V. M.; Oostra, Ben A.; Paterson, Andrew D.; Mackey, David A.; Bergen, Arthur A. B.; Reis, Andre; Hammond, Christopher J.; Vingerling, Johannes R.; Lemij, Hans G.; Klaver, Caroline C. W.; van Duijn, Cornelia M.

2012-01-01

Intraocular pressure (IOP) is a highly heritable risk factor for primary open-angle glaucoma and is the only target for current glaucoma therapy. The genetic factors which determine IOP are largely unknown. We performed a genome-wide association study for IOP in 11,972 participants from 4

Fast radio bursts: the observational case for a Galactic origin

OpenAIRE

Maoz, Dan; Loeb, Abraham; Shvartzvald, Yossi; Sitek, Monika; Engel, Michael; Kiefer, Flavien; Kiraga, Marcin; Levi, Amir; Mazeh, Tsevi; Pawlak, Michal; Rich, R. Michael; Tal-Or, Lev; Wyrzykowski, Lukasz

2015-01-01

There are by now ten published detections of fast radio bursts (FRBs), single bright GHz-band millisecond pulses of unknown origin. Proposed explanations cover a broad range from exotic processes at cosmological distances to atmospheric and terrestrial sources. Loeb et al. have previously suggested that FRB sources could be nearby flare stars, and pointed out the presence of a W-UMa-type contact binary within the beam of one out of three FRB fields that they examined. Using time-domain optica...

Survival in 76 cats with epilepsy of unknown cause: a retrospective study.

Science.gov (United States)

Szelecsenyi, Arlette Cornelia; Giger, Urs; Golini, Lorenzo; Mothersill, Ian; Torgerson, Paul R; Steffen, Frank

2017-11-01

Survival of cats with epilepsy of unknown cause (EUC) has not been reported. Seizure semiology and its relationship to treatment outcome and survival was studied in a population of 76 cats. A questionnaire for seizure semiology was developed based on experimental data. Seizure semiology was characterised by owner interviews at least one year after discharge. Seizures were classified as (1) primary generalised and (2) focal without and (3) with secondary generalisation. Median age at seizure onset was four (range 0.3-18) years. One-third of cats with EUC presented with primary generalised seizures and 78 per cent of those with initially focal seizures progressed to secondary generalised seizures. Clinical signs of generalised seizures included sudden onset of loss of consciousness and tonic-clonic seizures, while cats with focal seizures had unilateral signs. Antiepileptic drug (AED) therapy was initiated in 62 cats. Complete remission rate was 42 per cent and the median survival time was 3.2 (range 1-11) years with or without AED, and 91 per cent were still alive at the time of interview. Neither semiology nor seizure type predicted survival, response to treatment and outcome in cats with EUC. A seizure-free status of more than 12 months was observed in 79 per cent of cats without AED. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Primary Adenocarcinoma of the Vermiform Appendix. A Case Report

Directory of Open Access Journals (Sweden)

Luis Antonio Revuelta Pérez

2014-11-01

Full Text Available Primary adenocarcinoma of the vermiform appendix is the least common carcinoma of this organ; its exact frequency is unknown. Primary malignant tumors of the appendix are rare; they are generally found in 1 to 2% of all appendices examined. Most appendiceal malignancies arise from a primary tumor in the adjacent organs, and in some cases, may be metastases from distant tumors. The case of a 43-year-old patient with a history of emergency surgery who was presumptively diagnosed with acute appendicitis is presented. The presence of an adenocarcinoma at the base of the appendix was reported by the pathology department. Because of the rarity of the condition, the publication of this case is considered scientifically important.

Treatment Strategies in Primary Vitreoretinal Lymphoma A 17-Center European Collaborative Study

NARCIS (Netherlands)

Riemens, Anjo; Bromberg, Jacoline; Touitou, Valerie; Sobolewska, Bianka; Missotten, Tom; Baarsma, Seerp; Hoyng, Carel; Cordero-Coma, Miguel; Tomkins-Netzer, Oren; Rozalski, Anna; Tugal-Tutkun, Ilknur; Guex-Crosier, Yan; Los, Leonoor I.; Bollemeijer, Jan Geert; Nolan, Andrew; Pawade, Joya; Willermain, Francois; Bodaghi, Bahram; ten Dam-van Loon, Ninette; Dick, Andrew; Zierhut, Manfred; Lightman, Susan; Mackensen, Friederike; Moulin, Alexandre; Erckens, Roel; Wensing, Barbara; le Hoang, Phuc; Lokhorst, Henk; Rothova, Aniki

IMPORTANCE The best treatment option for primary vitreoretinal lymphoma (PVRL) without signs of central nervous system lymphoma (CNSL) involvement determined on magnetic resonance imaging or in cerebrospinal fluid is unknown. OBJECTIVE To evaluate the outcomes of treatment regimens used for PVRL in

Consequences of the low density of the lunar primary crust on its magmatic history (Invited)

Science.gov (United States)

Michaut, C.; Thorey, C.

2013-12-01

The lunar highlands are very old, with ages covering a timespan between 4.5 to 4.2 Gyr, and probably formed by flotation of light plagioclase minerals on top of the lunar magma ocean. The lunar crust provides thus an invaluable evidence of the geological and magmatic processes occurring in the first times of the terrestrial planets history. According to the last estimates from the GRAIL mission, the lunar primary crust is particularly light and relatively thick. This low-density crust acted as a barrier for the dense primary mantle melts. This is particularly evident in the fact that subsequent mare basalts erupted primarily within large impact basins: at least part of the crust must have been removed for the magma to reach the surface. However, the trajectory of the magma from the mantle to the surface is unknown. Here, we provide evidence of intrusions within the crust of the Moon as surface deformations in the form of low-slope lunar domes and floor-fractured craters. All these geological features have morphologies consistent with models of magma spreading at depth and deforming an overlying elastic layer. Furthermore, at floor-fractured craters, the deformation is contained within the crater interior, suggesting that the overpressure at the origin of magma ascent and intrusion was less than the pressure due to the weight of the crust removed by impact. The pressure release due to material removal by impact is significant over a depth equivalent to the crater radius. Because many of these floor-fractured craters are relatively small, i.e. less than 20 to 30 km in radius, this observation suggests that the magma at the origin of the intrusion was already stored within or just below the crust, in deeper intrusions. Thus, a large fraction of the mantle melt might have stored at depth below or within the light primary crust before reaching shallower layers. And hence, magma intrusions must have had a large influence on the thermal and geological evolution of the

Scheme for teleportation of unknown states of trapped ion

Institute of Scientific and Technical Information of China (English)

Chen Mei-Feng; Ma Song-She

2008-01-01

A scheme is presented for teleporting an unknown state in a trapped ion system.The scheme only requires a single laser beam.It allows the trap to be in any state with a few phonons,e.g.a thermal motion.Furthermore,it works in the regime,where the Rabi frequency of the laser is on the order of the trap frequency.Thus,the teleportation speed is greatly increased,which is important for decreasing the decoherence effect.This idea can also be used to teleport an unknown ionic entangled state.

Primary intraosseous carcinoma arising from odontogenic keratocyst with parotid lymph node metastasis. A case report

Directory of Open Access Journals (Sweden)

Siddesh Shenoy

2007-01-01

Full Text Available Squamous cell carcinoma (SCC arising from odontogenic cyst lining is rare. The exact incidence of carcinoma arising in odontogenic cyst is unknown, but it is estimated to vary between 1 and 2/1000. The pathogenesis is unknown, but a long-standing inflammation and continuous intracystic pressure have been suggested as possible causative factors. Metastasis from these lesions is not common (< 20%, and most of the carcinomas are moderately to well differentiated. To qualify as a primary intraosseous carcinoma, there must be no initial connection with the oral mucosa, overlying skin, or antral or nasal mucosa. This paper presents a case of primary intraosseous carcinoma arising from odontogenic keratocyst in the anterior mandible with metastasis to left parotid lymph nodes.

Prevalence and Impact of Unknown Diabetes in the ICU.

Science.gov (United States)

Carpenter, David L; Gregg, Sara R; Xu, Kejun; Buchman, Timothy G; Coopersmith, Craig M

2015-12-01

Many patients with diabetes and their care providers are unaware of the presence of the disease. Dysglycemia encompassing hyperglycemia, hypoglycemia, and glucose variability is common in the ICU in patients with and without diabetes. The purpose of this study was to determine the impact of unknown diabetes on glycemic control in the ICU. Prospective observational study. Nine ICUs in an academic, tertiary hospital and a hybrid academic/community hospital. Hemoglobin A1c levels were ordered at all ICU admissions from March 1, 2011 to September 30, 2013. Electronic medical records were examined for a history of antihyperglycemic medications or International Classification of Diseases, 9th Edition diagnosis of diabetes. Patients were categorized as having unknown diabetes (hemoglobin A1c > 6.5%, without history of diabetes), no diabetes (hemoglobin A1c 6.5%, with documented history of diabetes). None. A total of 15,737 patients had an hemoglobin A1c and medical record evaluable for the history of diabetes, and 5,635 patients had diabetes diagnosed by either medical history or an elevated hemoglobin A1c in the ICU. Of these, 1,460 patients had unknown diabetes, accounting for 26.0% of all patients with diabetes. This represented 41.0% of patients with an hemoglobin A1c > 6.5% and 9.3% of all ICU patients. Compared with patients without diabetes, patients with unknown diabetes had a higher likelihood of requiring an insulin infusion (44.3% vs 29.3%; p 180 mg/dL; p < 0.0001) and hypoglycemia (8.9% vs 2.5%; blood glucose < 70 mg/dL; p < 0.0001), higher glycemic variability (55.6 vs 28.8, average of patient SD of glucose; p < 0.0001), and increased mortality (13.8% vs 11.4%; p = 0.01). Patients with unknown diabetes represent a significant percentage of ICU admissions. Measurement of hemoglobin A1c at admission can prospectively identify a population that are not known to have diabetes but have significant challenges in glycemic control in the ICU.

Primary thyroid lymphoma: a rare thyroid malignancy

International Nuclear Information System (INIS)

Mukhtar, R.; Khattak, R.; Mateen, A.

2011-01-01

Incidence of thyroidal masses is very high with predominance in females. Most of these masses are benign. Malignancy can be of thyroid or non-thyroid origin. Surgery is treatment of choice in the former but not in latter. Primary thyroid lymphoma (PTL) is a rare cause of thyroid malignancy of non-thyroid origin which is highly treatable without surgery but early diagnosis is important requisite to have better outcome. Fine needle aspiration cytology (FNAC) is an important tool in early diagnosis of PTL, which enables doctors to treat patient better without major surgery and its morbidity. Two cases of primary thyroid lymphoma are hereby presented. The patient diagnosed on FNAC had better outcome than the one who had major surgery. (author)

Assessing primary care data quality.

Science.gov (United States)

Lim, Yvonne Mei Fong; Yusof, Maryati; Sivasampu, Sheamini

2018-04-16

Purpose The purpose of this paper is to assess National Medical Care Survey data quality. Design/methodology/approach Data completeness and representativeness were computed for all observations while other data quality measures were assessed using a 10 per cent sample from the National Medical Care Survey database; i.e., 12,569 primary care records from 189 public and private practices were included in the analysis. Findings Data field completion ranged from 69 to 100 per cent. Error rates for data transfer from paper to web-based application varied between 0.5 and 6.1 per cent. Error rates arising from diagnosis and clinical process coding were higher than medication coding. Data fields that involved free text entry were more prone to errors than those involving selection from menus. The authors found that completeness, accuracy, coding reliability and representativeness were generally good, while data timeliness needs to be improved. Research limitations/implications Only data entered into a web-based application were examined. Data omissions and errors in the original questionnaires were not covered. Practical implications Results from this study provided informative and practicable approaches to improve primary health care data completeness and accuracy especially in developing nations where resources are limited. Originality/value Primary care data quality studies in developing nations are limited. Understanding errors and missing data enables researchers and health service administrators to prevent quality-related problems in primary care data.

Recurrent Merkel cell carcinoma of the testis with unknown primary site: a case report.

Science.gov (United States)

Mweempwa, Angela; Tan, Alvin; Dray, Michael

2016-11-05

Merkel cell carcinoma is a rare and aggressive neuroendocrine tumor that commonly arises in the skin. It is rare for it to occur in the testes. There are only seven cases of testicular Merkel cell carcinoma reported in the literature. A 66-year-old Maori man presented to our hospital with left testicular swelling. His alpha-fetoprotein and beta-human chorionic gonadotrophin levels were within normal limits. His lactate dehydrogenase concentration was elevated to 267 U/L. Ultrasound imaging confirmed a large testicular mass, and he underwent left orchiectomy. His histological examination revealed a neuroendocrine tumor with an immunostaining pattern suggesting Merkel cell carcinoma. He presented to our hospital again 3 months later with right testicular swelling that was confirmed on ultrasound sonography to be a tumor. He underwent a right orchiectomy, and his histological examination revealed metastatic Merkel cell carcinoma. A primary lesion was not identified, and computed tomographic imaging did not reveal spread to other organs. He received six cycles of adjuvant carboplatin and etoposide chemotherapy and remained disease-free 18 months after completion of chemotherapy. Given the paucity of studies, standard adjuvant treatment for testicular Merkel cell carcinoma remains uncertain, although platinum-based chemotherapy seems to be an appropriate option.

Decentralised output feedback control of Markovian jump interconnected systems with unknown interconnections

Science.gov (United States)

Li, Li-Wei; Yang, Guang-Hong

2017-07-01

The problem of decentralised output feedback control is addressed for Markovian jump interconnected systems with unknown interconnections and general transition rates (TRs) allowed to be unknown or known with uncertainties. A class of decentralised dynamic output feedback controllers are constructed, and a cyclic-small-gain condition is exploited to dispose the unknown interconnections so that the resultant closed-loop system is stochastically stable and satisfies an H∞ performance. With slack matrices to cope with the nonlinearities incurred by unknown and uncertain TRs in control synthesis, a novel controller design condition is developed in linear matrix inequality formalism. Compared with the existing works, the proposed approach leads to less conservatism. Finally, two examples are used to illustrate the effectiveness of the new results.

Primary cultures of glomerular parietal epithelial cells or podocytes with proven origin.

NARCIS (Netherlands)

Kabgani, N.; Grigoleit, T.; Schulte, K.; Sechi, A.; Sauer-Lehnen, S.; Tag, C.; Boor, P.; Kuppe, C.; Warsow, G.; Schordan, S.; Mostertz, J.; Chilukoti, R.K.; Homuth, G.; Endlich, N.; Tacke, F.; Weiskirchen, R.; Fuellen, G.; Endlich, K.; Floege, J.; Smeets, B.; Moeller, M.J.

2012-01-01

Parietal epithelial cells (PECs) are crucially involved in the pathogenesis of rapidly progressive glomerulonephritis (RPGN) as well as in focal and segmental glomerulosclerosis (FSGS). In this study, transgenic mouse lines were used to isolate pure, genetically tagged primary cultures of PECs or

Autonomous Flight in Unknown Indoor Environments

OpenAIRE

Bachrach, Abraham Galton; He, Ruijie; Roy, Nicholas

2009-01-01

This paper presents our solution for enabling a quadrotor helicopter, equipped with a laser rangefinder sensor, to autonomously explore and map unstructured and unknown indoor environments. While these capabilities are already commodities on ground vehicles, air vehicles seeking the same performance face unique challenges. In this paper, we describe the difficulties in achieving fully autonomous helicopter flight, highlighting the differences between ground and helicopter robots that make it ...

Occurrence of an unknown Atlantic eruption in the Chaîne des Puys volcanic field (Massif Central, France)

Science.gov (United States)

Jouannic, G.; Walter-Simonnet, A. V.; Bossuet, G.; Cubizolle, H.; Boivin, P.; Devidal, J. L.; Oberlin, C.

2014-08-01

A volcanic ash layer, called MF1, was recently identified in Holocene sediments from the Gourgon and Molhiac peat bogs (Monts du Forez, French Massif Central). This ash layer consists of colorless shards with a heterogeneous trachytic to rhyolitic composition. The trace elements analyzed by Laser Ablation Inductively Coupled Plasma Mass Spectrometry (LA-ICP-MS) attest to a local origin. Radiocarbon dating of peat samples taken within and below the ash layer indicates the best age at 6339 ± 61 cal yr BP, i.e. an age contemporaneous with the volcanic activity of Montchal, Montcineyre and Pavin volcanoes from the Chaîne des Puys volcanic field. These volcanoes are characterized by basaltic and trachytic products, thus the rhyolitic composition of MF1 tephra suggests that it is likely originated from an unknown eruption. These results again confirm the interest of studying the distal volcanic ash fallouts in order to establish or specify records of past eruptions of volcanic fields. Identification of this new tephra layer also provides an additional tephrochronological marker for Eastern French Massif Central.

Primary carcinoma of the duodenum

International Nuclear Information System (INIS)

Steidle, B.; Huetter, B.; Ziegler, F.

1984-01-01

Primary carcinoma of the duodenum represents about 0.35% of all gastrointestinal carcinomas and is thus a rare disease. The radiological diagnosis of a duodenal origin is made more difficult by the close proximity of the pancreas, biliary system, right kidney and transverse colon. Histologically, duodenal malignant tumours are usually adenocarcinomas. Between 1973 and 1983, eight patients with primary duodenal carcinomas were diagnosed at the University of Tuebingen. Average age of the patients was 67 years. There was no sex difference. Average survival was 3.3 years. (orig.) [de

Designing towards the Unknown: Engaging with Material and Aesthetic Uncertainty

Directory of Open Access Journals (Sweden)

Danielle Wilde

2017-12-01

Full Text Available New materials with new capabilities demand new ways of approaching design. Destabilising existing methods is crucial to develop new methods. Yet, radical destabilisation—where outcomes remain unknown long enough that new discoveries become possible—is not easy in technology design where complex interdisciplinary teams with time and resource constraints need to deliver concrete outcomes on schedule. The Poetic Kinaesthetic Interface project (PKI engages with this problematic directly. In PKI we use unfolding processes—informed by participatory, speculative and critical design—in emergent actions, to design towards unknown outcomes, using unknown materials. The impossibility of this task is proving as useful as it is disruptive. At its most potent, it is destabilising expectations, aesthetics and processes. Keeping the researchers, collaborators and participants in a state of unknowing, is opening the research potential to far-ranging possibilities. In this article we unpack the motivations driving the PKI project. We present our mixed-methodology, which entangles textile crafts, design interactions and materiality to shape an embodied enquiry. Our research outcomes are procedural and methodological. PKI brings together diverse human, non-human, known and unknown actors to discover where the emergent assemblages might lead. Our approach is re-invigorating—as it demands re-envisioning of—the design process.

Fever of unknown origin: prospective comparison of [18F]FDG imaging with a double-head coincidence camera and gallium-67 citrate SPET

International Nuclear Information System (INIS)

Meller, J.; Altenvoerde, G.; Jauho, A.; Behe, M.; Gratz, S.; Luig, H.; Becker, W.; Munzel, U.

2000-01-01

Gallium-67 citrate is currently considered as the tracer of first choice in the diagnostic workup of fever of unknown origin (FUO). Fluorine-18 2'-deoxy-2-fluoro-D-glucose (FDG) has been shown to accumulate in malignant tumours but also in inflammatory processes. The aim of this study was to prospectively evaluate FDG imaging with a double-head coincidence camera (DHCC) in patients with FUO in comparison with planar and single-photon emission tomography (SPET) 67 Ga citrate scanning. Twenty FUO patients underwent FDG imaging with a DHCC which included transaxial and longitudinal whole-body tomography. In 18 of these subjects, 67 Ga citrate whole-body and SPET imaging was performed. The 67 Ga citrate and FDG images were interpreted by two investigators, both blinded to the results of other diagnostic modalities. Forty percent (8/20) of the patients had infection, 25% (5/20) had auto-immune diseases, 10% (2/20) had neoplasms and 15% (3/20) had other diseases. Fever remained unexplained in 10% (2/20) of the patients. Of the 20 patients studied, FDG imaging was positive and essentially contributed to the final diagnosis in 11 (55%). The sensitivity of transaxial FDG tomography in detecting the focus of fever was 84% and the specificity, 86%. Positive and negative predictive values were 92% and 75%, respectively. If the analysis was restricted to the 18 patients who were investigated both with 67 Ga citrate and FDG, sensitivity was 81% and specificity, 86%. Positive and negative predictive values were 90% and 75%, respectively. The diagnostic accuracy of whole-body FDG tomography (again restricted to the aforementioned 18 patients) was lower (sensitivity, 36%; specificity, 86%; positive and negative predictive values, 80% and 46%, respectively). 67 Ga citrate SPET yielded a sensitivity of 67% in detecting the focus of fever and a specificity of 78%. Positive and negative predictive values were 75% and 70%, respectively. A low sensitivity (45%), but combined with a high

Characteristics of Children with Phonologic Disorders of Unknown Origin.

Science.gov (United States)

Shriberg, Lawrence D.; And Others

1986-01-01

Descriptive data are presented from three studies of children referred for assessment of developmental speech disorders. Group findings indicate involvements in mechanism, cognitive, and psychosocial areas. The reliability, learnability, and efficiency of a diagnostic classification system is also considered. (Author/CL)

Evaluation of fever of unknown origin before starting antiretroviral ...

African Journals Online (AJOL)

A 34-year-old woman tested HIV-positive in December 2005, and was referred to a specialist HIV unit in mid-January 2006. She had presented to her general practitioner with oesophageal candidiasis and a history of a cough and occasional loose stools since November 2005, with an 8 kg weight loss over the past 6 ...

[69-year-old patient with seizure of unknown origin].

Science.gov (United States)

Riediger, Ch; Iff, S; Stucki, A; Donati, F; Stanga, Z

2007-03-07

Diseases associated with cobalamin deficiency often present a variety of neurological disorders apart from the well known megaloblastic anaemia as haematological manifestation. The peripheral and the central nervous system can be affected in different levels by the metabolic changes due to an impaired Vitamin B12 metabolism. Based upon an observed case we discuss the manifestation of cerebral convulsion possibly due to a secondarily acquired cobalamin deficiency. We conclude that in de novo cerebral convulsion in the elderly a cobalamin deficiency could play an important role.

Primary mental health prevention themes in published research and academic programs in Israel

OpenAIRE

Nakash, Ora; Razon, Liat; Levav, Itzhak

2015-01-01

Background The World Health Organization Comprehensive Mental Health Action Plan (CMHAP) 2013?2020 proposes the implementation of primary prevention strategies to reduce the mental health burden of disease. The extent to which Israeli academic programs and published research adhere to the principles spelled out by the CMHAP is unknown. Objective To investigate the presence of mental health primary prevention themes in published research and academic programs in Israel. Methods We searched for...

A perspective on plant origin radiolabeled compounds, their biological affinities and interaction between plant extracts with radiopharmaceuticals

International Nuclear Information System (INIS)

Zumrut Biber Muftuler, F.; Ayfer Yurt Kilcar; Perihan Unak

2015-01-01

Plant origin products having anticancer properties come into prominence due to widespread of cancer. There is significant increase on the usage of plant origin products and their purification to investigate the potential use at the treatment and diagnosis. Plant origin radiolabeled compounds have been attracting more scientific attention since the achievement of earlier researches. Furthermore, plant extracts are consumed quite a lot with unknown side effects of their contents. Researchers focus on investigation of their interactions with radiopharmaceuticals. Current review is carried out to evaluate the contribution of plant extracts for the development of new plant origin radiolabeled ( 125 / 131 I, 99m Tc) compounds for imaging and/or therapy and to investigate the interaction of plant extracts with radiopharmaceuticals. (author)

Short- and Long-Term Cause of Death in Patients Treated With Primary PCI for STEMI

DEFF Research Database (Denmark)

Pedersen, Frants; Butrymovich, Vitalij; Kelbæk, Henning

2014-01-01

BACKGROUND: Short-term mortality has been studied thoroughly in patients undergoing primary percutaneous coronary intervention (PCI), whereas long-term cause of death in patients with ST-segment elevation myocardial infarction (STEMI) remains unknown. OBJECTIVES: The goal of this study was to des......BACKGROUND: Short-term mortality has been studied thoroughly in patients undergoing primary percutaneous coronary intervention (PCI), whereas long-term cause of death in patients with ST-segment elevation myocardial infarction (STEMI) remains unknown. OBJECTIVES: The goal of this study...... was to describe the association between time and cause of death in patients with STEMI undergoing primary PCI. METHODS: A centralized civil registration system, patient files, and public disease and death cause registries with an accurate record linkage were used to trace time and cause of death in 2......,804 consecutive patients with STEMI (age 63 ± 13 years, 72% males) treated with primary PCI. RESULTS: Patients were followed up for a median of 4.7 years. During a total of 13,447 patient-years, 717 patients died. Main causes of death within the first 30 days were cardiogenic shock and anoxic brain injury after...

High-Resolution Profiling of Drosophila Replication Start Sites Reveals a DNA Shape and Chromatin Signature of Metazoan Origins

Directory of Open Access Journals (Sweden)

Federico Comoglio

2015-05-01

Full Text Available At every cell cycle, faithful inheritance of metazoan genomes requires the concerted activation of thousands of DNA replication origins. However, the genetic and chromatin features defining metazoan replication start sites remain largely unknown. Here, we delineate the origin repertoire of the Drosophila genome at high resolution. We address the role of origin-proximal G-quadruplexes and suggest that they transiently stall replication forks in vivo. We dissect the chromatin configuration of replication origins and identify a rich spatial organization of chromatin features at initiation sites. DNA shape and chromatin configurations, not strict sequence motifs, mark and predict origins in higher eukaryotes. We further examine the link between transcription and origin firing and reveal that modulation of origin activity across cell types is intimately linked to cell-type-specific transcriptional programs. Our study unravels conserved origin features and provides unique insights into the relationship among DNA topology, chromatin, transcription, and replication initiation across metazoa.

Towards high-speed autonomous navigation of unknown environments

Science.gov (United States)

Richter, Charles; Roy, Nicholas

2015-05-01

In this paper, we summarize recent research enabling high-speed navigation in unknown environments for dynamic robots that perceive the world through onboard sensors. Many existing solutions to this problem guarantee safety by making the conservative assumption that any unknown portion of the map may contain an obstacle, and therefore constrain planned motions to lie entirely within known free space. In this work, we observe that safety constraints may significantly limit performance and that faster navigation is possible if the planner reasons about collision with unobserved obstacles probabilistically. Our overall approach is to use machine learning to approximate the expected costs of collision using the current state of the map and the planned trajectory. Our contribution is to demonstrate fast but safe planning using a learned function to predict future collision probabilities.

Elimination of some unknown parameters and its effect on outlier detection

Directory of Open Access Journals (Sweden)

Serif Hekimoglu

Full Text Available Outliers in observation set badly affect all the estimated unknown parameters and residuals, that is because outlier detection has a great importance for reliable estimation results. Tests for outliers (e.g. Baarda's and Pope's tests are frequently used to detect outliers in geodetic applications. In order to reduce the computational time, sometimes elimination of some unknown parameters, which are not of interest, is performed. In this case, although the estimated unknown parameters and residuals do not change, the cofactor matrix of the residuals and the redundancies of the observations change. In this study, the effects of the elimination of the unknown parameters on tests for outliers have been investigated. We have proved that the redundancies in initial functional model (IFM are smaller than the ones in reduced functional model (RFM where elimination is performed. To show this situation, a horizontal control network was simulated and then many experiences were performed. According to simulation results, tests for outlier in IFM are more reliable than the ones in RFM.

Evolutionary origins, molecular cloning and expression of carotenoid hydroxylases in eukaryotic photosynthetic algae

Science.gov (United States)

2013-01-01

Background Xanthophylls, oxygenated derivatives of carotenes, play critical roles in photosynthetic apparatus of cyanobacteria, algae, and higher plants. Although the xanthophylls biosynthetic pathway of algae is largely unknown, it is of particular interest because they have a very complicated evolutionary history. Carotenoid hydroxylase (CHY) is an important protein that plays essential roles in xanthophylls biosynthesis. With the availability of 18 sequenced algal genomes, we performed a comprehensive comparative analysis of chy genes and explored their distribution, structure, evolution, origins, and expression. Results Overall 60 putative chy genes were identified and classified into two major subfamilies (bch and cyp97) according to their domain structures. Genes in the bch subfamily were found in 10 green algae and 1 red alga, but absent in other algae. In the phylogenetic tree, bch genes of green algae and higher plants share a common ancestor and are of non-cyanobacterial origin, whereas that of red algae is of cyanobacteria. The homologs of cyp97a/c genes were widespread only in green algae, while cyp97b paralogs were seen in most of algae. Phylogenetic analysis on cyp97 genes supported the hypothesis that cyp97b is an ancient gene originated before the formation of extant algal groups. The cyp97a gene is more closely related to cyp97c in evolution than to cyp97b. The two cyp97 genes were isolated from the green alga Haematococcus pluvialis, and transcriptional expression profiles of chy genes were observed under high light stress of different wavelength. Conclusions Green algae received a β-xanthophylls biosynthetic pathway from host organisms. Although red algae inherited the pathway from cyanobacteria during primary endosymbiosis, it remains unclear in Chromalveolates. The α-xanthophylls biosynthetic pathway is a common feature in green algae and higher plants. The origination of cyp97a/c is most likely due to gene duplication before divergence of

Evolutionary origins, molecular cloning and expression of carotenoid hydroxylases in eukaryotic photosynthetic algae.

Science.gov (United States)

Cui, Hongli; Yu, Xiaona; Wang, Yan; Cui, Yulin; Li, Xueqin; Liu, Zhaopu; Qin, Song

2013-07-08

Xanthophylls, oxygenated derivatives of carotenes, play critical roles in photosynthetic apparatus of cyanobacteria, algae, and higher plants. Although the xanthophylls biosynthetic pathway of algae is largely unknown, it is of particular interest because they have a very complicated evolutionary history. Carotenoid hydroxylase (CHY) is an important protein that plays essential roles in xanthophylls biosynthesis. With the availability of 18 sequenced algal genomes, we performed a comprehensive comparative analysis of chy genes and explored their distribution, structure, evolution, origins, and expression. Overall 60 putative chy genes were identified and classified into two major subfamilies (bch and cyp97) according to their domain structures. Genes in the bch subfamily were found in 10 green algae and 1 red alga, but absent in other algae. In the phylogenetic tree, bch genes of green algae and higher plants share a common ancestor and are of non-cyanobacterial origin, whereas that of red algae is of cyanobacteria. The homologs of cyp97a/c genes were widespread only in green algae, while cyp97b paralogs were seen in most of algae. Phylogenetic analysis on cyp97 genes supported the hypothesis that cyp97b is an ancient gene originated before the formation of extant algal groups. The cyp97a gene is more closely related to cyp97c in evolution than to cyp97b. The two cyp97 genes were isolated from the green alga Haematococcus pluvialis, and transcriptional expression profiles of chy genes were observed under high light stress of different wavelength. Green algae received a β-xanthophylls biosynthetic pathway from host organisms. Although red algae inherited the pathway from cyanobacteria during primary endosymbiosis, it remains unclear in Chromalveolates. The α-xanthophylls biosynthetic pathway is a common feature in green algae and higher plants. The origination of cyp97a/c is most likely due to gene duplication before divergence of green algae and higher plants

Classifying brain metastases by their primary site of origin using a radiomics approach based on texture analysis: a feasibility study.

Science.gov (United States)

Ortiz-Ramón, Rafael; Larroza, Andrés; Ruiz-España, Silvia; Arana, Estanislao; Moratal, David

2018-05-14

To examine the capability of MRI texture analysis to differentiate the primary site of origin of brain metastases following a radiomics approach. Sixty-seven untreated brain metastases (BM) were found in 3D T1-weighted MRI of 38 patients with cancer: 27 from lung cancer, 23 from melanoma and 17 from breast cancer. These lesions were segmented in 2D and 3D to compare the discriminative power of 2D and 3D texture features. The images were quantized using different number of gray-levels to test the influence of quantization. Forty-three rotation-invariant texture features were examined. Feature selection and random forest classification were implemented within a nested cross-validation structure. Classification was evaluated with the area under receiver operating characteristic curve (AUC) considering two strategies: multiclass and one-versus-one. In the multiclass approach, 3D texture features were more discriminative than 2D features. The best results were achieved for images quantized with 32 gray-levels (AUC = 0.873 ± 0.064) using the top four features provided by the feature selection method based on the p-value. In the one-versus-one approach, high accuracy was obtained when differentiating lung cancer BM from breast cancer BM (four features, AUC = 0.963 ± 0.054) and melanoma BM (eight features, AUC = 0.936 ± 0.070) using the optimal dataset (3D features, 32 gray-levels). Classification of breast cancer and melanoma BM was unsatisfactory (AUC = 0.607 ± 0.180). Volumetric MRI texture features can be useful to differentiate brain metastases from different primary cancers after quantizing the images with the proper number of gray-levels. • Texture analysis is a promising source of biomarkers for classifying brain neoplasms. • MRI texture features of brain metastases could help identifying the primary cancer. • Volumetric texture features are more discriminative than traditional 2D texture features.

Rendezvous with connectivity preservation for multi-robot systems with an unknown leader

Science.gov (United States)

Dong, Yi

2018-02-01

This paper studies the leader-following rendezvous problem with connectivity preservation for multi-agent systems composed of uncertain multi-robot systems subject to external disturbances and an unknown leader, both of which are generated by a so-called exosystem with parametric uncertainty. By combining internal model design, potential function technique and adaptive control, two distributed control strategies are proposed to maintain the connectivity of the communication network, to achieve the asymptotic tracking of all the followers to the output of the unknown leader system, as well as to reject unknown external disturbances. It is also worth to mention that the uncertain parameters in the multi-robot systems and exosystem are further allowed to belong to unknown and unbounded sets when applying the second fully distributed control law containing a dynamic gain inspired by high-gain adaptive control or self-tuning regulator.

Searching for the origin of masses

International Nuclear Information System (INIS)

Iwasaki, Hiroyuki

2002-01-01

The origin of masses of weak gauge bosons as well as quarks and leptons is one of the most mysterious themes in high energy physics. In the standard model, it is explained as a result of a spontaneous symmetry breaking of the vacuum, which is caused by self-interaction of an unknown complex scalar field. Three weak gauge bosons acquire their masses by 'eating' the three components of the scalar field. The remaining one component survives and called the 'Higgs boson'. Masses of quarks and leptons are generated by an interaction between those particles and the scalar field. Searching for the Higgs boson is a key step toward deeper understanding of nature. In the lecture, a brief introduction of theoretical aspects and an experimental approach based on an ongoing project will be given

Lod score curves for phase-unknown matings.

Science.gov (United States)

Hulbert-Shearon, T; Boehnke, M; Lange, K

1996-01-01

For a phase-unknown nuclear family, we show that the likelihood and lod score are unimodal, and we describe conditions under which the maximum occurs at recombination fraction theta = 0, theta = 1/2, and 0 < theta < 1/2. These simply stated necessary and sufficient conditions seem to have escaped the notice of previous statistical geneticists.

Adaptive Incentive Controls for Stackelberg Games with Unknown Cost Functionals.

Science.gov (United States)

1984-01-01

APR EZT:: F I AN 73S e OsL:-: UNCLASSI?:-- Q4~.’~- .A.., 6, *~*i i~~*~~*.- U ADAPTIVE INCENTIVE CONTROLS FOR STACKELBERG GAMES WITH UNKNOWN COST...AD-A161 885 ADAPTIVE INCENTIVE CONTROLS FOR STACKELBERG GAMES WITH i/1 UNKNOWN COST FUNCTIONALSCU) ILLINOIS UNIV AT URBANA DECISION AND CONTROL LAB T...ORGANIZATION 6b. OFFICE SYMBOL 7.. NAME OF MONITORING ORGANIZATION CoriaeLcenef~pda~ Joint Services Electronics Program Laboratory, Univ. of Illinois N/A

M-MRAC Backstepping for Systems with Unknown Virtual Control Coefficients

Science.gov (United States)

Stepanyan, Vahram; Krishnakumar, Kalmanje

2015-01-01

The paper presents an over-parametrization free certainty equivalence state feedback backstepping adaptive control design method for systems of any relative degree with unmatched uncertainties and unknown virtual control coefficients. It uses a fast prediction model to estimate the unknown parameters, which is independent of the control design. It is shown that the system's input and output tracking errors can be systematically decreased by the proper choice of the design parameters. The benefits of the approach are demonstrated in numerical simulations.

Plasma Outflows: Known Knowns, Known Unknowns, and The Unknown

Science.gov (United States)

Moore, T. E.

2012-01-01

A brief summary is given of i) what we know from observing ionospheric outflows and ii) how outflow parameterizations are being used in global simulations to evaluate their effects on magnetospheric dynamics. Then, a list of unanswered questions and issues to be resolved is given, followed by a description of the known future mission plans expressed in the Heliophysics Roadmap, such as Origin of Near-Earth Plasmas (ONEP), and Ion-Neutral Coupling in the Atmosphere (INCA). Finally, a set of requirements for definitive plasma outflow observations are identified, along with possible methods for fulfilling them in future missions. Since results of the current Heliophysics Decadal Survey are expected soon, it is hoped that future plans can be summarized and discussed without speculation at the GEM 2012 meeting.

North American montane red foxes: expansion, fragmentation, and the origin of the Sacramento Valley red fox

Science.gov (United States)

Benjamin N. Sacks; Mark J. Statham; John D. Perrine; Samantha M. Wisely; Keith B. Aubry

2010-01-01

Most native red foxes (Vulpes vulpes) in the western contiguous United States appear to be climatically restricted to colder regions in the major mountain ranges and, in some areas, have suffered precipitous declines in abundance that may be linked to warming trends. However, another population of unknown origin has occurred in arid habitats in the...

Contemporary management of lymph node metastases from an unknown primary to the neck : I. A review of diagnostic approaches

NARCIS (Netherlands)

Strojan, Primoz; Ferlito, Alfio; Medina, Jesus E.; Woolgar, Julia A.; Rinaldo, Alessandra; Robbins, K. Thomas; Fagan, Johannes J.; Mendenhall, William M.; Paleri, Vinidh; Silver, Carl E.; Olsen, Kerry D.; Corry, June; Suarez, Carlos; Rodrigo, Juan P.; Langendijk, Johannes A.; Devaney, Kenneth O.; Kowalski, Luiz P.; Hartl, Dana M.; Haigentz, Missak; Werner, Jochen A.; Pellitteri, Phillip K.; de Bree, Remco; Wolf, Gregory T.; Takes, Robert P.; Genden, Eric M.; Hinni, Michael L.; Mondin, Vanni; Shaha, Ashok R.; Barnes, Leon

In an era of advanced diagnostics, metastasis to cervical lymph nodes from an occult primary tumor is a rare clinical entity and accounts for approximately 3% of head and neck malignancies. Histologically, two thirds of cases are squamous cell carcinomas (SCCs), with other tissue types less common

Contemporary management of lymph node metastases from an unknown primary to the neck: I. A review of diagnostic approaches

NARCIS (Netherlands)

Strojan, P.; Ferlito, A.; Medina, J.E.; Woolgar, J.A.; Rinaldo, A.; Robbins, K.T.; Fagan, J.J.; Mendenhall, W.M.; Paleri, V.; Silver, C.E.; Olsen, K.D.; Corry, J.; Suarez, C.; Rodrigo, J.P.; Langendijk, J.A.; Devaney, K.O.; Kowalski, L.P.; Hartl, D.M.; Haigentz Jr., M.; Werner, J.A.; Pellitteri, P.K.; Bree, R. de; Wolf, G.T.; Takes, R.P.; Genden, E.M.; Hinni, M.L.; Mondin, V.; Shaha, A.R.; Barnes, L.

2013-01-01

In an era of advanced diagnostics, metastasis to cervical lymph nodes from an occult primary tumor is a rare clinical entity and accounts for approximately 3% of head and neck malignancies. Histologically, two thirds of cases are squamous cell carcinomas (SCCs), with other tissue types less common

Asteroid Origins Satellite (AOSAT): Science in a CubeSat Centrifuge

Science.gov (United States)

Perera, V.; Cotto-Figueroa, D.; Noviello, J.; Asphaug, E.; Morris, M.

2015-01-01

Both the study of primary accretion and the surface properties of asteroids are important for the field of planetary science. The Asteroid Origins Satellite (AOSAT) will help study these subjects by creating a long duration microgravity laboratory.

Primary localized amyloidosis of the eyelid

DEFF Research Database (Denmark)

Olsen, K E; Sandgren, O; Sletten, K

1996-01-01

Primary localized amyloidosis has been described in many different organs in the body. Studies by immunohistochemical techniques have suggested an immunoglobulin light chain origin of the amyloid material. Only in a limited number of cases has the amyloid protein been characterized by amino acid...

Temperature sensing by primary roots of maize

Science.gov (United States)

Poff, K. L.

1990-01-01

Zea mays L. seedlings, grown on agar plates at 26 degrees C, reoriented the original vertical direction of their primary root when exposed to a thermal gradient applied perpendicular to the gravity vector. The magnitude and direction of curvature can not be explained simply by either a temperature or a humidity effect on root elongation. It is concluded that primary roots of maize sense temperature gradients in addition to sensing the gravitational force.

Speeding up transmissions of unknown quantum information along Ising-type quantum channels

International Nuclear Information System (INIS)

Guo W J; Wei L F

2017-01-01

Quantum teleportation with entanglement channels and a series of two-qubit SWAP gates between the nearest-neighbor qubits are usually utilized to achieve the transfers of unknown quantum state from the sender to the distant receiver. In this paper, by simplifying the usual SWAP gates we propose an approach to speed up the transmissions of unknown quantum information, specifically including the single-qubit unknown state and two-qubit unknown entangled ones, by a series of entangling and disentangling operations between the remote qubits with distant interactions. The generic proposal is demonstrated specifically with experimentally-existing Ising-type quantum channels without transverse interaction; liquid NMR-molecules driven by global radio frequency electromagnetic pulses and capacitively-coupled Josephson circuits driven by local microwave pulses. The proposal should be particularly useful to set up the connections between the distant qubits in a chip of quantum computing. (paper)

Robust Control for the Segway with Unknown Control Coefficient and Model Uncertainties

Directory of Open Access Journals (Sweden)

Byung Woo Kim

2016-06-01

Full Text Available The Segway, which is a popular vehicle nowadays, is an uncertain nonlinear system and has an unknown time-varying control coefficient. Thus, we should consider the unknown time-varying control coefficient and model uncertainties to design the controller. Motivated by this observation, we propose a robust control for the Segway with unknown control coefficient and model uncertainties. To deal with the time-varying unknown control coefficient, we employ the Nussbaum gain technique. We introduce an auxiliary variable to solve the underactuated problem. Due to the prescribed performance control technique, the proposed controller does not require the adaptive technique, neural network, and fuzzy logic to compensate the uncertainties. Therefore, it can be simple. From the Lyapunov stability theory, we prove that all signals in the closed-loop system are bounded. Finally, we provide the simulation results to demonstrate the effectiveness of the proposed control scheme.

Identification of fractional-order systems with unknown initial values and structure

Energy Technology Data Exchange (ETDEWEB)

Du, Wei, E-mail: duwei0203@gmail.com [Key Laboratory of Advanced Control and Optimization for Chemical Processes, Ministry of Education, East China University of Science and Technology, Shanghai 200237 (China); Miao, Qingying, E-mail: qymiao@sjtu.edu.cn [School of Continuing Education, Shanghai Jiao Tong University, Shanghai 200030 (China); Tong, Le, E-mail: tongle0328@gmail.com [Faculty of Applied Science and Textiles, The Hong Kong Polytechnic University, Hong Kong (China); Tang, Yang [Key Laboratory of Advanced Control and Optimization for Chemical Processes, Ministry of Education, East China University of Science and Technology, Shanghai 200237 (China)

2017-06-21

In this paper, the identification problem of fractional-order chaotic systems is proposed and investigated via an evolutionary optimization approach. Different with other studies to date, this research focuses on the identification of fractional-order chaotic systems with not only unknown orders and parameters, but also unknown initial values and structure. A group of fractional-order chaotic systems, i.e., Lorenz, Lü, Chen, Rössler, Arneodo and Volta chaotic systems, are set as the system candidate pool. The identification problem of fractional-order chaotic systems in this research belongs to mixed integer nonlinear optimization in essence. A powerful evolutionary algorithm called composite differential evolution (CoDE) is introduced for the identification problem presented in this paper. Extensive experiments are carried out to show that the fractional-order chaotic systems with unknown initial values and structure can be successfully identified by means of CoDE. - Highlights: • Unknown initial values and structure are introduced in the identification of fractional-order chaotic systems; • Only a series of output is utilized in the identification of fractional-order chaotic systems; • CoDE is used for the identification problem and the results are satisfactory when compared with other DE variants.

Primary Ectopic Ethmoidal Craniopharyngioma.

Science.gov (United States)

Preti, Andrea; Karligkiotis, Apostolos; Facco, Carla; Ottini, Giorgia; Volpi, Luca; Castelnuovo, Paolo

2017-06-01

Craniopharyngiomas are benign but aggressive epithelial tumors usually originating in the anterior lobe of the pituitary gland from squamous remnants of an incompletely involuted craniopharingeal duct developing from the Rathke pouch. To the authors' knowledge only 1 patient of a primary isolated ethmoidal craniopharyngioma has been reported in the literature.The authors report the case of a 17-year-old boy with a primary extracranial ethmoidal craniopharyngioma. An endoscopic endonasal approach was employed to resect the tumor. After 2 years of clinical and radiological follow-up no recurrence of disease was observed.Primary ethmoidal craniopharyngiomas are rare entities and biopsy is necessary for diagnosis. However, a preoperative assessment by means of nasal endoscopy, computed tomography scan, and enhanced magnetic resonance imaging is mandatory to better evaluate the extension and characteristics of the tumor. The endoscopic endonasal technique is a safe and effective approach for the treatment of these lesions.

Multidimensional procurement auctions with unknown weights

DEFF Research Database (Denmark)

Greve, Thomas

This paper studies the consequences of holding a procurement auction when the principal chooses not to show its preferences. My paper extends the procurement auction model of Che (1993) to a situation where both the principal and the agents have private information. Thus, unknown parameters of bo...... gives rise to an analysis of a principal that can not fully commit to the outcome induced by the scoring rule. Therefore, my result apply to contract theory and it’s problems with imperfect commitment....

Three-Party Quantum State Sharing of an Arbitrary Unknown Two-Qubit State Based on Entanglement Swapping and Bell-State Measurements

International Nuclear Information System (INIS)

Yuan Hao; Song Jun; Hou Kui; Hu Xiaoyuan; Shi Shouhua; Han Lianfang

2009-01-01

We propose a scheme for sharing an arbitrary unknown two-qubit state among three parties by using a four-qubit cluster-class state and a Bell state as a quantum channel. With a quantum controlled phase gate (QCPG) operation and a local unitary operation, any one of the two agents has the access to reconstruct the original state if he/she collaborates with the other one, whilst individual agent obtains no information. As all quantum resource can be used to carry the useful information, the intrinsic efficiency of qubits approaches the maximal value. Moreover, the present scheme is more feasible with present-day technique.

Estimation of livestock appropriation of net primary productivity in Texas Drylands

Science.gov (United States)

Robert Washington-Allen; Jody Fitzgerald; Stephanie Grounds; Faisar Jihadi; John Kretzschmar; Kathryn Ramirez; John Mitchell

2009-01-01

The ecological state of US Drylands is unknown. This research is developing procedures to determine the impact of the ecological footprint of grazing livestock on the productive capacity of US Drylands. A pilot geodatabase was developed for the state of Texas that includes 2002 data for county boundaries, net primary productivity (NPP) derived from the Moderate...

Clostridium difficile: A healthcare-associated infection of unknown ...

African Journals Online (AJOL)

Clostridium difficile: A healthcare-associated infection of unknown significance in adults in sub-Saharan Africa. ... Abstract. Background: Clostridium difficile infection (CDI) causes a high burden of disease in high-resource healthcare systems, with significant morbidity, mortality, and financial implications. CDI is a ...

Glioblastoma Cell Malignancy and Drug Sensitivity Are Affected by the Cell of Origin

Directory of Open Access Journals (Sweden)

Yiwen Jiang

2017-01-01

Full Text Available The identity of the glioblastoma (GBM cell of origin and its contributions to disease progression and treatment response remain largely unknown. We have analyzed how the phenotypic state of the initially transformed cell affects mouse GBM development and essential GBM cell (GC properties. We find that GBM induced in neural stem-cell-like glial fibrillary acidic protein (GFAP-expressing cells in the subventricular zone of adult mice shows accelerated tumor development and produces more malignant GCs (mGC1GFAP that are less resistant to cancer drugs, compared with those originating from more differentiated nestin- (mGC2NES or 2,′3′-cyclic nucleotide 3′-phosphodiesterase (mGC3CNP-expressing cells. Transcriptome analysis of mouse GCs identified a 196 mouse cell origin (MCO gene signature that was used to partition 61 patient-derived GC lines. Human GC lines that clustered with the mGC1GFAP cells were also significantly more self-renewing, tumorigenic, and sensitive to cancer drugs compared with those that clustered with mouse GCs of more differentiated origin.

Severe scratcher-reaction: an unknown health hazard?

Directory of Open Access Journals (Sweden)

Carsten Sauer Mikkelsen

2015-03-01

Full Text Available Tattoos are well known to cause skin problems and the number of reported adverse reactions after tattooing has increased. Illegally imported tattoo ink is unrestrained and can contain unknown ingredients and contamination thereby posing a serious health hazard. We present a case illustrating the risk of pronounced phototoxic allergic reaction and other severe complications after using home kit tattoo ink.

Documenting costs and yield of crops of organic origin

Directory of Open Access Journals (Sweden)

J.P. Melnychuk

2016-06-01

Full Text Available The article focuses on the study of primary cost accounting and output of organic crop production. The article has also agreed the key issues that ensure in the primary accounting of organic crop production. For the survey we have used such general scientific methods as induction and deduction, dialectic, historical and systematic methods and some specific methods of accounting which include documentation, inventory, assessment, calculation, accounting records, double entry, balance sheet and financial statements. . As for the documentation of costs and yield of crops of organic origin, it should be noted that documentation is an important method of accounting as it’s the basis of initial observation of commercial operations and it’s a prerequisite for their reflection in accounting. The article has highlighted the features of documenting the posting of production costs and crop production of organic origin, and has also studied the order of registration of land in the operating lease for the production of organic products. The author submits the suggestions for improvement of documenting costs and yields of organic crop production in order to develop reliable information about the costs of production and the grown crop of organic origin for management decision-making.

Row Reduced Echelon Form for Solving Fully Fuzzy System with Unknown Coefficients

Directory of Open Access Journals (Sweden)

Ghassan Malkawi

2014-08-01

Full Text Available This study proposes a new method for finding a feasible fuzzy solution in positive Fully Fuzzy Linear System (FFLS, where the coefficients are unknown. The fully fuzzy system is transferred to linear system in order to obtain the solution using row reduced echelon form, thereafter; the crisp solution is restricted in obtaining the positive fuzzy solution. The fuzzy solution of FFLS is included crisp intervals, to assign alternative values of unknown entries of fuzzy numbers. To illustrate the proposed method, numerical examples are solved, where the entries of coefficients are unknown in right or left hand side, to demonstrate the contributions in this study.

Functional and genetic deconstruction of the cellular origin in liver cancer

DEFF Research Database (Denmark)

Marquardt, Jens U; Andersen, Jesper B; Thorgeirsson, Snorri S

2015-01-01

During the past decade, research on primary liver cancers has particularly highlighted the uncommon plasticity of differentiated parenchymal liver cells (that is, hepatocytes and cholangiocytes (also known as biliary epithelial cells)), the role of liver progenitor cells in malignant transformation......, the importance of the tumour microenvironment and the molecular complexity of liver tumours. Whereas other reviews have focused on the landscape of genetic alterations that promote development and progression of primary liver cancers and the role of the tumour microenvironment, the crucial importance...... of the cellular origin of liver cancer has been much less explored. Therefore, in this Review, we emphasize the importance and complexity of the cellular origin in tumour initiation and progression, and attempt to integrate this aspect with recent discoveries in tumour genomics and the contribution...

Vision-based autonomous grasping of unknown piled objects

International Nuclear Information System (INIS)

Johnson, R.K.

1994-01-01

Computer vision techniques have been used to develop a vision-based grasping capability for autonomously picking and placing unknown piled objects. This work is currently being applied to the problem of hazardous waste sorting in support of the Department of Energy's Mixed Waste Operations Program

48 CFR 52.222-49 - Service Contract Act-Place of Performance Unknown.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Service Contract Act-Place... Provisions and Clauses 52.222-49 Service Contract Act—Place of Performance Unknown. As prescribed in 22.1006(f), insert the following clause: Service Contract Act—Place of Performance Unknown (MAY 1989) (a...

Autosomal recessive primary microcephaly (MCPH): clinical manifestations, genetic heterogeneity and mutation continuum

Science.gov (United States)

2011-01-01

Autosomal Recessive Primary Microcephaly (MCPH) is a rare disorder of neurogenic mitosis characterized by reduced head circumference at birth with variable degree of mental retardation. In MCPH patients, brain size reduced to almost one-third of its original volume due to reduced number of generated cerebral cortical neurons during embryonic neurogensis. So far, seven genetic loci (MCPH1-7) for this condition have been mapped with seven corresponding genes (MCPH1, WDR62, CDK5RAP2, CEP152, ASPM, CENPJ, and STIL) identified from different world populations. Contribution of ASPM and WDR62 gene mutations in MCPH World wide is more than 50%. By and large, primary microcephaly patients are phenotypically indistinguishable, however, recent studies in patients with mutations in MCPH1, WDR62 and ASPM genes showed a broader clinical and/or cellular phenotype. It has been proposed that mutations in MCPH genes can cause the disease phenotype by disturbing: 1) orientation of mitotic spindles, 2) chromosome condensation mechanism during embryonic neurogenesis, 3) DNA damage-response signaling, 4) transcriptional regulations and microtubule dynamics, 5) certain unknown centrosomal mechanisms that control the number of neurons generated by neural precursor cells. Recent discoveries of mammalian models for MCPH have open up horizons for researchers to add more knowledge regarding the etiology and pathophysiology of MCPH. High incidence of MCPH in Pakistani population reflects the most probable involvement of consanguinity. Genetic counseling and clinical management through carrier detection/prenatal diagnosis in MCPH families can help reducing the incidence of this autosomal recessive disorder. PMID:21668957

Cosmic ray antimatter: Is it primary or secondary?

Science.gov (United States)

Stecker, F. W.; Protheroe, R. J.; Kazanas, D.

1981-01-01

The relative merits and difficulties of the primary and secondary origin hypotheses for the observed cosmic ray antiprotons, including the low energy measurement of Buffington, were examined. It is concluded that the cosmic ray antiproton data may be strong evidence for antimatter galaxies and baryon symmetric cosmology. The present antiproton data are consistent with a primary extragalactic component having antiproton/proton approximately equal to .0032 + or - 0.7.

[Early diagnosis of HIV in Primary Care in Spain. Results of a pilot study based on targeted screening based on indicator conditions, behavioral criteria and region of origin].

Science.gov (United States)

Agustí, Cristina; Martín-Rabadán, María; Zarco, José; Aguado, Cristina; Carrillo, Ricard; Codinachs, Roger; Carmona, Jose Manuel; Casabona, Jordi

2018-03-01

To estimate the prevalence of HIV infection in patients diagnosed with an indicator condition (IC) for HIV and/or risk behavior for their acquisition and/or coming from high prevalence countries. To determine the acceptability and feasibility of offering HIV testing based on IC and behavioral and origin criteria in Primary Care (PC). Cross-sectional study in a convenience sample. Six PC centers in Spain. The inclusion criteria were: patients between 16 and 65years old who presented at least one of the proposed ICs and/or at least one of the proposed behavioral and/or origin criteria. A total of 388 patients participated. HIV serology was offered to all patients who met the inclusion criteria. Description of IC frequency, behavioral and origin criteria. Prevalence of HIV infection. Level of acceptability and feasibility of the HIV screening based on IC and behavioral and origin criteria. A total of 174 patients had an IC (44.84%). The most common behavioral criterion was: having unprotected sex at some time in life with people who did not know their HIV status (298; 76.8%). Four HIV+ patients (1.03%) were diagnosed. All had an IC and were men who had sex with men. The level of acceptability in PC was high. Offering HIV testing to patients with IC and behavioral criteria is feasible and effective in PC. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Atmospheric turbulence profiling with unknown power spectral density

Science.gov (United States)

Helin, Tapio; Kindermann, Stefan; Lehtonen, Jonatan; Ramlau, Ronny

2018-04-01

Adaptive optics (AO) is a technology in modern ground-based optical telescopes to compensate for the wavefront distortions caused by atmospheric turbulence. One method that allows to retrieve information about the atmosphere from telescope data is so-called SLODAR, where the atmospheric turbulence profile is estimated based on correlation data of Shack-Hartmann wavefront measurements. This approach relies on a layered Kolmogorov turbulence model. In this article, we propose a novel extension of the SLODAR concept by including a general non-Kolmogorov turbulence layer close to the ground with an unknown power spectral density. We prove that the joint estimation problem of the turbulence profile above ground simultaneously with the unknown power spectral density at the ground is ill-posed and propose three numerical reconstruction methods. We demonstrate by numerical simulations that our methods lead to substantial improvements in the turbulence profile reconstruction compared to the standard SLODAR-type approach. Also, our methods can accurately locate local perturbations in non-Kolmogorov power spectral densities.

Primary amenorrhea in anorexia nervosa: impact on characteristic masculine and feminine traits.

Science.gov (United States)

Baker, Jessica H; Sisk, Cheryl L; Thornton, Laura M; Brandt, Harry; Crawford, Steven; Fichter, Manfred M; Halmi, Katherine A; Johnson, Craig; Jones, Ian; Kaplan, Allan S; Mitchell, James E; Strober, Michael; Treasure, Janet; Woodside, D Blake; Berrettini, Wade H; Kaye, Walter H; Bulik, Cynthia M; Klump, Kelly L

2014-01-01

Animal studies indicate that gonadal hormones at puberty have an effect on the development of masculine and feminine traits. However, it is unknown whether similar processes occur in humans. We examined whether women with anorexia nervosa (AN), who often experience primary amenorrhea, exhibit attenuated feminization in their psychological characteristics in adulthood due to the decrease/absence of gonadal hormones at puberty. Women with AN were compared on a number of psychological characteristics using general linear models on the basis of the presence/absence of primary amenorrhea. Although women with primary amenorrhea exhibited lower anxiety scores than those without primary amenorrhea, in general, results did not provide evidence of attenuated feminization in women with AN with primary amenorrhea. Future research should utilize novel techniques and direct hormone measurement to explore the effects of pubertal gonadal hormones on masculine and feminine traits. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Use of the Graded Prognostic Assessment (GPA) score in patients with brain metastases from primary tumours not represented in the diagnosis-specific GPA studies

Energy Technology Data Exchange (ETDEWEB)

Nieder, C. [Nordland Hospital, Bodoe (Norway). Dept. of Oncology and Palliative Medicine; Tromsoe Univ. (Norway). Inst. of Clinical Medicine; Andratschke, N.H. [University Hospital Rostock (Germany). Dept. of Radiation Oncology; Geinitz, H. [Klinikum rechts der Isar der Technischen Univ. Muenchen (Germany). Dept. of Radiation Oncology; Grosu, A.L. [University Hospital Freiburg (Germany). Dept. of Radiation Oncology

2012-08-15

Background and purpose: Assessment of prognostic factors might influence treatment decisions in patients with brain metastases. Based on large studies, the diagnosis-specific graded prognostic assessment (GPA) score is a useful tool. However, patients with unknown or rare primary tumours are not represented in this model. A pragmatic approach might be use of the first GPA version which is not limited to specific primary tumours. Patients and methods: This retrospective analysis examines for the first time whether the GPA is a valid score in patients not eligible for the diagnosis-specific GPA. It includes 71 patients with unknown primary tumour, bladder cancer, ovarian cancer, thyroid cancer or other uncommon primaries. Survival was evaluated in uni- and multivariate tests. Results: The GPA significantly predicted survival. Moreover, improved survival was seen in patients treated with surgical resection or radiosurgery (SRS) for brain metastases. The older recursive partitioning analysis (RPA) score was significant in univariate analysis. However, the multivariate model with RPA, GPA and surgery or SRS versus none showed that only GPA and type of treatment were independent predictors of survival. Conclusion: Ideally, cooperative research efforts would lead to development of diagnosis-specific scores also for patients with rare or unknown primary tumours. In the meantime, a pragmatic approach of using the general GPA score appears reasonable. (orig.)

Use of the Graded Prognostic Assessment (GPA) score in patients with brain metastases from primary tumours not represented in the diagnosis-specific GPA studies

International Nuclear Information System (INIS)

Nieder, C.; Tromsoe Univ.; Andratschke, N.H.; Geinitz, H.; Grosu, A.L.

2012-01-01

Background and purpose: Assessment of prognostic factors might influence treatment decisions in patients with brain metastases. Based on large studies, the diagnosis-specific graded prognostic assessment (GPA) score is a useful tool. However, patients with unknown or rare primary tumours are not represented in this model. A pragmatic approach might be use of the first GPA version which is not limited to specific primary tumours. Patients and methods: This retrospective analysis examines for the first time whether the GPA is a valid score in patients not eligible for the diagnosis-specific GPA. It includes 71 patients with unknown primary tumour, bladder cancer, ovarian cancer, thyroid cancer or other uncommon primaries. Survival was evaluated in uni- and multivariate tests. Results: The GPA significantly predicted survival. Moreover, improved survival was seen in patients treated with surgical resection or radiosurgery (SRS) for brain metastases. The older recursive partitioning analysis (RPA) score was significant in univariate analysis. However, the multivariate model with RPA, GPA and surgery or SRS versus none showed that only GPA and type of treatment were independent predictors of survival. Conclusion: Ideally, cooperative research efforts would lead to development of diagnosis-specific scores also for patients with rare or unknown primary tumours. In the meantime, a pragmatic approach of using the general GPA score appears reasonable. (orig.)

Sleep duration differences between children of migrant and native origins

NARCIS (Netherlands)

L.J.W.W. Labree (L. J. W. (Wim)); H. van de Mheen (Dike); F.F.H. Rutten (Frans); G. Rodenburg (Gerda); G. Koopmans (Gerrit); M.M.E. Foets (Marleen)

2015-01-01

textabstractAim: To explore whether primary school children of migrant and native Dutch origins differ regarding their sleep duration per night, a risk for overweight and obesity, and to determine to what degree differences in parenting styles contribute to these differences. Subjects and methods: A

The role of human papilloma virus and p16 in occult primary of the head and neck: a comprehensive review of the literature.

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Fotopoulos, George; Pavlidis, Nicholas

2015-02-01

Cancer of unknown primary of the head and neck is a challenging entity for the oncologist. The role of human papilloma virus/p16 in carcinogenesis and in prognosis is well established in certain HNSCC especially in that of the oropharynx. In the case of occult primary of the head and neck the role of HPV/p16 positivity is not well defined regarding prognosis and localization of the primary. An independent review of PubMed and ScienceDirect database was performed up to May 2014 using combinations of terms such as "occult primary of the head and neck", "CUP of the head and neck" "metastatic cervical squamous cell carcinoma of unknown primary", "HPV" and "HPV and head and neck cancer". Literature review shows a strong association between HPV/p16 positivity and primary location in the oropharynx in patients with CUP of the head and neck as well as a better clinical outcome. HPV positivity and p16 overexpression could be used as surrogate markers in the search of the primary site of patients with CUP of the head and neck therefore maybe guiding treatment decisions. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Safe and effective administration of carboplatin-based chemotherapy in a patient undergoing hemodialysis with cancer of unknown primary by monitoring observed AUC of carboplatin-a case report].

Science.gov (United States)

Kondo, Masahiro; Kuroda, Junko; Ikai, Yoshitomo; Hayashi, Rumiko; Uegaki, Shiori; Yoshida, Tatsuya; Yoshida, Atsuhiro; Komatsu, Hirokazu; Kimura, Kazunori

2012-11-01

Here we report a case of successful treatment with combination chemotherapy of carboplatin(CBDCA)and paclitaxel for a patient undergoing hemodialysis(HD)with cancer of unknown primary, conducted by monitoring the observed AUC of ultrafilterable CBDCA. CBDCA was administered at a dose of 125 mg on day 1 in each course, an amount which had been calculated by the Calvert formula(GFR: 0, target AUC: 5). HD was started at a point in time one hour after the completion of each CBDCA administration, and performed for 5 hours in each course. Blood samples were collected during the first 3 courses of chemotherapy to measure the plasma concentration of free-platinum. The observed AUCs(o-AUC)of CBDCA in the first, second and third courses were 3. 03, 3. 44 and 3. 50mg·min/mL, respectively. The o-AUC in the first course was lower than that in the second course. The o-AUC in the second course was nearly equal to that in the third course, while each o-AUC was below the target AUC(t-AUC). Partial response was achieved after two courses of the CBDCA and paclitaxel combination chemotherapy, with adverse events of Grade 3 neutropenia and Grade 3 peripheral neuropathy observed in each course after the second course of chemotherapy. o-AUC of CBDCA administered to HD patients can not only be below t-AUC, as in this case, but also oppositely above t-AUC in cases with different doses of CBDCA or HD settings. Our results suggest that the monitoring of o-AUC of CBDCA is useful when practicing CBDCA-based chemotherapy safely and effectively in cancer patients undergoing HD.

Origins of food crops connect countries worldwide

Science.gov (United States)

Achicanoy, Harold A.; Bjorkman, Anne D.; Navarro-Racines, Carlos; Guarino, Luigi; Flores-Palacios, Ximena; Engels, Johannes M. M.; Wiersema, John H.; Dempewolf, Hannes; Sotelo, Steven; Ramírez-Villegas, Julian; Castañeda-Álvarez, Nora P.; Fowler, Cary; Jarvis, Andy; Rieseberg, Loren H.; Struik, Paul C.

2016-01-01

Research into the origins of food plants has led to the recognition that specific geographical regions around the world have been of particular importance to the development of agricultural crops. Yet the relative contributions of these different regions in the context of current food systems have not been quantified. Here we determine the origins (‘primary regions of diversity’) of the crops comprising the food supplies and agricultural production of countries worldwide. We estimate the degree to which countries use crops from regions of diversity other than their own (‘foreign crops’), and quantify changes in this usage over the past 50 years. Countries are highly interconnected with regard to primary regions of diversity of the crops they cultivate and/or consume. Foreign crops are extensively used in food supplies (68.7% of national food supplies as a global mean are derived from foreign crops) and production systems (69.3% of crops grown are foreign). Foreign crop usage has increased significantly over the past 50 years, including in countries with high indigenous crop diversity. The results provide a novel perspective on the ongoing globalization of food systems worldwide, and bolster evidence for the importance of international collaboration on genetic resource conservation and exchange.

[Primary headache and depression].

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Gesztelyi, Gyöngyi

2004-11-28

Primary headaches--mainly tension-type headache and migraine--affect a significant portion of the population. Depression is also highly prevalent. The co-existence of a primary headache and depression in the same patient therefore might be a coincidence due to the high prevalence of these conditions, but there might be a causal relationship between them, or headaches and depression might have a common background. This review of the literature summarizes the features of the relationship between primary headaches and depression. Depression is more prevalent in headache patients than in the headache-free population. Prospective epidemiological studies suggest a common genetic, biochemical or environmental background behind primary headaches and depression. This theory is supported by the role of the same neurotransmitter systems (mostly serotonin and dopamine) in headaches as well as in depression. Comorbid depression is associated with female gender, higher age, and higher frequency of headaches. Most depression inventories--questionnaires used to screen for the severity of depressive symptoms--contain transdiagnostic items, therefore their use in their original form is limited in organic diseases: due to the somatic items they might overestimate the severity of depression. When examining a headache patient special attention should be paid to the recognition of comorbid depression. The diagnosis of suspected mood disorder could be supported by using simple screening methods, such as the original or the abbreviated versions of standard depression inventories, but the final diagnosis of major depression needs psychiatric evaluation. Quality of life of the headache patient is affected not only by the characteristics of pain (frequency, duration, severity) but also by the disability caused by headache and the associating mood disorder. Recognizing coexisting mood disorder and disability helps to make the best treatment choice for the acute and preventive treatment of

Primary extracranial vertebral artery aneurysms.

Science.gov (United States)

Morasch, Mark D; Phade, Sachin V; Naughton, Peter; Garcia-Toca, Manuel; Escobar, Guillermo; Berguer, Ramon

2013-05-01

Extracranial vertebral artery aneurysms are uncommon and are usually associated with trauma or dissection. Primary cervical vertebral aneurysms are even rarer and are not well described. The presentation and natural history are unknown and operative management can be difficult. Accessing aneurysms at the skull base can be difficult and, because the frail arteries are often afflicted with connective tissue abnormalities, direct repair can be particularly challenging. We describe the presentation and surgical management of patients with primary extracranial vertebral artery aneurysms. In this study we performed a retrospective, multi-institutional review of patients with primary aneurysms within the extracranial vertebral artery. Between January 2000 and January 2011, 7 patients, aged 12-56 years, were noted to have 9 primary extracranial vertebral artery aneurysms. All had underlying connective tissue or another hereditary disorder, including Ehler-Danlos syndrome (n=3), Marfan's disease (n=2), neurofibromatosis (n=1), and an unspecified connective tissue abnormality (n=1). Eight of 9 aneurysms were managed operatively, including an attempted bypass that ultimately required vertebral ligation; the contralateral aneurysm on this patient has not been treated. Open interventions included vertebral bypass with vein, external carotid autograft, and vertebral transposition to the internal carotid artery. Special techniques were used for handling the anastomoses in patients with Ehler-Danlos syndrome. Although endovascular exclusion was not performed in isolation, 2 hybrid procedures were performed. There were no instances of perioperative stroke or death. Primary extracranial vertebral artery aneurysms are rare and occur in patients with hereditary disorders. Operative intervention is warranted in symptomatic patients. Exclusion and reconstruction may be performed with open and hybrid techniques with low morbidity and mortality. Copyright © 2013 Elsevier Inc. All rights

Design of a DNA chip for detection of unknown genetically modified organisms (GMOs).

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Nesvold, Håvard; Kristoffersen, Anja Bråthen; Holst-Jensen, Arne; Berdal, Knut G

2005-05-01

Unknown genetically modified organisms (GMOs) have not undergone a risk evaluation, and hence might pose a danger to health and environment. There are, today, no methods for detecting unknown GMOs. In this paper we propose a novel method intended as a first step in an approach for detecting unknown genetically modified (GM) material in a single plant. A model is designed where biological and combinatorial reduction rules are applied to a set of DNA chip probes containing all possible sequences of uniform length n, creating probes capable of detecting unknown GMOs. The model is theoretically tested for Arabidopsis thaliana Columbia, and the probabilities for detecting inserts and receiving false positives are assessed for various parameters for this organism. From a theoretical standpoint, the model looks very promising but should be tested further in the laboratory. The model and algorithms will be available upon request to the corresponding author.

The Effect of Known-and-Unknown Word Combinations on Intentional Vocabulary Learning

Science.gov (United States)

Kasahara, Kiwamu

2011-01-01

The purpose of this study is to examine whether learning a known-and-unknown word combination is superior in terms of retention and retrieval of meaning to learning a single unknown word. The term "combination" in this study means a two-word collocation of a familiar word and a word that is new to the participants. Following the results of…

High Precision Fast Projective Synchronization for Chaotic Systems with Unknown Parameters

Science.gov (United States)

Nian, Fuzhong; Wang, Xingyuan; Lin, Da; Niu, Yujun

2013-08-01

A high precision fast projective synchronization method for chaotic systems with unknown parameters was proposed by introducing optimal matrix. Numerical simulations indicate that the precision be improved about three orders compared with other common methods under the same condition of software and hardware. Moreover, when average error is less than 10-3, the synchronization speed is 6500 times than common methods, the iteration needs only 4 times. The unknown parameters also were identified rapidly. The theoretical analysis and proof also were given.

On the Origin of De Novo Genes in Arabidopsis thaliana Populations.

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Li, Zi-Wen; Chen, Xi; Wu, Qiong; Hagmann, Jörg; Han, Ting-Shen; Zou, Yu-Pan; Ge, Song; Guo, Ya-Long

2016-08-03

De novo genes, which originate from ancestral nongenic sequences, are one of the most important sources of protein-coding genes. This origination process is crucial for the adaptation of organisms. However, how de novo genes arise and become fixed in a population or species remains largely unknown. Here, we identified 782 de novo genes from the model plant Arabidopsis thaliana and divided them into three types based on the availability of translational evidence, transcriptional evidence, and neither transcriptional nor translational evidence for their origin. Importantly, by integrating multiple types of omics data, including data from genomes, epigenomes, transcriptomes, and translatomes, we found that epigenetic modifications (DNA methylation and histone modification) play an important role in the origination process of de novo genes. Intriguingly, using the transcriptomes and methylomes from the same population of 84 accessions, we found that de novo genes that are transcribed in approximately half of the total accessions within the population are highly methylated, with lower levels of transcription than those transcribed at other frequencies within the population. We hypothesized that, during the origin of de novo gene alleles, those neutralized to low expression states via DNA methylation have relatively high probabilities of spreading and becoming fixed in a population. Our results highlight the process underlying the origin of de novo genes at the population level, as well as the importance of DNA methylation in this process. © The Author 2016. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

Mapping vaccinia virus DNA replication origins at nucleotide level by deep sequencing.

Science.gov (United States)

Senkevich, Tatiana G; Bruno, Daniel; Martens, Craig; Porcella, Stephen F; Wolf, Yuri I; Moss, Bernard

2015-09-01

Poxviruses reproduce in the host cytoplasm and encode most or all of the enzymes and factors needed for expression and synthesis of their double-stranded DNA genomes. Nevertheless, the mode of poxvirus DNA replication and the nature and location of the replication origins remain unknown. A current but unsubstantiated model posits only leading strand synthesis starting at a nick near one covalently closed end of the genome and continuing around the other end to generate a concatemer that is subsequently resolved into unit genomes. The existence of specific origins has been questioned because any plasmid can replicate in cells infected by vaccinia virus (VACV), the prototype poxvirus. We applied directional deep sequencing of short single-stranded DNA fragments enriched for RNA-primed nascent strands isolated from the cytoplasm of VACV-infected cells to pinpoint replication origins. The origins were identified as the switching points of the fragment directions, which correspond to the transition from continuous to discontinuous DNA synthesis. Origins containing a prominent initiation point mapped to a sequence within the hairpin loop at one end of the VACV genome and to the same sequence within the concatemeric junction of replication intermediates. These findings support a model for poxvirus genome replication that involves leading and lagging strand synthesis and is consistent with the requirements for primase and ligase activities as well as earlier electron microscopic and biochemical studies implicating a replication origin at the end of the VACV genome.

A specialized odor memory buffer in primary olfactory cortex.

Science.gov (United States)

Zelano, Christina; Montag, Jessica; Khan, Rehan; Sobel, Noam

2009-01-01

The neural substrates of olfactory working memory are unknown. We addressed the questions of whether olfactory working memory involves a verbal representation of the odor, or a sensory image of the odor, or both, and the location of the neural substrates of these processes. We used functional magnetic resonance imaging to measure activity in the brains of subjects who were remembering either nameable or unnameable odorants. We found a double dissociation whereby remembering nameable odorants was reflected in sustained activity in prefrontal language areas, and remembering unnameable odorants was reflected in sustained activity in primary olfactory cortex. These findings suggest a novel dedicated mechanism in primary olfactory cortex, where odor information is maintained in temporary storage to subserve ongoing tasks.

Primary Angiosarcoma of the Breast after Bilateral Breast Reduction

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Justus Philip

2018-01-01

Full Text Available Angiosarcoma of the breast is a rare malignancy of endothelial cell origin, representing less than 1% of all breast malignancy. Primary angiosarcomas can occur in the setting of chronic lymphedema, but it also may occur spontaneously without any preceding treatment. Surgery is the primary therapeutic intervention for breast angiosarcomas with radiation and chemotherapy as adjuvant treatment. Angiosarcomas are aggressive and tend to have a high risk of local and metastatic recurrence. We present a case of primary angiosarcoma that developed in a patient who had bilateral breast reduction surgery in the past.

DNA fingerprinting of pearls to determine their origins.

Directory of Open Access Journals (Sweden)

Joana B Meyer

Full Text Available We report the first successful extraction of oyster DNA from a pearl and use it to identify the source oyster species for the three major pearl-producing oyster species Pinctada margaritifera, P. maxima and P. radiata. Both mitochondrial and nuclear gene fragments could be PCR-amplified and sequenced. A polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP assay in the internal transcribed spacer (ITS region was developed and used to identify 18 pearls of unknown origin. A micro-drilling technique was developed to obtain small amounts of DNA while maintaining the commercial value of the pearls. This DNA fingerprinting method could be used to document the source of historic pearls and will provide more transparency for traders and consumers within the pearl industry.

Territorial expansion and primary state formation.

Science.gov (United States)

Spencer, Charles S

2010-04-20

A major research problem in anthropology is the origin of the state and its bureaucratic form of governance. Of particular importance for evaluating theories of state origins are cases of primary state formation, whereby a first-generation state evolves without contact with any preexisting states. A general model of this process, the territorial-expansion model, is presented and assessed with archaeological data from six areas where primary states emerged in antiquity: Mesoamerica, Peru, Egypt, Mesopotamia, the Indus Valley, and China. In each case, the evidence shows a close correspondence in time between the first appearance of state institutions and the earliest expansion of the state's political-economic control to regions lying more than a day's round-trip from the capital. Although additional research will add detail and clarity to the empirical record, the results to date are consistent with the territorial-expansion model, which argues that the success of such long-distance expansion not only demanded the bureaucratization of central authority but also helped provide the resources necessary to underwrite this administrative transformation.

Isolated nail lichen planus with primary sclerosing cholangitis in a child

International Nuclear Information System (INIS)

Al-Ajroush, N.; Al-Khenaizan, S.

2007-01-01

Lichen planus (LP) is an uncommon, inflammatory dermatosis with characteristic lesions affecting the skin, nails and the mucous membranes. It is rare in childhood. Although nail abnormalities have been reported in 1-10% of patients with LP, the prevalence of nail involvement in affected children is unknown. Here we report a 2-year-old child with isolated nail LP, in association with primary sclerosing cholangitis. (author)

High-grade primary pulmonary leiomyosarcoma

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Rodrigo Afonso da Silva Sardenberg

2011-12-01

Full Text Available Primary sarcomas of the lung are rare and account for 0.5% of all primary lung tumors. There were approximately 300 cases described in the literature as of 2006. All histologic types of sarcoma were described, and the most common intrathoracic types reported were angiosarcoma, leiomyosarcoma, fibrosarcoma, hemangiopericytoma, and rhabdomyosarcoma. The biological behavior of these tumors is not well-known due to their low frequency. Leiomyosarcomas represent one of the most common subtypes encountered in the lungs, and usually occur during the sixth decade, with male predominance. Although the frequency of metastatic disease is not related to tumor size, prognosis was reported to be poorer in high-grade tumors. In comparison with other sarcomas, survival after complete resection of pulmonary leiomyosarcoma was reported as longer. We report on a patient with primary leiomyosarcoma originating from the bronchus with complete resection and long-term follow-up.

The origin of recently established red fox populations in the United States: translocations or natural range expansions?

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Mark J. Statham; Benjamin N. Sacks; Keith B. Aubry; John D. Perrine; Samantha M. Wisely

2012-01-01

Red foxes (Vulpes vulpes) are native to boreal and western montane portions of North America but their origins are unknown in many lowland areas of the United States. Red foxes were historically absent from much of the East Coast at the time of European settlement and did not become common until the mid-1800s. Some early naturalists described an...

F.D.G. PET role in the localisation of primary neoplasias

International Nuclear Information System (INIS)

Audigier, C.; Billotey, C.; Deshayes, E.; Banayan, S.; Janier, M.

2009-01-01

Carcinomas of unknown primary site (C.U.P.) and para neoplastic syndromes have the common characteristic that an extensive conventional biological and imaging analysis fails in some instance to detect the primary tumour. F.D.G.-PET becomes recognized to provide interesting information in the case of 'head and neck' C.U.P. as well as in the case of neurological para neoplastic syndromes biologically well defined. When, either C.U.P. or para neoplastic syndromes, are less defined, F.D.G.-PET will not provide as much information as in the previous situation, although it can help in the etiologic diagnosis (oncologic or not) in some cases. (authors)

Correlation of FDG-PET and MRI/CT with histopathology in primary diagnosis, lymph node staging and diagnosis of recurrency of head and neck cancer

International Nuclear Information System (INIS)

Poepperl, G.; Tiling, R.; Hahn, K.; Tatsch, K.; Lang, S.; Dagdelen, O.; Jaeger, L.

2002-01-01

Aim: Correct staging of head and neck cancer is important for the patient's prognosis and further therapeutic strategies. Aim of the present study was to investigate the diagnostic value of FDG-PET regarding the pre-surgical diagnosis of primary tumor and cervical lymph node metastases, the diagnosis of tumour recurrence, and the localisation of unknown primary, further to compare the results to those of morphological imaging modalities (CT/MRI) and to correlate the results of both methods with histopathological findings. Patients/Methods: 115 patients (pts) (72 x primary diagnosis, 37 x recurrence, and 6 x unknown primary) underwent FDG-PET (ECAT EXACT HR+) and CT or MRI. Results were correlated with histopathological findings in terms of detection of primary and recurrent tumors as well as lymph node metastases. Results: Regarding the pre-surgical diagnosis, sensitivity and specificity for identifying primary tumors were 85% and 100% for PET and 88% and 75% for CT/MRI, respectively. Accuracy was 86% for PET and 87% for CT/MRI. Sensitivity and specificity for detecting primary lymph node envolvement were 71%/86% for PET and 68% with morphological imaging. In 23 pts histopathology revealed pT1 stages with tumor diameters [de

Primary care and pattern of skin diseases in a mediterranean island

Directory of Open Access Journals (Sweden)

Lyronis Ioannis

2006-01-01

Full Text Available Abstract Background In Greece where primary health care services are not fully developed, patients with simple or minor conditions have to attend to hospitals to be treated. We analysed the data of patients with cutaneous disorders attending the tertiary referral hospital on the Island of Crete, with the aim to identify the most common conditions that patients complain of, in order to define the areas where the education of General Practitioners in Dermatology must focus. Methods All patients attending the Dermatology ambulatory office in the Emergency Department of the University General Hospital of Heraklion from January 2003 to December 2003 were included in this retrospective analysis. The medical records of the patients (history, physical examination and laboratory investigations were analysed to ascertain the diagnosis and the management of cases. All patients were evaluated by qualified dermatologists. Results A total of 3715 patients attended the Dermatology Clinic. Most patients were young adults in the age group 21–40 years (38.4%, and the male to female ratio was 1 to 1.2. Allergic skin diseases, mostly dermatitis and urticaria (35.7% were the most common for attendance, followed by infectious diseases (26.1% and insect bites (10.2%. Inflammatory and autoimmune disorders accounted for 7.9% of the cases. Pruritus of unknown origin was diagnosed in 6.3% of patients. Skin tumors were detected in 2.7%. The management of the vast majority of cases (85.0% consisted of advice with or without a prescription, while only 4.8% of patients required admission. Conclusion Allergic and infectious skin diseases were the most common cutaneous diseases in patients attending this tertiary University hospital, while the management of most patients did not require specialised care. On the basis of the present data, the training of primary health care providers in Dermatology should emphasize these common conditions, with the aim of improving primary

Intrathecal immunoglobulin synthesis in patients with symptomatic epilepsy and epilepsy of unknown etiology ('cryptogenic').

Science.gov (United States)

Fauser, S; Soellner, C; Bien, C G; Tumani, H

2017-09-01

To compare the frequency of intrathecal immunoglobulin (Ig) synthesis in patients with symptomatic epilepsy and epilepsy of unknown etiology ('cryptogenic'). Patients with epileptic (n = 301) and non-epileptic (n = 10) seizures were retrospectively screened for autochthonous intrathecal Ig synthesis and oligoclonal bands (OCBs) in the cerebrospinal fluid. Intrathecal IgG/OCBs were detected in 8% of patients with epilepsies of unknown etiology, 5% of patients with first seizures of unknown cause and 0-4% of patients with epilepsy due to brain tumors, cerebrovascular disease or other etiologies. Intrathecal IgG/OCBs were not seen in patients with psychogenic seizures. Identical OCBs in serum and cerebrospinal fluid were more common in all patient groups (10-40% depending on underlying etiology). Intrathecal IgG synthesis/OCBs were observed slightly more frequently in patients with 'cryptogenic' epilepsy and with first seizures of unknown etiology than in other patient groups. However, this remained an infrequent finding and thus we could not confirm humoral immunity as a leading disease mechanism in patients with epilepsy in general or with unknown etiology in particular. © 2017 EAN.

RBF neural network based H∞ synchronization for unknown chaotic ...

Indian Academy of Sciences (India)

, 172 ... the effect of disturbance to an H∞ norm constraint. It is shown that ... unknown chaotic systems; linear matrix inequality (LMI); learning law. 1. Introduction .... (9) is RBFNN H∞ synchronized if the synchronization error e(t) satisfies. ∫ ∞.

Primary Cardiac Leiomyoma Causing Right Ventricular Obstruction and Tricuspid Regurgitation.

Science.gov (United States)

Careddu, Lucio; Foà, Alberto; Leone, Ornella; Agostini, Valentina; Gargiulo, Gaetano Domenico; Rapezzi, Claudio; Di Bartolomeo, Roberto; Pacini, Davide

2017-09-01

We report the unique case of a primary cardiac leiomyoma originating from the right ventricle and involving the tricuspid valve in a 43-year-old woman. Echocardiography showed a giant mass causing severe pulmonary stenosis and tricuspid valve regurgitation. The patient underwent surgical excision and histologic examination revealed a primary cardiac leiomyoma. To the best of our knowledge only three cases of primary cardiac leiomyoma have so far been reported, and this is the first case of primary cardiac leiomyoma involving the tricuspid valve apparatus. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Primary intracranial leiomyoma in renal transplant recipient

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Upasana Patel

2017-01-01

Full Text Available Leiomyoma, the benign tumor of smooth muscle cell origin, is commonly seen in genitourinary and gastrointestinal tracts. Primary intracranial leiomyoma, however, is extremely rare occurrence. We hereby report a case of Epstein-Barr negative primary intracranial leiomyoma in a middle-aged renal transplant recipient, which mimicked left frontal parasagittal meningioma on neuroimaging. The tumor was completely excised and diagnosis of leiomyoma was clinched on pathological analysis with immunohistochemistry. The patient improved after tumor removal, and no evidence of tumor recurrence was noted on follow-up study after 10 months postsurgically.

Primary leiomyoma of ureter coexisting with renal cell carcinoma: A case report

International Nuclear Information System (INIS)

Baek, Seung Hwan; Kim, Hee Jin; Han, Hyun Young

2014-01-01

Mesenchymal origin of ureter tumors account for less than 3 percent of all primary ureteral tumors. Among mesenchymal tumors, primary leiomyoma of ureter is extremely rare. Here, we present a case of primary leiomyoma of ureter coexisting with renal cell carcinoma. When encountering well-defined homogeneously enhanced mass of ureter on computed tomography, radiologist should keep in mind that ureteral leiomyoma should be considered as differential diagnosis.

Primary leiomyoma of ureter coexisting with renal cell carcinoma: A case report

Energy Technology Data Exchange (ETDEWEB)

Baek, Seung Hwan; Kim, Hee Jin; Han, Hyun Young [Dept. of Radiology, Eulji University Hospital, Daejeon (Korea, Republic of)

2014-12-15

Mesenchymal origin of ureter tumors account for less than 3 percent of all primary ureteral tumors. Among mesenchymal tumors, primary leiomyoma of ureter is extremely rare. Here, we present a case of primary leiomyoma of ureter coexisting with renal cell carcinoma. When encountering well-defined homogeneously enhanced mass of ureter on computed tomography, radiologist should keep in mind that ureteral leiomyoma should be considered as differential diagnosis.

Content-Based Multimedia Retrieval in the Presence of Unknown User Preferences

DEFF Research Database (Denmark)

Beecks, Christian; Assent, Ira; Seidl, Thomas

2011-01-01

Content-based multimedia retrieval requires an appropriate similarity model which reflects user preferences. When these preferences are unknown or when the structure of the data collection is unclear, retrieving the most preferable objects the user has in mind is challenging, as the notion...... address the problem of content-based multimedia retrieval in the presence of unknown user preferences. Our idea consists in performing content-based retrieval by considering all possibilities in a family of similarity models simultaneously. To this end, we propose a novel content-based retrieval approach...

Unraveling the origin of the Appalachian gametophyte, Vittaria appalachiana.

Science.gov (United States)

Pinson, Jerald B; Schuettpelz, Eric

2016-04-01

Ferns and lycophytes are distinct among plants in producing two free-living life stages: a long-lived sporophyte phase and a (usually) short-lived gametophyte phase. Notably, however, some species have perennial, vegetatively reproducing gametophytes. Vittaria appalachiana is one of just three species in which mature sporophytes are unknown. It has a wide range throughout the Appalachian Mountains and Plateau, where it reproduces asexually via gemmae. The origin of V. appalachiana, however, has long been a mystery, with most previous studies suggesting it may have resulted from hybridization of two closely related Vittaria species (V. graminifolia and V. lineata). A four-gene plastid data set including 32 samples of six Vittaria species, plus samples of five outgroup species, was analyzed to uncover phylogenetic relationships. Additional analyses of nuclear DET1 gene sequences allowed for the examination of hypotheses involving a hybrid origin for V. appalachiana. In the plastid phylogeny, V. appalachiana is well supported as monophyletic, but is embedded within V. graminifolia. With the exception of a single aberrant allele, this result is mirrored in the nuclear tree. Through analyses of plastid and nuclear data sets, this study demonstrates that a hybrid origin for V. appalachiana is unlikely. Instead, it appears that this species emerged from within the V. graminifolia lineage. Further work is needed to fully elucidate the genetic structure within this group. © 2016 Botanical Society of America.

Diagnostic investigations in 101 dogs with pyrexia of unknown origin

International Nuclear Information System (INIS)

Dunn, K.J.; Dunn, J.K.

1998-01-01

Records from 101 dogs presented for investigation of unexplained pyrexia were reviewed. The most common diagnosis was immune-mediated disease (22 per cent of cases), with immune-mediated polyarthritis accounting for 20 per cent of all diagnoses. The frequency of positive results obtained in investigative tests was also assessed. Cytological and radiological examinations provided a high diagnostic success rate, although routine haematology and plasma biochemistry were also useful screening tests. On the basis of these results it is suggested that, in the investigation of unexplained pyrexia, a diagnosis of immune-mediated polyarthritis should be excluded before less common diagnoses are considered

Arterial stiffness &Sri Lankan chronic kidney disease of unknown origin.

Science.gov (United States)

Gifford, Fiona; Kimmitt, Robert; Herath, Chula; Webb, David J; Melville, Vanessa; Siribaddana, Sisira; Eddleston, Michael; Dhaun, Neeraj

2016-09-02

Chronic kidney disease (CKD) is common and independently associated with cardiovascular disease (CVD). Arterial stiffness contributes to CVD risk in CKD. In many developing countries a considerable proportion of CKD remains unexplained, termed CKDu. We assessed arterial stiffness in subjects with Sri Lankan CKDu, in matched controls without CKD and in those with defined CKD. Aortic blood pressure (BP), pulse wave velocity (PWV) and augmentation index (AIx) were assessed in 130 subjects (50 with CKDu, 45 with CKD and 35 without CKD) using the validated TensioMed™ Arteriograph monitor. Brachial and aortic BP was lower in controls than in CKDu and CKD subjects but no different between CKDu and CKD. Controls had a lower PWV compared to subjects with CKDu and CKD. Despite equivalent BP and renal dysfunction, CKDu subjects had a lower PWV than those with CKD (8.7 ± 1.5 vs. 9.9 ± 2.2 m/s, p CKDu vs. CKD: 6.7 ± 0.9 vs. 8.7 ± 1.5 vs. 10.4 ± 1.5 m/s, p CKDu is associated with less arterial stiffening than defined causes of CKD. Whether this translates to lower cardiovascular morbidity and mortality long term is unclear and should be the focus of future studies.

Fever of Unknown Origin: A Case of Post Obstructive Pneumonia ...

African Journals Online (AJOL)

Mediastinal teratomas are rare germ cell tumors in children accounting for only 4.3% of all germ cell tumours. Here, we describe a three year old child who was misdiagnosed as a case of pulmonary tuberculosis at periphery despite of his chest X ray showing large homogenous opacification of left hemithorax with areas of ...

Liability for Unknown Risks: A Law and Economics Perspective

NARCIS (Netherlands)

M.G. Faure (Michael); L.T. Visscher (Louis); F. Weber (Franziska)

2017-01-01

textabstractIn the law and economics literature liability is generally regarded as an instrument which provides potential tortfeasors with incentives for optimal care taking. The question, however, arises whether liability can still provide those incentives when risks are unknown. That is the

Teleportation of Unknown Superpositions of Collective Atomic Coherent States

Institute of Scientific and Technical Information of China (English)

ZHENG ShiBiao

2001-01-01

We propose a scheme to teleport an unknown superposition of two atomic coherent states with different phases. Our scheme is based on resonant and dispersive atom-field interaction. Our scheme provides a possibility of teleporting macroscopic superposition states of many atoms first time.``

Third-order non-Coulomb correction to the S-wave quarkonium wave functions at the origin

International Nuclear Information System (INIS)

Beneke, M.; Kiyo, Y.; Schuller, K.

2008-01-01

We compute the third-order correction to the S-wave quarkonium wave functions |ψ n (0)| 2 at the origin from non-Coulomb potentials in the effective non-relativistic Lagrangian. Together with previous results on the Coulomb correction and the ultrasoft correction computed in a companion paper, this completes the third-order calculation up to a few unknown matching coefficients. Numerical estimates of the new correction for bottomonium and toponium are given

Are all pelvic (nonuterine) serous carcinomas of tubal origin?

Science.gov (United States)

Przybycin, Christopher G; Kurman, Robert J; Ronnett, Brigitte M; Shih, Ie-Ming; Vang, Russell

2010-10-01

It has been proposed that the presence of tubal intraepithelial carcinoma (TIC), in association with one-third to nearly half of pelvic serous carcinomas, is evidence of fallopian tube origin for high-grade serous carcinomas that would have been otherwise classified as primary ovarian or peritoneal. To address this hypothesis, we evaluated a series of 114 consecutive pelvic (nonuterine) gynecologic carcinomas at our institution (2006 to 2008) to determine the frequency of TIC in 52 cases in which all the resected fallopian tube tissue was examined microscopically. These 52 cases were classified as ovarian (n=37), peritoneal (n=8), or fallopian tube (n=7) in origin as per conventional criteria based on disease distribution. The presence of TIC and its location and relationship to invasive carcinoma in the fallopian tubes and ovaries were assessed. Among the 45 cases of ovarian/peritoneal origin, carcinoma subtypes included 41 high-grade serous, 1 endometrioid, 1 mucinous, 1 high-grade, not otherwise specified, and 1 malignant mesodermal mixed tumor. TIC was identified in 24 cases (59%) of high-grade serous carcinoma but not among any of the other subtypes; therefore, the term serous TIC (STIC) is a more specific appellation. STICs were located in the fimbriated end of the tube in 22 cases (92%) and in the ampulla in 2 (8%); they were unilateral in 21 (88%) and bilateral in 3 (13%). STICs in the absence of an associated invasive carcinoma in the same tube were detected in 7 cases (30%) and with invasive carcinoma in the same tube in 17 (71%). Unilateral STICs were associated with bilateral ovarian involvement in 15 cases and unilateral (ipsilateral) ovarian involvement in 5 (the remaining case with a unilateral STIC had a primary peritoneal tumor with no ovarian involvement); the bilateral STICs were all associated with bilateral ovarian involvement. Six of the 7 primary tubal tumors were high-grade serous carcinomas, and 4 of these 6 (67%) had STICs. Based on

Adresse inconnue / Address unknown / Suchwiin Bulmyeong

OpenAIRE

Serge Gruzinski

2005-01-01

Tous les films asiatiques parlent de métissage, même ceux qui se présentent comme de vastes fresques historiques perdues dans le temps. Les emprunts aux traditions hollywoodiennes et européennes n'ont cessé d'enrichir une cinématographie aussi ancienne que celle du monde occidental. Dans Adresse inconnue (Address unknown) le cinéaste coréen Kim Ki-duk explore l'expérience du métissage et le corps du métis à la frontière entre Corée du Nord et Corée du sud. Fils d'un GI américain et noir et d'...

Adaptive Tracking and Obstacle Avoidance Control for Mobile Robots with Unknown Sliding

Directory of Open Access Journals (Sweden)

Mingyue Cui

2012-11-01

Full Text Available An adaptive control approach is proposed for trajectory tracking and obstacle avoidance for mobile robots with consideration given to unknown sliding. A kinematic model of mobile robots is established in this paper, in which both longitudinal and lateral sliding are considered and processed as three time-varying parameters. A sliding model observer is introduced to estimate the sliding parameters online. A stable tracking control law for this nonholonomic system is proposed to compensate the unknown sliding effect. From Lyapunov-stability analysis, it is proved, regardless of unknown sliding, that tracking errors of the controlled closed-loop system are asymptotically stable, the tracking errors converge to zero outside the obstacle detection region and obstacle avoidance is guaranteed inside the obstacle detection region. The efficiency and robustness of the proposed control system are verified by simulation results.

T/sub hot/ reduction: a program for lowering primary temperatures on a PWR

International Nuclear Information System (INIS)

Augustine, D.B.; DiTommaso, S.M.; Manz, E.M.; Reister, P.

1987-01-01

This paper focuses on the key technical issues addressed in a program to support operation of the Byron Unit 1 pressurized water reactor at primary side temperatures significantly lowered with respect at primary side temperatures significantly lowered with respect to the original design temperatures. These operating temperatures were lowered in order to reduce the potential for initiation of primary water stress corrosion cracking in the steam generator tubing. The efforts of this program were aimed at maintaining operation of the unit at the maximum possible power level at the reduced temperatures. In addition, the program is designed to allow for cycle-to-cycle flexibility within a range of operating temperatures from the original design temperatures to temperatures lowered by ∼ 11 0 C (20 0 F)

Strategies of Pre-Service Primary School Teachers for Solving Addition Problems with Negative Numbers

Science.gov (United States)

Almeida, Rut; Bruno, Alicia

2014-01-01

This paper analyses the strategies used by pre-service primary school teachers for solving simple addition problems involving negative numbers. The findings reveal six different strategies that depend on the difficulty of the problem and, in particular, on the unknown quantity. We note that students use negative numbers in those problems they find…

Diverging Conclusions from the Same Meta-Analysis in Drug Safety: Source of Data (Primary Versus Secondary) Takes a Toll.

Science.gov (United States)

Prada-Ramallal, Guillermo; Takkouche, Bahi; Figueiras, Adolfo

2017-04-01

Meta-analyses of observational studies represent an important tool for assessing efficacy and safety in the pharmacoepidemiologic field. The data from the individual studies are either primary (i.e., collected through interviews or self-administered questionnaires) or secondary (i.e., collected from databases that were established for other purposes). So far, the origin of the data (primary vs. secondary) has not been systematically assessed as a source of heterogeneity in pharmacoepidemiologic meta-analyses. The aim was to assess the impact of considering the source of exposure data as a criterion in sensitivity and subgroup analysis on the conclusions of drug safety meta-analyses. We selected meta-analyses published between 2013 and 2015 in which the intake of frequently used over-the-counter medicines was either the main exposure or a concomitant treatment and the outcome had short latency and induction periods. We stratified the results by origin of data (primary vs. secondary) and compared the new results to those presented originally in the meta-analyses. We used four meta-analyses that fulfilled our criteria of inclusion. The results were selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: original estimate odds ratio (OR) = 1.71 [95% confidence interval (CI) 1.44-2.04], OR primary data = 1.19 (95% CI 0.90-1.58), OR secondary data = 1.81 (95% CI 1.50-2.17); proton pump inhibitors and cardiac events: original estimate hazard ratio (HR) = 1.35 (95% CI 1.18-1.54), HR primary data = 1.05 (95% CI 0.87-1.26), HR secondary data = 1.43 (95% CI 1.23-1.66); non-aspirin non-steroidal anti-inflammatory drugs and myocardial infarction: original estimate risk ratio (RR) = 1.08 (95% CI 0.95-1.22), RR primary data = 0.57 (95% CI 0.34-0.96), RR secondary data = 1.15 (95% CI 1.03-1.28); paracetamol during pregnancy and childhood asthma: original estimate OR = 1.32 (95% CI 1.14-1.52), OR primary data = 1.23 (95% CI 1.06-1.42), OR

Multiple analysis of an unknown optical multilayer coating

International Nuclear Information System (INIS)

Dobrowolski, J.A.; Ho, F.C.; Waldorf, A.

1985-01-01

Results are given of the analysis at five different laboratories of an unknown optical multilayer coating. In all, eleven different analytical and laboratory techniques were applied to the problem. The multilayer nominally consisted of three dielectric and two metallic layers. It was demonstrated convincingly that with present day techniques it is possible to determine the basic structure of such a coating

Distributed Optimization Design of Continuous-Time Multiagent Systems With Unknown-Frequency Disturbances.

Science.gov (United States)

Wang, Xinghu; Hong, Yiguang; Yi, Peng; Ji, Haibo; Kang, Yu

2017-05-24

In this paper, a distributed optimization problem is studied for continuous-time multiagent systems with unknown-frequency disturbances. A distributed gradient-based control is proposed for the agents to achieve the optimal consensus with estimating unknown frequencies and rejecting the bounded disturbance in the semi-global sense. Based on convex optimization analysis and adaptive internal model approach, the exact optimization solution can be obtained for the multiagent system disturbed by exogenous disturbances with uncertain parameters.

Estimation of the false discovery proportion with unknown dependence.

Science.gov (United States)

Fan, Jianqing; Han, Xu

2017-09-01

Large-scale multiple testing with correlated test statistics arises frequently in many scientific research. Incorporating correlation information in approximating false discovery proportion has attracted increasing attention in recent years. When the covariance matrix of test statistics is known, Fan, Han & Gu (2012) provided an accurate approximation of False Discovery Proportion (FDP) under arbitrary dependence structure and some sparsity assumption. However, the covariance matrix is often unknown in many applications and such dependence information has to be estimated before approximating FDP. The estimation accuracy can greatly affect FDP approximation. In the current paper, we aim to theoretically study the impact of unknown dependence on the testing procedure and establish a general framework such that FDP can be well approximated. The impacts of unknown dependence on approximating FDP are in the following two major aspects: through estimating eigenvalues/eigenvectors and through estimating marginal variances. To address the challenges in these two aspects, we firstly develop general requirements on estimates of eigenvalues and eigenvectors for a good approximation of FDP. We then give conditions on the structures of covariance matrices that satisfy such requirements. Such dependence structures include banded/sparse covariance matrices and (conditional) sparse precision matrices. Within this framework, we also consider a special example to illustrate our method where data are sampled from an approximate factor model, which encompasses most practical situations. We provide a good approximation of FDP via exploiting this specific dependence structure. The results are further generalized to the situation where the multivariate normality assumption is relaxed. Our results are demonstrated by simulation studies and some real data applications.

Numerical method of identification of an unknown source term in a heat equation

Directory of Open Access Journals (Sweden)

Fatullayev Afet Golayo?lu

2002-01-01

Full Text Available A numerical procedure for an inverse problem of identification of an unknown source in a heat equation is presented. Approach of proposed method is to approximate unknown function by polygons linear pieces which are determined consecutively from the solution of minimization problem based on the overspecified data. Numerical examples are presented.

Cancer of unknown primitive metastatic. About two clinical cases

International Nuclear Information System (INIS)

Cawen, L; Cordoba, A.

2010-01-01

This work is about the two clinical cases about the unknown primitive metastatic cancer. The main techniques used for the diagnosis, treatment and monitoring of different s carcinomas are: Electronic microscope, molecular biology and genetics, especially histopathological study, topographic survey, ultrasound, radiography, chemotherapy, radiotherapy

High-order sliding mode observer for fractional commensurate linear systems with unknown input

KAUST Repository

Belkhatir, Zehor; Laleg-Kirati, Taous-Meriem

2017-01-01

In this paper, a high-order sliding mode observer (HOSMO) is proposed for the joint estimation of the pseudo-state and the unknown input of fractional commensurate linear systems with single unknown input and a single output. The convergence of the proposed observer is proved using a Lyapunov-based approach. In addition, an enhanced variant of the proposed fractional-HOSMO is introduced to avoid the peaking phenomenon and thus to improve the estimation results in the transient phase. Simulation results are provided to illustrate the performance of the proposed fractional observer in both noise-free and noisy cases. The effect of the observer’s gains on the estimated pseudo-state and unknown input is also discussed.

High-order sliding mode observer for fractional commensurate linear systems with unknown input

KAUST Repository

Belkhatir, Zehor

2017-05-20

In this paper, a high-order sliding mode observer (HOSMO) is proposed for the joint estimation of the pseudo-state and the unknown input of fractional commensurate linear systems with single unknown input and a single output. The convergence of the proposed observer is proved using a Lyapunov-based approach. In addition, an enhanced variant of the proposed fractional-HOSMO is introduced to avoid the peaking phenomenon and thus to improve the estimation results in the transient phase. Simulation results are provided to illustrate the performance of the proposed fractional observer in both noise-free and noisy cases. The effect of the observer’s gains on the estimated pseudo-state and unknown input is also discussed.

Primary endosymbiosis: have cyanobacteria and Chlamydiae ever been roommates?

Directory of Open Access Journals (Sweden)

Philippe Deschamps

2014-12-01

Full Text Available Eukaryotes acquired the ability to process photosynthesis by engulfing a cyanobacterium and transforming it into a genuine organelle called the plastid. This event, named primary endosymbiosis, occurred once more than a billion years ago, and allowed the emergence of the Archaeplastida, a monophyletic supergroup comprising the green algae and plants, the red algae and the glaucophytes. Of the other known cases of symbiosis between cyanobacteria and eukaryotes, none has achieved a comparable level of cell integration nor reached the same evolutionary and ecological success than primary endosymbiosis did. Reasons for this unique accomplishment are still unknown and difficult to comprehend. The exploration of plant genomes has revealed a considerable amount of genes closely related to homologs of Chlamydiae bacteria, and probably acquired by horizontal gene transfer. Several studies have proposed that these transferred genes, which are mostly involved in the functioning of the plastid, may have helped the settlement of primary endosymbiosis. Some of these studies propose that Chlamydiae and cyanobacterial symbionts coexisted in the eukaryotic host of the primary endosymbiosis, and that Chlamydiae provided solutions for the metabolic symbiosis between the cyanobacterium and the host, ensuring the success of primary endosymbiosis. In this review, I present a reevaluation of the contribution of Chlamydiae genes to the genome of Archaeplastida and discuss the strengths and weaknesses of this tripartite model for primary endosymbiosis.

Synthesis of vibration control and health monitoring of building structures under unknown excitation

International Nuclear Information System (INIS)

He, Jia; Huang, Qin; Xu, You-Lin

2014-01-01

The vibration control and health monitoring of building structures have been actively investigated in recent years but often treated separately according to the primary objective pursued. In this study, a time-domain integrated vibration control and health monitoring approach is proposed based on the extended Kalman filter (EKF) for identifying the physical parameters of the controlled building structures without the knowledge of the external excitation. The physical parameters and state vectors of the building structure are then estimated and used for the determination of the control force for the purpose of the vibration attenuation. The interaction between the health monitoring and vibration control is revealed and assessed. The feasibility and reliability of the proposed approach is numerically demonstrated via a five-story shear building structure equipped with magneto-rheological (MR) dampers. Two types of excitations are considered: (1) the EI-Centro ground excitation underneath of the building and (2) a swept-frequency excitation applied on the top floor of the building. Results show that the structural parameters as well as the unknown dynamic loadings could be identified accurately; and, at the same time, the structural vibration is significantly reduced in the building structure. (paper)

On reconstruction of an unknown polygonal cavity in a linearized elasticity with one measurement

International Nuclear Information System (INIS)

Ikehata, M; Itou, H

2011-01-01

In this paper we consider a reconstruction problem of an unknown polygonal cavity in a linearized elastic body. For this problem, an extraction formula of the convex hull of the unknown polygonal cavity is established by means of the enclosure method introduced by Ikehata. The advantages of our method are that it needs only a single set of boundary data and we do not require any a priori assumptions for the unknown polygonal cavity and any constraints on boundary data. The theoretical formula may have possibility of application in nondestructive evaluation.

A newly designed radiation therapy protocol in combination with prednisolone as treatment for meningoencephalitis of unknown origin in dogs: a prospective pilot study introducing magnetic resonance spectroscopy as monitor tool.

Science.gov (United States)

Beckmann, Katrin; Carrera, Inés; Steffen, Frank; Golini, Lorenzo; Kircher, Patrick R; Schneider, Uwe; Bley, Carla Rohrer

2015-01-31

A plethora of treatment options have been described for canine meningoencephalitis of unknown origin (MUO), yet a gold standard has not been established. The aim of this prospective pilot study was to document the effect of a newly designed 30 Gray (Gy) radiation therapy (RT) protocol plus corticosteroids as treatment for focal and multifocal MUO, to monitor clinical and imaging changes during the course of the disease with conventional magnetic resonance imaging (MRI) and proton MR Spectroscopy (H-1 MRS) and to detect the occurrence of radiation related side effects. Six dogs (3 with focal and 3 with multifocal lesions) were included in the study. The RT protocol used consisted of 30 Gy in 10 fractions. The neurological status of all six dogs improved during RT, with 3 of 6 cases returning to a normal condition. One dog was euthanized early during follow-up (dog and improved in 3 dogs and H-1 MRS normalized in 4. In the dog without improvement of the MRI lesions, the N-acetyl aspartate continued to decrease, while choline and creatine concentrations remained stable during that time. This dog was euthanized 18 month after the end of RT due to relapse. One dog was lost to follow up 12 month after completion of RT. The other 3 dogs are still alive at the time of writing. RT with 30 Gy in 10 fractions can provide an additional option for anti-inflammatory treatment of focal and multifocal MUO. The protocol used for treatment monitoring was feasible while no side effects of RT could be observed during the follow up period. Moreover, H-1 MRS could represent a new and non-invasive tool to control the progression of the disease during the treatment course.

Learning Unknown Structure in CRFs via Adaptive Gradient Projection Method

Directory of Open Access Journals (Sweden)

Wei Xue

2016-08-01

Full Text Available We study the problem of fitting probabilistic graphical models to the given data when the structure is not known. More specifically, we focus on learning unknown structure in conditional random fields, especially learning both the structure and parameters of a conditional random field model simultaneously. To do this, we first formulate the learning problem as a convex minimization problem by adding an l_2-regularization to the node parameters and a group l_1-regularization to the edge parameters, and then a gradient-based projection method is proposed to solve it which combines an adaptive stepsize selection strategy with a nonmonotone line search. Extensive simulation experiments are presented to show the performance of our approach in solving unknown structure learning problems.

Origin of the unique ventilatory apparatus of turtles.

Science.gov (United States)

Lyson, Tyler R; Schachner, Emma R; Botha-Brink, Jennifer; Scheyer, Torsten M; Lambertz, Markus; Bever, G S; Rubidge, Bruce S; de Queiroz, Kevin

2014-11-07

The turtle body plan differs markedly from that of other vertebrates and serves as a model system for studying structural and developmental evolution. Incorporation of the ribs into the turtle shell negates the costal movements that effect lung ventilation in other air-breathing amniotes. Instead, turtles have a unique abdominal-muscle-based ventilatory apparatus whose evolutionary origins have remained mysterious. Here we show through broadly comparative anatomical and histological analyses that an early member of the turtle stem lineage has several turtle-specific ventilation characters: rigid ribcage, inferred loss of intercostal muscles and osteological correlates of the primary expiratory muscle. Our results suggest that the ventilation mechanism of turtles evolved through a division of labour between the ribs and muscles of the trunk in which the abdominal muscles took on the primary ventilatory function, whereas the broadened ribs became the primary means of stabilizing the trunk. These changes occurred approximately 50 million years before the evolution of the fully ossified shell.

The origins of originality: the neural bases of creative thinking and originality.

Science.gov (United States)

Shamay-Tsoory, S G; Adler, N; Aharon-Peretz, J; Perry, D; Mayseless, N

2011-01-01

Although creativity has been related to prefrontal activity, recent neurological case studies postulate that patients who have left frontal and temporal degeneration involving deterioration of language abilities may actually develop de novo artistic abilities. In this study, we propose a neural and cognitive model according to which a balance between the two hemispheres affects a major aspect of creative cognition, namely, originality. In order to examine the neural basis of originality, that is, the ability to produce statistically infrequent ideas, patients with localized lesions in the medial prefrontal cortex (mPFC), inferior frontal gyrus (IFG), and posterior parietal and temporal cortex (PC), were assessed by two tasks involving divergent thinking and originality. Results indicate that lesions in the mPFC involved the most profound impairment in originality. Furthermore, precise anatomical mapping of lesions indicated that while the extent of lesion in the right mPFC was associated with impaired originality, lesions in the left PC were associated with somewhat elevated levels of originality. A positive correlation between creativity scores and left PC lesions indicated that the larger the lesion is in this area the greater the originality. On the other hand, a negative correlation was observed between originality scores and lesions in the right mPFC. It is concluded that the right mPFC is part of a right fronto-parietal network which is responsible for producing original ideas. It is possible that more linear cognitive processing such as language, mediated by left hemisphere structures interferes with creative cognition. Therefore, lesions in the left hemisphere may be associated with elevated levels of originality. Copyright © 2010 Elsevier Ltd. All rights reserved.

PET and PET/CT in tumour of undetermined origin; PET y PET/CT en tumor de origen indeterminado

Energy Technology Data Exchange (ETDEWEB)

Garcia O, J R [Nuclear Medicine and Molecular Imaging, PET/CT, Centro Medico ABC, Mexico D.F. (Mexico)

2007-07-01

In this presentation the following conclusions were obtained regarding the use of PET and PET/CT in patient with cancer of unknown primary: 1. Detection of the primary one in 1/3 at 1/2 of patient. 2. It detects metastases in other places in 50%. 3. It changes the initial therapy planned in 1/3 at 1/2 of patient. 4. Useful in initial phases of protocol study to limit the other procedures. After standard evaluation. Before advanced protocol. 5. PET/CT study increases the % of primary detection, although in a non significant way vs. PET. 6. They are required more studies to value their utility to a more objective manner. (Author)

Cementoblastoma Relating to Right Mandibular Second Primary Molar

Directory of Open Access Journals (Sweden)

Sivakumar Nuvvula

2016-01-01

Full Text Available Cementoblastoma is a benign lesion of the odontogenic ectomesenchymal origin. It rarely occurs in primary dentition. This report describes a case of a cementoblastoma relating to the right mandibular second primary molar in a 7-year-old girl. Her panoramic radiograph revealed a well-defined radiopaque lesion with a radiolucent border extending from the distal surface of the mandibular right first primary molar to the distal surface of mandibular second primary molar. The tumor was attached to the mesial root of primary second molar and was excised along with the teeth involved and sent for histopathological evaluation, which showed irregular trabeculae of mineralized tissue interspersed with fibrovascular connective tissue, trabeculae of mineralized tissue with prominent reversal lines, and peripheral rimming of the mineralized tissue with blast cells. On a six-month follow-up, there has been no recurrence of the lesion.

Teleportation of an Unknown Atomic State via Adiabatic Passage

Institute of Scientific and Technical Information of China (English)

无

2007-01-01

We propose a scheme for teleporting an unknown atomic state via adiabatic passage. Taking advantage of adiabatic passage, the atom has no probability of being excited and thus the atomic spontaneous emission is suppressed.We also show that the fidelity can reach 1 under certain condition.

Origin of irradiations by ionizing radiations

International Nuclear Information System (INIS)

Metivier, H.

1998-01-01

Irradiations by ionizing radiations proceed from two main sources: the natural radiations from the environment and the sources of 'human' origin, i.e. linked with modern technology. In most countries the irradiation by natural sources remains the most important. The irradiations for medical purposes comes in second position and depends on the degree of technological evolution of the country, and in the last position are the irradiations linked with nuclear industry. The inventory of these irradiations is regularly updated by the Scientific Committee of the United Nations for the study of ionizing radiation effects (UNSCEAR). In France the mean individual irradiation due to natural radioactivity is of 2 mSv per year of efficient dose and can vary with a factor 3 from one region to the other. Irradiation of medical diagnosis origin is of about 1 mSv per year. This paper presents successively: the natural irradiation sources (cosmic radiation, cosmic rays and cosmogenic radionuclides, the Earth's radiations, primary radionuclides and radon), the natural sources modified by the technology (extraction industries, fossil fuels and phosphated ores, aerial transports and space activities, consumer products), the irradiation sources of technological origin (nuclear weapons, electric power production, major accidents, occupational irradiations), and the medical irradiations (diagnosis techniques, radiology, nuclear medicine and therapeutic uses). (J.S.)

Quadrotor Control in the Presence of Unknown Mass Properties

Science.gov (United States)

Duivenvoorden, Rikky Ricardo Petrus Rufino

Quadrotor UAVs are popular due to their mechanical simplicity, as well as their capability to hover and vertically take-off and land. As applications diversify, quadrotors are increasingly required to operate under unknown mass properties, for example as a multirole sensor platform or for package delivery operations. The work presented here consists of the derivation of a generalized quadrotor dynamic model without the typical simplifying assumptions on the first and second moments of mass. The maximum payload capacity of a quadrotor in hover, and the observability of the unknown mass properties are discussed. A brief introduction of L1 adaptive control is provided, and three different L 1 adaptive controllers were designed for the Parrot AR.Drone quadrotor. Their tracking and disturbance rejection performance was compared to the baseline nonlinear controller in experiments. Finally, the results of the combination of L1 adaptive control with iterative learning control are presented, showing high performance trajectory tracking under uncertainty.

A survey of infectious agents as risk factors for primary sclerosing cholangitis: are Chlamydia species involved?

NARCIS (Netherlands)

Ponsioen, Cyriel Y.; Defoer, Jacqueline; ten Kate, Fiebo J. W.; Weverling, Gerrit J.; Tytgat, Guido N. J.; Pannekoek, Yvonne; Wertheim-Dillen, Pauline M. E.

2002-01-01

Objectives The aetiology of primary sclerosing cholangitis (PSC) is unknown, and the role of micro-organisms has been studied only to a limited extent. We tested the hypothesis that past or persisting infection with common viruses or atypical bacteria might play a role in genetically susceptible

Dense genotyping of immune-related disease regions identifies nine new risk loci for primary sclerosing cholangitis

NARCIS (Netherlands)

Liu, Jimmy Z.; Hov, Johannes Roksund; Folseraas, Trine; Ellinghaus, Eva; Rushbrook, Simon M.; Doncheva, Nadezhda T.; Andreassen, Ole A.; Weersma, Rinse K.; Weismüller, Tobias J.; Eksteen, Bertus; Invernizzi, Pietro; Hirschfield, Gideon M.; Gotthardt, Daniel Nils; Pares, Albert; Ellinghaus, David; Shah, Tejas; Juran, Brian D.; Milkiewicz, Piotr; Rust, Christian; Schramm, Christoph; Müller, Tobias; Srivastava, Brijesh; Dalekos, Georgios; Nöthen, Markus M.; Herms, Stefan; Winkelmann, Juliane; Mitrovic, Mitja; Braun, Felix; Ponsioen, Cyriel Y.; Croucher, Peter J. P.; Sterneck, Martina; Teufel, Andreas; Mason, Andrew L.; Saarela, Janna; Leppa, Virpi; Dorfman, Ruslan; Alvaro, Domenico; Floreani, Annarosa; Onengut-Gumuscu, Suna; Rich, Stephen S.; Thompson, Wesley K.; Schork, Andrew J.; Næss, Sigrid; Thomsen, Ingo; Mayr, Gabriele; König, Inke R.; Hveem, Kristian; Cleynen, Isabelle; Gutierrez-Achury, Javier; Ricaño-Ponce, Isis; van Heel, David; Björnsson, Einar; Sandford, Richard N.; Durie, Peter R.; Melum, Espen; Vatn, Morten H.; Silverberg, Mark S.; Duerr, Richard H.; Padyukov, Leonid; Brand, Stephan; Sans, Miquel; Annese, Vito; Achkar, Jean-Paul; Boberg, Kirsten Muri; Marschall, Hanns-Ulrich; Chazouillères, Olivier; Bowlus, Christopher L.; Wijmenga, Cisca; Schrumpf, Erik; Vermeire, Severine; Albrecht, Mario; Rioux, John D.; Alexander, Graeme; Bergquist, Annika; Cho, Judy; Schreiber, Stefan; Manns, Michael P.; Färkkilä, Martti; Dale, Anders M.; Chapman, Roger W.; Lazaridis, Konstantinos N.; Franke, Andre; Anderson, Carl A.; Karlsen, Tom H.

2013-01-01

Primary sclerosing cholangitis (PSC) is a severe liver disease of unknown etiology leading to fibrotic destruction of the bile ducts and ultimately to the need for liver transplantation. We compared 3,789 PSC cases of European ancestry to 25,079 population controls across 130,422 SNPs genotyped

Matrix- and tensor-based recommender systems for the discovery of currently unknown inorganic compounds

Science.gov (United States)

Seko, Atsuto; Hayashi, Hiroyuki; Kashima, Hisashi; Tanaka, Isao

2018-01-01

Chemically relevant compositions (CRCs) and atomic arrangements of inorganic compounds have been collected as inorganic crystal structure databases. Machine learning is a unique approach to search for currently unknown CRCs from vast candidates. Herein we propose matrix- and tensor-based recommender system approaches to predict currently unknown CRCs from database entries of CRCs. Firstly, the performance of the recommender system approaches to discover currently unknown CRCs is examined. A Tucker decomposition recommender system shows the best discovery rate of CRCs as the majority of the top 100 recommended ternary and quaternary compositions correspond to CRCs. Secondly, systematic density functional theory (DFT) calculations are performed to investigate the phase stability of the recommended compositions. The phase stability of the 27 compositions reveals that 23 currently unknown compounds are newly found to be stable. These results indicate that the recommender system has great potential to accelerate the discovery of new compounds.

The evolution of milk secretion and its ancient origins.

Science.gov (United States)

Oftedal, O T

2012-03-01

Lactation represents an important element of the life history strategies of all mammals, whether monotreme, marsupial, or eutherian. Milk originated as a glandular skin secretion in synapsids (the lineage ancestral to mammals), perhaps as early as the Pennsylvanian period, that is, approximately 310 million years ago (mya). Early synapsids laid eggs with parchment-like shells intolerant of desiccation and apparently dependent on glandular skin secretions for moisture. Mammary glands probably evolved from apocrine-like glands that combined multiple modes of secretion and developed in association with hair follicles. Comparative analyses of the evolutionary origin of milk constituents support a scenario in which these secretions evolved into a nutrient-rich milk long before mammals arose. A variety of antimicrobial and secretory constituents were co-opted into novel roles related to nutrition of the young. Secretory calcium-binding phosphoproteins may originally have had a role in calcium delivery to eggs; however, by evolving into large, complex casein micelles, they took on an important role in transport of amino acids, calcium and phosphorus. Several proteins involved in immunity, including an ancestral butyrophilin and xanthine oxidoreductase, were incorporated into a novel membrane-bound lipid droplet (the milk fat globule) that became a primary mode of energy transfer. An ancestral c-lysozyme lost its lytic functions in favor of a role as α-lactalbumin, which modifies a galactosyltransferase to recognize glucose as an acceptor, leading to the synthesis of novel milk sugars, of which free oligosaccharides may have predated free lactose. An ancestral lipocalin and an ancestral whey acidic protein four-disulphide core protein apparently lost their original transport and antimicrobial functions when they became the whey proteins β-lactoglobulin and whey acidic protein, which with α-lactalbumin provide limiting sulfur amino acids to the young. By the late

The unknown-unknowns: Revealing the hidden insights in massive biomedical data using combined artificial intelligence and knowledge networks

Directory of Open Access Journals (Sweden)

Chris Yoo

2017-12-01

Full Text Available Genomic data is estimated to be doubling every seven months with over 2 trillion bases from whole genome sequence studies deposited in Genbank in just the last 15 years alone. Recent advances in compute and storage have enabled the use of artificial intelligence techniques in areas such as feature recognition in digital pathology and chemical synthesis for drug development. To apply A.I. productively to multidimensional data such as cellular processes and their dysregulation, the data must be transformed into a structured format, using prior knowledge to create contextual relationships and hierarchies upon which computational analysis can be performed. Here we present the organization of complex data into hypergraphs that facilitate the application of A.I. We provide an example use case of a hypergraph containing hundreds of biological data values and the results of several classes of A.I. algorithms applied in a popular compute cloud. While multiple, biologically insightful correlations between disease states, behavior, and molecular features were identified, the insights of scientific import were revealed only when exploration of the data included visualization of subgraphs of represented knowledge. The results suggest that while machine learning can identify known correlations and suggest testable ones, the greater probability of discovering unexpected relationships between seemingly independent variables (unknown-unknowns requires a context-aware system – hypergraphs that impart biological meaning in nodes and edges. We discuss the implications of a combined hypergraph-A.I. analysis approach to multidimensional data and the pre-processing requirements for such a system.

Adresse inconnue / Address unknown / Suchwiin Bulmyeong

Directory of Open Access Journals (Sweden)

Serge Gruzinski

2005-03-01

Full Text Available Tous les films asiatiques parlent de métissage, même ceux qui se présentent comme de vastes fresques historiques perdues dans le temps. Les emprunts aux traditions hollywoodiennes et européennes n'ont cessé d'enrichir une cinématographie aussi ancienne que celle du monde occidental. Dans Adresse inconnue (Address unknown le cinéaste coréen Kim Ki-duk explore l'expérience du métissage et le corps du métis à la frontière entre Corée du Nord et Corée du sud. Fils d'un GI américain et noir et d...

A case study to determine the geographical origin of unknown GM papaya in routine food sample analysis, followed by identification of papaya events 16-0-1 and 18-2-4

NARCIS (Netherlands)

Prins, Theo W.; Scholtens-Toma, Ingrid; Bak, Arno W.; Dijk, Van Jeroen P.; Voorhuijzen, Marleen M.; Laurensse, Emile J.; Kok, Esther J.

2016-01-01

During routine monitoring for GMOs in food in the Netherlands, papaya-containing food supplements were found positive for the genetically modified (GM) elements P-35S and T-nos. The goal of this study was to identify the unknown and EU unauthorised GM papaya event(s). A screening strategy was

Extended gamma-ray sources around pulsars constrain the origin of the positron flux at Earth

OpenAIRE

Abeysekara, A. U.; Albert, A.; Alfaro, R.; Alvarez, C.; Álvarez, J. D.; Arceo, R.; Arteaga-Velázquez, J. C.; Rojas, D. Avila; Solares, H. A. Ayala; Barber, A. S.; Bautista-Elivar, N.; Becerril, A.; Belmont-Moreno, E.; BenZvi, S. Y.; Berley, D.

2017-01-01

The unexpectedly high flux of cosmic ray positrons detected at Earth may originate from nearby astrophysical sources, dark matter, or unknown processes of cosmic-ray secondary production. We report the detection, using the HighAltitude Water Cherenkov Observatory (HAWC), of extended tera-electron volt gamma-ray emission coincident with the locations of two nearby middle-aged pulsars (Geminga and PSR B0656+14). The HAWC observations demonstrate that these pulsars are indeed local sources of ac...

Squamous cell carcinomas metastatic to cervical lymph nodes from an unknown head and neck mucosal site treated with radiation therapy with palliative intent

International Nuclear Information System (INIS)

Erkal, Haldun S.; Mendenhall, William M.; Amdur, Robert J.; Villaret, Douglas B.; Stringer, Scott P.

2001-01-01

Minimal information has been published about the results of palliative irradiation for squamous cell carcinoma metastatic to cervical lymph nodes from an unknown head and neck primary site. Forty patients with this diagnosis were treated at the University of Florida with radiation therapy with palliative intent. The nodal response rate was 65% and the symptomatic response rate was 57% at 1 year. The absolute survival rate was 25% at 1 year, as was the cause-specific survival rate. Radiotherapy successfully palliates more than half of those treated. Approximately one fourth are alive 1 year after irradiation

Optimal conclusive teleportation of a d-dimensional two-particle unknown quantum state

Institute of Scientific and Technical Information of China (English)

Yang Yu-Guang; Wen Qiao-Yan; Zhu Fu-Chen

2006-01-01

A conclusive teleportation protocol of a d-dimensional two-particle unknown quantum state using three ddimensional particles in an arbitrary pure state is proposed. A sender teleports the unknown state conclusively to a receiver by using the positive operator valued measure(POVM) and introducing an ancillary qudit to perform the generalized Bell basis measurement. We calculate the optimal teleportation fidelity. We also discuss and analyse the reason why the information on the teleported state is lost in the course of the protocol.

Blind Identification of FIR Channels in the Presence of Unknown Noise

Directory of Open Access Journals (Sweden)

Kon Max Wong

2007-01-01

Full Text Available Blind channel identification techniques based on second-order statistics (SOS of the received data have been a topic of active research in recent years. Among the most popular is the subspace method (SS proposed by Moulines et al. (1995. It has good performance when the channel output is corrupted by white noise. However, when the channel noise is correlated and unknown as is often encountered in practice, the performance of the SS method degrades severely. In this paper, we address the problem of estimating FIR channels in the presence of arbitrarily correlated noise whose covariance matrix is unknown. We propose several algorithms according to the different available system resources: (1 when only one receiving antenna is available, by upsampling the output, we develop the maximum a posteriori (MAP algorithm for which a simple criterion is obtained and an efficient implementation algorithm is developed; (2 when two receiving antennae are available, by upsampling both the outputs and utilizing canonical correlation decomposition (CCD to obtain the subspaces, we present two algorithms (CCD-SS and CCD-ML to blindly estimate the channels. Our algorithms perform well in unknown noise environment and outperform existing methods proposed for similar scenarios.

A novel algorithm for fast grasping of unknown objects using C-shape configuration

Science.gov (United States)

Lei, Qujiang; Chen, Guangming; Meijer, Jonathan; Wisse, Martijn

2018-02-01

Increasing grasping efficiency is very important for the robots to grasp unknown objects especially subjected to unfamiliar environments. To achieve this, a new algorithm is proposed based on the C-shape configuration. Specifically, the geometric model of the used under-actuated gripper is approximated as a C-shape. To obtain an appropriate graspable position, this C-shape configuration is applied to fit geometric model of an unknown object. The geometric model of unknown object is constructed by using a single-view partial point cloud. To examine the algorithm using simulations, a comparison of the commonly used motion planners is made. The motion planner with the highest number of solved runs, lowest computing time and the shortest path length is chosen to execute grasps found by this grasping algorithm. The simulation results demonstrate that excellent grasping efficiency is achieved by adopting our algorithm. To validate this algorithm, experiment tests are carried out using a UR5 robot arm and an under-actuated gripper. The experimental results show that steady grasping actions are obtained. Hence, this research provides a novel algorithm for fast grasping of unknown objects.

Dense genotyping of immune-related disease regions identifies nine new risk loci for primary sclerosing cholangitis

NARCIS (Netherlands)

Liu, Jimmy Z.; Hov, Johannes Roksund; Folseraas, Trine; Ellinghaus, Eva; Rushbrook, Simon M.; Doncheva, Nadezhda T.; Andreassen, Ole A.; Weersma, Rinse K.; Weismueller, Tobias J.; Eksteen, Bertus; Invernizzi, Pietro; Hirschfield, Gideon M.; Gotthardt, Daniel Nils; Pares, Albert; Ellinghaus, David; Shah, Tejas; Juran, Brian D.; Milkiewicz, Piotr; Rust, Christian; Schramm, Christoph; Mueller, Tobias; Srivastava, Brijesh; Dalekos, Georgios; Noethen, Markus M.; Herms, Stefan; Winkelmann, Juliane; Mitrovic, Mitja; Braun, Felix; Ponsioen, Cyriel Y.; Croucher, Peter J. P.; Sterneck, Martina; Teufel, Andreas; Mason, Andrew L.; Saarela, Janna; Leppa, Virpi; Dorfman, Ruslan; Alvaro, Domenico; Floreani, Annarosa; Onengut-Gumuscu, Suna; Rich, Stephen S.; Thompson, Wesley K.; Schork, Andrew J.; Naess, Sigrid; Thomsen, Ingo; Mayr, Gabriele; Koenig, Inke R.; Hveem, Kristian; Cleynen, Isabelle; Gutierrez-Achury, Javier; Ricano-Ponce, Isis; van Heel, David; Bjoernsson, Einar; Sandford, Richard N.; Durie, Peter R.; Melum, Espen; Vatn, Morten H.; Silverberg, Mark S.; Duerr, Richard H.; Padyukov, Leonid; Brand, Stephan; Sans, Miquel; Annese, Vito; Achkar, Jean-Paul; Boberg, Kirsten Muri; Marschall, Hanns-Ulrich; Chazouilleres, Olivier; Bowlus, Christopher L.; Wijmenga, Cisca; Schrumpf, Erik; Vermeire, Severine; Albrecht, Mario; Rioux, John D.; Alexander, Graeme; Bergquist, Annika; Cho, Judy; Schreiber, Stefan; Manns, Michael P.; Farkkila, Martti; Dale, Anders M.; Chapman, Roger W.; Lazaridis, Konstantinos N.; Franke, Andre; Anderson, Carl A.; Karlsen, Tom H.

Primary sclerosing cholangitis (PSC) is a severe liver disease of unknown etiology leading to fibrotic destruction of the bile ducts and ultimately to the need for liver transplantation(1-3). We compared 3,789 PSC cases of European ancestry to 25,079 population controls across 130,422 SNPs genotyped

Genetic analysis of an orbital metastasis from a primary hepatic neuroendocrine carcinoma

DEFF Research Database (Denmark)

Rasmussen, Jacob Ø; von Holstein, Sarah L; Prause, Jan U

2014-01-01

and immunohistochemical features, and high-resolution, array-based comparative genomic hybridization demonstrated loss of one copy each of chromosomes 3 and 18, and gain of 1q both in the primary hepatic neuroendocrine carcinoma and in the orbital tumour. The orbital mass was diagnosed as a metastasis from the primary...... hepatic neuroendocrine carcinoma. Primary hepatic neuroendocrine tumours are extremely rare, and the orbit is an extremely rare location for a neuroendocrine carcinoma metastasis. This is the first reported case of an orbital metastasis with origin from a primary hepatic neuroendocrine carcinoma....

Adenocarcinoid of the appendix presenting with metastases to the liver

DEFF Research Database (Denmark)

Bak, Martin; Jørgensen, L J

1987-01-01

A case of hepatomegalia due to multiple metastases of unknown origin to the liver is described. At autopsy the primary tumor, an adenocarcinoid tumor of the appendix, was identified along with multiple metastases to the lymph nodes and widespread peritoneal carcinoidosis. Hepatic metastases from...

Magnetic resonance appearance of monoclonal gammopathies of unknown significance and multiple myeloma. The GRI Study Group.

Science.gov (United States)

Bellaïche, L; Laredo, J D; Lioté, F; Koeger, A C; Hamze, B; Ziza, J M; Pertuiset, E; Bardin, T; Tubiana, J M

1997-11-01

A prospective multicenter study. To evaluate the use of magnetic resonance imaging, in the differentiation between monoclonal gammopathies of unknown significance and multiple myeloma. Although multiple myeloma has been studied extensively with magnetic resonance imaging, to the authors' knowledge, no study has evaluated the clinical interest of magnetic resonance imaging in the differentiation between monoclonal gammopathies of unknown significance and multiple myeloma. The magnetic resonance examinations of the thoracolumbar spine in 24 patients with newly diagnosed monoclonal gammopathies of unknown significance were compared with those performed in 44 patients with newly diagnosed nontreated multiple myeloma. All findings on magnetic resonance examination performed in patients with monoclonal gammopathies of unknown significance were normal, whereas findings on 38 (86%) of the 44 magnetic resonance examinations performed in patients with multiple myeloma were abnormal. Magnetic resonance imaging can be considered as an additional diagnostic tool in differentiating between monoclonal gammopathies of unknown significance and multiple myeloma, which may be helpful when routine criteria are not sufficient. An abnormal finding on magnetic resonance examination in a patient with monoclonal gammopathies of unknown significance should suggest the diagnosis of multiple myeloma after other causes of marrow signal abnormalities are excluded. Magnetic resonance imaging also may be proposed in the long-term follow-up of monoclonal gammopathies of unknown significance when a new biologic or clinical event suggests the diagnosis of malignant monoclonal gammopathy.

Original antigenic sin: A comprehensive review.

Science.gov (United States)

Vatti, Anup; Monsalve, Diana M; Pacheco, Yovana; Chang, Christopher; Anaya, Juan-Manuel; Gershwin, M Eric

2017-09-01

The concept of "original antigenic sin" was first proposed by Thomas Francis, Jr. in 1960. This phenomenon has the potential to rewrite what we understand about how the immune system responds to infections and its mechanistic implications on how vaccines should be designed. Antigenic sin has been demonstrated to occur in several infectious diseases in both animals and humans, including human influenza infection and dengue fever. The basis of "original antigenic sin" requires immunological memory, and our immune system ability to autocorrect. In the context of viral infections, it is expected that if we are exposed to a native strain of a pathogen, we should be able to mount a secondary immune response on subsequent exposure to the same pathogen. "Original antigenic sin" will not contradict this well-established immunological process, as long as the subsequent infectious antigen is identical to the original one. But "original antigenic sin" implies that when the epitope varies slightly, then the immune system relies on memory of the earlier infection, rather than mount another primary or secondary response to the new epitope which would allow faster and stronger responses. The result is that the immunological response may be inadequate against the new strain, because the immune system does not adapt and instead relies on its memory to mount a response. In the case of vaccines, if we only immunize to a single strain or epitope, and if that strain/epitope changes over time, then the immune system is unable to mount an accurate secondary response. In addition, depending of the first viral exposure the secondary immune response can result in an antibody-dependent enhancement of the disease or at the opposite, it could induce anergy. Both of them triggering loss of pathogen control and inducing aberrant clinical consequences. Copyright © 2017 Elsevier Ltd. All rights reserved.

Psychological Study on the Origin of Life, Death and Life after Death: Differences between Beliefs According to Age and Schooling

Science.gov (United States)

Silva Bautista, Jesús; Herrera Escobar, Venazir; Corona Miranda, Rodolfo

2018-01-01

The present work proposes a psychological study via beliefs, about the origin of life, death, and life after death. Beliefs have played a decisive role in the development of humanity, from the primitive man who gave to the unknown divine forces, the judgments of the Holy Inquisition in the Medieval Age, the impact provoked by the conviction that…

MUSIC-type imaging of small perfectly conducting cracks with an unknown frequency

International Nuclear Information System (INIS)

Park, Won-Kwang

2015-01-01

MUltiple SIgnal Classification (MUSIC) is a famous non-iterative detection algorithm in inverse scattering problems. However, when the applied frequency is unknown, inaccurate locations are identified via MUSIC. This fact has been confirmed through numerical simulations. However, the reason behind this phenomenon has not been investigated theoretically. Motivated by this fact, we identify the structure of MUSIC-type imaging functionals with unknown frequency, by establishing a relationship with Bessel functions of order zero of the first kind. Through this, we can explain why inaccurate results appear. (paper)

MUSIC-type imaging of small perfectly conducting cracks with an unknown frequency

Science.gov (United States)

Park, Won-Kwang

2015-09-01

MUltiple SIgnal Classification (MUSIC) is a famous non-iterative detection algorithm in inverse scattering problems. However, when the applied frequency is unknown, inaccurate locations are identified via MUSIC. This fact has been confirmed through numerical simulations. However, the reason behind this phenomenon has not been investigated theoretically. Motivated by this fact, we identify the structure of MUSIC-type imaging functionals with unknown frequency, by establishing a relationship with Bessel functions of order zero of the first kind. Through this, we can explain why inaccurate results appear.

Primary pulmonary malignant melanoma: a clinicopathologic study of two cases.

Science.gov (United States)

Gong, Li; Liu, Xiao-Yan; Zhang, Wen-Dong; Zhu, Shao-Jun; Yao, Li; Han, Xiu-Juan; Lan, Miao; Li, Yan-Hong; Zhang, Wei

2012-09-19

Malignant melanoma involving the respiratory tract is nearly always metastatic in origin, and primary tumors are very rare. To our knowledge, about 30 cases have been reported in the English literature, one of which involved multiple brain metastases. Here, we report two cases of primary pulmonary malignant melanoma. The first case, which occurred in a 52-year-old Chinese female patient who died 4 months after the initial diagnosis, involved rapid intrapulmonary and intracranial metastases. The second patient, a 65-year-old female, underwent surgical excision, and clinical examination, histopathological characteristics, and immunohistochemical features supported the diagnosis of pulmonary malignant melanoma. No evidence for recurrence and/or metastasis has been found more than one year after the initial surgery. To establish the diagnosis of primary pulmonary malignant melanoma, any extrapulmonary origin must be excluded by detailed examination. Moreover, the tumor should be removed surgically whether it occurs as a single lesion or multiple lesions. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1480477335765055.

Primary pulmonary malignant melanoma: a clinicopathologic study of two cases

Directory of Open Access Journals (Sweden)

Gong Li

2012-09-01

Full Text Available Abstract Malignant melanoma involving the respiratory tract is nearly always metastatic in origin, and primary tumors are very rare. To our knowledge, about 30 cases have been reported in the English literature, one of which involved multiple brain metastases. Here, we report two cases of primary pulmonary malignant melanoma. The first case, which occurred in a 52-year-old Chinese female patient who died 4 months after the initial diagnosis, involved rapid intrapulmonary and intracranial metastases. The second patient, a 65-year-old female, underwent surgical excision, and clinical examination, histopathological characteristics, and immunohistochemical features supported the diagnosis of pulmonary malignant melanoma. No evidence for recurrence and/or metastasis has been found more than one year after the initial surgery. To establish the diagnosis of primary pulmonary malignant melanoma, any extrapulmonary origin must be excluded by detailed examination. Moreover, the tumor should be removed surgically whether it occurs as a single lesion or multiple lesions. Virtual slide The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1480477335765055.

Editoria: EBOLA: Fear of the unknown | Comoro | Tanzania Journal ...

African Journals Online (AJOL)

Tanzania Journal of Health Research. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 3, No 2 (2001) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Editoria: EBOLA: Fear of the unknown. C. Comoro, J.

Automated pathway and reaction prediction facilitates in silico identification of unknown metabolites in human cohort studies.

Science.gov (United States)

Quell, Jan D; Römisch-Margl, Werner; Colombo, Marco; Krumsiek, Jan; Evans, Anne M; Mohney, Robert; Salomaa, Veikko; de Faire, Ulf; Groop, Leif C; Agakov, Felix; Looker, Helen C; McKeigue, Paul; Colhoun, Helen M; Kastenmüller, Gabi

2017-12-15

Identification of metabolites in non-targeted metabolomics continues to be a bottleneck in metabolomics studies in large human cohorts. Unidentified metabolites frequently emerge in the results of association studies linking metabolite levels to, for example, clinical phenotypes. For further analyses these unknown metabolites must be identified. Current approaches utilize chemical information, such as spectral details and fragmentation characteristics to determine components of unknown metabolites. Here, we propose a systems biology model exploiting the internal correlation structure of metabolite levels in combination with existing biochemical and genetic information to characterize properties of unknown molecules. Levels of 758 metabolites (439 known, 319 unknown) in human blood samples of 2279 subjects were measured using a non-targeted metabolomics platform (LC-MS and GC-MS). We reconstructed the structure of biochemical pathways that are imprinted in these metabolomics data by building an empirical network model based on 1040 significant partial correlations between metabolites. We further added associations of these metabolites to 134 genes from genome-wide association studies as well as reactions and functional relations to genes from the public database Recon 2 to the network model. From the local neighborhood in the network, we were able to predict the pathway annotation of 180 unknown metabolites. Furthermore, we classified 100 pairs of known and unknown and 45 pairs of unknown metabolites to 21 types of reactions based on their mass differences. As a proof of concept, we then looked further into the special case of predicted dehydrogenation reactions leading us to the selection of 39 candidate molecules for 5 unknown metabolites. Finally, we could verify 2 of those candidates by applying LC-MS analyses of commercially available candidate substances. The formerly unknown metabolites X-13891 and X-13069 were shown to be 2-dodecendioic acid and 9

Imaging findings of a primary paraganglioma of the liver: A case report

Energy Technology Data Exchange (ETDEWEB)

Ji, Seung Woo; Kang, Ung Rae; Park, Jae Bok [Daegu Catholic University Medical Center, Catholic University of Daegu College of Medicine, Daegu (Korea, Republic of)

2016-11-15

Primary hepatic paraganglioma is an extremely rare type of tumor originating from extra-adrenal chromaffin cells. We report a case of primary intrahepatic paraganglioma in a 52-year-old man, with pathologic confirmation through right hepatectomy. An imaging study indicated a predominately hemorrhagic septated cystic mass and peripheral marked enhancement of the solid portions, which showed persistent enhancement.

Communication in cross-cultural consultations in primary care in Europe: the case for improvement. The rationale for the RESTORE FP 7 project.

Science.gov (United States)

van den Muijsenbergh, Maria; van Weel-Baumgarten, Evelyn; Burns, Nicola; O'Donnell, Catherine; Mair, Frances; Spiegel, Wolfgang; Lionis, Christos; Dowrick, Chris; O'Reilly-de Brún, Mary; de Brun, Tomas; MacFarlane, Anne

2014-04-01

The purpose of this paper is to substantiate the importance of research about barriers and levers to the implementation of supports for cross-cultural communication in primary care settings in Europe. After an overview of migrant health issues, with the focus on communication in cross-cultural consultations in primary care and the importance of language barriers, we highlight the fact that there are serious problems in routine practice that persist over time and across different European settings. Language and cultural barriers hamper communication in consultations between doctors and migrants, with a range of negative effects including poorer compliance and a greater propensity to access emergency services. It is well established that there is a need for skilled interpreters and for professionals who are culturally competent to address this problem. A range of professional guidelines and training initiatives exist that support the communication in cross-cultural consultations in primary care. However, these are commonly not implemented in daily practice. It is as yet unknown why professionals do not accept or implement these guidelines and interventions, or under what circumstances they would do so. A new study involving six European countries, RESTORE (REsearch into implementation STrategies to support patients of different ORigins and language background in a variety of European primary care settings), aims to address these gaps in knowledge. It uses a unique combination of a contemporary social theory, normalisation process theory (NPT) and participatory learning and action (PLA) research. This should enhance understanding of the levers and barriers to implementation, as well as providing stakeholders, with the opportunity to generate creative solutions to problems experienced with the implementation of such interventions.

Navigation through unknown and dynamic open spaces using topological notions

Science.gov (United States)

Miguel-Tomé, Sergio

2018-04-01

Until now, most algorithms used for navigation have had the purpose of directing system towards one point in space. However, humans communicate tasks by specifying spatial relations among elements or places. In addition, the environments in which humans develop their activities are extremely dynamic. The only option that allows for successful navigation in dynamic and unknown environments is making real-time decisions. Therefore, robots capable of collaborating closely with human beings must be able to make decisions based on the local information registered by the sensors and interpret and express spatial relations. Furthermore, when one person is asked to perform a task in an environment, this task is communicated given a category of goals so the person does not need to be supervised. Thus, two problems appear when one wants to create multifunctional robots: how to navigate in dynamic and unknown environments using spatial relations and how to accomplish this without supervision. In this article, a new architecture to address the two cited problems is presented, called the topological qualitative navigation architecture. In previous works, a qualitative heuristic called the heuristic of topological qualitative semantics (HTQS) has been developed to establish and identify spatial relations. However, that heuristic only allows for establishing one spatial relation with a specific object. In contrast, navigation requires a temporal sequence of goals with different objects. The new architecture attains continuous generation of goals and resolves them using HTQS. Thus, the new architecture achieves autonomous navigation in dynamic or unknown open environments.

The Origin of the Second Centriole in the Zygote of Drosophila melanogaster

Science.gov (United States)

Blachon, Stephanie; Khire, Atul; Avidor-Reiss, Tomer

2014-01-01

Centrosomes are composed of two centrioles surrounded by pericentriolar material (PCM). However, the sperm and the oocyte modify or lose their centrosomes. Consequently, how the zygote establishes its first centrosome, and in particular, the origin of the second zygotic centriole, is uncertain. Drosophila melanogaster spermatids contain a single centriole called the Giant Centriole (GC) and a Proximal centriole-like (PCL) structure whose function is unknown. We found that, like the centriole, the PCL loses its protein markers at the end of spermiogenesis. After fertilization, the first two centrioles are observed via the recruitment of the zygotic PCM proteins and are seen in asterless mutant embryos that cannot form centrioles. The zygote’s centriolar proteins label only the daughter centrioles of the first two centrioles. These observations demonstrate that the PCL is the origin for the second centriole in the Drosophila zygote and that a paternal centriole precursor, without centriolar proteins, is transmitted to the egg during fertilization. PMID:24532732

Clinicopathological Analysis of a Primary and Solitary Brain Plasmacytoma: Case Report with an Encephalocoele

Institute of Scientific and Technical Information of China (English)

2007-01-01

@@ A primary and solitary plasmacytoma with an encephalocoele is an extremely rare tumor[1]. The origin of plasmacytoma cells has not been clarified, but a number of studies have suggested the possibility that it originates from the meninges and reticular cells of the Virchow-Robin space.

Is ursodeoxycholic acid effective in primary biliary cirrhosis?

Directory of Open Access Journals (Sweden)

Gabriel Rada

2014-09-01

Full Text Available Ursodeoxycholic acid is considered as first line treatment in patients with primary biliary cirrhosis. Its mechanism of action in this disease is unknown and there is controversy about its clinical impact. Searching in Epistemonikos database, which is maintained by screening 19 databases, we identified four systematic reviews including 16 studies. We combined the evidence using tables with summary of findings following the GRADE approach and concluded ursodeoxycholic acid may not have any effect on pruritus, and there is uncertainty about its effect on mortality, need for liver transplantation or on any other important outcome for the patient.

99mTc-EDDA/HYNIC-TOC somatostatin receptor scintigraphy in daily clinical practice.

Science.gov (United States)

Chrapko, Beata Ewa; Nocuń, Anna; Gołebiewska, Renata; Stefaniak, Bogusław; Korobowicz, Elzbieta; Czekajska-Chehab, Elzbieta; Sawicki, Marek; Polkowski, Wojciech Piotr

2010-04-01

This study aimed to assess the impact of 99mTc-EDDA/HYNIC-TOC (99mTc-TOC) somatostatin receptor scintigraphy (SRS) in clinical practice. One hundred seventeen patients were divided into 6 groups: 1, initial detection and localization of suspected neuroendocrine tumor (NET); 2, tumor staging before therapy; 3, staging of NET of unknown origin, 4, restaging after surgery of primary tumor; 5, diagnosis of solitary pulmonary nodules (SPNs), and 6, follow-up after "cold" somatostatin analogues treatment. In group 1, clinical suspicions were not confirmed in any of the patients; in group 2, most of the primary lesions showed overexpression of somatostatin receptors (SSRT); in group 3, the primary tumor was not identified in any of the patients; in group 4, recurrences were depicted in 7 out of 47 patients; in group 5, only 1 malignant SPN was detected, and in group 6, regression of primary mass and metastases were seen on follow-up SRS in 1 patient. 99mTc-TOC SRS is useful in staging of SSRT-overexpressing tumors of known and unknown primary origin, as well as in restaging after primary tumor surgery. This method is less effective in detecting suspected NET and assessing SPNs. Further investigation is necessary to evaluate the usefulness of SRS in monitoring patients after biological treatment.

Neurological autoantibodies in drug-resistant epilepsy of unknown cause.