Science.gov

Sample records for cisplatin-based highly emetogenic

  1. Efficacy of Olanzapine Combined Therapy for Patients Receiving Highly Emetogenic Chemotherapy Resistant to Standard Antiemetic Therapy

    PubMed Central

    Abe, Masakazu; Kasamatsu, Yuka; Kado, Nobuhiro; Kuji, Shiho; Tanaka, Aki; Takahashi, Nobutaka; Takekuma, Munetaka; Hirashima, Yasuyuki

    2015-01-01

    Objective. Olanzapine is proved to be effective for chemotherapy induced nausea and vomiting (CINV). But its efficacy in combination with standard antiemetic therapy is unknown. The purpose of this study is to prove the preventive effect of olanzapine for the prevention of CINV caused by highly emetogenic chemotherapy when used with standard antiemetic therapy. Method. Gynecologic cancer patients receiving cisplatin-based chemotherapy who had grade 2 or 3 nausea in overall phase (0–120 h after chemotherapy) despite standard therapy were assigned to this study. From the next cycles to cycles in which patients developed grade 2 or 3 nausea, they received olanzapine with standard therapy. 5 mg oral olanzapine was administered for 7 days from the day before chemotherapy. The effectiveness of preventive administration of olanzapine was evaluated retrospectively. The primary endpoint was nausea control rate (grade 0 or 1) with olanzapine. Results. Fifty patients were evaluable. The nausea control rate with olanzapine was improved from 58% to 98% in acute phase (0–24 h after chemotherapy) and 2% to 94% in delayed phase (24–120 h after chemotherapy). In overall phase, the nausea control rate improved from 0% to 92%, and it was statistically significant (P < 0.001). Conclusion. Preventive use of olanzapine combined with standard antiemetic therapy showed improvement in control of refractory nausea. PMID:26425564

  2. Acupressure in Controlling Nausea in Young Patients Receiving Highly Emetogenic Chemotherapy | Division of Cancer Prevention

    Cancer.gov

    RATIONALE: Acupressure wristbands may prevent or reduce nausea and caused by chemotherapy. It is not yet known whether standard care is more effective with or without acupressure wristbands in controlling acute and delayed nausea. PURPOSE: This randomized phase III trial is studying how well acupressure wristbands work with or without standard care in controlling nausea in young patients receiving highly emetogenic chemotherapy. |

  3. The Efficacy, Safety, and Cost Benefit of Olanzapine versus Aprepitant in Highly Emetogenic Chemotherapy: A Pilot Study from South India.

    PubMed

    Babu, Govind; Saldanha, Smitha Carol; Kuntegowdanahalli Chinnagiriyappa, Lakshmaiah; Jacob, Linu Abraham; Mallekavu, Suresh Babu; Dasappa, Loknatha; Kiran, Pretesh Rohan; Sreevatsa, Aparna; Appachu, Sandhya; Unnikrishnan, Vineetha; Arroju, Venugopal

    2016-01-01

    Background. The efficacy, safety, and cost benefit of olanzapine (OLN) when compared to aprepitant (APR) in the prevention of chemotherapy induced nausea and vomiting (CINV) in patients receiving highly emetogenic chemotherapy (HEC) were evaluated. Methods. A prospective pilot study was done in chemotherapy-naive patients receiving HEC to compare OLN versus APR along with palonosetron and dexamethasone. 100 patients consented to the protocol and were randomized and evaluated for Complete Response (CR) (no emesis, no rescue). Results. CR was 86% for the acute period, 86% for the delayed period, and 80% for the overall period in 50 patients receiving the APD regimen. CR was 84% for the acute period, 88% for the delayed period, and 78% for the overall period for 50 patients receiving the OPD regimen. Patients without nausea were APD: 88% acute, 84% delayed, and 84% overall, and OPD: 84% acute, 88% delayed, and 84% overall. There were no significant grade 3 or 4 toxicities. OPD was comparable to APD in the control of CINV. Conclusion. In this study, there was no significant difference between olanzapine and aprepitant in preventing CINV with highly emetogenic chemotherapy. Olanzapine may thus be used as a potential, safe, and cost beneficial alternative to prevent nausea and vomiting in HEC. PMID:26925265

  4. The Efficacy, Safety, and Cost Benefit of Olanzapine versus Aprepitant in Highly Emetogenic Chemotherapy: A Pilot Study from South India

    PubMed Central

    Babu, Govind; Saldanha, Smitha Carol; Kuntegowdanahalli Chinnagiriyappa, Lakshmaiah; Jacob, Linu Abraham; Mallekavu, Suresh Babu; Dasappa, Loknatha; Kiran, Pretesh Rohan; Sreevatsa, Aparna; Appachu, Sandhya; Unnikrishnan, Vineetha; Arroju, Venugopal

    2016-01-01

    Background. The efficacy, safety, and cost benefit of olanzapine (OLN) when compared to aprepitant (APR) in the prevention of chemotherapy induced nausea and vomiting (CINV) in patients receiving highly emetogenic chemotherapy (HEC) were evaluated. Methods. A prospective pilot study was done in chemotherapy-naive patients receiving HEC to compare OLN versus APR along with palonosetron and dexamethasone. 100 patients consented to the protocol and were randomized and evaluated for Complete Response (CR) (no emesis, no rescue). Results. CR was 86% for the acute period, 86% for the delayed period, and 80% for the overall period in 50 patients receiving the APD regimen. CR was 84% for the acute period, 88% for the delayed period, and 78% for the overall period for 50 patients receiving the OPD regimen. Patients without nausea were APD: 88% acute, 84% delayed, and 84% overall, and OPD: 84% acute, 88% delayed, and 84% overall. There were no significant grade 3 or 4 toxicities. OPD was comparable to APD in the control of CINV. Conclusion. In this study, there was no significant difference between olanzapine and aprepitant in preventing CINV with highly emetogenic chemotherapy. Olanzapine may thus be used as a potential, safe, and cost beneficial alternative to prevent nausea and vomiting in HEC. PMID:26925265

  5. Antiemetic Therapy With or Without Olanzapine in Preventing Chemotherapy-Induced Nausea and Vomiting in Patients With Cancer Receiving Highly Emetogenic Chemotherapy | Division of Cancer Prevention

    Cancer.gov

    This randomized phase III trial studies antiemetic therapy with olanzapine to see how well they work compared to antiemetic therapy alone in preventing chemotherapy-induced nausea and vomiting in patients with cancer receiving highly emetogenic (causes vomiting) chemotherapy. Antiemetic drugs, such as palonosetron hydrochloride, ondansetron, and granisetron hydrochloride, may help lessen or prevent nausea and vomiting in patients treated with chemotherapy. |

  6. A randomized controlled study evaluating the efficacy of aprepitant for highly/moderately emetogenic chemotherapies in hematological malignancies.

    PubMed

    Nasu, R; Nannya, Y; Kurokawa, M

    2015-04-01

    Chemotherapy-induced nausea and vomiting (CINV) is a serious complication of treatments of hematological malignancies. Although aprepitant, an NK1 receptor antagonist, has been shown to control CINV in highly emetogenic therapies for solid tumors, the antiemetic effect of this agent in hematological chemotherapies is not well established. In this randomized controlled trial, we examined the additional effect of aprepitant in combination with conventional 5HT3 blocker-based prophylaxis for CINV in highly or moderately emetic chemotherapies for hematological malignancies (n = 41). The complete response rate, defined as no emetic episodes and no salvage treatments, was significantly higher in the aprepitant arm than the control arm (82 versus 47 %, p = 0.026), with no increase in severe adverse effects. However, the difference of nausea, measured with visual analog scale, and of oral intake impairment was moderate, which suggests insufficiency of blocking NK receptor for these events. Furthermore, sub-group analysis revealed that merit of aprepitant addition depends on treatment regimens. Our results indicate the overall advantage of applying aprepitant in the control of CINV in hematological malignancies and the need for further refinement of anti-CINV strategies, including stratification according to regimen. PMID:25644148

  7. Pharmacokinetics, safety, and efficacy of APF530 (extended-release granisetron) in patients receiving moderately or highly emetogenic chemotherapy: results of two Phase II trials

    PubMed Central

    Gabrail, Nashat; Yanagihara, Ronald; Spaczyński, Marek; Cooper, William; O’Boyle, Erin; Smith, Carrie; Boccia, Ralph

    2015-01-01

    Background Despite advances with new therapies, a significant proportion of patients (>30%) suffer delayed-onset chemotherapy-induced nausea and vomiting (CINV) despite use of antiemetics. APF530 is a sustained-release subcutaneous (SC) formulation of granisetron for preventing CINV. APF530 pharmacokinetics, safety, and efficacy were studied in two open-label, single-dose Phase II trials (C2005-01 and C2007-01, respectively) in patients receiving moderately emetogenic chemotherapy or highly emetogenic chemotherapy. Methods In C2005-01, 45 patients received APF530 250, 500, or 750 mg SC (granisetron 5, 10, or 15 mg, respectively). In C2007-01, 35 patients were randomized to APF530 250 or 500 mg SC. Injections were given 30 to 60 minutes before single-day moderately emetogenic chemotherapy or highly emetogenic chemotherapy. Plasma granisetron was measured from predose to 168 hours after study drug administration. Safety and efficacy were also evaluated. Results APF530 pharmacokinetics were dose proportional, with slow absorption and elimination of granisetron after a single SC dose. Median time to maximum plasma concentration and half-life were similar for APF530 250 and 500 mg in both trials, with no differences between the groups receiving moderately and highly emetogenic chemotherapy. Exposure to granisetron was maintained at a therapeutic level over the delayed-onset phase, at least 168 hours. Adverse events in both trials were as expected for granisetron; injection site reactions (eg, erythema and induration) were predominantly mild and seen in ≤20% of patients. Complete responses (no emesis, with no rescue medication) were obtained in the acute, delayed, and overall phases in ≥80% and ≥75% of patients in both trials with the 250 and 500 mg doses, respectively. Conclusion After a single injection of APF530, there were dose-proportional pharmacokinetics and sustained concentrations of granisetron over 168 hours. The 250 and 500 mg doses were well tolerated

  8. Pilot study on the efficacy of an ondansetron-versus palonosetron-containing antiemetic regimen prior to highly emetogenic chemotherapy

    PubMed Central

    Wenzell, Candice M.; Berger, Michael J.; Blazer, Marlo A.; Crawford, Brooke S.; Griffith, Niesha L.; Wesolowski, Robert; Lustberg, Maryam B.; Phillips, Gary S.; Ramaswamy, Bhuvaneswari; Mrozek, Ewa; Flynn, Joseph M.; Shapiro, Charles L.; Layman, Rachel M.

    2013-01-01

    Purpose Nausea and vomiting are among the most feared complications of chemotherapy reported by patients. The objective of this study was to establish the overall complete response (CR; no emesis or use of rescue medication 0–120 h after chemotherapy) with either ondansetron- or palonosetron-containing antiemetic regimens in patients receiving highly emetogenic chemotherapy (HEC). Methods This was a prospective, open-label, randomized, single-center, pilot study that enrolled patients receiving their first cycle of HEC. Patients were randomized to receive either palonosetron 0.25 mg IV (PAD) or ondansetron 24 mg orally (OAD) on day 1 prior to HEC. All patients received oral aprepitant 125 mg on day 1, then 80 mg on days 2 and 3, and oral dexamethasone 12 mg on day 1, then 8 mg on days 2, 3, and 4. Descriptive statistics were used to summarize the data. Results A total of 40 patients were enrolled, 20 in each arm. All patients were female, and 39 received doxorubicin/cyclophosphamide chemotherapy for breast cancer. For the primary endpoint, 65 % (95 % CI, 40.8–84.6 %) of patients in the PAD arm and 40 % (95 % CI, 19.1–63.9 %) of patients in the OAD arm achieved an overall CR. Conclusions While CR rates for aprepitant and dexamethasone plus palonosetron or ondansetron-containing regimens have been published previously, this is the first documentation of CR rates with these regimens in the same patient population. These results may be used to design a larger, adequately powered, prospective study comparing these regimens. PMID:23748485

  9. Concurrent cisplatin-based chemoradiotherapy versus exclusive radiotherapy in high-risk cervical cancer: a meta-analysis

    PubMed Central

    Meng, Xiang-Yu; Liao, Yi; Liu, Xiao-Ping; Li, Sheng; Shi, Ming-Jun; Zeng, Xian-Tao

    2016-01-01

    Objective To evaluate the efficacy and safety of cisplatin-based concurrent chemoradiotherapy (DDP-CCRT) in patients with high-risk cervical carcinoma (CC) compared with exclusive radiotherapy (RT). Materials and methods Databases were searched for randomized controlled trials (RCTs) and cohort studies comparing DDP-CCRT with RT alone. Risk of bias assessment for RCTs was performed using the Cochrane Collaboration’s tool, and the Newcastle–Ottawa quality scale was used to perform quality assessment for cohort studies. Meta-analysis was conducted using Review Manager 5 and Stata 12.0 software. Results Finally, eight RCTs and three cohort studies containing 2,130 subjects were included. Analysis on total failures revealed a statistically significant difference in favor of DDP-CCRT (risk ratio =0.77, 95% confidence intervals [CIs]: 0.67–0.89). No significant heterogeneity was detected for pooled analysis concerning overall survival; the result of which demonstrated the superiority of DDP-CCRT over RT alone (hazard ratio =0.68, 95% CI: 0.57–0.80), and stable and established accumulative effects were observed in cumulative meta-analysis. Similar results were observed for progression-free survival (hazard ratio =0.63, 95% CI: 0.50–0.76). In terms of treatment-related Grade 3 and 4 adverse events, our pooled analysis with a fixed-effects model showed significantly enhanced toxicity in the DDP-CCRT group compared with that in the RT group (odds ratio =3.13, 95% CI: 2.37–4.13). Conclusion Solid and stable beneficial effects are associated with DDP-CCRT, and its superiority over comparative RT in patients with high-risk CC is confirmed. DDP-CCRT should be considered one of the frontline treatment options for high-risk CC patients without contraindications. However, enhanced toxicity associated with DDP-CCRT should never be ignored. PMID:27099519

  10. Personalized Estimate of Chemotherapy-Induced Nausea and Vomiting: Development and External Validation of a Nomogram in Cancer Patients Receiving Highly/Moderately Emetogenic Chemotherapy.

    PubMed

    Hu, Zhihuang; Liang, Wenhua; Yang, Yunpeng; Keefe, Dorothy; Ma, Yuxiang; Zhao, Yuanyuan; Xue, Cong; Huang, Yan; Zhao, Hongyun; Chen, Likun; Chan, Alexandre; Zhang, Li

    2016-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is presented in over 30% of cancer patients receiving highly/moderately emetogenic chemotherapy (HEC/MEC). The currently recommended antiemetic therapy is merely based on the emetogenic level of chemotherapy, regardless of patient's individual risk factors. It is, therefore, critical to develop an approach for personalized management of CINV in the era of precision medicine.A number of variables were involved in the development of CINV. In the present study, we pooled the data from 2 multi-institutional investigations of CINV due to HEC/MEC treatment in Asian countries. Demographic and clinical variables of 881 patients were prospectively collected as defined previously, and 862 of them had full documentation of variables of interest. The data of 548 patients from Chinese institutions were used to identify variables associated with CINV using multivariate logistic regression model, and then construct a personalized prediction model of nomogram; while the remaining 314 patients out of China (Singapore, South Korea, and Taiwan) entered the external validation set. C-index was used to measure the discrimination ability of the model.The predictors in the final model included sex, age, alcohol consumption, history of vomiting pregnancy, history of motion sickness, body surface area, emetogenicity of chemotherapy, and antiemetic regimens. The C-index was 0.67 (95% CI, 0.62-0.72) for the training set and 0.65 (95% CI, 0.58-0.72) for the validation set. The C-index was higher than that of any single predictor, including the emetogenic level of chemotherapy according to current antiemetic guidelines. Calibration curves showed good agreement between prediction and actual occurrence of CINV.This easy-to-use prediction model was based on chemotherapeutic regimens as well as patient's individual risk factors. The prediction accuracy of CINV occurrence in this nomogram was well validated by an independent data set. It could

  11. Personalized Estimate of Chemotherapy-Induced Nausea and Vomiting: Development and External Validation of a Nomogram in Cancer Patients Receiving Highly/Moderately Emetogenic Chemotherapy

    PubMed Central

    Hu, Zhihuang; Liang, Wenhua; Yang, Yunpeng; Keefe, Dorothy; Ma, Yuxiang; Zhao, Yuanyuan; Xue, Cong; Huang, Yan; Zhao, Hongyun; Chen, Likun; Chan, Alexandre; Zhang, Li

    2016-01-01

    Abstract Chemotherapy-induced nausea and vomiting (CINV) is presented in over 30% of cancer patients receiving highly/moderately emetogenic chemotherapy (HEC/MEC). The currently recommended antiemetic therapy is merely based on the emetogenic level of chemotherapy, regardless of patient's individual risk factors. It is, therefore, critical to develop an approach for personalized management of CINV in the era of precision medicine. A number of variables were involved in the development of CINV. In the present study, we pooled the data from 2 multi-institutional investigations of CINV due to HEC/MEC treatment in Asian countries. Demographic and clinical variables of 881 patients were prospectively collected as defined previously, and 862 of them had full documentation of variables of interest. The data of 548 patients from Chinese institutions were used to identify variables associated with CINV using multivariate logistic regression model, and then construct a personalized prediction model of nomogram; while the remaining 314 patients out of China (Singapore, South Korea, and Taiwan) entered the external validation set. C-index was used to measure the discrimination ability of the model. The predictors in the final model included sex, age, alcohol consumption, history of vomiting pregnancy, history of motion sickness, body surface area, emetogenicity of chemotherapy, and antiemetic regimens. The C-index was 0.67 (95% CI, 0.62–0.72) for the training set and 0.65 (95% CI, 0.58–0.72) for the validation set. The C-index was higher than that of any single predictor, including the emetogenic level of chemotherapy according to current antiemetic guidelines. Calibration curves showed good agreement between prediction and actual occurrence of CINV. This easy-to-use prediction model was based on chemotherapeutic regimens as well as patient's individual risk factors. The prediction accuracy of CINV occurrence in this nomogram was well validated by an independent data set

  12. High ABCG4 Expression Is Associated with Poor Prognosis in Non-Small-Cell Lung Cancer Patients Treated with Cisplatin-Based Chemotherapy

    PubMed Central

    Zhou, Yong-An; Tian, Feng; Zhao, Jin-Bo; Chen, Peng; Liu, Bo-Ya; Wen, Miao-Miao; Li, Xiao-Fei; Zhang, Zhi-Pei

    2015-01-01

    ATP-binding cassette (ABC) transporters are associated with poor response to chemotherapy, and confer a poor prognosis in various malignancies. However, the association between the expression of the ABC sub-family G member 4 (ABCG4) and prognosis in patients with non-small-cell lung cancer (NSCLC) remains unclear. NSCLC tissue samples (n = 140) and normal lung tissue samples (n = 90) were resected from patients with stage II to IV NSCLC between May 2004 and May 2009. ABCG4 mRNA and protein expressions were detected by RT-PCR, western blot, and immunohistochemistry. Patients received four cycles of cisplatin-based post-surgery chemotherapy and were followed up until May 31st, 2014. ABCG4 positivity rate was higher in NSCLC than in normal lung tissues (48.6% vs. 0%, P<0.001) and ABCG4 expression was significantly associated with poor differentiation, higher tumor node metastasis (TNM) stage, and adenocarcinoma histological type (all P<0.001). Univariate (HR = 2.284, 95%CI: 1.570–3.324, P<0.001) and multivariate (HR = 2.236, 95%CI: 1.505–3.321, P<0.001) analyses showed that ABCG4 expression was an independent factor associated with a poor prognosis in NSCLC. Patients with ABCG4-positive NSCLC had shorter median survival than ABCG4-negative NSCLC (20.1 vs. 43.2 months, P<0.001). The prognostic significance of ABCG4 expression was apparent in stages III and IV NSCLC. In conclusion, high ABCG4 expression was associated with a poor prognosis in patients with NSCLC treated with cisplatin-based chemotherapy. PMID:26270652

  13. Effective cross-over to granisetron after failure to ondansetron, a randomized double blind study in patients failing ondansetron plus dexamethasone during the first 24 hours following highly emetogenic chemotherapy

    PubMed Central

    de Wit, R; de Boer, A C; vd Linden, G H M; Stoter, G; Sparreboom, A; Verweij, J

    2001-01-01

    In view of the similarity in chemical structure of the available 5HT3-receptor antagonists it is assumed, whilst these agents all act at the same receptor, that failure to one agent would predict subsequent failure to all 5HT3-receptor antagonists. We conducted a randomized double blind trial of granisetron 3 mg plus dexamethasone 10 mg versus continued treatment with ondansetron 8 mg plus dexamethasone 10 mg in patients with protection failure on ondansetron 8 mg plus dexamethasone 10 mg during the first 24 hours following highly emetogenic chemotherapy. Of 40 eligible patients, 21 received ondansetron + dexamethasone and 19 received granisetron + dexamethasone. We found a significant benefit from crossing-over to granisetron after failure on ondansetron. Of the 19 patients who crossed over to granisetron, 9 patients obtained complete protection, whereas this was observed in 1 of the 21 patients continuing ondansetron, P = 0.005. These results indicate that there is no complete cross-resistance between 5HT3-receptor antagonists, and that patients who have acute protection failure on one 5HT3-receptor antagonist should be offered cross-over to another 5HT3-receptor antagonist. © 2001 Cancer Research Campaign  http://www.bjcancer.com PMID:11710819

  14. Phase III Double-Blind, Placebo-Controlled Study of Gabapentin for the Prevention of Delayed Chemotherapy-Induced Nausea and Vomiting in Patients Receiving Highly Emetogenic Chemotherapy, NCCTG N08C3 (Alliance)

    PubMed Central

    Barton, Debra L.; Thanarajasingam, Gita; Sloan, Jeff A.; Diekmann, Brent; Fuloria, Jyotsna; Kottschade, Lisa A.; Lyss, Alan P.; Jaslowski, Anthony J.; Mazurczak, Miroslaw A.; Blair, Scott C.; Terstriep, Shelby; Loprinzi, Charles L.

    2014-01-01

    BACKGROUND Despite targeted antiemetics, data support an unmet need related to the management of delayed nausea and vomiting (NV). Promising pilot data informed this phase III trial evaluating gabapentin for delayed NV from highly emetogenic chemotherapy (HEC). METHODS Participants were randomized to receive prophylactic treatment with 20 mg of dexamethasone and a 5HT3 receptor antagonist (RA) on the day of chemotherapy, followed by gabapentin 300 mg twice a day and dexamethasone (dex) or placebo and dex after HEC. Gabapentin/placebo was started the day of chemotherapy and continued through day 5 for the first chemotherapy cycle, whereas dex was titrated down on days 2–4. The primary end point was complete response (CR), defined as no emesis and no use of rescue medications on days 2–6, using an NV diary. The percentages of those in each group with a CR were compared by Fisher’s exact test. RESULTS Four hundred thirty patients were enrolled in this study. Forty-seven percent of patients in the gabapentin arm and 41% in the placebo arm had a CR (P = .23). Mean number of emesis episodes was <0.5 daily, and mean nausea severity was <2 (mild). In both arms, patient satisfaction with NV control was greater than 8 (with 10 being perfectly satisfied). There were no significant differences in unwanted side effects. CONCLUSIONS In this study, gabapentin did not significantly improve delayed NV. Patients were satisfied with the control of their nausea and vomiting irrespective of arm. The use of a 5HT3 RA and dexamethasone provided good control of nausea and vomiting for most patients. PMID:25043153

  15. Nephrotoxicity as a Dose-Limiting Factor in a High-Dose Cisplatin-Based Chemoradiotherapy Regimen for Head and Neck Carcinomas

    PubMed Central

    Hoek, Jantien; Bloemendal, Karen M.; van der Velden, Lilly-Ann A.; van Diessen, Judi N.A.; van Werkhoven, Erik; Klop, Willem M.C.; Tesselaar, Margot E.T.

    2016-01-01

    Purpose: Loco-regional control and organ preservation are significantly improved with concomitant cisplatin/radiotherapy and are compromised with less than 5% grade 3 nephrotoxicity (creatinine clearance 15–29 mL/min). However, although clinically important, in none of the randomized trials is grade 2 nephrotoxicity (defined as creatinine clearance 59–30 mL/min) mentioned. In this study, we assessed nephrotoxicity in daily practice among patients treated with high-dose cisplatin (100 mg/m2 on days 1, 22, and 43), concurrently with chemoradiotherapy (CCRT) and the impact on treatment modifications. Methods: 208 patients with advanced-stage malignancies of the head and neck region were evaluated. All patients were treated with high-dose cisplatin CCRT. The main outcome parameters were nephrotoxicity (defined as creatinine clearance grade 2 or more) and cumulative doses of cisplatin and radiation. Results: 133 patients (64%) completed all pre-planned courses of cisplatin. Nephrotoxicity was the main reason to discontinue the chemotherapy. Grade 3 nephrotoxicity was seen in 16 patients (8%) while grade 2 nephrotoxicity was seen in 53 patients (25%). Thirty six patients (17%) could not complete the pre-planned chemotherapy due to nephrotoxicity. Conclusions: In head and neck cancer patients, nephrotoxicity grade 2 is under-reported but is the major factor for discontinuing cisplatin during CCRT. PMID:26891330

  16. Parameters that influence the outcome of nausea and emesis in cisplatin based chemotherapy.

    PubMed

    Tsavaris, N; Kosmas, C; Mylonakis, N; Bacoyiannis, C; Kalergis, G; Vadiaka, M; Boulamatsis, D; Iakovidis, V; Kosmidis, P

    2000-01-01

    Some factors have demonstrated an influence on emesis and antiemetic response. In order to study these factors, 306 patients (pts) entered this study receiving cisplatin based combination chemotherapy (CT) (100 mg/m3, with ondansetron (8 mg, 3 times daily for 4 days) as the only antiemetic treatment. Known factors that influence the result of antiemetic therapy such as age, sex, performance status (Karnofsky), site of primary tumor, weight loss, anxiety, depression, psychological problems related to CT (psychological PRC) etc, were included in the evaluation. We evaluated the number of vomits, retches and nausea. The existence of psychological PRC was found to be a prominent factor for the development of nausea and emesis, being at the same time strongly associated with scaling variables (Gralla, retching and nausea grading) used to measure the severity of nausea and emesis (p = 0.001). Stress was also a significant predictor; patients with stress had an almost two times higher probability to develop nausea or retching compared to patients without stress indications (p = 0.001), while the occurrence of retching was marginal. Younger patients (less than 40 years old) were found to be almost three times more susceptible to retching compared to older patients (more than 40 years old) (P 0.006). With all possible evaluations, we concluded that significant factors are psychological PRC, stress and age. In conclusion, three factors, age, stress and psychological PRC, should be taken seriously into consideration in the design of future trials evaluating antiemetic treatment, as well as in the every-day clinical practice, in order to provide patients with a better quality of life during emetogenic CT. PMID:11205218

  17. Cisplatin based chemotherapy in testicular cancer patients: long term platinum excretion and clinical effects.

    PubMed

    Hohnloser, J H; Schierl, R; Hasford, B; Emmerich, B

    1996-09-20

    Patients with advanced testicular cancer (TC) have a very good long-term prognosis owing to cisplatin-based polychemotherapy. Platinum is believed to be excreted at a rapid rate via urine within weeks after chemotherapy. As a new, highly sensitive method has become available detecting even natural background platinum levels in body fluids, this study was set up to analyze urinary and serum platinum levels in long-term survivors of testicular neoplasm after cisplatin based polychemotherapy and to correlate clinical data with urinary and serum platinum levels. Urinary platinum concentrations were measured in 64 healthy controls (C) and 22 male patients (TC) 150 to 3022 days after the last application of i.v. cisplatin using voltammetry after UV-photolysis. In the latter group (TC), serum platinum levels were measured as well. Clinical data were analysed as to long-term organ toxicity. Mean urinary platinum levels were 2700 times higher in the patient group (TC) than natural background noise (p < 0.0001). There was a decline of urinary and serum platinum levels over time, being significantly above normal even 8 years after cisplatin exposure. The only significant variables related to the urine platinum concentration were a) the interval between the last i.v. cisplatin application and time of study and b) the total dose given. Not significant were the number of chemotherapy cycles, pre-therapy renal disease, patient age, tumour resection before/after chemotherapy, site of pre/post therapy resection, clinical staging, histological subtypes or tumour markers. Post-therapy renal disease or peripheral nerve damage were not significantly associated with urinary platinum levels. Our data indicate that even 8 years after cisplatin based chemotherapy 500 times elevated urinary and serum platinum levels can be measured in testicular cancer patients. No organ toxicity related to long-term platinum excretion could be detected. This may be due to our small sample size. PMID

  18. SERPINB1 expression is predictive for sensitivity and outcome of cisplatin-based chemotherapy in melanoma

    PubMed Central

    Willmes, Christoph; Kumar, Rajiv; Becker, Jürgen C.; Fried, Isabella; Rachakonda, P. Sivaramakrishna; Poppe, Lidia M.; Hesbacher, Sonja; Schadendorf, Dirk; Sucker, Antje

    2016-01-01

    Despite of highly effective new therapeutic strategies, chemotherapy still is an important treatment option in metastatic melanoma. Since predictors of chemotherapy response are rare, drugs and regimens are currently chosen arbitrarily. The present study was aimed at the identification of molecular markers predicting the outcome of chemotherapy in melanoma. Tumor biopsies from metastatic lesions were collected from 203 stage IV melanoma patients prior to chemotherapy onset and used for gene expression profiling (n = 6; marker identification set), quantitative real-time PCR (n = 127; validation set 1), and immunohistochemistry on tissue microarrays (n = 70; validation set 2). The results were correlated to the tumors' in-vitro chemosensitivity and to the patients' in-vivo chemotherapy outcome. SERPINB1 was found to correlate to the in-vitro sensitivity to cisplatin-containing chemotherapy regimens (p = 0.005). High SERPINB1 gene expression was associated with favorable tumor response (p = 0.012) and prolonged survival (p = 0.081) under cisplatin-based chemotherapy. High SERPINB1 protein expression in tumor tissue from cisplatin-treated patients was associated with a favorable survival (p = 0.011), and proved as an independent predictor of survival (p = 0.008) by multivariate analysis. We conclude, that SERPINB1 expression, although not functionally involved, is predictive for the outcome of cisplatin-based chemotherapy in melanoma, and thus may be useful to personalize melanoma chemotherapy. PMID:26799424

  19. Efficacy of triplet regimen antiemetic therapy for chemotherapy-induced nausea and vomiting (CINV) in bone and soft tissue sarcoma patients receiving highly emetogenic chemotherapy, and an efficacy comparison of single-shot palonosetron and consecutive-day granisetron for CINV in a randomized, single-blinded crossover study.

    PubMed

    Kimura, Hiroaki; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Tanzawa, Yoshikazu; Takeuchi, Akihiko; Igarashi, Kentaro; Inatani, Hiroyuki; Shimozaki, Shingo; Kato, Takashi; Aoki, Yu; Higuchi, Takashi; Tsuchiya, Hiroyuki

    2015-03-01

    The first aim of this study was to evaluate combination antiemetic therapy consisting of 5-HT3 receptor antagonists, neurokinin-1 receptor antagonists (NK-1RAs), and dexamethasone for multiple high emetogenic risk (HER) anticancer agents in bone and soft tissue sarcoma. The second aim was to compare the effectiveness of single-shot palonosetron and consecutive-day granisetron in a randomized, single-blinded crossover study. A single randomization method was used to assign eligible patients to the palonosetron or granisetron arm. Patients in the palonosetron arm received a palonosetron regimen during the first and third chemotherapy courses and a granisetron regimen during the second and fourth courses. All patients received NK-1RA and dexamethasone. Patients receiving the palonosetron regimen were administered 0.75 mg palonosetron on day 1, and patients receiving the granisetron regimen were administered 3 mg granisetron twice daily on days 1 through 5. All 24 patients in this study received at least 4 chemotherapy courses. A total of 96 courses of antiemetic therapy were evaluated. Overall, the complete response CR rate (no emetic episodes and no rescue medication use) was 34%, while the total control rate (a CR plus no nausea) was 7%. No significant differences were observed between single-shot palonosetron and consecutive-day granisetron. Antiemetic therapy with a 3-drug combination was not sufficient to control chemotherapy-induced nausea and vomiting (CINV) during chemotherapy with multiple HER agents for bone and soft tissue sarcoma. This study also demonstrated that consecutive-day granisetron was not inferior to single-shot palonosetron for treating CINV. PMID:25533447

  20. Ototoxicity After Intensity-Modulated Radiation Therapy and Cisplatin-Based Chemotherapy in Children With Medulloblastoma

    SciTech Connect

    Paulino, Arnold C.; Lobo, Mark; Teh, Bin S.; Okcu, M. Fatih; South, Michael; Butler, E. Brian; Su, Jack; Chintagumpala, Murali

    2010-12-01

    Purpose: To report the incidence of Pediatric Oncology Group (POG) Grade 3 or 4 ototoxicity in a cohort of patients treated with craniospinal irradiation (CSI) followed by posterior fossa (PF) and/or tumor bed (TB) boost using intensity-modulated radiation therapy (IMRT). Methods and Materials: From 1998 to 2006, 44 patients with medulloblastoma were treated with CSI followed by IMRT to the PF and/or TB and cisplatin-based chemotherapy. Patients with standard-risk disease were treated with 18 to 23.4 Gy CSI followed by either a (1) PF boost to 36 Gy and TB boost to 54 to 55.8 Gy or (2) TB boost to 55.8 Gy. Patients with high-risk disease received 36 to 39.6 Gy CSI followed by a (1) PF boost to 54 to 55.8 Gy, (2) PF boost to 45 Gy and TB boost to 55.8 Gy, or (3) TB boost to 55.8 Gy. Median audiogram follow-up was 41 months (range, 11-92.4 months). Results: POG Grade Ototoxicity 0, 1, 2, 3. and 4 was found in 29, 32, 11, 13. and 3 ears. respectively, with POG Grade 3 or 4 accounting for 18.2% of cases. There was a statistically significant difference in mean radiation dose (D{sub mean}) cochlea according to degree of ototoxicity, with D{sub mean} cochlea increasing with severity of hearing loss (p = 0.027). Conclusions: Severe ototoxicity was seen in 18.2% of ears in children treated with IMRT boost and cisplatin-based chemotherapy. Increasing dose to the cochlea was associated with increasing severity of hearing loss.

  1. Association of cytoplasmic p27 expression with an unfavorable response to cisplatin-based chemotherapy and poor outcomes in non-small cell lung cancer.

    PubMed

    Lin, Tsang-Chi; Tsai, Lung-Hung; Chou, Ming-Chih; Chen, Chih-Yi; Lee, Huei

    2016-03-01

    Reduced nuclear p27 expression is associated with a poor outcome in various cancers, including non-small cell lung cancer (NSCLC). Cytoplasmic p27 expression was shown to be associated with an unfavorable response to chemotherapy and poor outcomes in some carcinomas, but it has not been well studied in NSCLC. Herein, p27 expression in 219 tumors surgically resected from NSCLC patients was evaluated by immunohistochemistry (IHC). The most common of p27 immunostaining in lung tumors was observed in the cytoplasm (N-/C+, 32 %), followed by negative (N-/C-, 29 %), nucleus (N+/C-, 24 %), and nucleus plus cytoplasm (N+/C+, 15 %). Kaplan-Meier and Cox regression models showed that p27 N-/C+ tumors exhibited the worst overall survival (OS) and relapse-free survival (RFS) among the four categories of tumors. Among 135 of 219 patients who received cisplatin-based chemotherapy, p27 N-/C+ tumors most commonly showed an unfavorable response to cisplatin-based chemotherapy, followed by p27 N-/C- tumors when p27 N+/C- tumors were used as a reference. IHC analysis for phosphorylated extracellular signal-regulated kinase (p-ERK) and Bcl-2 expression in the lung tumors was performed to test whether ERK activation could enhance p27 nuclear export and the expression of Bcl-2 to test whether ERK activation could enhance p27 nuclear export and Bcl-2 expression. The data showed that p-ERK expression was positively correlated with cytoplasmic p27 (N-/C+) and Bcl-2 expression in the lung tumors. Patients with high Bcl-2-expressing tumors treated with cisplatin-based chemotherapy showed unfavorable predictive values in a subset of this study population. Therefore, we suggest that cytoplasmic p27 (N-/C+) via ERK-activated Bcl-2 expression may predict an unfavorable response to cisplatin-based chemotherapy and poor outcomes in NSCLC. PMID:26482622

  2. Management of Chemotherapy Induced Nausea and Vomiting in Patients on Multiday Cisplatin Based Combination Chemotherapy

    PubMed Central

    Ranganath, Praveen; Einhorn, Lawrence; Albany, Costantine

    2015-01-01

    Introduction of cisplatin based chemotherapy has revolutionized the treatment of germ cell tumors. A common side effect of multiday cisplatin chemotherapy is severe nausea and vomiting. Considerable progress has been made in the control of these side effects since the introduction of cisplatin based chemotherapy in the 1970s. Germ cell tumor which is a model for a curable neoplasm has also turned into an excellent testing ground to develop effective strategies to prevent chemotherapy induced nausea and vomiting (CINV) in multiday cisplatin based regimens. The use of combination of a 5-hydroxytryptamine (HT)3 receptor antagonist, a neurokinin-1 (NK1) antagonist, and dexamethasone has greatly improved our ability to prevent and control acute and delayed CINV. Mechanism and pattern of CINV with multiday chemotherapy may differ from those in single day chemotherapy and therefore efficacy of antiemetic drugs as observed in single day chemotherapy may not be applicable. There are only few randomized clinical trials with special emphasis on multiday chemotherapy. Further studies are essential to determine the efficacy, optimal dose, and duration of the newer agents and combinations in multiday cisplatin based chemotherapy. PMID:26425563

  3. Leukemia following cisplatin-based chemotherapy for ovarian carcinoma at Roswell Park.

    PubMed

    Sprance, H E; Hempling, R E; Piver, M S

    1992-01-01

    Three cases of leukemia following cisplatin-based chemotherapy are reported. All three patients received cyclophosphamide, a known leukemogen. In two cases, the leukemia was diagnosed after second line chemotherapy with intraperitoneal cisplatin and cytarabine, one of which is the first report of a chronic granulocytic leukemia as a result of cytotoxic chemotherapy. PMID:1587290

  4. Relative Contributions of Radiation and Cisplatin-Based Chemotherapy to Sensorineural Hearing Loss in Head-and-Neck Cancer Patients

    SciTech Connect

    Hitchcock, Ying J. Tward, Jonathan D.; Szabo, Aniko; Bentz, Brandon G.; Shrieve, Dennis C.

    2009-03-01

    Purpose: To investigate the risk of sensorineural hearing loss (SNHL) in patients with head-and-neck cancer and treated with radiation therapy (RT) or concomitant cisplatin-based chemoradiation, the relationship among SNHL and radiation dose to the cochlea, the use of two common cisplatin dose regimens. Methods and Materials: A total of 62 head-and-neck cancer patients treated with curative intent were included in this prospective study. Of the patients, 21 received RT alone, 27 received 40 mg/m{sup 2} weekly cisplatin, 13 received 100 mg/m{sup 2} every 3 weeks during RT, and 1 received RT with weekly epidermal growth factor receptor inhibitor antibody. The effect of chemotherapy and RT dose on hearing was determined using a model that accounted for the age and variability between each ear for each patient. Results: We constructed a model to predict dose-dependent hearing loss for RT or cisplatin-based chemotherapy either alone or in combination. For patients only receiving RT, no significant hearing loss was found at doses to the cochlea of less than 40 Gy. Patients receiving 100 mg/m{sup 2} or 40 mg/m{sup 2} of cisplatin chemotherapy had an estimated +21.5 dB and +9.5 dB hearing loss at 8,000 Hz with low radiation doses (10 Gy), which rose to +38.4 dB and +18.9 dB for high radiation doses (40 Gy). Conclusions: Use of RT alone with doses of less than 40 Gy did not result in clinically significant hearing loss. High-frequency SNHL was profoundly damaged in patients who received concomitant cisplatin when doses of 100 mg/m{sup 2} were used. The threshold cochlear dose for hearing loss with cisplatin-based chemotherapy and RT was predicted to be 10 Gy. The inner ear radiation dose constraints and cisplatin dose intensity should be considered in the treatment of advanced head-and-neck cancer.

  5. [Severe Hyponatremia after Cisplatin-Based Chemotherapy : Two Case Reports].

    PubMed

    Ohtaka, Mari; Hattori, Yusuke; Kumano, Yohei; Maeda, Yoko; Kondo, Takuya; Mochizuki, Taku; Kawahara, Takashi; Teranishi, Jun-Ichi; Miyoshi, Yasuhide; Yumura, Yasushi; Uemura, Hiroji

    2016-07-01

    Hyponatremia is one of the common electrolyte disorders associated with cisplatin (CDDP) administration. We report here two cases of hyponatremia associated with CDDP. Case 1 : A 75-year-old man with urothelial carcinoma of bladder (cT3N1M0) underwent neoadjuvant chemotherapy with CDDP and gemcitabine. He lost consciousness on the eighth day after the chemotherapy. Blood tests showed severe hyponatremia (Na 113 mEq/l), low plasma osmolality and high level of plasma vasopressin. Urine tests showed low osmolality. These findings were consistent with the syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH). His consciousness level was improved after saline infusion and fluid restriction. Case 2 : A 54-year-old man with penile cancer (cT3N2M0) underwent neoadjuvant chemotherapy with CDDP, paclitaxel and fluorouracil. He lost consciousness on the seventh day after the chemotherapy. Blood tests showed hyponatremia(Na 121 mEq/l) with renal dysfunction. We concluded that the hyponatremia is due to the renal salt wasting syndrome (RSWS) based on renal dysfunction and high urinary sodium excretion. His consciousness level was improved after saline infusion. Although it is difficult to distinguish between SIADH and RSWS, correct evaluation is necessary for appropriate management of hyponatremia after CDDP administration. PMID:27569354

  6. Evaluating the effect of zingiber officinalis on nausea and vomiting in patients receiving Cisplatin based regimens.

    PubMed

    Fahimi, Fanak; Khodadad, Kian; Amini, Somayeh; Naghibi, Farzaneh; Salamzadeh, Jamshid; Baniasadi, Shadi

    2011-01-01

    Ginger, the rhizome of Zingiber officinalis, has long been used as herbal medicine for its antiemetic effect. For evaluating the effect of zingiber officinalis on nausea and vomiting (N and V) in patients receiving cisplatin based regimens, a randomized double-blind placebo-controlled cross-over clinical trial was carried out in patients receiving cisplatin in combination with other chemotherapeutic agents. The patients were randomly assigned to receive ginger capsules (rhizome of zingiber officinalis) or placebo in their first cycle of the study. All patients received standard antiemetics for chemotherapy induced nausea and vomiting (CINV). The patients were crossed-over to receive ginger or placebo in their next cycle of chemotherapy. Among 36 eligible patients who received both cycles of treatment, there were no difference in prevalence, severity, and duration of both acute and delayed N and V. Addition of ginger to the standard antiemetic regimen has shown no advantage in reducing acute and delayed N and V in patients with cisplatin-based regimen in this study. PMID:24250368

  7. Evaluating the Effect of Zingiber Officinalis on Nausea and Vomiting in Patients Receiving Cisplatin Based Regimens

    PubMed Central

    Fahimi, Fanak; Khodadad, Kian; Amini, Somayeh; Naghibi, Farzaneh; Salamzadeh, Jamshid; Baniasadi, Shadi

    2011-01-01

    Ginger, the rhizome of Zingiber officinalis, has long been used as herbal medicine for its antiemetic effect. For evaluating the effect of zingiber officinalis on nausea and vomiting (N and V) in patients receiving cisplatin based regimens, a randomized double-blind placebo-controlled cross-over clinical trial was carried out in patients receiving cisplatin in combination with other chemotherapeutic agents. The patients were randomly assigned to receive ginger capsules (rhizome of zingiber officinalis) or placebo in their first cycle of the study. All patients received standard antiemetics for chemotherapy induced nausea and vomiting (CINV). The patients were crossed-over to receive ginger or placebo in their next cycle of chemotherapy. Among 36 eligible patients who received both cycles of treatment, there were no difference in prevalence, severity, and duration of both acute and delayed N and V. Addition of ginger to the standard antiemetic regimen has shown no advantage in reducing acute and delayed N and V in patients with cisplatin-based regimen in this study. PMID:24250368

  8. Risk Factors for Febrile Neutropenia in Children With Solid Tumors Treated With Cisplatin-based Chemotherapy.

    PubMed

    Castelán-Martínez, Osvaldo D; Rodríguez-Islas, Felipe; Vargas-Neri, Jessica L; Palomo-Colli, Miguel A; López-Aguilar, Enrique; Clark, Patricia; Castañeda-Hernández, Gilberto; Rivas-Ruiz, Rodolfo

    2016-04-01

    Febrile neutropenia (FN) is a common and potentially fatal adverse drug reaction of cisplatin-based chemotherapy (CDDPBC) in pediatric patients. Hence, the aim of this study was to determine the incidence and independent risk factors for FN in pediatric patients with solid tumors treated with CDPPBC. Cohort integration was performed in the first cycle of chemotherapy with CDDPBC and patients were followed up to 6 months after the last cycle. FN was defined according to the Common Terminology Criteria for Adverse Events. Relative risks were calculated with confidence intervals at 95% (95% CI) to determine FN risk factors. Multiple logistic regression was performed to identify independent risk factors. One hundred and thirty-nine pediatric patients (median age 7.4 y, range 0.08 to 17 y) were included in the study. FN incidence was 62.5%. Independent risk factors for FN were chemotherapy regimens including anthracyclines (odds ratio [OR]=19.44 [95% CI, 5.40-70.02), hypomagnesaemia (OR=8.20 [95% CI, 1.81-37.14]), and radiotherapy (OR=6.67 [95% CI, 1.24-35.94]). It is therefore concluded that anthracyclines-containing regimens, hypomagnesaemia, and radiotherapy are independent risk factors for FN in patients receiving CDDPBC. PMID:26907640

  9. Complete Remission of Acute Myeloid Leukemia following Cisplatin Based Concurrent Therapy with Radiation for Squamous Cell Laryngeal Cancer

    PubMed Central

    Gill, Harpaul S.; Higgins, Kristin A.; Saba, Nabil F.; Kota, Vamsi K.

    2016-01-01

    Acute myeloid leukemia (AML) is a myeloid disorder with several established treatment regimens depending on patient and leukemic factors. Cisplatin is known to have strong leukemogenic potential and is rarely used even as salvage therapy in relapsed or refractory AML. We present a patient simultaneously diagnosed with AML and squamous cell carcinoma of the larynx, who was found to be in complete remission from AML following treatment with cisplatin based chemoradiotherapy for his laryngeal cancer. PMID:27127664

  10. The potent emetogenic effects of the endocannabinoid, 2-AG (2-arachidonoylglycerol) are blocked by delta(9)-tetrahydrocannabinol and other cannnabinoids.

    PubMed

    Darmani, Nissar A

    2002-01-01

    Cannabinoids, including the endogenous cannabinoid or endocannabinoid, anandamide, modulate several gastrointestinal functions. To date, the gastrointestinal effects of the second putative endocannabinoid 2-arachidonoylglycerol (2-AG) have not been studied. In the present study using a shrew (Cryptotis parva) emetic model, 2-AG (0.25-10 mg/kg, i.p.) potently and dose-dependently increased vomiting frequency (ED(50) = 1.13 mg/kg) and the number of animals vomiting (ED(50) = 0.48 mg/kg). In contrast, neither anandamide (2.5-20 mg/kg) nor methanandamide (5-10 mg/kg) induced a dose-dependent emetogenic response, but both could partially block the induced emetic effects. Delta(9)-Tetrahydrocannabinol and its synthetic analogs reduced 2-AG-induced vomiting with the rank order potency: CP 55,940 > WIN 55,212-2 > Delta(9)-tetrahydrocannabinol. The nonpsychoactive cannabinoid, cannabidiol, was inactive. Nonemetic doses of SR 141716A (1-5 mg/kg) also blocked 2-AG-induced vomiting. The 2-AG metabolite arachidonic acid also caused vomiting. Indomethacin, a cyclooxygenase inhibitor, blocked the emetogenic effects of both arachidonic acid and 2-AG. CP 55,940 also blocked the emetic effects of arachidonic acid. 2-AG (0.25-10 mg/kg) reduced spontaneous locomotor activity (ED(50) = 11 mg/kg) and rearing frequency (ED(50) = 4.3 mg/kg) in the shrew, whereas such doses of both anandamide and methanandamide had no effect on locomotor parameters. The present study indicates that: 1) 2-AG is an efficacious endogenous emetogenic cannabinoid involved in vomiting circuits, 2) the emetic action of 2-AG and the antiemetic effects of tested cannabinoids are mediated via CB(1) receptors, and 3) the emetic effects of 2-AG occur in lower doses relative to its locomotor suppressant actions. PMID:11752094

  11. Prognostic factors in children with extracranial germ cell tumors treated with cisplatin-based chemotherapy

    PubMed Central

    Kim, Jinsup; Lee, Na Hee; Yoo, Keon Hee; Sung, Ki Woong; Koo, Hong Hoe; Seo, Jeong-Meen; Lee, Suk-Koo

    2015-01-01

    Purpose To evaluate the outcomes and prognostic factors in children with extracranial germ cell tumors (GCTs) treated at a single institution. Methods Sixty-six children diagnosed with extracranial GCTs between 1996 and 2012 were included in the study. Primary treatment was surgical excision, followed by six cycles of cisplatin-based chemotherapy. The survival rates were compared according to the International Germ Cell Cancer Cooperative Group classification used for GCTs in adults to validate the classification guidelines for GCTs in children. Results The median patient age was 4.4 years. In 34 patients (51.5%), the primary tumor site was the gonad. Extragonadal GCTs were detected in 32 patients. The 5-year overall survival and event-free survival (EFS) were 92.0%±3.5% and 90.4%±3.7%, respectively. In univariate analysis, tumor histology, metastasis, and elevated alpha-fetoprotein were not prognostic factors in children with extracranial GCTs. However, EFS was poorer in patients with mediastinal disease (n=12, 66.7%±13.6 %) than in those with nonmediastinal disease (n=54, 96.0%±2.8%) (P=0.001). The 5-year EFS was lower in patients older than 10 years, (n=21, 80.0%±8.9%) compared with those younger than 10 years (n=45, 95.2%±3.3%) (P=0.04). Multivariate analysis identified the mediastinal tumor site as the only independent prognostic factor. Conclusion The prognosis of children with extracranial GCTs was favorable. However, nongerminomatous mediastinal tumors were associated with poor survival in children. Further research is needed to improve the prognosis of children with malignant mediastinal GCTs. PMID:26576183

  12. Factors that influence the antiemetic activity of metoclopramide to cisplatin based chemotherapy.

    PubMed

    Tsavaris, N; Mylonakis, N; Bacoyiannis, C; Kosmas, C; Kalergis, G; Iakovidis, V; Tzaninis, D; Kosmidis, P

    1998-01-01

    Some clinical parameters play a role in developing effective antiemetic therapy. In the present study, 310 patients entered and 301 were evaluable. They received cisplatin based combination chemotherapy (100 mg/m2), with antiemetic therapy based in metoclopramide, at a standard dose and schedule (2 mg/kg in 5 doses). Patient characteristics such as age, sex, performance status (Karnofsky), site of primary tumor, weight loss >15%, previous chemotherapy, previous radiotherapy, history of vomiting during pregnancy, additional drugs (dexamethasone, alprazolam), in the antiemetic regimen were included in the evaluation. We also studied the manifestation of anxiety and depression and the presence of psychosocial problems related to therapy, evaluated them with specific psychological indexes modified for our study. We evaluated incidence of vomiting, retches, and nausea, with several scales. We distinguished three groups of factors influencing nausea and vomiting. Factors that predicted for increased nausea and vomiting was gender (women), stress and age (younger patients experienced more prolonged duration and higher grades of nausea). The addition of alprazolam (a sedative drug) and dexamethasone, was associated with decreased incidence of nausea and vomiting. The weight loss (increased nausea and decreased vomiting control according to Gralla's scale). Previous chemotherapy decreased the number of patients without nausea and vomiting control according to Gralla's scale. Patients with previous radiotherapy presented an increased grade of nausea. Patients with head and neck cancer presented less nausea with shorter duration, less frequent episodes of vomiting. Patients with ovarian cancer presented increased mean number of retches. In conclusion, despite difficulties in assessing nausea and vomiting among clinical trials, several factors, especially stress, gender, weight loss, additional drugs (corticosteroids and sedatives) may play an important role in modulating the

  13. Are additional trace elements necessary in total parenteral nutrition for patients with esophageal cancer receiving cisplatin-based chemotherapy?

    PubMed

    Akutsu, Yasunori; Kono, Tsuguaki; Uesato, Masaya; Hoshino, Isamu; Murakami, Kentaro; Fujishiro, Takeshi; Imanishi, Shunsuke; Endo, Satoshi; Toyozumi, Takeshi; Matsubara, Hisahiro

    2012-12-01

    It is known that cisplatin induces the excretion of zinc from the urine and thereby reduces its serum concentration. However, the fluctuation of these trace elements during or after cisplatin-based chemotherapy has not been evaluated. To answer this question, we performed a clinical study in esophageal cancer patients undergoing cisplatin-based chemotherapy. Eighteen patients with esophageal cancer who were not able to swallow food or water orally due to complete stenosis of the esophagus were evaluated. The patients were divided into a control group [total parenteral nutrition (TPN) alone for 28 days, ten cases] and an intervention group (TPN with additional trace elements for 28 days, eight cases). The serum concentrations of zinc, iron, copper, manganese, triiodothyronin (T3), and thyroxin (T4), as alternative indicators of iodine, were measured on days 0, 14, and 28 of treatment, and statistically analyzed on day 28. In the control group, the serum concentration of copper was significantly decreased from 135.4 (day 0) to 122.1 μg/ml (day 14), and finally to 110.6 μg/ml (day 28, p = 0.015). The concentration of manganese was also significantly decreased from 1.34 (day 0) to 1.17 μg/ml (day 14) and finally to 1.20 (day 28, p = 0.049). The levels of zinc, iron, T3, and T4 were not significantly changed. In the intervention group, the supplementation with trace elements successfully prevented these decreases in their concentrations. TPN with supplementary trace elements is preferable and recommended for patients who are undergoing chemotherapy in order to maintain the patients' nutrient homeostasis. PMID:23054866

  14. A randomized phase III study evaluating the efficacy and safety of NEPA, a fixed-dose combination of netupitant and palonosetron, for prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy

    PubMed Central

    Aapro, M.; Rugo, H.; Rossi, G.; Rizzi, G.; Borroni, M. E.; Bondarenko, I.; Sarosiek, T.; Oprean, C.; Cardona-Huerta, S.; Lorusso, V.; Karthaus, M.; Schwartzberg, L.; Grunberg, S.

    2014-01-01

    Background Antiemetic guidelines recommend co-administration of agents that target multiple molecular pathways involved in emesis to maximize prevention and control of chemotherapy-induced nausea and vomiting (CINV). NEPA is a new oral fixed-dose combination of 300 mg netupitant, a highly selective NK1 receptor antagonist (RA) and 0.50 mg palonosetron (PALO), a pharmacologically and clinically distinct 5-HT3 RA, which targets dual antiemetic pathways. Patients and methods This multinational, randomized, double-blind, parallel group phase III study (NCT01339260) in 1455 chemotherapy-naïve patients receiving moderately emetogenic (anthracycline–cyclophosphamide) chemotherapy evaluated the efficacy and safety of a single oral dose of NEPA versus a single oral dose (0.50 mg) of PALO. All patients also received oral dexamethasone (DEX) on day 1 only (12 mg in the NEPA arm and 20 mg in the PALO arm). The primary efficacy end point was complete response (CR: no emesis, no rescue medication) during the delayed (25–120 h) phase in cycle 1. Results The percentage of patients with CR during the delayed phase was significantly higher in the NEPA group compared with the PALO group (76.9% versus 69.5%; P = 0.001), as were the percentages in the overall (0–120 h) (74.3% versus 66.6%; P = 0.001) and acute (0–24 h) (88.4% versus 85.0%; P = 0.047) phases. NEPA was also superior to PALO during the delayed and overall phases for all secondary efficacy end points of no emesis, no significant nausea and complete protection (CR plus no significant nausea). NEPA was well tolerated with a similar safety profile as PALO. Conclusions NEPA plus a single dose of DEX was superior to PALO plus DEX in preventing CINV following moderately emetogenic chemotherapy in acute, delayed and overall phases of observation. As a fixed-dose antiemetic drug combination, NEPA along with a single dose of DEX on day 1 offers guideline-based prophylaxis with a convenient, single-day treatment. PMID

  15. A phase II, randomized study of aprepitant in the prevention of chemotherapy-induced nausea and vomiting associated with moderately emetogenic chemotherapies in colorectal cancer patients

    PubMed Central

    ARIDOME, KUNIAKI; MORI, SHIN-ICHIROU; BABA, KENJI; YANAGI, MASAYUKI; HAMANOUE, MASAHIRO; MIYAZONO, FUTOSHI; TOKUDA, KOUKI; IMAMURA, HIROSHI; OGURA, YOSHITO; KANEKO, KOUICHI; KIJIMA, FUMIO; MAEMURA, KOUSEI; ISHIGAMI, SUMIYA; NATSUGOE, SHOJI

    2016-01-01

    The present study aimed to study the efficacy of aprepitant in the prevention of chemotherapy-induced nausea and vomiting (CINV) in patients receiving moderately emetogenic chemotherapy (MEC) for colorectal cancer (CRC), and comprised a multicenter, phase II, open-label, randomized, parallel comparative study conducted as part of the Kagoshima aprepitant study for colon cancer in Japan. Patients with advanced or recurrent CRC were treated with standard MEC regimens (FOLFOX, XELOX or FOLFIRI) and received either standard chemotherapy [5-hydroxytryptamine-3 receptor antagonist (5-HT3RA) + dexamethasone] or aprepitant regimen chemotherapy (5-HT3 RA + reduced-dose dexamethasone + aprepitant). The primary endpoint of the present study was the proportion of patients who achieved a complete response (CR) during the overall, acute, and delayed phases of the first planned chemotherapy cycle. Secondary endpoints were complete protection, the proportions of patients without emetic episodes or nausea, patients with no more than moderate nausea during the overall, acute and delayed phases, and the time to treatment failure. The CR rates in the overall, acute and delayed phases were similar in the aprepitant and the standard-regimen groups. Additionally, there were no significant differences in secondary endpoints between the two groups. In summary, aprepitant in combination with 5-HT3 RA and reduced-dose corticosteroids was well tolerated and effective in preventing CINV associated with moderately emetogenic antitumor agents in Japanese patients with CRC. PMID:26998290

  16. Comparison of Four Cisplatin-Based Radiochemotherapy Regimens for Nonmetastatic Stage III/IV Squamous Cell Carcinoma of the Head and Neck;Head-and-neck cancer; Cisplatin-based radiochemotherapy; Toxicity; Treatment outcomes

    SciTech Connect

    Rades, Dirk; Kronemann, Stefanie; Meyners, Thekla; Bohlen, Guenther; Tribius, Silke; Kazic, Nadja; Schroeder, Ursula; Hakim, Samer G.; Schild, Steven E.; Dunst, Juergen

    2011-07-15

    Purpose: To compare the outcomes of four cisplatin-based radiochemotherapy regimens in 311 patients with Stage III/IV squamous cell carcinoma of the head and neck. Methods and Materials: Concurrent chemotherapy consisted of three courses of cisplatin 100 mg/m{sup 2} on Day 1 (Group A, n = 74), two courses of cisplatin 20 mg/m{sup 2} on Days 1-5 plus 5-fluorouracil 1,000 mg/m{sup 2} on Days 1-5 (Group B, n = 49), two courses of cisplatin 20 mg/m{sup 2} on Days 1-5 plus 5-fluorouracil 600 mg/m{sup 2} on Days 1-5 (Group C, n = 102), or two courses of cisplatin 20 mg/m{sup 2} on Days 1-5 (Group D, n = 86). The groups were retrospectively compared for toxicity and outcomes, and 11 additional factors were evaluated for outcomes. Results: No significant difference was observed among the groups regarding radiation-related acute oral mucositis and radiation-related late toxicities. Acute Grade 3 skin toxicity was significantly more frequent in Group B than in the patients of the other three groups (p = .013). The chemotherapy-related Grade 3 nausea/vomiting rate was 24% for Group A, 8% for Group B, 9% for Group C, and 6% for Group D (p = .003). The corresponding Grade 3 nephrotoxicity rates were 8%, 1%, 2%, and 1% (p = .019). The corresponding Grade 3-4 hematologic toxicity rates were 35%, 41%, 19%, and 21% (p = .027). Chemotherapy could be completed in 50%, 59%, 74%, and 83% of the Group A, B, C, and D patients, respectively (p = .002). Toxicity-related radiotherapy breaks occurred in 39%, 43%, 21%, and 15% of Groups A, B, C, and D, respectively (p = .005). The 3-year locoregional control rate was 67%, 72%, 60%, and 59% for Groups A, B, C, and D, respectively (p = .48). The corresponding 3-year metastasis-free survival rates were 67%, 74%, 63%, and 79% (p = .31), and the corresponding 3-year survival rates were 60%, 63%, 50%, and 71% (p = .056). On multivariate analysis, Karnofsky performance status, histologic grade, T/N category, preradiotherapy hemoglobin level

  17. Prognostic Value of Neutrophil-Related Factors in Locally Advanced Cervical Squamous Cell Carcinoma Patients Treated with Cisplatin-Based Concurrent Chemoradiotherapy

    PubMed Central

    Wang, Yan-Yang; Bai, Zhou-Lan; He, Jian-Li; Yang, Yan; Zhao, Ren; Hai, Ping; Zhe, Hong

    2016-01-01

    The aim of this study was to explore the relationship between neutrophil-related factors, including neutrophil-lymphocyte ratio (NLR) and the responses of neutrophil to granulocyte colony-stimulating factors (RNG), and the prognosis of patients with locally advanced cervical squamous cell carcinoma (LACSCC) undergoing cisplatin-based concurrent chemoradiotherapy (CCCRT). A total of sixty LACSCC patients were enrolled in this study. We analyzed the association of NLR or RNG with clinicopathologic characteristics of these patients. The prognostic factors were evaluated by univariate and multivariate survival analysis. The optimal cut-off value of the NLR was determined to be 2.0 for the overall survival (OS). A higher level of the NLR was associated with younger age (P = 0.017) and higher baseline platelet count (P = 0.040). NLR was identified to be the only independent prognostic factor for OS by multivariate analysis (P = 0.037). The median RNG was 3.01, with a range of 1.19–16.84. RNG level was significantly associated with lymph node metastasis of these patients (P = 0.023). And higher RNG was identified as being a closely independent poor prognostic factor for OS (P = 0.055). This study showed that NLR and RNG may be used as potential biomarkers for survival prediction in patients with LACSCC receiving CCCRT. PMID:27087737

  18. Maintenance monotherapy with Gemcitabine following cisplatin-based primary combination chemotherapy in surgically treated advanced urothelial carcinoma: A matched-pair single institution analysis

    PubMed Central

    KALOGIROU, CHARIS; SVISTUNOV, ANDREY; KREBS, MARKUS; LAUSENMEYER, EVA MARIA; VERGHO, DANIEL; RIEDMILLER, HUBERTUS; KOCOT, ARKADIUS

    2016-01-01

    The role of maintenance therapy with Gemcitabine (GEM) following cisplatin-based combination chemotherapy (CBCC) in patients with surgically treated advanced urothelial carcinoma (UC) remains to be fully elucidated. In the present case control study, a retrospective analysis was performed to evaluate the role of GEM monotherapy following surgical intervention for advanced UC. Between 1999 and 2013, 38 patients were identified with surgically treated advanced UC after having completed CBCC, who were additionally treated quarterly with two consecutive GEM (1,250 mg/m2) infusions as maintenance therapy. This collective was matched by propensity score matching to a control collective (n=38) that received primary CBCC alone, and the overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS) rates were determined for the two collectives using Kaplan-Meier estimates and the log-rank test. Regression analysis was performed using the Cox proportional hazards model. The median follow-up time was 37 months (interquartile range: 9–148). Interestingly, patients treated with GEM following primary chemotherapy had a significantly improved outcome with respect to the 5-year OS (46.2 vs. 26.4%, P=0.0314) and 5-year CSS (61.3 vs. 33.4%, P=0.0386) rates. Notably, the 5-year PFS rate did not differ between the two groups (10.3 vs. 16.1%, P=0.134). It is proposed that additional GEM maintenance monotherapy is able to improve survival rates following primary CBCC in surgically treated patients with advanced UC, suggesting a possible treatment option for patients with, e.g., unclear disease status, or those who would require an active maintenance therapy in the future. Prospective studies should further determine the impact of GEM monotherapy with respect to PFS rates in groups comprising larger numbers of patients. PMID:27073682

  19. The effects of miR-1207-5p expression in peripheral blood on cisplatin-based chemosensitivity of primary gallbladder carcinoma

    PubMed Central

    Shen, Er-Dong; Liu, Bo; Yu, Xin-Shuang; Xiang, Zhen-Fei; Huang, Hui-Yun

    2016-01-01

    in the NC and non-T groups, whereas the cell survival rates in the inhibitor group were significantly lower than the rates in the NC and non-T groups (all P<0.05). The concentration and action time of cisplatin were negatively associated with the cell survival rate in each group (all P<0.05). Conclusion Cisplatin-based chemosensitivity of PGBC increased as expression of miR-1207-5p in peripheral blood declined. Thus, miR-1207-5p appears to be a promising and novel chemosensitizer for the treatment of PGBC. PMID:27382301

  20. Genetic variation in radiation and platinum pathways predicts severe acute radiation toxicity in patients with esophageal adenocarcinoma treated with cisplatin-based preoperative radiochemotherapy: results from the Eastern Cooperative Oncology Group

    PubMed Central

    Catalano, P.; Gibson, M. K.; Skaar, T. C.; Philips, S.; Montgomery, E. A.; Hafez, M. J.; Powell, M.; Liu, G.; Forastiere, A. A.; Benson, A. B.; Kleinberg, L. R.; Murphy, K. M.

    2013-01-01

    Purpose Germline genetic variations may partly explain the clinical observation that normal tissue tolerance to radiochemotherapy varies by individual. Our objective was to evaluate the association between single-nucleotide polymorphisms (SNPs) in radiation/platinum pathways and serious treatment-related toxicity in subjects with esophageal adenocarcinoma who received cisplatin-based preoperative radiochemotherapy. Methods In a multicenter clinical trial (E1201), 81 eligible treatment-naïve subjects with resectable esophageal adenocarcinoma received cisplatin-based chemotherapy concurrent with radiotherapy, with planned subsequent surgical resection. Toxicity endpoints were defined as grade ≥3 radiation-related or myelosuppressive events probably or definitely related to therapy, occurring during or up to 6 weeks following the completion of radiochemotherapy. SNPs were analyzed in 60 subjects in pathways related to nucleotide/base excision- or double stranded break repair, or platinum influx, efflux, or detoxification. Results Grade ≥3 radiation-related toxicity (mostly dysphagia) and myelosuppression occurred in 18 and 33% of subjects, respectively. The variant alleles of the XRCC2 5′ flanking SNP (detected in 28% of subjects) and of GST-Pi Ile-105-Val (detected in 65% of subjects) were each associated with higher odds of serious radiation-related toxicity compared to the major allele homozygote (47% vs. 9%, and 31% vs. 0%, respectively; P = 0.005). No SNP was associated with myelosuppression. Conclusions This novel finding in a well-characterized cohort with robust endpoint data supports further investigation of XRCC2 and GST-Pi as potential predictors of radiation toxicity. PMID:21286719

  1. Prognostic Value of Plasma Epstein-Barr Virus DNA for Local and Regionally Advanced Nasopharyngeal Carcinoma Treated With Cisplatin-Based Concurrent Chemoradiotherapy in Intensity-Modulated Radiotherapy Era.

    PubMed

    Chen, Wen-Hui; Tang, Lin-Quan; Guo, Shan-Shan; Chen, Qiu-Yan; Zhang, Lu; Liu, Li-Ting; Qian, Chao-Nan; Guo, Xiang; Xie, Dan; Zeng, Mu-Sheng; Mai, Hai-Qiang

    2016-02-01

    This study aimed to evaluate the prognostic value of plasma Epstein-Barr Virus DNA (EBV DNA) for local and regionally advanced nasopharyngeal carcinoma (NPC) patients treated with concurrent chemoradiotherapy in intensity-modulated radiotherapy (IMRT) era.In this observational study, 404 nonmetastatic local and regionally advanced NPC patients treated with IMRT and cisplatin-based concurrent chemotherapy were recruited. Blood samples were collected before treatment for examination of plasma EBV DNA levels. We evaluated the association of pretreatment plasma EBV DNA levels with progression-free survival rate (PFS), distant metastasis-free survival rate (DMFS), and overall survival rate (OS).Compared to patients with an EBV DNA level <4000 copies/mL, patients with an EBV DNA ≥4000 copies/mL had a lower rate of 3-year PFS (76%, 95% CI [68-84]) versus (93%, 95% CI [90-96], P < 0.001), DMFS (83%, 95% CI [76-89]) versus (97%, 95% CI [94-99], P < 0.001), and OS (85%, 95% CI [78-92]) versus (98%, 95% CI [95-100], P < 0.001). Multivariate analysis showed that pretreatment EBV DNA levels (HR = 3.324, 95% CI, 1.80-6.138, P < 0.001) and clinical stage (HR = 1.878, 95% CI, 1.036-3.404, P = 0.038) were the only independent factor associated with PFS, pretreatment EBV DNA level was the only significant factor to predict DMFS (HR = 6.292, 95% CI, 2.647-14.956, P < 0.001), and pretreatment EBV DNA levels (HR = 3.753, 95% CI, 1.701-8.284, P < 0.001) and clinical stage (HR = 2.577, 95% CI, 1.252-5.050, P = 0.010) were significantly associated with OS. In subgroup analysis, higher plasma EBV DNA levels still predicted a worse PFS, DMFS, and OS for the patients stage III or stage IVa-b, compared with those with low EBV DNA levels.Elevated plasma EBV DNA was still effective prognostic biomarker for local and regionally advanced NPC patients treated with IMRT and cisplatin-based concurrent chemotherapy. Future ramdomized clinical

  2. Prognostic Value of Plasma Epstein–Barr Virus DNA for Local and Regionally Advanced Nasopharyngeal Carcinoma Treated With Cisplatin-Based Concurrent Chemoradiotherapy in Intensity-Modulated Radiotherapy Era

    PubMed Central

    Chen, Wen-Hui; Tang, Lin-Quan; Guo, Shan-Shan; Chen, Qiu-Yan; Zhang, Lu; Liu, Li-Ting; Qian, Chao-Nan; Guo, Xiang; Xie, Dan; Zeng, Mu-Sheng; Mai, Hai-Qiang

    2016-01-01

    Abstract This study aimed to evaluate the prognostic value of plasma Epstein–Barr Virus DNA (EBV DNA) for local and regionally advanced nasopharyngeal carcinoma (NPC) patients treated with concurrent chemoradiotherapy in intensity-modulated radiotherapy (IMRT) era. In this observational study, 404 nonmetastatic local and regionally advanced NPC patients treated with IMRT and cisplatin-based concurrent chemotherapy were recruited. Blood samples were collected before treatment for examination of plasma EBV DNA levels. We evaluated the association of pretreatment plasma EBV DNA levels with progression-free survival rate (PFS), distant metastasis-free survival rate (DMFS), and overall survival rate (OS). Compared to patients with an EBV DNA level <4000 copies/mL, patients with an EBV DNA ≥4000 copies/mL had a lower rate of 3-year PFS (76%, 95% CI [68–84]) versus (93%, 95% CI [90–96], P < 0.001), DMFS (83%, 95% CI [76–89]) versus (97%, 95% CI [94–99], P < 0.001), and OS (85%, 95% CI [78–92]) versus (98%, 95% CI [95–100], P < 0.001). Multivariate analysis showed that pretreatment EBV DNA levels (HR = 3.324, 95% CI, 1.80–6.138, P < 0.001) and clinical stage (HR = 1.878, 95% CI, 1.036–3.404, P = 0.038) were the only independent factor associated with PFS, pretreatment EBV DNA level was the only significant factor to predict DMFS (HR = 6.292, 95% CI, 2.647–14.956, P < 0.001), and pretreatment EBV DNA levels (HR = 3.753, 95% CI, 1.701–8.284, P < 0.001) and clinical stage (HR = 2.577, 95% CI, 1.252–5.050, P = 0.010) were significantly associated with OS. In subgroup analysis, higher plasma EBV DNA levels still predicted a worse PFS, DMFS, and OS for the patients stage III or stage IVa-b, compared with those with low EBV DNA levels. Elevated plasma EBV DNA was still effective prognostic biomarker for local and regionally advanced NPC patients treated with IMRT and cisplatin-based concurrent

  3. Risk Factors of Ototoxicity After Cisplatin-Based Chemo-Irradiation in Patients With Locally Advanced Head-and-Neck Cancer: A Multivariate Analysis

    SciTech Connect

    Zuur, Charlotte L. . E-mail: cl.zuur@vumc.nl; Simis, Yvonne J.; Lansdaal, Pauline E.; Hart, Augustinus A.; Rasch, Coen R.; Schornagel, Jan H.; Dreschler, Wouter A.; Balm, Alfons J.

    2007-08-01

    Purpose: Cisplatin chemo-irradiation is increasingly used in locally advanced squamous cell carcinoma of the head and neck. The objective of this study is to determine risk factors of ototoxicity due to intra-arterial high-dose cisplatin chemoradiation. Methods and Materials: A prospective analysis of hearing thresholds at low and (ultra) high frequencies obtained before, during, and after treatment in 146 patients. Treatment consisted of intra-arterial infusion of high-dose cisplatin (150 mg/m{sup 2}, four courses) with sodium thiosulfate rescue and concurrent radiation therapy (70 Gy). Patient and chemoradiation variables were studied in a multivariate analysis. Results: After treatment, 23% of the ears were under consideration for hearing aids because of therapy. Twenty-two percent of the patients developed an increase in air-bone gap >10 dB during or after therapy. In the multivariate explanatory analysis, cumulative dose of cisplatin and radiation therapy, and young age displayed a causal relationship with increased sensorineural hearing loss during and after therapy (p < 0.001). In the multivariate prediction analysis, pretreatment hearing level of the concerning ear was identified as an independent predictive factor for hearing capability after therapy (p < 0.0001). Conclusions: Both cisplatin and radiation therapy were proven to induce sensorineural hearing loss, in this study with short-term follow-up. Of all patient and treatment variables studied, the patients pretreatment hearing level appeared to be the main predictive factor for hearing capability after high-dose intra-arterial cisplatin chemoradiation.

  4. Single-dose fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting associated with moderately emetogenic chemotherapy: results of a randomized, double-blind phase III trial†

    PubMed Central

    Weinstein, C.; Jordan, K.; Green, S. A.; Camacho, E.; Khanani, S.; Beckford-Brathwaite, E.; Vallejos, W.; Liang, L. W.; Noga, S. J.; Rapoport, B. L.

    2016-01-01

    Background To establish the role of antiemetic therapy with neurokinin-1 (NK1) receptor antagonists (RAs) in nonanthracycline and cyclophosphamide (AC)-based moderately emetogenic chemotherapy (MEC) regimens, this study evaluated single-dose intravenous (i.v.) fosaprepitant for the prevention of chemotherapy-induced nausea and vomiting (CINV) associated with non-AC MEC. Patients and methods In this international, phase III, double-blind trial, adult cancer subjects scheduled to receive ≥1 non-AC MEC on day 1 were randomized to a regimen comprising single-dose i.v. fosaprepitant 150 mg or placebo along with ondansetron and dexamethasone on day 1; control regimen recipients received ondansetron on days 2 and 3. Primary end points were the proportion of subjects achieving a complete response (CR; no vomiting and no use of rescue medication) in the delayed phase (25–120 h after MEC initiation) and safety. Secondary end points included CR in the overall and acute phases (0–120 and 0–24 h after MEC initiation, respectively) and no vomiting in the overall phase. Nausea and the Functional Living Index-Emesis were assessed as exploratory end points. Results The fosaprepitant regimen improved CR significantly in the delayed (78.9% versus 68.5%; P < 0.001) and overall (77.1% versus 66.9%; P < 0.001) phases, but not in the acute phase (93.2% versus 91.0%; P = 0.184), versus control. In the overall phase, the proportion of subjects with no vomiting (82.7% versus 72.9%; P < 0.001) and no significant nausea (83.2% versus 77.9%; P = 0.030) was also significantly improved with the fosaprepitant regimen. The fosaprepitant regimen was generally well tolerated. Conclusion Single-dose fosaprepitant added to a 5-HT3 RA and dexamethasone was well tolerated and demonstrated superior control of CINV (primary end point achieved) associated with non-AC MEC. This is the first study to evaluate NK1 RA therapy as an i.v. formulation in a well-defined non-AC MEC population. Clinical

  5. Expression of DNA Translesion Synthesis Polymerase η in Head and Neck Squamous Cell Cancer Predicts Resistance to Gemcitabine and Cisplatin-Based Chemotherapy

    PubMed Central

    Zhou, Wendi; Chen, Yih-wen; Liu, Xiyong; Chu, Peiguo; Loria, Sofia; Wang, Yafan; Yen, Yun; Chou, Kai-Ming

    2013-01-01

    Purpose The development of resistance against anticancer drugs has been a persistent clinical problem for the treatment of locally advanced malignancies in the head and neck mucosal derived squamous cell carcinoma (HNSCC). Recent evidence indicates that the DNA translesion synthesis (TLS) polymerase η (Pol η; hRad30a gene) reduces the effectiveness of gemcitabine/cisplatin. The goal of this study is to examine the relationship between the expression level of Pol η and the observed resistance against these chemotherapeutic agents in HNSCC, which is currently unknown. Methods Sixty-four mucosal derived squamous cell carcinomas of head and neck (HNSCC) from 1989 and 2007 at the City of Hope National Medical Center (Duarte, CA) were retrospectively analyzed. Pretreatment samples were immunostained with anti-Pol η antibody and the correlation between the expression level of Pol η and clinical outcomes were evaluated. Forty-nine cases treated with platinum (n=40) or gemcitabine (n=9) based chemotherapy were further examined for Pol η expression level for comparison with patient response to chemotherapy. Results The expression of Pol η was elevated in 67% of the head and neck tumor samples. Pol η expression level was significantly higher in grade 1 to grade 2 tumors (well to moderately differentiated). The overall benefit rate (complete response+ partial response) in patients treated with platinum and gemcitabine based chemotherapy was 79.5%, where low Pol η level was significantly associated with high complete response rate (p=0.03), although not associated with overall survival. Furthermore, no significant correlation was observed between Pol η expression level with gender, age, tobacco/alcohol history, tumor stage and metastatic status. Conclusions Our data suggest that Pol η expression may be a useful prediction marker for the effectiveness of platinum or gemcitabine based therapy for HNSCC. PMID:24376779

  6. Randomized Clinical Trial of Weekly vs. Triweekly Cisplatin-Based Chemotherapy Concurrent With Radiotherapy in the Treatment of Locally Advanced Cervical Cancer

    SciTech Connect

    Ryu, Sang-Young; Lee, Won-Moo; Kim, Kidong; Park, Sang-Il; Kim, Beob-Jong; Kim, Moon-Hong; Choi, Seok-Cheol; Cho, Chul-Koo; Nam, Byung-Ho; Lee, Eui-Don

    2011-11-15

    Purpose: To compare compliance, toxicity, and outcome of weekly and triweekly cisplatin administration concurrent with radiotherapy in locally advanced cervical cancer. Methods and Materials: In this open-label, randomized trial, 104 patients with histologically proven Stage IIB-IVA cervical cancer were randomly assigned by a computer-generated procedure to weekly (weekly cisplatin 40 mg/m{sup 2}, six cycles) and triweekly (cisplatin 75 mg/m{sup 2} every 3 weeks, three cycles) chemotherapy arms during concurrent radiotherapy. The difference of compliance and the toxicity profiles between the two arms were investigated, and the overall survival rate was analyzed after 5 years. Results: All patients tolerated both treatments very well, with a high completion rate of scheduled chemotherapy cycles. There was no statistically significant difference in compliance between the two arms (86.3% in the weekly arm, 92.5% in the triweekly arm, p > 0.05). Grade 3-4 neutropenia was more frequent in the weekly arm (39.2%) than in the triweekly arm (22.6%) (p = 0.03). The overall 5-year survival rate was significantly higher in the triweekly arm (88.7%) than in the weekly arm (66.5%) (hazard ratio 0.375; 95% confidence interval 0.154-0.914; p = 0.03). Conclusions: Triweekly cisplatin 75-mg/m{sup 2} chemotherapy concurrent with radiotherapy is more effective and feasible than the conventional weekly cisplatin 40-mg/m{sup 2} regimen and may be a strong candidate for the optimal cisplatin dose and dosing schedule in the treatment of locally advanced cervical cancer.

  7. Excision repair cross complementation group 1 is a chemotherapy-tolerating gene in cisplatin-based treatment for non-small cell lung cancer.

    PubMed

    Wang, Shoufeng; Pan, Hong; Liu, Desen; Mao, Naiquan; Zuo, Chuantian; Li, Li; Xie, Tong; Huang, Dingming; Huang, Yaoyuan; Pan, Qi; Yang, Li; Wu, Junwei

    2015-02-01

    This study aimed to evaluate the biological functions of excision repair cross complementation goup 1 (ERCC1) in cell proliferation, cell cycle, invasion and cisplatin response of non-small cell lung cancer (NSCLC) cells. Firstly, ERCC1 gene was successfully transfected into H1299 cells by gene cloning and transfection techniques. Then, cell proliferation was determined with the cell growth curve and colony-forming assays. Flow cytometry (FCM) was employed to investigate the cell cycle distribution. The ability of cell invasion was estimated by means of Matrigel invasion assays. Response of NSCLC cells to cisplatin was detected utilizing MTT assays, and the intracellular drug concentrations were determined by the high performance liquid chromatography (HPLC) analysis. Expression of the two cell membrane proteins, P-glycoprotein (P-gp) and multidrug resistance-associated protein (MRP), was also evaluated utilizing FCM technique. By contrast, ERCC1 expression in the NSCLC A549 cells was silenced by small interfering RNA (siRNA) through RNAi technique. In addition, the cytotoxic effect of cisplatin on A549 cells was detected by MTT assays. In the present study, the results demonstrated that ERCC1 had no effect on cell proliferation, cell cycle and the ability of invasion, but showed significant impact on cisplatin response of the NSCLC H1299 cells. Furthermore, siRNA-induced suppression of ERCC1 evidently enhanced sensitivity to cisplatin of NSCLC A549 cells. Therefore, it is confirmed that ERCC1 is a chemotherapy-tolerating gene and a promising predictor in tailoring chemotherapy of NSCLC. PMID:25434755

  8. Netupitant/Palonosetron: A Review in the Prevention of Chemotherapy-Induced Nausea and Vomiting.

    PubMed

    Keating, Gillian M

    2015-12-01

    An oral fixed combination of netupitant/palonosetron (NEPA; Akynzeo(®)) is available for use in the prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV). Netupitant is a highly selective neurokinin-1 receptor antagonist and palonosetron is a serotonin 5-HT3 receptor antagonist with a distinct pharmacological profile. Complete response rates during the delayed, acute and overall phases were significantly higher with single-dose netupitant 300 mg plus palonosetron 0.5 mg than with single-dose palonosetron 0.5 mg in cycle 1 of cisplatin-based highly emetogenic chemotherapy (HEC) in a phase II trial and with single-dose netupitant/palonosetron 300/0.5 mg than with single-dose palonosetron 0.5 mg in cycle 1 of anthracycline-cyclophosphamide (AC) moderately emetogenic chemotherapy (MEC) in a phase III trial; the greater efficacy of netupitant/palonosetron was maintained over repeated cycles of AC MEC in the phase III trial. In another phase III trial, netupitant/palonosetron 300/0.5 mg was effective over repeated cycles of non-AC MEC or HEC. Netupitant/palonosetron was well tolerated, with no cardiac safety concerns. The convenience of administering netupitant/palonosetron as a single dose in a fixed combination has the potential to improve adherence to CINV prevention guidelines. In conclusion, netupitant/palonosetron is an important option to consider in the prevention of acute and delayed CINV in patients receiving MEC or HEC. PMID:26613606

  9. Extended high-frequency audiometry (9,000-20,000 Hz). Usefulness in audiological diagnosis.

    PubMed

    Rodríguez Valiente, Antonio; Roldán Fidalgo, Amaya; Villarreal, Ithzel M; García Berrocal, José R

    2016-01-01

    Early detection and appropriate treatment of hearing loss are essential to minimise the consequences of hearing loss. In addition to conventional audiometry (125-8,000 Hz), extended high-frequency audiometry (9,000-20,000 Hz) is available. This type of audiometry may be useful in early diagnosis of hearing loss in certain conditions, such as the ototoxic effect of cisplatin-based treatment, noise exposure or oral misunderstanding, especially in noisy environments. Eleven examples are shown in which extended high-frequency audiometry has been useful in early detection of hearing loss, despite the subject having a normal conventional audiometry. The goal of the present paper was to highlight the importance of the extended high-frequency audiometry examination for it to become a standard tool in routine audiological examinations. PMID:26025356

  10. Postoperative Chemotherapy Followed by Conformal Concomitant Chemoradiotherapy in High-Risk Gastric Cancer

    SciTech Connect

    Quero, Laurent; Bouchbika, Zineb; Kouto, Honorine; Baruch-Hennequin, Valerie; Gornet, Jean-Marc; Munoz, Nicolas; Cojean-Zelek, Isabelle; Houdart, Remi; Panis, Yves; Valleur, Patrice; Aparicio, Thomas; Maylin, Claude; Hennequin, Christophe

    2012-06-01

    Purpose: To analyze the efficacy, toxicity, and pattern of relapse after adjuvant cisplatin-based chemotherapy followed by three-dimensional irradiation and concomitant LV5FU2 chemotherapy (high-dose leucovorin and 5-fluorouracil bolus plus continuous infusion) in the treatment of completely resected high-risk gastric cancer. Methods and Materials: This was a retrospective analysis of 52 patients with high-risk gastric cancer initially treated by total/partial gastrectomy and lymphadenectomy between January 2002 and June 2007. Median age was 54 years (range, 36-75 years). Postoperative treatment consisted of 5-fluorouracil and cisplatin chemotherapy. Adjuvant chemotherapy was followed by three-dimensional conformal radiotherapy in the tumor bed and regional lymph nodes at 4500 cGy/25 fractions in association with concomitant chemotherapy. Concomitant chemotherapy consisted of a 2-h infusion of leucovorin (200 mg/m Superscript-Two ) followed by a bolus of 5-fluorouracil (400 mg/m Superscript-Two ) and then a 44-h continuous infusion of 5-fluorouracil (2400-3600 mg/m Superscript-Two ) given every 14 days, for three cycles (LV5FU2 protocol). Results: Five-year overall and disease-free survival were 50% and 48%, respectively. Distant metastases and peritoneal spread were the most frequent sites of relapse (37% each). After multivariate analysis, only pathologic nodal status was significantly associated with disease-free and overall survival. Acute toxicities were essentially gastrointestinal and hematologic. One myocardial infarction and one pulmonary embolism were also reported. Eighteen patients had a radiotherapy program interruption because of acute toxicity. All patients but 2 have completed radiotherapy. Conclusion: Postoperative cisplatin-based chemotherapy followed by conformal radiotherapy in association with concurrent 5-fluorouracil seemed to be feasible and resulted in successful locoregional control.

  11. Is High Dose Therapy Superior to Conventional Dose Therapy as Initial Treatment for Relapsed Germ Cell Tumors? The TIGER Trial

    PubMed Central

    Feldman, Darren R.; Huddart, Robert; Hall, Emma; Beyer, Jörg; Powles, Thomas

    2011-01-01

    Metastatic germ cell tumours (GCTs) are usually cured with cisplatin based chemotherapy and standard treatment algorithms are established. However when this treatment fails and the disease relapses, standard treatment is much more uncertain. Both conventional dose therapy (CDT) and high dose therapy (HDT) are widely used, due to the lack of conclusive data supporting one specific approach. A recent retrospective analysis focusing on this population suggested a significant benefit for HDT. Retrospective analyses are prone to bias, and therefore while this data is provocative it is by no mean conclusive. For this reason the international community is supporting a prospective randomised trial in this area comparing CDT(TIP) with sequential HDT (TICE). The planned open labelled randomised phase III study (TIGER) is due to open in 2011 and will recruit 390 patients to detect a 13% difference in 2 year progression free survival (primary endpoint). It is hoped that this large study will conclusively resolve the uncertainty which currently exists. PMID:21750688

  12. Review of oral fixed-dose combination netupitant and palonosetron (NEPA) for the treatment of chemotherapy-induced nausea and vomiting.

    PubMed

    Lorusso, Vito; Karthaus, Meinolf; Aapro, Matti

    2015-01-01

    Current guidelines recommend the combination of a neurokinin-1 (NK1) receptor antagonist (RA) and a 5-hydroxytryptamine-3 (5-HT3) RA, together with corticosteroids, in order to prevent chemotherapy-induced nausea and vomiting with anthracycline-cyclophosphamide and highly emetogenic chemotherapy, and it is to be considered with moderately emetogenic chemotherapy. Netupitant and palonosetron (NEPA) is a fixed-dose combination of netupitant, a novel, highly selective NK1 RA, and palonosetron, a new-generation 5-HT3 RA, targeting two major emetic pathways in a single oral capsule. In clinical trials, NEPA administered on day 1 together with dexamethasone was highly effective and well tolerated in the prevention of chemotherapy-induced nausea and vomiting in patients with solid tumors undergoing moderately emetogenic chemotherapy or highly emetogenic chemotherapy. NEPA offers maximal convenience, and as a simple guideline-based regimen, has the potential to improve adherence to guidelines. PMID:25360998

  13. Mitomycin-C- or Cisplatin-Based Chemoradiotherapy for Anal Canal Carcinoma: Long-Term Results

    SciTech Connect

    Olivatto, Luis O.; Cabral, Vania; Rosa, Arthur; Bezerra, Marcos; Santarem, Erick; Fassizoli, Ana; Castro, Leonaldson; Simoes, Jose Humberto; Small, Isabele A.; Ferreira, Carlos Gil

    2011-02-01

    Purpose: To evaluate the long-term efficacy of concurrent radiotherapy with mitomycin-C (MMC)-based or cisplatin (CP)-based combinations in a cohort of patients with locally advanced anal canal carcinoma. Methods and Materials: Between 1988 and 2000, 179 patients with locally advanced anal canal carcinoma were treated at the Instituto Nacional de Cancer with two cycles of chemotherapy during Weeks 1 and 5 of radiotherapy. 5-Fluorouracil (750 mg/m{sup 2} 120-hour infusion or 1,000 mg/m{sup 2} 96-hour infusion) plus CP (100 mg/m{sup 2}) on the first day of each cycle or MMC (10-15 mg/m{sup 2}) on the first day of Cycle 1 was administered concurrent with radiotherapy (total dose, 55-59.4 Gy). Of the 179 patients, 60% were included from a randomized trial initiated at the Instituto Nacional de Cancer in 1991 that compared concurrent chemoradiotherapy with MMC vs. CP. Results: The median follow-up for the whole chemoradiotherapy group was 83 months. The median patient age was 58 years, 57% had Stage T3-T4 tumors, and 35% had N-positive disease. The 5-year cumulative colostomy rate was not significantly different between the CP group (22%) and MMC group (29%; p = .28). The actuarial 10-year overall survival and disease-free survival rate for the CP group was 54% and 49% and for the MMC group was 52% and 53%, respectively (p = .32 and p = .92, respectively). On multivariate analysis, male gender (p = .042) and advanced Stage T3-T4 disease (p <.0001) were statistically significant for worse disease-free survival. Stage T3-T4 (p = .039) and N+ (p = .039) disease remained independently significant for overall survival. Conclusion: Long-term follow-up has confirmed the good results of chemoradiotherapy with CP plus 5-fluorouracil, which seem to provide results equivalent to those with MMC plus 5-fluorouracil.

  14. Initial high anti-emetic efficacy of granisetron with dexamethasone is not maintained over repeated cycles.

    PubMed Central

    de Wit, R.; van den Berg, H.; Burghouts, J.; Nortier, J.; Slee, P.; Rodenburg, C.; Keizer, J.; Fonteyn, M.; Verweij, J.; Wils, J.

    1998-01-01

    We have reported previously that the anti-emetic efficacy of single agent 5HT3 antagonists is not maintained when analysed with the measurement of cumulative probabilities. Presently, the most effective anti-emetic regimen is a combination of a 5HT3 antagonist plus dexamethasone. We, therefore, assessed the sustainment of efficacy of such a combination in 125 patients, scheduled to receive cisplatin > or = 70 mg m(-2) either alone or in combination with other cytotoxic drugs. Anti-emetic therapy was initiated with 10 mg of dexamethasone and 3 mg of granisetron intravenously, before cisplatin. On days 1-6, patients received 8 mg of dexamethasone and 1 mg of granisetron twice daily by oral administration. Protection was assessed during all cycles and calculated based on cumulative probability analyses using the method of Kaplan-Meier and a model for transitional probabilities. Irrespective of the type of analysis used, the anti-emetic efficacy of granisetron/dexamethasone decreased over cycles. The initial complete acute emesis protection rate of 66% decreased to 30% according to the method of Kaplan-Meier and to 39% using the model for transitional probabilities. For delayed emesis, the initial complete protection rate of 52% decreased to 21% (Kaplan-Meier) and to 43% (transitional probabilities). In addition, we observed that protection failure in the delayed emesis period adversely influenced the acute emesis protection in the next cycle. We conclude that the anti-emetic efficacy of a 5HT3 antagonist plus dexamethasone is not maintained over multiple cycles of highly emetogenic chemotherapy, and that the acute emesis protection is adversely influenced by protection failure in the delayed emesis phase. PMID:9652766

  15. Nasal absorption studies of granisetron in rats using a validated high-performance liquid chromatographic method with mass spectrometric detection.

    PubMed

    Woo, Jong Soo

    2007-06-01

    Granisetron is a selective 5-HT3 receptor antagonist that is used therapeutically for the prevention of vomiting and nausea associated with emetogenic cancer chemotherapy. Although forms of the drug are commercially available for intravenous and oral dosage, there is a need for intranasal delivery formulations in specific patient populations in which the use of these dosage forms may be unfeasible and/or inconvenient. A rapid and specific high-performance liq uid chromatography method with mass spectrometric detection (LC-MS) was developed and validated for the analysis of granisetron in plasma after nasal administration in rats. Granisetron was separated in a reverse-phase C-18 column without interference from other components of plasma. This method involves a rapid assay for the determination of granisetron in a small volume of plasma with a run time of 12 min using ondansetron as an internal standard. Data were acquired in the electrospray ionization (ESI) mode with positive ion detection and application of single ion recording (SIR). Granisetron and ondansetron were detected at m/z values of 313.2 and 294.2, respectively. The method described was found to be suitable for the analysis of all samples collected during preclinical pharmacokinetic investigations of granisetron in rats after nasal administration. To date, the first pharmacokinetic study after intranasal administration of granisetron was performed and some pharmacokinetic parameters were presented in this paper. Granisetron was found to be well absorbed through nasal route and the bioavailability of this drug following nasal administration was comparable with that of intravenous administration. PMID:17679558

  16. Assessment of adherence to the guidelines for the management of nausea and vomiting induced by chemotherapy

    PubMed Central

    França, Monique Sedlmaier; Usón, Pedro Luiz Serrano; Antunes, Yuri Philippe Pimentel Vieira; Prado, Bernard Lobato; Donnarumma, Carlos del Cistia; Mutão, Taciana Sousa; Rodrigues, Heloisa Veasey; del Giglio, Auro

    2015-01-01

    ABSTRACT Objective: To assess adherence of the prescribing physicians in a private cancer care center to the American Society of Clinical Oncology guideline for antiemetic prophylaxis, in the first cycle of antineoplastic chemotherapy. Methods: A total of 139 chemotherapy regimens, of 105 patients, were evaluated retrospectively from 2011 to 2013. Results: We observed 78% of non-adherence to the guideline rate. The main disagreements with the directive were the prescription of higher doses of dexamethasone and excessive use of 5-HT3 antagonist for low risk emetogenic chemotherapy regimens. On univariate analysis, hematological malignancies (p=0.005), the use of two or more chemotherapy (p=0.05) and high emetogenic risk regimes (p=0.012) were factors statistically associated with greater adherence to guidelines. Treatment based on paclitaxel was the only significant risk factor for non-adherence (p=0.02). By multivariate analysis, the chemotherapy of high emetogenic risk most correlated with adherence to guideline (p=0.05). Conclusion: We concluded that the adherence to guidelines is greater if the chemotherapy regime has high emetogenic risk. Educational efforts should focus more intensely on the management of chemotherapy regimens with low and moderate emetogenic potential. Perhaps the development of a computer generated reminder may improve the adherence to guidelines. PMID:26154543

  17. Efficient Stem Cell Collection after Modified Cisplatin-Based Mobilization Chemotherapy in Patients with Diffuse Large B Cell Lymphoma.

    PubMed

    Lisenko, Katharina; Cremer, Martin; Schwarzbich, Mark-Alexander; Kriegsmann, Mark; Ho, Anthony D; Witzens-Harig, Mathias; Wuchter, Patrick

    2016-08-01

    In patients with relapsed or refractory diffuse large B cell lymphoma (DLBCL), R-DHAP (rituximab, dexamethasone, cytarabine, and cisplatin) is a commonly used regimen for salvage therapy and for mobilization of peripheral blood stem cells (PBSCs). At our center, a modified R-DHAP regimen with administration of 25 mg/m(2) cisplatin as a 3-hour infusion over 4 consecutive days, instead of a single infusion of 100 mg/m(2) over 24 hours, has been established. The aim of this study was to analyze the efficiency of this modified R-DHAP regimen plus G-CSF as a mobilization strategy. We retrospectively analyzed clinical characteristics, PBSC collection and autologous stem cell transplantation parameters, and hematologic reconstitution data for 65 patients with relapsed or refractory DLBCL who underwent PBSC collection after mobilization with the modified R-DHAP protocol at our institution between 2002 and 2013. Data were evaluated for the overall cohort and with regard to the number of R-DHAP cycles received before PBSC collection. PBSC collection was performed after the first R-DHAP course in 32 patients (49%), after the second course in 30 patients (46%), and after the third course in 3 patients (5%). Sixty-three patients (97%) achieved the collection goal of ≥2.0 × 10(6) CD34(+) cells/kg body weight. A significantly higher median CD34(+) cell collection yield was achieved when cells were collected after the first R-DHAP course compared with after the second course (P < .01). A peripheral blood leukocyte increase of ≥1.0 × 10(9)/L and a platelet increase of ≥20 × 10(9)/L were observed by 11 days after ASCT. In our cohort, the modified R-DHAP regimen proved safe and feasible, showed an overall response rate (complete response, complete response unconfirmed, and partial response) of 66%, and allowed efficient mobilization of CD34(+) cells for PBSC collection. PMID:27060439

  18. Tailored Selection of First-Line Cisplatin-Based Chemotherapy in Patients with Metastatic Urothelial Carcinoma of Bladder

    PubMed Central

    Hsieh, Meng-Che; Huang, Cheng-Hua; Chiang, Po-Hui; Chen, Yen-Yang; Tang, Yeh; Su, Yu-Li

    2016-01-01

    Purpose: Methotrexate, vinblastine, doxorubicin plus cisplatin (MVAC) and gemcitabine plus cisplatin (GC) are both effective first-line chemotherapy. We explore the responsive variables of MVAC and GC for patients with metastatic urothelial carcinoma of bladder (mUCB). Materials and Methods: Patients who were initially diagnosed to have mUCB and received MVAC or GC as metastatic first-line chemotherapy between 2000 and 2014 at Kaohsiung Chang Gung Memorial Hospital were reviewed. Totally, 130 patients were enrolled into our study. Univariable Cox proportional hazard models were constructed for OS. Hazard ratio (HR) and 95% confidence intervals (CIs) was also presented. Results: There were 50 patients (38%) in the MVAC group and 80 patients (62%) in the GC group. The median OS was insignificantly different between MVAC and GC groups, accounting for 17.0 and 14.4 months (P = 0.214), respectively. OS of MVAC group was significantly longer with regard to age ≦ 60 years (HR: 0.38, 95% CI: 0.12-0.97, P = 0.036), pure urothelial carcinoma (HR: 0.56, 95% CI: 0.34-0.90, P = 0.015), > 1 metastatic sites (HR: 0.19, 95% CI: 0.08-0.44, P = < 0.001), and neutrophil to lymphocyte ratio > 3(HR: 0.45, 95% CI: 0.25-0.81, P = 0.006), while OS with GC group was significantly longer with regard to variant urothelial carcinoma (HR: 0.56, 95% CI: 0.34-0.90, P = 0.015). Conclusions: Our study disclosed the predictive factors of different regimen for mUCB. These results have clinical implication for physicians who treat patients with mUCB. PMID:27390610

  19. Platinum Concentration and Pathologic Response to Cisplatin-Based Neoadjuvant Chemotherapy in Muscle-Invasive Bladder Cancer

    PubMed Central

    Kilari, Deepak; Xiao, Guang-Qian; Abu-Farsakh, Sohaib H.; Baran, Andrea; Messing, Edward M.; Kim, Eric S.

    2016-01-01

    Background Platinum (Pt)-based chemotherapy is the standard of care for muscle-invasive bladder cancer (MIBC). However, resistance is a major limitation. Reduced intratumoral drug accumulation is an important mechanism of platinum resistance. Our group previously demonstrated a significant correlation between tissue Pt concentration and tumor response to Pt-based neoadjuvant chemotherapy (NAC) in lung cancer. We hypothesized that increased Pt concentration in radical cystectomy (RC) specimens would correlate with improved pathologic response to Pt-based NAC in MIBC. Methods A cohort of 19 clinically annotated, archived, fresh frozen RC specimens from patients with MIBC treated with Pt-based NAC was identified [ypT0 (pathologic complete response, pCR), N = 4; ≤ypT1N0M0 (pathologic partial response, pPR), N = 6; ≥ypT2 (minimal pathologic response/progression), N = 9)]. RC specimens from 2 patients with MIBC who did not receive NAC and 1 treated with a non-Pt containing NAC regimen were used as negative controls. Total Pt concentration in normal adjacent urothelial tissue and bladder tumors from RC specimens was measured by flameless atomic absorption spectrophotometry. Results Total Pt concentration in normal urothelium differed by tumor pathologic response (P = 0.011). Specimens with pCR had the highest Pt concentrations compared to those with pPR (P = 0.0095) or no response/progression (P = 0.020). There was no significant difference in Pt levels in normal urothelium and tumor between pPR and no response/progression groups (P = 0.37; P = 0.25, respectively). Conclusions: Our finding of increased intracellular Pt in RC specimens with pCR following NAC for MIBC compared to those with residual disease suggests that enhanced Pt accumulation may be an important determinant of Pt sensitivity. Factors that modulate intracellular Pt concentration, such as expression of Pt transporters, warrant further investigation as predictive biomarkers of response to Pt-based NAC in MIBC. PMID:27187160

  20. Anterior gradient protein 2 expression in high grade head and neck squamous cell carcinoma correlated with cancer stem cell and epithelial mesenchymal transition.

    PubMed

    Ma, Si-Rui; Wang, Wei-Ming; Huang, Cong-Fa; Zhang, Wen-Feng; Sun, Zhi-Jun

    2015-04-20

    Anterior gradient protein 2 (AGR2) is a novel biomarker with potential oncogenic role. We sought to investigate the diagnostic and prognostic role of AGR2 on head and neck squamous cell carcinoma (HNSCC) with an emphasis on its correlation of cancer stemloid cells (CSC) and epithelial mesenchymal transition (EMT). We found that AGR2 protein levels were higher in HNSCC than in normal oral mucosa. High levels of AGR2 were associated with the T category, pathological grade and lymph node metastasis of HNSCC. Expression of AGR2 increased in recurring HNSCC after radiotherapy and in post cisplatin-based chemotherapeutic tissues. In HNSCC cell lines, knock-down of AGR2 induced apoptosis, reduced sphere formation, and down-regulated Survivin, Cyclin D1, Bcl2, Bcl2l1, Slug, Snail, Nanog and Oct4. In addition, over-expressed AGR2 in transgenic mice with spontaneous HNSCC was associated with lost function of Tgfbr1 and/ or lost function of Pten. In vitro knockdown TGFBR1 in HNSCC cell lines increased AGR2 expression. These results suggest that AGR2 is involved in EMT and self-renewal of CSC and may present a potential therapeutic target (oncotarget) for HNSCC. PMID:25871396

  1. Fosaprepitant and aprepitant: an update of the evidence for their place in the prevention of chemotherapy-induced nausea and vomiting

    PubMed Central

    Langford, Patrick; Chrisp, Paul

    2010-01-01

    Introduction: The selective neurokinin-1 receptor antagonist aprepitant is effective in the treatment of acute and delayed chemotherapy-induced nausea and vomiting (CINV) associated with both moderately and highly emetogenic chemotherapy. Fosaprepitant has been developed as an intravenous prodrug of aprepitant. Aims: To update the evidence underlying the use of fosaprepitant to prevent CINV. Evidence review: Aprepitant in combination with a serotonin antagonist and a corticosteroid controls acute and delayed symptoms of CINV in patients receiving moderately to highly emetogenic chemotherapy. Bioequivalence of fosaprepitant with aprepitant has recently been demonstrated, which has led to its inclusion in clinical guidelines for treatment of acute CINV with highly, and some regimens of moderately, emetogenic chemotherapy. Early studies of the clinical efficacy of fosaprepitant have shown improvement over treatment with ondansetron. Both aprepitant and fosaprepitant are well tolerated with most adverse events observed of mild or moderate intensity. Conflicting economic evidence has shown that whilst aprepitant provides an increased quality of life in patients treated for CINV, there are differing views over its absolute cost in relation to standard therapy. The incremental cost-effectiveness ratio of aprepitant, however, appears to lie within acceptable bounds. Place in therapy: Fosaprepitant and aprepitant are recommended in guidelines for preventing CINV due to moderately and highly emetogenic chemotherapy. Fosaprepitant is bioequivalent to aprepitant, and could offer potential benefits for patients who may be unable to tolerate oral administration of antiemetics during an episode of nausea or vomiting. PMID:21042544

  2. Prevention of Nausea and Vomiting in Patients Undergoing Oral Anticancer Therapies for Solid Tumors

    PubMed Central

    Costa, Ana Lúcia; Abreu, Catarina; Pacheco, Teresa Raquel; Macedo, Daniela; Sousa, Ana Rita; Pulido, Catarina; Quintela, António; Costa, Luís

    2015-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is still a common and debilitating side effect despite recent advances in its prevention and treatment. The intrinsic emetogenicity of chemotherapy agents allowed grouping into four risk groups (high, moderate, low, and minimal risk of emetogenicity). The prevention of acute and delayed CINV for intravenous agents and one day regimens is well studied, although, there are few data about management of CINV induced by oral cytotoxic agents and targeted therapies, usually administered in extended regimens of daily oral use. Until now treatment of nausea and vomiting caused by oral antineoplastic agents remains largely empirical. The level of evidence of prophylactic antiemetics recommended for these agents is low. There are differences in the classification of emetogenic potential of oral antineoplastic agents between the international guidelines and different recommendations for prophylactic antiemetic regimens. Herein we review the evidence for antiemetic regimens for the most used oral antineoplastic agents for solid tumors and propose antiemetic regimens for high to moderate risk and low to minimal risk of emetogenicity. PMID:26421283

  3. Management of acute and delayed chemotherapy-induced nausea and vomiting: role of netupitant–palonosetron combination

    PubMed Central

    Janicki, Piotr K

    2016-01-01

    Purpose The purpose of this review is to summarize and discuss the recently published data (both original studies and reviews) on the oral medication NEPA, consisting of netupitant (a neurokinin-1 receptor antagonist [NK1RA], 300 mg dose) and palonosetron (5-hydroxytryptamine [serotonin or 5HT] type 3 receptor antagonist [5HT3RA], 0.5 mg dose), in the prevention of the acute and delayed nausea and vomiting in patients receiving highly or moderately emetogenic chemotherapy. Methods This review was based on the very limited number of available published trials consisting of two Phase III studies and one Phase II dose-selecting trial. Results These studies demonstrated some therapeutic benefits of NEPA over related chemotherapy-induced nausea and vomiting (CINV) prophylaxis management, as well as its beneficial safety profile. In particular, compared with single-dose 0.5 mg palonosetron, the complete response rates for all phases of CINV for the first cycle of highly emetogenic chemotherapy (with cisplatin), as well as anthracycline–cyclophosphamide-based moderately emetogenic chemotherapy, were significantly higher for single-dose NEPA. The high efficacy of NEPA in terms of prevention of CINV continued throughout repeated cycles of highly and moderately emetogenic therapies. Conclusion It is currently recommended that patients who are administered highly emetogenic chemotherapy regimens should obtain a three-drug combination consisting of NK1RA, 5HT3RA, and dexamethasone. The recently available oral combination of NEPA plus dexamethasone provides an additional pharmacological management option that could be considered in this scenario. PMID:27194913

  4. Inverse Planned High-Dose-Rate Brachytherapy for Locoregionally Advanced Cervical Cancer: 4-Year Outcomes

    SciTech Connect

    Tinkle, Christopher L.; Weinberg, Vivian; Chen, Lee-May; Littell, Ramey; Cunha, J. Adam M.; Sethi, Rajni A.; Chan, John K.; Hsu, I-Chow

    2015-08-01

    Purpose: Evaluate the efficacy and toxicity of image guided brachytherapy using inverse planning simulated annealing (IPSA) high-dose-rate brachytherapy (HDRB) boost for locoregionally advanced cervical cancer. Methods and Materials: From December 2003 through September 2009, 111 patients with primary cervical cancer were treated definitively with IPSA-planned HDRB boost (28 Gy in 4 fractions) after external radiation at our institution. We performed a retrospective review of our experience using image guided brachytherapy. Of the patients, 70% had a tumor size >4 cm, 38% had regional nodal disease, and 15% had clinically evident distant metastasis, including nonregional nodal disease, at the time of diagnosis. Surgical staging involving pelvic lymph node dissection was performed in 15% of patients, and 93% received concurrent cisplatin-based chemotherapy. Toxicities are reported according to the Common Terminology Criteria for Adverse Events version 4.0 guidelines. Results: With a median follow-up time of 42 months (range, 3-84 months), no acute or late toxicities of grade 4 or higher were observed, and grade 3 toxicities (both acute and late) developed in 8 patients (1 constitutional, 1 hematologic, 2 genitourinary, 4 gastrointestinal). The 4-year Kaplan-Meier estimate of late grade 3 toxicity was 8%. Local recurrence developed in 5 patients (4 to 9 months after HDRB), regional recurrence in 3 (6, 16, and 72 months after HDRB), and locoregional recurrence in 1 (4 months after HDR boost). The 4-year estimates of local, locoregional, and distant control of disease were 94.0%, 91.9%, and 69.1%, respectively. The overall and disease-free survival rates at 4 years were 64.3% (95% confidence interval [CI] of 54%-73%) and 61.0% (95% CI, 51%-70%), respectively. Conclusions: Definitive radiation by use of inverse planned HDRB boost for locoregionally advanced cervical cancer is well tolerated and achieves excellent local control of disease. However, overall

  5. Association of GSTs gene polymorphisms with treatment outcome of advanced non-small cell lung cancer patients with cisplatin-based chemotherapy.

    PubMed

    Wu, Gun; Jiang, Bin; Liu, Xiaoqin; Shen, Yi; Yang, Shujuan

    2015-01-01

    We evaluated the association of GSTM1 null/present, GSTT1 null/present, and GSTP1 IIe105Val polymorphisms with the clinical response to chemotherapy and treatment outcome of NSCLC. Between October 2009 and October 2012, a total of 282 patients with advanced NSCLC were enrolled into our study, and they were followed up until October 2014. The genotypes of GSTM1, GSTT1, and GSTP1 IIe105Val were performed by polymerase chain reaction (PCR) coupled with restriction fragment length polymorphism (RFLP). By logistic regression analysis, our study found that the Val/Val genotype of GSTP1 IIe105Val was associated with more CR+PR response to chemotherapy when compared with the IIe/IIe genotype, and the OR (95% CI) was 2.18 (1.16-4.12). By multivariate Cox proportional hazards regression analysis, we found the Val/Val genotype of GSTP1 was correlated with lower risk of death in advanced NSCLC (HR, 0.48; 95% CI, 0.25-0.93). However, no association was found between GSTT1 and GSTM1 polymorphisms and response to chemotherapy and overall survival of advanced NSCLC. Moreover, the IIe/Val + Val/Val genotypes of GSTP1 were associated with lower risk of death in never smokers, and the adjusted HR (95% CI) was 0.34 (0.12-0.93). In conclusion, we found that the GSTP1 polymorphism was correlated with better response to chemotherapy and lower risk of death in advanced NSCLC patients. PMID:26722539

  6. A meta-analysis comparing cisplatin-based to carboplatin-based chemotherapy in moderate to advanced squamous cell carcinoma of head and neck (SCCHN)

    PubMed Central

    Zhang, Yue; Xiao, Nanjie; Chen, Min; Zhang, Yaowei; Li, Lu; Chen, Longhua

    2016-01-01

    Purpose This study was performed to compare the efficacies and toxicities of cisplatin (CDDP)- and carboplatin (CBDCA)-based chemotherapy (CT) in patients with SCCHN. Methods The search strategy included Pubmed, Science Direct, the Cochrane Library, and the China National Knowledge Internet Web. Statistical analyses were performed using RevMan 5.2. The primary endpoint was overall survival (OS) with secondary endpoints of locoregional control (LRC) and grade≥3 toxicity. Results Overall, 12 studies and 1165 patients were included. CDDP-based CT significantly improved 5-year OS (HR=0.67, 95% CI, 0.49 to 0.91; P=0.01) compared to the CBDCA group. No difference in the 3-year OS/LRC was observed, but a subgroup analysis showed a better 3-year OS in the CDDP arm for non-nasopharynx carcinoma (non-NPC) SCCHN (HR=0.66, 95% CI, 0.48 to 0.91; P=0.01). The CDDP-based CT was associated with more gastrointestinal toxicities (RR=4.58; P=0.005) and nephrotoxicity (4/110=3.6%) compared to the CBDCA group, but fewer anemia, leukopenia and thrombocytopenia with RRs of 0.27, 0.71, and 0.28 respectively. Conclusions Patients with CDDP-based CT can achieve a higher OS, but there is no significant difference in LRC. The CDDP-based CT is associated with fewer hematological toxicities but more gastrointestinal toxicities and nephrotoxicity compared to the CBDCA arm. PMID:26755647

  7. Rolapitant for the treatment of chemotherapy-induced nausea and vomiting: a review of the clinical evidence.

    PubMed

    Chasen, Martin R; Rapoport, Bernardo L

    2016-03-01

    Chemotherapy-induced nausea and vomiting (CINV), both acute and delayed, has a dramatic effect on the well-being and quality of life of patients with cancer. Improved understanding of the mechanisms involved in CINV has led to the development of agents targeting the 5-HT3 receptor as well as the NK-1 receptor. Antiemetic prophylaxis given to patients receiving highly emetogenic chemotherapy combines agents blocking the 5-HT3 and NK-1 receptors along with corticosteroids given regularly and repeatedly. Rolapitant is a long-acting NK-1 receptor antagonist with proven efficacy in controlling CINV as part of the prophylaxis regimen. This review will detail the clinical efficacy and safety of rolapitant in the treatment of patients with cancer receiving highly or moderately emetogenic chemotherapy. PMID:26842387

  8. The role of netupitant and palonosetron in chemotherapy-induced nausea and vomiting.

    PubMed

    Abramovitz, Rebecca Briana; Gaertner, Kelly Marie

    2016-06-01

    The combination of netupitant and palonosetron was approved by the Food and Drug Administration in October 2014 for the prevention of acute and delayed chemotherapy-induced nausea and vomiting associated with initial and repeat courses of moderately and highly emetogenic chemotherapy. Netupitant and palonosetron is available as a single capsule to be administered prior to each cycle of chemotherapy. The approval was based on phase II and III data in patients undergoing treatment with moderately and highly emetogenic chemotherapy. Netupitant and palonosetron's benefits include a convenient dosage form, dual-targeted mechanism, and favorable side effect profile, while its main limitations are cost and potential logistical issues surrounding administration. More studies are needed to adequately determine its role in therapy as well as which patients will derive the most benefit from its use. PMID:25914408

  9. A Phase II Multi-institutional Trial of Chemoradiation Using Weekly Docetaxel and Erythropoietin for High-Risk Postoperative Head and Neck Cancer Patients

    SciTech Connect

    Willey, Christopher D.; Murphy, Barbara A.; Netterville, James L.; Burkey, Brian B.; Shyr, Yu; Shakhtour, Bashar; Kish, Bonnie; Raben, David; Chen Changhu; Song, John I.; Kane, Madeleine A.; Cmelak, Anthony J. . E-mail: anthony.cmelak@vanderbilt.edu

    2007-04-01

    Purpose: To determine efficacy and toxicities of postoperative concurrent chemoradiation using docetaxel in high-risk head and neck cancer. Methods and Materials: High-risk patients were enrolled 2-8 weeks after surgery. Treatment included 60 Gy for 6 weeks with weekly docetaxel 25 mg/m{sup 2} and erythropoietin alpha 40,000 U for hemoglobin {<=}12 g/dL. Primary endpoints included locoregional control (LC), disease-free survival (DFS), and patterns of failure (POF). Secondary endpoints were toxicity and quality of life. Results: Eighteen patients were enrolled (14 male, 4 female), aged 24-70 years (median, 55 years). Primary site included oropharynx = 7, oral cavity 8, hypopharynx = 1, and larynx = 2. Pathologic American Joint Committee on Cancer Stage was III = 3 patients, IV = 15 patients. High-risk eligibility included {>=}2 positive lymph nodes = 13, extracapsular extension = 10, positive margins = 8 (11 patients with two or more risk factors). Docetaxel was reduced to 20 mg/m{sup 2}/week after 5 patients had prolonged Grade 3 or higher mucositis. Overall, number of doses delivered was 2 of 6 = 1, 3 of 6 2, 4 of 6 = 2, 5 of 6 = 4, 6 of 6 = 9 patients. With median follow-up of 30 months (range, 5-66), 10 (56%) patients are alive and have no evidence of disease (NED); POF: three local recurrences (two with distant) and 1 distant only. One-year survival was 76%, median PFS and DFS had not been reached. Three-year LC was 82%. No Grade 3 or higher late toxicities were observed, although a few cases of prolonged mucositis and taste loss (>3 months) were seen, particularly at 25 mg/m{sup 2}/week. Conclusion: Postoperative radiation therapy with weekly docetaxel 20 or 25 mg/m{sup 2}/week for high-risk postoperative head and neck cancer caused intolerable mucosal toxicity, prompting early study termination. Further studies should consider 15 mg/m{sup 2}. Actuarial 3-year LC is 82%, similar to cisplatin-based chemoradiation regimens. Distant metastasis remains an

  10. Aprepitant: drug-drug interactions in perspective.

    PubMed

    Aapro, M S; Walko, C M

    2010-12-01

    The implications of chemotherapeutic drug-drug interactions can be serious and thus need to be addressed. This review concerns the potential interactions of the antiemetic aprepitant, a neurokinin-1 receptor antagonist indicated for use (in Europe) in highly emetogenic chemotherapy and moderately emetogenic chemotherapy (MEC) in combination with a 5-hydroxytryptamine-3 (5-HT3) receptor antagonist and corticosteroids and (in the United States) in combination with other antiemetic agents, for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy including high-dose cisplatin. When considering use of aprepitant for prevention of chemotherapy-induced nausea and vomiting, its potential drug-drug interaction profile as a moderate inhibitor of cytochrome P-450 isoenzyme 3A4 (CYP3A4) has been a source of concern for some physicians and other health care professionals. We explore in this paper how real those concerns are. Our conclusion is that either no interaction or no clinically relevant interaction exists with chemotherapeutic agents (intravenous cyclophosphamide, docetaxel, intravenous vinorelbine) or 5-HT3 antagonists (granisetron, ondansetron, palonosetron). For relevant interactions, appropriate measures, such as corticosteroid dose modifications and extended International Normalized Ratio monitoring of patients on warfarin therapy, can be taken to effectively manage them. Therefore, the concern of negative interactions remains largely theoretical but needs to be verified with new agents extensively metabolized through the 3A4 pathway. PMID:20488873

  11. High Tech High.

    ERIC Educational Resources Information Center

    Hardy, Lawrence

    2001-01-01

    In an era of high-stakes testing and prescriptive teaching styles, a San Diego charter high school embraces project learning, multilevel classrooms, and video portfolios of student work. The school lacks dining, music, and athletic facilities, but features hefty teacher salaries, student freedom, and real-world problem solving. (MLH)

  12. High arch

    MedlinePlus

    ... is on the back and balls of the foot (metatarsals head). Your health care provider will check to see if the high ... Call your health care provider if you suspect you are having foot pain related to high arches.

  13. High PRF high current switch

    DOEpatents

    Moran, Stuart L.; Hutcherson, R. Kenneth

    1990-03-27

    A triggerable, high voltage, high current, spark gap switch for use in pu power systems. The device comprises a pair of electrodes in a high pressure hydrogen environment that is triggered by introducing an arc between one electrode and a trigger pin. Unusually high repetition rates may be obtained by undervolting the switch, i.e., operating the trigger at voltages much below the self-breakdown voltage of the device.

  14. High arch

    MedlinePlus

    Pes cavus; High foot arch ... High foot arches are much less common than flat feet. They are more likely to be caused by a ... stress is placed on the section of the foot between the ankle and toes (metatarsals). This condition ...

  15. The ratio of CD8 to Treg tumor-infiltrating lymphocytes is associated with response to cisplatin-based neoadjuvant chemotherapy in patients with muscle invasive urothelial carcinoma of the bladder

    PubMed Central

    Baras, Alexander S.; Drake, Charles; Liu, Jen-Jane; Gandhi, Nilay; Kates, Max; Hoque, Mohamed O.; Meeker, Alan; Hahn, Noah; Taube, Janis M.; Schoenberg, Mark P.; Netto, George; Bivalacqua, Trinity J.

    2016-01-01

    ABSTRACT Introduction: Randomized controlled trials of platinum-based neoadjuvant chemotherapy (NAC) for bladder cancer have shown that patients who achieve a pathologic response to NAC exhibit 5 y survival rates of approximately 80–90% while NAC resistant (NR) cases exhibit 5 y survival rates of approximately 30–40%. These findings highlight the need to predict who will benefit from conventional NAC and the need for plausible alternatives. Methods: The pre-treatment biopsy tissues from a cohort of 41 patients with muscle invasive bladder who were treated with NAC were incorporated in tissue microarray and immunohistochemistry for PD-L1, CD8, and FOXP3 was performed. Percentage of PD-L1 positive tumor cells was measured. Tumor-infiltrating lymphocytes (TIL) densities, along with CD8 and Treg-specific TILs, were measured. Results: TIL density was strongly correlated with tumor PD-L1 expression, consistent with the mechanism of adaptive immune resistance in bladder cancer. Tumor cell PD-L1 expression was not a significant predictor of response. Neither was the CD8 nor Treg TIL density associated with response. Intriguingly though, the ratio of CD8 to Treg TIL densities was strongly associated with response (p = 0.0003), supporting the hypothesis that the immune system plays a role in the response of bladder cancer to chemotherapy. Discussion: To our knowledge, this is the first report in bladder cancer showing that the CD8 to Treg TIL density in the pre-treatment tissues is predictive for conventional NAC response. These findings warrant further investigations to both better characterize this association in larger cohorts and begin to elucidate the underlying mechanism(s) of this phenomenon.

  16. A randomized comparative study of antiemetic prophylaxis with ondansentron in a single 32-mg loading dose versus 8 mg every 6 h in patients undergoing cisplatin-based chemotherapy.

    PubMed

    Tsavaris, N; Fountzilas, G; Mylonakis, N; Athanassiadis, A; Kosmas, C; Karakousis, C; Bacoyiannis, C; Kosmidis, P

    1998-01-01

    In several studies a single dose of 32 mg was compared to an ondansentron (OND) administration schedule of every 6 h, yielding no differences in overall efficacy. The aim of this randomized comparative study was to identify differences of these two schedules on an hour-to-hour control of nausea and vomiting, during the first 24 h in patients receiving cisplatin (CDDP)-based chemotherapy. One hundred ten patients were randomly assigned to two groups (A and B); all received combination chemotherapy with CDDP at a dose of 100 mg/m2. OND was administered as follows: group A: 8 mg, 30 min before the infusion of CDDP, and repeated every 6 h after the first dose (totally 4 doses) in the first 24 h, and group B: 32 mg before CDDP, as a loading dose and this was the total dose for the first 24 h. No overall difference was noticed during the first 24 h, as well as the next 3 days from the infusion of CDDP in the intensity of vomits, vomits without gastric content (retches), and nausea. In a more detailed monitoring of the distribution of emetic episodes during the first 24 h, there were important differences between these two antiemetic schedules: for group A an increased vomiting with or without gastric content between midnight and 6 p.m. was observed, and for group B between 6 p.m. and midnight (vomits with p 0.03, and without gastric content p 0.02). Preloading with the total 24-hour dose of OND 32 mg exhibits a more potent antiemetic activity during the initial 18 h, becoming weaker over the last 5 h of the first day, whereas the every-6-hour schedule leaves periods of poor emesis control between dosing intervals. PMID:9778615

  17. High Class

    ERIC Educational Resources Information Center

    Waldecker, Mark

    2005-01-01

    Education administrators make buying decisions for furniture based on many factors. Cost, durability, functionality, safety and aesthetics represent just a few. Those issues always will be important, but gaining greater recognition in recent years has been the role furniture plays in creating positive, high-performance learning environments. The…

  18. Flying High

    ERIC Educational Resources Information Center

    Litvin, Margaret

    2000-01-01

    Nearly a decade ago, the Montreal School of Aerospace Trades became part of a massive education reform that takes most career education in the province out of comprehensive high schools and invests millions of dollars in specialized vocational schools. Through education-industry partnerships, these schools helping to change the image of vocational…

  19. High Stakes

    ERIC Educational Resources Information Center

    Elgin, Catherine Z.

    2004-01-01

    I discuss the contributions of Harvey Siegel, Francis Schrag and Randall Curren to this volume. Their articles cast in bold relief the relation of High Stakes Testing to the goals of education, the nature of mind and the demands of justice. I argue that the connections are deep, but that the considerations these authors raise do not show that High…

  20. Highly dominating, highly authoritarian personalities.

    PubMed

    Altemeyer, Bob

    2004-08-01

    The author considered the small part of the population whose members score highly on both the Social Dominance Orientation scale and the Right-Wing Authoritarianism scale. Studies of these High SDO-High RWAs, culled from samples of nearly 4000 Canadian university students and over 2600 of their parents and reported in the present article, reveal that these dominating authoritarians are among the most prejudiced persons in society. Furthermore, they seem to combine the worst elements of each kind of personality, being power-hungry, unsupportive of equality, manipulative, and amoral, as social dominators are in general, while also being religiously ethnocentric and dogmatic, as right-wing authoritarians tend to be. The author suggested that, although they are small in number, such persons can have considerable impact on society because they are well-positioned to become the leaders of prejudiced right-wing political movements. PMID:15279331

  1. FHIT loss confers cisplatin resistance in lung cancer via the AKT/NF-κB/Slug-mediated PUMA reduction.

    PubMed

    Wu, D-W; Lee, M-C; Hsu, N-Y; Wu, T-C; Wu, J-Y; Wang, Y-C; Cheng, Y-W; Chen, C-Y; Lee, H

    2015-05-01

    Fragile histidine triad (FHIT) loss by the two-hit mechanism of loss of heterozygosity and promoter hypermethylation commonly occurrs in non-small cell lung cancer (NSCLC) and may confer cisplatin resistance in NSCLC cells. However, the underlying mechanisms of FHIT loss in cisplatin resistance and the response to cisplatin-based chemotherapy in NSCLC patients have not yet been reported. In the present study, inhibition concentration of 50% cell viability induced by cisplatin (IC50) and soft agar growth and invasion capability were increased and decreased in FHIT-knockdown and -overexpressing cells, respectively. Mechanistically, Slug transcription is upregulated by AKT/NF-κB activation due to FHIT loss and, in turn, Slug suppresses PUMA expression; this decrease of PUMA by FHIT loss is responsible for cisplatin resistance. In addition, cisplatin resistance due to FHIT loss can be conquered by AKT inhibitor-perifosine in xenograft tumors. Among NSCLC patients, low FHIT, high p-AKT, high Slug and low PUMA were correlated with shorter overall survival, relapse-free survival and poorer response to cisplatin-based chemotherapy. Therefore, the AKT inhibitor perifosine might potentially overcome the resistance to cisplatin-based chemotherapy in NSCLC patients with low-FHIT tumors, and consequently improve the outcome. PMID:24998847

  2. PKM2 enhances chemosensitivity to cisplatin through interaction with the mTOR pathway in cervical cancer.

    PubMed

    Zhu, Haiyan; Wu, Jun; Zhang, Wenwen; Luo, Hui; Shen, Zhaojun; Cheng, Huihui; Zhu, Xueqiong

    2016-01-01

    Pyruvate kinase M2 (PKM2) is a key driver of aerobic glycolysis in cancer cells and has been shown to be up-regulated by mTOR in vitro. Our previous proteomic profiling studies showed that PKM2 was significantly upregulated in cervical cancer tissues after treatment with neoadjuvant chemotherapy (NACT). Whether PKM2 expression predicts cisplatin-based NACT sensitivity and is mTOR dependent in cervical cancer patients remains unclear. Using paired tumor samples (pre- and post-chemotherapy) from 36 cervical cancer patients, we examined mTOR, HIF-1α, c-Myc, and PKM2 expression in cervical cancer samples and investigated the response to cisplatin-based NACT. In addition, we established PKM2 suppressed cervical cancer cell lines and evaluated their sensitivity to cisplatin in vitro. We found that the mTOR/HIF-1α/c-Myc/PKM2 signaling pathway was significantly downregulated in post-chemotherapy cervical cancer tissues. High levels of mTOR, HIF-1α, c-Myc, and PKM2 were associated with a positive chemotherapy response in cervical cancer patients treated with cisplatin-based NACT. In vitro, PKM2 knockdown desensitized cervical cancer cells to cisplatin. Moreover, PKM2 had complex interactions with mTOR pathways. mTOR, HIF1α, c-Myc, and PKM2 expression in cervical cancer may serve as predictive biomarkers to cisplatin-based chemotherapy. PKM2 enhances chemosensitivity to cisplatin through interaction with the mTOR pathway in cervical cancer. PMID:27492148

  3. Role of neurofilament light polypeptide in head and neck cancer chemoresistance.

    PubMed

    Chen, Baishen; Chen, Ju; House, Michael G; Cullen, Kevin J; Nephew, Kenneth P; Guo, Zhongmin

    2012-03-01

    Resistance to cisplatin-based chemotherapy is responsible for therapeutic failure of many common human cancers including cancer of head and neck (HNC). Mechanisms underlying cisplatin resistance remain unclear. In this study, we identified neurofilament light polypeptide (NEFL) as a novel hypermethylated gene associated with resistance to cisplatin-based chemotherapy in HNC. Analysis of 14 HNC cell lines revealed that downregulation of NEFL expression significantly correlated with increased resistance to cisplatin. Hypermethylation of NEFL promoter CpG islands was observed in cell lines as examined by bisulfite DNA sequencing and methylation-specific PCR (MSP) and tightly correlated with reduced NEFL mRNA and protein expression. Furthermore, in patient samples with HNC (n = 51) analyzed by quantitative MSP, NEFL promoter hypermethylation was associated with resistance to cisplatin-based chemotherapy [relative risk (RR), 3.045; 95% confidence interval (CI), 1.459-6.355; P = 0.007] and predicted diminished overall and disease-free survival for patients treated with cisplatin-based chemotherapy. Knockdown of NEFL by siRNA in the highly cisplatin-sensitive cell line PCI13 increased (P < 0.01) resistance to cisplatin. In cisplatin-resistant O11 and SCC25cp cells, restored expression of NEFL significantly increased sensitivity to the drug. Furthermore, NEFL physically associated with tuberous sclerosis complex 1 (TSC1), a known inhibitor of the mTOR pathway, and NEFL downregulation led to functional activation of mTOR pathway and consequentially conferred cisplatin resistance. This is the first study to show a role for NEFL in HNC chemoresistance. Our findings suggest that NEFL methylation is a novel mechanism for HNC chemoresistance and may represent a candidate biomarker predictive of chemotherapeutic response and survival in patients with HNC. PMID:22246235

  4. PKM2 enhances chemosensitivity to cisplatin through interaction with the mTOR pathway in cervical cancer

    PubMed Central

    Zhu, Haiyan; Wu, Jun; Zhang, Wenwen; Luo, Hui; Shen, Zhaojun; Cheng, Huihui; Zhu, Xueqiong

    2016-01-01

    Pyruvate kinase M2 (PKM2) is a key driver of aerobic glycolysis in cancer cells and has been shown to be up-regulated by mTOR in vitro. Our previous proteomic profiling studies showed that PKM2 was significantly upregulated in cervical cancer tissues after treatment with neoadjuvant chemotherapy (NACT). Whether PKM2 expression predicts cisplatin-based NACT sensitivity and is mTOR dependent in cervical cancer patients remains unclear. Using paired tumor samples (pre- and post-chemotherapy) from 36 cervical cancer patients, we examined mTOR, HIF-1α, c-Myc, and PKM2 expression in cervical cancer samples and investigated the response to cisplatin-based NACT. In addition, we established PKM2 suppressed cervical cancer cell lines and evaluated their sensitivity to cisplatin in vitro. We found that the mTOR/HIF-1α/c-Myc/PKM2 signaling pathway was significantly downregulated in post-chemotherapy cervical cancer tissues. High levels of mTOR, HIF-1α, c-Myc, and PKM2 were associated with a positive chemotherapy response in cervical cancer patients treated with cisplatin-based NACT. In vitro, PKM2 knockdown desensitized cervical cancer cells to cisplatin. Moreover, PKM2 had complex interactions with mTOR pathways. mTOR, HIF1α, c-Myc, and PKM2 expression in cervical cancer may serve as predictive biomarkers to cisplatin-based chemotherapy. PKM2 enhances chemosensitivity to cisplatin through interaction with the mTOR pathway in cervical cancer. PMID:27492148

  5. [Recent Status of Postoperative Adjuvant Chemotherapy after Completely Resected Lung Cancer].

    PubMed

    Naito, Masahito; Tsuboi, Masahiro

    2016-02-01

    Several landmark study elucidated that adjuvant cisplatin-based chemotherapy for stage II-IIIA non-small cell lung cancer (NSCLC)patients after appropriate surgical resection can significantly improve 5-year survival rate. Meta-analysis of modern cisplatin based adjuvant chemotherapy trial confirmed this benefit. Furthermore, in Japan, large randomized trial and metaanalysis assessing the efficacy of uracil-tegafur(UFT)for stage I patients with completely resected NSCLC reported that UFT can significantly improve 5-year survival rate. Meta-analysis of subgroup assessed that effectiveness of UFT for stage I NSCLC patients with a tumor lager than 2 cm. According to these evidence, cisplatin-based adjuvant chemotherapy for stage II-III A NSCLC and UFT for stage I NSCLC patients with a tumor lager than 2 cm are used standard postoperative adjuvant chemotherapy in Japan. In recent year, it is presumed that personalized care will be necessary to re-evaluate strategies for postoperative adjuvant chemotherapy of lung cancer. Considering histological subtype of lung cancer, several randomize trial for postoperative adjuvant chemotherapy with non-squamous NSCLC or high neuroendocrine tumor of lung are ongoing. In addition, recent studies of biological research indicate that some tumor marker such as ERCC1 may had a predictive value for selecting patients who will derive the benefit from adjuvant chemotherapy. PMID:27067681

  6. New therapies for antiemetic prophylaxis for chemotherapy.

    PubMed

    Davis, Mellar P

    2016-01-01

    A number of new advances have occurred over the past 2 years in the management of chemotherapy-related nausea and vomiting (CINV). A new neurokinin-1 receptor antagonist (NK1RA), netupitant, has been combined with palonosetron in a single oral tablet for treating the effects of moderately emetogenic chemotherapy (MEC) and highly emetogenic chemotherapy (HEC). Rolapitant, another NK1RA, unlike aprepitant, has a long half-life and does not block CYP-3A4 and therefore has fewer drug interactions. Olanzapine reduces nausea more effectively than aprepitant in patients who are receiving HEC and is a better rescue antiemetic than is metoclopramide. Ginger lacks efficacy as an antiemetic agent for CINV. Although there was some evidence in a pilot study of gabapentin as an antiemetic, it was no better in reducing CINV than was placebo. Compliance to guidelines in multiple settings ranges from 50%-60% but is improved by computerized order entry of antiemetics and recommendations displayed with chemotherapy. PMID:26870838

  7. Aprepitant and Fosaprepitant Use in Children and Adolescents at an Academic Medical Center

    PubMed Central

    Biondo, Lisa

    2014-01-01

    OBJECTIVE: To describe the use of aprepitant and fosaprepitant, a neurokinin 1 (NK-1) receptor inhibitor, in children and adolescents at a large academic medical center, for the prevention and management of chemotherapy-induced nausea and vomiting (CINV). METHODS: A retrospective chart review was conducted using an electronic medical record system to evaluate the use of aprepitant and fosaprepitant in all pediatric patients that were discharged from a single academic medical center between February 25, 2009 and May 25, 2012. RESULTS: Twenty-six patients were included in this review and received a total of 287 doses over the span of 114 cycles. Mean age was 10.1 years, with a range of 11 months to 17 years old. In 16 of 26 patients, aprepitant was used as the primary prophylaxis. Of those patients who received primary prophylaxis, 6 of 16 received it for highly emetogenic chemotherapy, and 10 of 16 received it for moderately emetogenic chemotherapy. Intravenous fosaprepitant was used in 7 of 26 patients, ages 13 to 17 (median 14) years old. No adverse effects attributable to aprepitant were reported. CONCLUSIONS: Use of aprepitant and fosaprepitant in pediatric patients appeared to be well tolerated. No currently published reports data using aprepitant in a patient younger than 32 months old, whereas we reported its use in patients as young as 11 months old. PMID:25024673

  8. High Poverty, High Performing Schools. IDRA Focus.

    ERIC Educational Resources Information Center

    IDRA Newsletter, 1997

    1997-01-01

    This theme issue includes four articles on high performance by poor Texas schools. In "Principal of National Blue Ribbon School Says High Poverty Schools Can Excel" (interview with Robert Zarate by Christie L. Goodman), the principal of Mary Hull Elementary School (San Antonio, Texas) describes how the high-poverty, high-minority school…

  9. Project Georgia High School/High Tech

    NASA Technical Reports Server (NTRS)

    2000-01-01

    Georgia High School/High Tech has been developing a suggested curriculum for use in its programs. The purpose of this instructional material is to provide a basic curriculum format for teachers of High School/High Tech students. The curriculum is designed to implement QCC classroom instruction that encourages career development in technological fields through post-secondary education, paid summer internships, and exposure to experiences in high technology.

  10. High Blood Pressure (Hypertension)

    MedlinePlus

    ... Print Page Text Size: A A A Listen High Blood Pressure (Hypertension) Nearly 1 in 3 American adults has high ... weight. How Will I Know if I Have High Blood Pressure? High blood pressure is a silent problem — you ...

  11. Highly Anisotropic, Highly Transparent Wood Composites.

    PubMed

    Zhu, Mingwei; Song, Jianwei; Li, Tian; Gong, Amy; Wang, Yanbin; Dai, Jiaqi; Yao, Yonggang; Luo, Wei; Henderson, Doug; Hu, Liangbing

    2016-07-01

    For the first time, two types of highly anisotropic, highly transparent wood composites are demonstrated by taking advantage of the macro-structures in original wood. These wood composites are highly transparent with a total transmittance up to 90% but exhibit dramatically different optical and mechanical properties. PMID:27147136

  12. Project Georgia High School/High Tech

    NASA Technical Reports Server (NTRS)

    2000-01-01

    The High School/High Tech initiative of the President's Committee on Employment of Disabilities, Georgia's application of the collaborative "Georgia Model" and NASA's commitment of funding have shown that opportunities for High School/High Tech students are unlimited. In Georgia, the partnership approach to meeting the needs of this program has opened doors previously closed. As the program grows and develops, reflecting the needs of our students and the marketplace, more opportunities will be available. Our collaboratives are there to provide these opportunities and meet the challenge of matching our students with appropriate education and career goals. Summing up the activities and outcomes of Project Georgia High School/High Tech is not difficult. Significant outcomes have already occurred in the Savannah area as a result of NASA's grant. The support of NASA has enabled Georgia Committee to "grow" High School/High Tech throughout the region-and, by example, the state. The success of the Columbus pilot project has fostered the proliferation of projects, resulting in more than 30 Georgia High School High Tech programs-with eight in the Savannah area.

  13. High Blood Pressure

    MedlinePlus

    ... version of this page please turn Javascript on. High Blood Pressure What Is High Blood Pressure? High blood pressure is a common disease in ... the heart, kidneys, brain, and eyes. Types of High Blood Pressure There are two main types of high blood ...

  14. High Blood Pressure

    MedlinePlus

    ... version High Blood Pressure Overview What is blood pressure? Blood pressure is the amount of force that your ... called your blood pressure. What is high blood pressure? High blood pressure (also called hypertension) occurs when your blood ...

  15. High blood pressure - infants

    MedlinePlus

    National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics . ...

  16. High blood sugar

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000332.htm High blood sugar To use the sharing features on this page, ... later when energy is needed. Symptoms of High Blood Sugar Symptoms of high blood sugar can include: Being ...

  17. High Blood Pressure

    MedlinePlus

    ... normal blood pressure 140/90 or higher is high blood pressure Between 120 and 139 for the top number, ... prehypertension. Prehypertension means you may end up with high blood pressure, unless you take steps to prevent it. High ...

  18. High Performance Networks for High Impact Science

    SciTech Connect

    Scott, Mary A.; Bair, Raymond A.

    2003-02-13

    This workshop was the first major activity in developing a strategic plan for high-performance networking in the Office of Science. Held August 13 through 15, 2002, it brought together a selection of end users, especially representing the emerging, high-visibility initiatives, and network visionaries to identify opportunities and begin defining the path forward.

  19. High strength high modulus ceramic fiber

    NASA Technical Reports Server (NTRS)

    Fetterolf, R. N.

    1972-01-01

    Low cost method was developed for producing high strength, high modulus, continuous ceramic oxide fibers. Process transforms inexpensive metallic salts into syrup-like liquids that can be fiberized at room temperatures. Resulting salt fibers are then converted to oxides by calcination at relatively low temperatures.

  20. High-Flying High-Poverty Schools

    ERIC Educational Resources Information Center

    American Educator, 2013

    2013-01-01

    In discussing socioeconomic integration before audiences, the author is frequently asked: What about high-poverty schools that do work? Don't they suggest that economic segregation isn't much of a problem after all? High-poverty public schools that beat the odds paint a heartening story that often attracts considerable media attention. In 2000,…

  1. Development of high strength, high temperature ceramics

    NASA Technical Reports Server (NTRS)

    Hall, W. B.

    1982-01-01

    Improvement in the high-pressure turbopumps, both fuel and oxidizer, in the Space Shuttle main engine were considered. The operation of these pumps is limited by temperature restrictions of the metallic components used in these pumps. Ceramic materials that retain strength at high temperatures and appear to be promising candidates for use as turbine blades and impellers are discussed. These high strength materials are sensitive to many related processing parameters such as impurities, sintering aids, reaction aids, particle size, processing temperature, and post thermal treatment. The specific objectives of the study were to: (1) identify and define the processing parameters that affect the properties of Si3N4 ceramic materials, (2) design and assembly equipment required for processing high strength ceramics, (3) design and assemble test apparatus for evaluating the high temperature properties of Si3N4, and (4) conduct a research program of manufacturing and evaluating Si3N4 materials as applicable to rocket engine applications.

  2. High pressure, high current, low inductance, high reliability sealed terminals

    DOEpatents

    Hsu, John S [Oak Ridge, TN; McKeever, John W [Oak Ridge, TN

    2010-03-23

    The invention is a terminal assembly having a casing with at least one delivery tapered-cone conductor and at least one return tapered-cone conductor routed there-through. The delivery and return tapered-cone conductors are electrically isolated from each other and positioned in the annuluses of ordered concentric cones at an off-normal angle. The tapered cone conductor service can be AC phase conductors and DC link conductors. The center core has at least one service conduit of gate signal leads, diagnostic signal wires, and refrigerant tubing routed there-through. A seal material is in direct contact with the casing inner surface, the tapered-cone conductors, and the service conduits thereby hermetically filling the interstitial space in the casing interior core and center core. The assembly provides simultaneous high-current, high-pressure, low-inductance, and high-reliability service.

  3. High Blood Pressure

    MedlinePlus

    ... page from the NHLBI on Twitter. Description of High Blood Pressure Español High blood pressure is a common disease ... defines high blood pressure severity levels. Stages of High Blood Pressure in Adults Stages Systolic (top number) Diastolic (bottom ...

  4. Bumball: Highly Engaging, Highly Inclusive, and Highly Entertaining

    ERIC Educational Resources Information Center

    Hall, Amber; Barney, David; Wilkinson, Carol

    2014-01-01

    Physical educators are always looking for new and exciting games and activities in which students can participate. This article describes Bumball, a high-intensity game that provides the opportunity for students to use many common game skills, such as hand-eye coordination, passing to a target, running, playing defense, and getting to an open…

  5. High-current, high-frequency capacitors

    NASA Technical Reports Server (NTRS)

    Renz, D. D.

    1983-01-01

    The NASA Lewis high-current, high-frequency capacitor development program was conducted under a contract with Maxwell Laboratories, Inc., San Diego, California. The program was started to develop power components for space power systems. One of the components lacking was a high-power, high-frequency capacitor. Some of the technology developed in this program may be directly usable in an all-electric airplane. The materials used in the capacitor included the following: the film is polypropylene, the impregnant is monoisopropyl biphenyl, the conductive epoxy is Emerson and Cuming Stycast 2850 KT, the foil is aluminum, the case is stainless steel (304), and the electrode is a modified copper-ceramic.

  6. High strength and high toughness steel

    DOEpatents

    Parker, Earl R.; Zackay, Victor F.

    1979-01-01

    A structural steel which possess both high strength and high toughness and has particular application of cryogenic uses. The steel is produced by the utilization of thermally induced phase transformation following heating in a three-phase field in iron-rich alloys of the Fe-Ni-Ti system, with a preferred composition of 12% nickel, 0.5% titanium, the remainder being iron.

  7. High strength, high ductility low carbon steel

    DOEpatents

    Koo, Jayoung; Thomas, Gareth

    1978-01-01

    A high strength, high ductility low carbon steel consisting essentially of iron, 0.05-0.15 wt% carbon, and 1-3 wt% silicon. Minor amounts of other constituents may be present. The steel is characterized by a duplex ferrite-martensite microstructure in a fibrous morphology. The microstructure is developed by heat treatment consisting of initial austenitizing treatment followed by annealing in the (.alpha. + .gamma.) range with intermediate quenching.

  8. High temperature, high power piezoelectric composite transducers.

    PubMed

    Lee, Hyeong Jae; Zhang, Shujun; Bar-Cohen, Yoseph; Sherrit, Stewart

    2014-01-01

    Piezoelectric composites are a class of functional materials consisting of piezoelectric active materials and non-piezoelectric passive polymers, mechanically attached together to form different connectivities. These composites have several advantages compared to conventional piezoelectric ceramics and polymers, including improved electromechanical properties, mechanical flexibility and the ability to tailor properties by using several different connectivity patterns. These advantages have led to the improvement of overall transducer performance, such as transducer sensitivity and bandwidth, resulting in rapid implementation of piezoelectric composites in medical imaging ultrasounds and other acoustic transducers. Recently, new piezoelectric composite transducers have been developed with optimized composite components that have improved thermal stability and mechanical quality factors, making them promising candidates for high temperature, high power transducer applications, such as therapeutic ultrasound, high power ultrasonic wirebonding, high temperature non-destructive testing, and downhole energy harvesting. This paper will present recent developments of piezoelectric composite technology for high temperature and high power applications. The concerns and limitations of using piezoelectric composites will also be discussed, and the expected future research directions will be outlined. PMID:25111242

  9. High Temperature, High Power Piezoelectric Composite Transducers

    PubMed Central

    Lee, Hyeong Jae; Zhang, Shujun; Bar-Cohen, Yoseph; Sherrit, StewarT.

    2014-01-01

    Piezoelectric composites are a class of functional materials consisting of piezoelectric active materials and non-piezoelectric passive polymers, mechanically attached together to form different connectivities. These composites have several advantages compared to conventional piezoelectric ceramics and polymers, including improved electromechanical properties, mechanical flexibility and the ability to tailor properties by using several different connectivity patterns. These advantages have led to the improvement of overall transducer performance, such as transducer sensitivity and bandwidth, resulting in rapid implementation of piezoelectric composites in medical imaging ultrasounds and other acoustic transducers. Recently, new piezoelectric composite transducers have been developed with optimized composite components that have improved thermal stability and mechanical quality factors, making them promising candidates for high temperature, high power transducer applications, such as therapeutic ultrasound, high power ultrasonic wirebonding, high temperature non-destructive testing, and downhole energy harvesting. This paper will present recent developments of piezoelectric composite technology for high temperature and high power applications. The concerns and limitations of using piezoelectric composites will also be discussed, and the expected future research directions will be outlined. PMID:25111242

  10. High assurance SPIRAL

    NASA Astrophysics Data System (ADS)

    Franchetti, Franz; Sandryhaila, Aliaksei; Johnson, Jeremy R.

    2014-06-01

    In this paper we introduce High Assurance SPIRAL to solve the last mile problem for the synthesis of high assurance implementations of controllers for vehicular systems that are executed in today's and future embedded and high performance embedded system processors. High Assurance SPIRAL is a scalable methodology to translate a high level specification of a high assurance controller into a highly resource-efficient, platform-adapted, verified control software implementation for a given platform in a language like C or C++. High Assurance SPIRAL proves that the implementation is equivalent to the specification written in the control engineer's domain language. Our approach scales to problems involving floating-point calculations and provides highly optimized synthesized code. It is possible to estimate the available headroom to enable assurance/performance trade-offs under real-time constraints, and enables the synthesis of multiple implementation variants to make attacks harder. At the core of High Assurance SPIRAL is the Hybrid Control Operator Language (HCOL) that leverages advanced mathematical constructs expressing the controller specification to provide high quality translation capabilities. Combined with a verified/certified compiler, High Assurance SPIRAL provides a comprehensive complete solution to the efficient synthesis of verifiable high assurance controllers. We demonstrate High Assurance SPIRALs capability by co-synthesizing proofs and implementations for attack detection and sensor spoofing algorithms and deploy the code as ROS nodes on the Landshark unmanned ground vehicle and on a Synthetic Car in a real-time simulator.

  11. Resource Utilization for Chemotherapy-Induced Nausea and Vomiting Events in Patients with Solid Tumors Treated with Antiemetic Regimens

    PubMed Central

    Schwartzberg, Lee; Harrow, Brooke; Lal, Lincy S.; Radtchenko, Janna; Lyman, Gary H.

    2015-01-01

    Background Chemotherapy-induced nausea and vomiting (CINV) can lead to increased emergency department visits and hospitalizations, which may contribute to increased cost of care. Antiemetic agents, such as neurokinin-1 (NK1) receptor antagonists and 5-hydroxytryptamine (5-HT3) receptor antagonists, are prescribed for patients receiving highly emetogenic chemotherapy (HEC) and moderately emetogenic chemotherapy (MEC). The current guidelines recommend a 3-drug combination of an NK1 receptor antagonist, a 5-HT3 receptor antagonist, and dexamethasone with HEC regimens and certain MEC regimens. Objective To compare the incidence of CINV and CINV-related resource utilization among patients who receive guideline-adherent HEC and MEC regimens and patients who receive non–guideline-adherent regimens. Methods In this retrospective, claims-based study, Inovalon's Medical Outcomes Research for Effectiveness and Economics Registry (MORE2 Registry) Research Edition database was used to identify 8089 patients with solid tumors receiving therapy with anthracycline plus cyclophosphamide (AC), cisplatin, or carboplatin from June 2013 to December 2013. The patients were stratified according to the use of an NK1 receptor antagonist regimen. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify CINV events associated with hospital, emergency department, and outpatient office visits among patients in the NK1 receptor antagonist group and the non-NK1 receptor antagonist group. Results A total of 1059 patients were included in the analysis, of whom 51% (N = 536) used an NK1 receptor antagonist–based regimen and 49% (N = 523) used non-NK1 receptor antagonist therapy. A higher percentage of patients receiving AC (73%) than cisplatin (56%) or carboplatin (23%) received an NK1 receptor antagonist. The incidence rates of total CINV events and CINV-related emergency department visits were lower in the group receiving an NK1 receptor

  12. High-Altitude Illness

    MedlinePlus

    ... altitude illness: Acute mountain sickness High-altitude pulmonary edema (also called HAPE), which affects the lungs High-altitude cerebral edema (also called HACE), which affects the brain These ...

  13. High blood pressure

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000468.htm High blood pressure To use the sharing features on ... body. Hypertension is the term used to describe high blood pressure. Blood pressure readings are given as ...

  14. High Speed data acquisition

    SciTech Connect

    Cooper, Peter S.

    1998-02-01

    A general introduction to high Speed data acquisition system techniques in modern particle physics experiments is given. Examples are drawn from the SELEX(E781) high statistics charmed baryon production and decay experiment now taking data at Fermilab.

  15. High potassium level

    MedlinePlus

    High potassium level is a problem in which the amount of potassium in the blood is higher than normal. The medical ... There are often no symptoms with a high level of potassium. When symptoms do occur, they may ...

  16. Cleaning Up High.

    ERIC Educational Resources Information Center

    Rittner-Heir, Robbin M.

    2001-01-01

    Discusses cleaning techniques and equipment for areas in a school that are hard to reach, such as the high spacious ceilings, the tall windows of a school atrium, and high points in gymnasiums and auditoriums. (GR)

  17. High blood pressure - infants

    MedlinePlus

    Hypertension - infants ... and blood vessels The health of the kidneys High blood pressure in infants may be due to kidney or ... Bronchopulmonary dysplasia Renal artery stenosis In newborn babies, high blood pressure is often caused by a blood clot in ...

  18. High energy neutron radiography

    SciTech Connect

    Gavron, A.; Morley, K.; Morris, C.; Seestrom, S.; Ullmann, J.; Yates, G.; Zumbro, J.

    1996-06-01

    High-energy spallation neutron sources are now being considered in the US and elsewhere as a replacement for neutron beams produced by reactors. High-energy and high intensity neutron beams, produced by unmoderated spallation sources, open potential new vistas of neutron radiography. The authors discuss the basic advantages and disadvantages of high-energy neutron radiography, and consider some experimental results obtained at the Weapons Neutron Research (WNR) facility at Los Alamos.

  19. Tunable high pressure lasers

    NASA Technical Reports Server (NTRS)

    Hess, R. V.

    1976-01-01

    Atmospheric transmission of high energy CO2 lasers is considerably improved by high pressure operation which, due to pressure broadening, permits tuning the laser lines off atmospheric absorption lines. Pronounced improvement is shown for horizontal transmission at altitudes above several kilometers and for vertical transmission through the entire atmosphere. Applications of tunable high pressure CO2 lasers to energy transmission and to remote sensing are discussed along with initial efforts in tuning high pressure CO2 lasers.

  20. High power microwave generator

    DOEpatents

    Ekdahl, C.A.

    1983-12-29

    A microwave generator efficiently converts the energy of an intense relativistic electron beam (REB) into a high-power microwave emission using the Smith-Purcell effect which is related to Cerenkov radiation. Feedback for efficient beam bunching and high gain is obtained by placing a cylindrical Smith-Purcell transmission grating on the axis of a toroidal resonator. High efficiency results from the use of a thin cold annular highly-magnetized REB that is closely coupled to the resonant structure.

  1. High power microwave generator

    DOEpatents

    Ekdahl, Carl A.

    1986-01-01

    A microwave generator efficiently converts the energy of an intense relativistic electron beam (REB) into a high-power microwave emission using the Smith-Purcell effect which is related to Cerenkov radiation. Feedback for efficient beam bunching and high gain is obtained by placing a cylindrical Smith-Purcell transmission grating on the axis of a toroidal resonator. High efficiency results from the use of a thin cold annular highly-magnetized REB that is closely coupled to the resonant structure.

  2. High performance systems

    SciTech Connect

    Vigil, M.B.

    1995-03-01

    This document provides a written compilation of the presentations and viewgraphs from the 1994 Conference on High Speed Computing given at the High Speed Computing Conference, {open_quotes}High Performance Systems,{close_quotes} held at Gleneden Beach, Oregon, on April 18 through 21, 1994.

  3. High speed civil transport

    NASA Technical Reports Server (NTRS)

    Mcknight, R. L.

    1992-01-01

    The design requirements of the High Speed Civil Transport (HSCT) are discussed. The following design concerns are presented: (1) environmental impact (emissions and noise); (2) critical components (the high temperature combustor and the lightweight exhaust nozzle); and (3) advanced materials (high temperature ceramic matrix composites (CMC's)/intermetallic matrix composites (IMC's)/metal matrix composites (MMC's)).

  4. High Technology Partnership Project.

    ERIC Educational Resources Information Center

    Francis Tuttle Vo-Tech Center, Oklahoma City, OK.

    The High Technology Center at Francis Tuttle Vo-Tech Center in Oklahoma City conducted an 18-month demonstration program, beginning in January 1989, to train or retrain average workers, unemployed because of cutbacks in their field or lack of marketable skills, for careers in high technology. The High Technology Center offered adults training in…

  5. High Technology Needs Assessment.

    ERIC Educational Resources Information Center

    Southeastern Louisiana Univ., Hammond.

    A project produced a high technology status report providing needs assessment data for educational planning. The purpose was to determine the impact and future of high technology in Louisiana. Information was obtained from 68 Louisiana manufacturing industries by mailed questionnaire. Data indicated that 45 industries were involved in high tech. A…

  6. Early College High Schools

    ERIC Educational Resources Information Center

    Dessoff, Alan

    2011-01-01

    For at-risk students who stand little chance of going to college, or even finishing high school, a growing number of districts have found a solution: Give them an early start in college while they still are in high school. The early college high school (ECHS) movement that began with funding from the Bill and Melinda Gates Foundation 10 years ago…

  7. Evaluating High School IT

    ERIC Educational Resources Information Center

    Thompson, Brett A.

    2004-01-01

    Since its inception in 1997, Cisco's curriculum has entered thousands of high schools across the U.S. and around the world for two reasons: (1) Cisco has a large portion of the computer networking market, and thus has the resources for and interest in developing high school academies; and (2) high school curriculum development teams recognize the…

  8. High Tech High: Cruising on the Internet.

    ERIC Educational Resources Information Center

    Wilson, Thomas F.

    1995-01-01

    A "driver's license" at one suburban Minnesota high school is a free round-trip ticket to the world. The Internet allows students to stroll through the Louvre, tour the White House, or examine current satellite weather photos at NASA's computer center. Students are developing friendships, exploring different cultures, and learning foreign…

  9. High power, high beam quality regenerative amplifier

    DOEpatents

    Hackel, Lloyd A.; Dane, Clifford B.

    1993-01-01

    A regenerative laser amplifier system generates high peak power and high energy per pulse output beams enabling generation of X-rays used in X-ray lithography for manufacturing integrated circuits. The laser amplifier includes a ring shaped optical path with a limited number of components including a polarizer, a passive 90 degree phase rotator, a plurality of mirrors, a relay telescope, and a gain medium, the components being placed close to the image plane of the relay telescope to reduce diffraction or phase perturbations in order to limit high peak intensity spiking. In the ring, the beam makes two passes through the gain medium for each transit of the optical path to increase the amplifier gain to loss ratio. A beam input into the ring makes two passes around the ring, is diverted into an SBS phase conjugator and proceeds out of the SBS phase conjugator back through the ring in an equal but opposite direction for two passes, further reducing phase perturbations. A master oscillator inputs the beam through an isolation cell (Faraday or Pockels) which transmits the beam into the ring without polarization rotation. The isolation cell rotates polarization only in beams proceeding out of the ring to direct the beams out of the amplifier. The diffraction limited quality of the input beam is preserved in the amplifier so that a high power output beam having nearly the same diffraction limited quality is produced.

  10. High power, high beam quality regenerative amplifier

    DOEpatents

    Hackel, L.A.; Dane, C.B.

    1993-08-24

    A regenerative laser amplifier system generates high peak power and high energy per pulse output beams enabling generation of X-rays used in X-ray lithography for manufacturing integrated circuits. The laser amplifier includes a ring shaped optical path with a limited number of components including a polarizer, a passive 90 degree phase rotator, a plurality of mirrors, a relay telescope, and a gain medium, the components being placed close to the image plane of the relay telescope to reduce diffraction or phase perturbations in order to limit high peak intensity spiking. In the ring, the beam makes two passes through the gain medium for each transit of the optical path to increase the amplifier gain to loss ratio. A beam input into the ring makes two passes around the ring, is diverted into an SBS phase conjugator and proceeds out of the SBS phase conjugator back through the ring in an equal but opposite direction for two passes, further reducing phase perturbations. A master oscillator inputs the beam through an isolation cell (Faraday or Pockels) which transmits the beam into the ring without polarization rotation. The isolation cell rotates polarization only in beams proceeding out of the ring to direct the beams out of the amplifier. The diffraction limited quality of the input beam is preserved in the amplifier so that a high power output beam having nearly the same diffraction limited quality is produced.

  11. Acute benzodiazepine toxicity exacerbated by concomitant oral olanzapine.

    PubMed

    Hoffmann, Marc S; Overman, Michael J; Nates, Joseph L

    2016-04-01

    Improvements in antiemetic therapy constitute a major advance in oncology. A recent poll of the oncology community by the American Society of Clinical Oncology ranked it as one of the top 5 advances in cancer in the last 50 years. Emetogenicity of chemotherapy is defined by risk of emesis in the patient given no antiemetics; high-risk regimens cause nausea and vomiting in >90% of patients, moderate risk in 30%-90%, and low risk in <30%. This risk profile serves as the basis for empiric antiemetic prophylaxis and offers alternatives to refractory patients. Modern antiemetic prophylaxis is extremely effective for high-risk chemotherapy, reducing the risk for breakthrough nausea and vomiting to 0%-13% in the acute setting (<24 hours from receipt of chemotherapy) and to 25%-30% in the delayed setting (24-72 hours from receipt of chemotherapy). PMID:27152518

  12. High performance polymer development

    NASA Technical Reports Server (NTRS)

    Hergenrother, Paul M.

    1991-01-01

    The term high performance as applied to polymers is generally associated with polymers that operate at high temperatures. High performance is used to describe polymers that perform at temperatures of 177 C or higher. In addition to temperature, other factors obviously influence the performance of polymers such as thermal cycling, stress level, and environmental effects. Some recent developments at NASA Langley in polyimides, poly(arylene ethers), and acetylenic terminated materials are discussed. The high performance/high temperature polymers discussed are representative of the type of work underway at NASA Langley Research Center. Further improvement in these materials as well as the development of new polymers will provide technology to help meet NASA future needs in high performance/high temperature applications. In addition, because of the combination of properties offered by many of these polymers, they should find use in many other applications.

  13. High modulus high temperature glass fibers

    NASA Technical Reports Server (NTRS)

    Bacon, J. F.

    1973-01-01

    The search for a new high-modulus, high-temperature glass fiber involved the preparation of 500 glass compositions lying in 12 glass fields. These systems consisted primarily of low atomic number oxides and rare-earth oxides. Direct optical measurements of the kinetics of crystallization of the cordierite-rare earth system, for example, showed that the addition of rare-earth oxides decreased the rate of formation of cordierite crystals. Glass samples prepared from these systems proved that the rare-earth oxides made large specific contributions to the Young's modulus of the glasses. The best glasses have moduli greater than 21 million psi, the best glass fibers have moduli greater than 18 million psi, and the best glass fiber-epoxy resin composites have tensile strengths of 298,000 psi, compressive strengths of at least 220,000 psi, flexural strengths of 290,000 psi, and short-beam shear strengths of almost 17,000 psi.

  14. High pressure and high temperature apparatus

    DOEpatents

    Voronov, Oleg A.

    2005-09-13

    A design for high pressure/high temperature apparatus and reaction cell to achieve .about.30 GPa pressure in .about.1 cm volume and .about.100 GPa pressure in .about.1 mm volumes and 20-5000.degree. C. temperatures in a static regime. The device includes profiled anvils (28) action on a reaction cell (14, 16) containing the material (26) to be processed. The reaction cell includes a heater (18) surrounded by insulating layers and screens. Surrounding the anvils are cylindrical inserts and supporting rings (30-48) whose hardness increases towards the reaction cell. These volumes may be increased considerably if applications require it, making use of presses that have larger loading force capability, larger frames and using larger anvils.

  15. High Resolution, High Frame Rate Video Technology

    NASA Technical Reports Server (NTRS)

    1990-01-01

    Papers and working group summaries presented at the High Resolution, High Frame Rate Video (HHV) Workshop are compiled. HHV system is intended for future use on the Space Shuttle and Space Station Freedom. The Workshop was held for the dual purpose of: (1) allowing potential scientific users to assess the utility of the proposed system for monitoring microgravity science experiments; and (2) letting technical experts from industry recommend improvements to the proposed near-term HHV system. The following topics are covered: (1) State of the art in the video system performance; (2) Development plan for the HHV system; (3) Advanced technology for image gathering, coding, and processing; (4) Data compression applied to HHV; (5) Data transmission networks; and (6) Results of the users' requirements survey conducted by NASA.

  16. A simple, high efficiency, high resolution spectropolarimeter

    NASA Astrophysics Data System (ADS)

    Barden, Samuel C.

    2012-09-01

    A simple concept is described that uses volume phase holographic gratings as polarizing dispersers for a high efficiency, high resolution spectropolarimeter. Although the idea has previously been mentioned in the literature as possible, such a concept has not been explored in detail. Performance analysis is presented for a VPHG spectropolarimeter concept that could be utilized for both solar and night-time astronomy. Instrumental peak efficiency can approach 100% with spectral dispersions permitting R~200,000 spectral resolution with diffraction limited telescopes. The instrument has 3-channels: two dispersed image planes with orthogonal polarization and an undispersed image plane. The concept has a range of versatility where it could be configured (with appropriate half-wave plates) for slit-fed spectroscopy or without slits for snapshot/hyperspectral/tomographic spectroscopic imaging. Multiplex gratings could also be used for the simultaneous recording of two separate spectral bands or multiple instruments could be daisy chained with beam splitters for further spectral coverage.

  17. HIGH VOLTAGE, HIGH CURRENT SPARK GAP SWITCH

    DOEpatents

    Dike, R.S.; Lier, D.W.; Schofield, A.E.; Tuck, J.L.

    1962-04-17

    A high voltage and current spark gap switch comprising two main electrodes insulatingly supported in opposed spaced relationship and a middle electrode supported medially between the main electrodes and symmetrically about the median line of the main electrodes is described. The middle electrode has a perforation aligned with the median line and an irradiation electrode insulatingly supported in the body of the middle electrode normal to the median line and protruding into the perforation. (AEC)

  18. High energy high brightness thin disk laser

    NASA Astrophysics Data System (ADS)

    Nixon, Matthew D.; Cates, Michael C.

    2012-11-01

    Boeing has been developing solid state lasers for high energy applications since 2004 using Yb:YAG thin disk lasers as pioneered by A. Giesen1 and commercialized by Trumpf Laser GmbH.2 In this paper, we report results of our second generation design and status of a third generation we are currently developing, which will produce 35 kW and a beam quality <2.

  19. High frequency, high power capacitor development

    NASA Technical Reports Server (NTRS)

    White, C. W.; Hoffman, P. S.

    1983-01-01

    A program to develop a special high energy density, high power transfer capacitor to operate at frequency of 40 kHz, 600 V rms at 125 A rms plus 600 V dc bias for space operation. The program included material evaluation and selection, a capacitor design was prepared, a thermal analysis performed on the design. Fifty capacitors were manufactured for testing at 10 kHz and 40 kHz for 50 hours at Industrial Electric Heating Co. of Columbus, Ohio. The vacuum endurance test used on environmental chamber and temperature plate furnished by Maxwell. The capacitors were energized with a special power conditioning apparatus developed by Industrial Electric Heating Co. Temperature conditions of the capacitors were monitored by IEHCo test equipment. Successful completion of the vacuum endurance test series confirmed achievement of the main goal of producing a capacitor or reliable operation at high frequency in an environment normally not hospitable to electrical and electronic components. The capacitor developed compared to a typical commercial capacitor at the 40 kHz level represents a decrease in size and weight by a factor of seven.

  20. High output lamp with high brightness

    DOEpatents

    Kirkpatrick, Douglas A.; Bass, Gary K.; Copsey, Jesse F.; Garber, Jr., William E.; Kwong, Vincent H.; Levin, Izrail; MacLennan, Donald A.; Roy, Robert J.; Steiner, Paul E.; Tsai, Peter; Turner, Brian P.

    2002-01-01

    An ultra bright, low wattage inductively coupled electrodeless aperture lamp is powered by a solid state RF source in the range of several tens to several hundreds of watts at various frequencies in the range of 400 to 900 MHz. Numerous novel lamp circuits and components are disclosed including a wedding ring shaped coil having one axial and one radial lead, a high accuracy capacitor stack, a high thermal conductivity aperture cup and various other aperture bulb configurations, a coaxial capacitor arrangement, and an integrated coil and capacitor assembly. Numerous novel RF circuits are also disclosed including a high power oscillator circuit with reduced complexity resonant pole configuration, parallel RF power FET transistors with soft gate switching, a continuously variable frequency tuning circuit, a six port directional coupler, an impedance switching RF source, and an RF source with controlled frequency-load characteristics. Numerous novel RF control methods are disclosed including controlled adjustment of the operating frequency to find a resonant frequency and reduce reflected RF power, controlled switching of an impedance switched lamp system, active power control and active gate bias control.

  1. High speed handpieces

    PubMed Central

    Bhandary, Nayan; Desai, Asavari; Shetty, Y Bharath

    2014-01-01

    High speed instruments are versatile instruments used by clinicians of all specialties of dentistry. It is important for clinicians to understand the types of high speed handpieces available and the mechanism of working. The centers for disease control and prevention have issued guidelines time and again for disinfection and sterilization of high speed handpieces. This article presents the recent developments in the design of the high speed handpieces. With a view to prevent hospital associated infections significant importance has been given to disinfection, sterilization & maintenance of high speed handpieces. How to cite the article: Bhandary N, Desai A, Shetty YB. High speed handpieces. J Int Oral Health 2014;6(1):130-2. PMID:24653618

  2. Highly directional thermal emitter

    DOEpatents

    Ribaudo, Troy; Shaner, Eric A; Davids, Paul; Peters, David W

    2015-03-24

    A highly directional thermal emitter device comprises a two-dimensional periodic array of heavily doped semiconductor structures on a surface of a substrate. The array provides a highly directional thermal emission at a peak wavelength between 3 and 15 microns when the array is heated. For example, highly doped silicon (HDSi) with a plasma frequency in the mid-wave infrared was used to fabricate nearly perfect absorbing two-dimensional gratings structures that function as highly directional thermal radiators. The absorption and emission characteristics of the HDSi devices possessed a high degree of angular dependence for infrared absorption in the 10-12 micron range, while maintaining high reflectivity of solar radiation (.about.64%) at large incidence angles.

  3. High lift selected concepts

    NASA Technical Reports Server (NTRS)

    Henderson, M. L.

    1979-01-01

    The benefits to high lift system maximum life and, alternatively, to high lift system complexity, of applying analytic design and analysis techniques to the design of high lift sections for flight conditions were determined and two high lift sections were designed to flight conditions. The influence of the high lift section on the sizing and economics of a specific energy efficient transport (EET) was clarified using a computerized sizing technique and an existing advanced airplane design data base. The impact of the best design resulting from the design applications studies on EET sizing and economics were evaluated. Flap technology trade studies, climb and descent studies, and augmented stability studies are included along with a description of the baseline high lift system geometry, a calculation of lift and pitching moment when separation is present, and an inverse boundary layer technique for pressure distribution synthesis and optimization.

  4. High-altitude headache.

    PubMed

    Marmura, Michael J; Hernandez, Pablo Bandres

    2015-05-01

    High-altitude headache is one of many neurological symptoms associated with the ascent to high altitudes. Cellular hypoxia due to decreased barometric pressure seems to be the common final pathway for headache as altitude increases. Susceptibility to high-altitude headache depends on genetic factors, history of migraine, and acclimatization, but symptoms of acute mountain sickness are universal at very high altitudes. This review summarizes the pathophysiology of acute mountain sickness and high-altitude headache as well as the evidence for treatment and prevention with different drugs and devices which may be useful for regular and novice mountaineers. This includes an examination of other headache disorders which may mimic high-altitude headache. PMID:25795155

  5. High-Temperature Superconductivity

    NASA Astrophysics Data System (ADS)

    Tanaka, Shoji

    2006-12-01

    A general review on high-temperature superconductivity was made. After prehistoric view and the process of discovery were stated, the special features of high-temperature superconductors were explained from the materials side and the physical properties side. The present status on applications of high-temperature superconductors were explained on superconducting tapes, electric power cables, magnets for maglev trains, electric motors, superconducting quantum interference device (SQUID) and single flux quantum (SFQ) devices and circuits.

  6. High redshift GRBs

    NASA Astrophysics Data System (ADS)

    Gehrels, Neil; Cannizzo, John K.

    2012-09-01

    The Swift mission has opened a new, high redshift window on the universe. In this review we provide an overview of gamma-ray burst (GRB) science, describe the Swift mission, discuss high-z GRBs and tools for high-z studies, and look forward at future capabilities. A new mission concept - Lobster - is described that would monitor the X-ray sky at order of magnitude higher sensitivity than current missions.

  7. High Redshift GRBs

    NASA Technical Reports Server (NTRS)

    Gehrels, Neil; Cannizzo, John K.

    2012-01-01

    The Swift mission has opened a new, high redshift window on the universe. In this review we provide an overview of gamma-ray burst (GRB) science, describe the Swift mission, discuss high-z GRBs and tools for high-z studies, and look forward at future capabilities. A new mission concept - Lobster - is described that would monitor the X-ray sky at order of magnitude higher sensitivity than current missions.

  8. High temperature furnace

    DOEpatents

    Borkowski, Casimer J.

    1976-08-03

    A high temperature furnace for use above 2000.degree.C is provided that features fast initial heating and low power consumption at the operating temperature. The cathode is initially heated by joule heating followed by electron emission heating at the operating temperature. The cathode is designed for routine large temperature excursions without being subjected to high thermal stresses. A further characteristic of the device is the elimination of any ceramic components from the high temperature zone of the furnace.

  9. High temperature refrigerator

    DOEpatents

    Steyert, Jr., William A.

    1978-01-01

    A high temperature magnetic refrigerator which uses a Stirling-like cycle in which rotating magnetic working material is heated in zero field and adiabatically magnetized, cooled in high field, then adiabatically demagnetized. During this cycle said working material is in heat exchange with a pumped fluid which absorbs heat from a low temperature heat source and deposits heat in a high temperature reservoir. The magnetic refrigeration cycle operates at an efficiency 70% of Carnot.

  10. High Reynolds Number Research

    NASA Technical Reports Server (NTRS)

    Baals, D. D. (Editor)

    1977-01-01

    Fundamental aerodynamic questions for which high Reynolds number experimental capability is required are discussed. The operational characteristics and design features of the National Transonic Facility are reviewed.

  11. High altitude decelerator systems

    NASA Technical Reports Server (NTRS)

    Silbert, Mendel N.; Moltedo, A. David; Gilbertson, Gaylord S.

    1989-01-01

    High Altitude Decelerator Systems are used to provide a stable descending platform when deployed from a sounding rocket at altitudes greater than 40 kilometers allowing a scientific mission to be conducted in a specific altitude region. The High Altitude Decelerator is designed to provide a highly stable, high drag area system packed in a minimum volume to deploy successfully from a sounding rocket. Deployment altitudes greater than 100 kilometers have been successfully demonstrated at dynamic pressures as low as 0.004 pounds per square foot.

  12. High power, high frequency helix TWT's

    NASA Astrophysics Data System (ADS)

    Sloley, H. J.; Willard, J.; Paatz, S. R.; Keat, M. J.

    The design and performance characteristics of a 34-GHz pulse tube capable of 75 W peak power output at 30 percent duty cycle and a broadband CW tube are presented. Particular attention is given to the engineering problems encountered during the development of the tubes, including the suppression of backward wave oscillation, the design of electron guns for small-diameter high-current beams, and the thermal capability of small helix structures. The discussion also covers the effects of various design parameters and choice of engineering materials on the ultimate practical limit of power and gain at the operating frequencies. Measurements are presented for advanced experimental tubes.

  13. High power, high frequency, vacuum flange

    DOEpatents

    Felker, B.; McDaniel, M.R.

    1993-03-23

    An improved waveguide flange is disclosed for high power operation that helps prevent arcs from being initiated at the junctions between waveguide sections. The flanges at the end of the waveguide sections have counter bores surrounding the waveguide tubes. When the sections are bolted together the counter bores form a groove that holds a fully annealed copper gasket. Each counterbore has a beveled step that is specially configured to insure the gasket forms a metal-to-metal vacuum seal without gaps or sharp edges. The resultant inner surface of the waveguide is smooth across the junctions between waveguide sections, and arcing is prevented.

  14. High power, high frequency, vacuum flange

    DOEpatents

    Felker, Brian; McDaniel, Michael R.

    1993-01-01

    An improved waveguide flange is disclosed for high power operation that helps prevent arcs from being initiated at the junctions between waveguide sections. The flanges at the end of the waveguide sections have counterbores surrounding the waveguide tubes. When the sections are bolted together the counterbores form a groove that holds a fully annealed copper gasket. Each counterbore has a beveled step that is specially configured to insure the gasket forms a metal-to-metal vacuum seal without gaps or sharp edges. The resultant inner surface of the waveguide is smooth across the junctions between waveguide sections, and arcing is prevented.

  15. High performance, high density hydrocarbon fuels

    NASA Technical Reports Server (NTRS)

    Frankenfeld, J. W.; Hastings, T. W.; Lieberman, M.; Taylor, W. F.

    1978-01-01

    The fuels were selected from 77 original candidates on the basis of estimated merit index and cost effectiveness. The ten candidates consisted of 3 pure compounds, 4 chemical plant streams and 3 refinery streams. Critical physical and chemical properties of the candidate fuels were measured including heat of combustion, density, and viscosity as a function of temperature, freezing points, vapor pressure, boiling point, thermal stability. The best all around candidate was found to be a chemical plant olefin stream rich in dicyclopentadiene. This material has a high merit index and is available at low cost. Possible problem areas were identified as low temperature flow properties and thermal stability. An economic analysis was carried out to determine the production costs of top candidates. The chemical plant and refinery streams were all less than 44 cent/kg while the pure compounds were greater than 44 cent/kg. A literature survey was conducted on the state of the art of advanced hydrocarbon fuel technology as applied to high energy propellents. Several areas for additional research were identified.

  16. Highly Parallel, High-Precision Numerical Integration

    SciTech Connect

    Bailey, David H.; Borwein, Jonathan M.

    2005-04-22

    This paper describes a scheme for rapidly computing numerical values of definite integrals to very high accuracy, ranging from ordinary machine precision to hundreds or thousands of digits, even for functions with singularities or infinite derivatives at endpoints. Such a scheme is of interest not only in computational physics and computational chemistry, but also in experimental mathematics, where high-precision numerical values of definite integrals can be used to numerically discover new identities. This paper discusses techniques for a parallel implementation of this scheme, then presents performance results for 1-D and 2-D test suites. Results are also given for a certain problem from mathematical physics, which features a difficult singularity, confirming a conjecture to 20,000 digit accuracy. The performance rate for this latter calculation on 1024 CPUs is 690 Gflop/s. We believe that this and one other 20,000-digit integral evaluation that we report are the highest-precision non-trivial numerical integrations performed to date.

  17. The American High School

    ERIC Educational Resources Information Center

    Ediger, Marlow

    2008-01-01

    Of all levels of schooling, the high school receives by far the most criticism. There are continuous innovations recommended in journal articles, textbooks, and speeches at state/national conventions on ways to improve the secondary level of schooling. At one teacher education convention, the speaker was criticizing the American high school and…

  18. High-Stakes Testing.

    ERIC Educational Resources Information Center

    Nieto, Sonia; Irizarry, Jason G.; Luna, Cathy

    2002-01-01

    Discusses four books that provide critical information about the nature of high-stakes tests; the impact of these tests on teaching, learning, and students; the political issues surrounding high-stakes testing; and ways that educators can take informed action to appropriately respond to these tests. (SG)

  19. High School Gifted.

    ERIC Educational Resources Information Center

    Drum, Jean, Ed.

    1993-01-01

    This theme issue on gifted high school students presents several feature articles, a California legislative update, and an editorial. In "Summer Seminar '93--California in the 21st Century," Janis Van Dreal describes a 2-week residential program in which gifted high school students examined California's future. "Visiting a Gifted Program in…

  20. High School Oceanography.

    ERIC Educational Resources Information Center

    Falmouth Public Schools, MA.

    This book is a compilation of a series of papers designed to aid high school teachers in organizing a course in oceanography for high school students. It consists of twelve papers, with references, covering each of the following: (1) Introduction to Oceanography, (2) Geology of the Ocean, (3) The Continental Shelves, (4) Physical Properties of Sea…

  1. High Blood Pressure (Hypertension)

    MedlinePlus

    ... For Consumers Consumer Information by Audience For Women High Blood Pressure (Hypertension) Share Tweet Linkedin Pin it More sharing options ... En Español Who is at risk? How is high blood pressure treated? Understanding your blood pressure: What do the ...

  2. High-Conflict Divorce.

    ERIC Educational Resources Information Center

    Johnston, Janet R.

    1994-01-01

    Reviews available research studies of high-conflict divorce and its effects on children. Factors believed to contribute to high-conflict divorce are explored, and a model of their interrelationships is proposed. Dispute resolution, intervention, and prevention programs are discussed, and implications for social policy are outlined. (SLD)

  3. High Involvement Work Teams.

    ERIC Educational Resources Information Center

    1996

    These three papers were presented at a symposium on high-involvement work teams moderated by Michael Leimbach at the 1996 conference of the Academy of Human Resource Development. "Beyond Training to the New Learning Environment: Workers on the High-Involvement Frontline" (Joseph Anthony Ilacqua, Carol Ann Zulauf) shows the link between an…

  4. High School Chemistry.

    ERIC Educational Resources Information Center

    Journal of Chemical Education, 1983

    1983-01-01

    Preparation for college or life, working conditions and continuing education for high school chemistry teachers, and form/function of high school chemistry textbooks were addressed in presentations at the Seventh Biennial Conference on Chemical Education (Stillwater, Oklahoma 1982). Workshops, lectures, and demonstrations were also presented to…

  5. High Speed data acquisition

    SciTech Connect

    Cooper, P.S.

    1998-02-01

    A general introduction to high Speed data acquisition system techniques in modern particle physics experiments is given. Examples are drawn from the SELEX(E781) high statistics charmed baryon production and decay experiment now taking data at Fermilab. {copyright} {ital 1998 American Institute of Physics.}

  6. High temperature sensor

    DOEpatents

    Tokarz, Richard D.

    1982-01-01

    A high temperature sensor includes a pair of electrical conductors separated by a mass of electrical insulating material. The insulating material has a measurable resistivity within the sensor that changes in relation to the temperature of the insulating material within a high temperature range (1,000 to 2,000 K.). When required, the sensor can be encased within a ceramic protective coating.

  7. High coking value pitch

    DOEpatents

    Miller, Douglas J.; Chang, Ching-Feng; Lewis, Irwin C.; Lewis, Richard T.

    2014-06-10

    A high coking value pitch prepared from coal tar distillate and has a low softening point and a high carbon value while containing substantially no quinoline insolubles is disclosed. The pitch can be used as an impregnant or binder for producing carbon and graphite articles.

  8. High School Programming.

    ERIC Educational Resources Information Center

    Update on Gifted Education, 1992

    1992-01-01

    This theme issue covers "High School Programming" and approaches to meeting the needs of gifted high school students in Texas. The first article is "Thematic Interdisciplinary Curricula for Secondary Gifted Students in English and Social Studies" (Joel E. McIntosh and April W. Meacham). This approach is contrasted with the traditional curriculum…

  9. High energy forming facility

    NASA Technical Reports Server (NTRS)

    Ciurlionis, B.

    1967-01-01

    Watertight, high-explosive forming facility, 25 feet in diameter and 15 feet deep, withstands repeated explosions of 10 pounds of TNT equivalent. The shell is fabricated of high strength steel and allows various structural elements to deform or move elastically and independently while retaining structural integrity.

  10. High School: Erasing Borders

    ERIC Educational Resources Information Center

    Wright, Dianne; Bogotch, Ira

    2006-01-01

    Over the last several years there have been numerous calls for reforming high school to college transitions. In 2000-2001, the American Youth Policy Forum (AYPF) and the National Commission on the High School Senior Year respectively called for a re-thinking of how students moved from secondary to postsecondary education. A widely-discussed…

  11. Reforming Underperforming High Schools

    ERIC Educational Resources Information Center

    MDRC, 2013

    2013-01-01

    Urban high schools are in trouble--high dropout rates, low student academic achievement, and graduates who are unprepared for college are just some of the disappointing indicators. However, recent research points to a select number of approaches to improving student outcomes and reforming underperforming schools--from particular ways of creating…

  12. High and Dry

    ERIC Educational Resources Information Center

    Johnson, Robert L.

    2005-01-01

    High-performance schools are facilities that improve the learning environment while saving energy, resources and money. Creating a high-performance school requires an integrated design approach. Key systems--including lighting, HVAC, electrical and plumbing--must be considered from the beginning of the design process. According to William H.…

  13. Palonosetron for the prevention of chemotherapy-induced nausea and vomiting.

    PubMed

    Mori-Vogt, Sherry; Blazer, Marlo

    2013-08-01

    Chemotherapy-induced nausea and vomiting (CINV) remains both a feared side effect of cancer treatment and a focus of many supportive care initiatives/guidelines. The class of medications known as serotonin receptor antagonists (5-HT3RAs) are integral in the prevention of CINV from both moderately and highly emetogenic chemotherapy. Palonosetron (ALOXI(®)), a second-generation 5-HT3RA, has a higher affinity for the 5-HT3 receptor, has a longer half-life and has unique interactions with the 5-HT3 receptor compared with the current first-generation 5-HT3RA such as ondansetron, granisetron, dolasetron and tropisetron. This may allow palonosetron an advantage in control of CINV. This review article examines the available evidence, the pharmacokinetics and the safety and tolerability of palonosetron in the prevention of CINV. PMID:23984894

  14. Fosaprepitant dimeglumine for the management of chemotherapy-induced nausea and vomiting: patient selection and perspectives

    PubMed Central

    Candelario, Nellowe; Lu, Marvin Louis Roy

    2016-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is a debilitating side effect of antineoplastic agents. Several treatment regimens are used to address this problem. Fosaprepitant is a neurokinin-1 receptor blocker used in the prevention and treatment of CINV, especially for moderately and severely emetogenic chemotherapy. It is highly effective in the treatment of delayed CINV. Data from previous studies show that fosaprepitant is noninferior to aprepitant in the management of CINV. Fosaprepitant is given as a single-dose intravenous infusion, thus offering better patient compliance. The dose-limiting side effect of fosaprepitant is an infusion-related reaction, ranging from pain at the infusion site to thrombophlebitis. This side effect has been reported with coadministration of anthracycline agents. PMID:27382332

  15. High current high accuracy IGBT pulse generator

    SciTech Connect

    Nesterov, V.V.; Donaldson, A.R.

    1995-05-01

    A solid state pulse generator capable of delivering high current triangular or trapezoidal pulses into an inductive load has been developed at SLAC. Energy stored in a capacitor bank of the pulse generator is switched to the load through a pair of insulated gate bipolar transistors (IGBT). The circuit can then recover the remaining energy and transfer it back to the capacitor bank without reversing the capacitor voltage. A third IGBT device is employed to control the initial charge to the capacitor bank, a command charging technique, and to compensate for pulse to pulse power losses. The rack mounted pulse generator contains a 525 {mu}F capacitor bank. It can deliver 500 A at 900V into inductive loads up to 3 mH. The current amplitude and discharge time are controlled to 0.02% accuracy by a precision controller through the SLAC central computer system. This pulse generator drives a series pair of extraction dipoles.

  16. High redshift quasars and high metallicities

    NASA Technical Reports Server (NTRS)

    Ferland, Gary J.

    1997-01-01

    A large-scale code called Cloudy was designed to simulate non-equilibrium plasmas and predict their spectra. The goal was to apply it to studies of galactic and extragalactic emission line objects in order to reliably deduce abundances and luminosities. Quasars are of particular interest because they are the most luminous objects in the universe and the highest redshift objects that can be observed spectroscopically, and their emission lines can reveal the composition of the interstellar medium (ISM) of the universe when it was well under a billion years old. The lines are produced by warm (approximately 10(sup 4)K) gas with moderate to low density (n less than or equal to 10(sup 12) cm(sup -3)). Cloudy has been extended to include approximately 10(sup 4) resonance lines from the 495 possible stages of ionization of the lightest 30 elements, an extension that required several steps. The charge transfer database was expanded to complete the needed reactions between hydrogen and the first four ions and fit all reactions with a common approximation. Radiative recombination rate coefficients were derived for recombination from all closed shells, where this process should dominate. Analytical fits to Opacity Project (OP) and other recent photoionization cross sections were produced. Finally, rescaled OP oscillator strengths were used to compile a complete set of data for 5971 resonance lines. The major discovery has been that high redshift quasars have very high metallicities and there is strong evidence that the quasar phenomenon is associated with the birth of massive elliptical galaxies.

  17. High-pressure microfluidics

    NASA Astrophysics Data System (ADS)

    Hjort, K.

    2015-03-01

    When using appropriate materials and microfabrication techniques, with the small dimensions the mechanical stability of microstructured devices allows for processes at high pressures without loss in safety. The largest area of applications has been demonstrated in green chemistry and bioprocesses, where extraction, synthesis and analyses often excel at high densities and high temperatures. This is accessible through high pressures. Capillary chemistry has been used since long but, just like in low-pressure applications, there are several potential advantages in using microfluidic platforms, e.g., planar isothermal set-ups, large local variations in geometries, dense form factors, small dead volumes and precisely positioned microstructures for control of reactions, catalysis, mixing and separation. Other potential applications are in, e.g., microhydraulics, exploration, gas driven vehicles, and high-pressure science. From a review of the state-of-art and frontiers of high pressure microfluidics, the focus will be on different solutions demonstrated for microfluidic handling at high pressures and challenges that remain.

  18. Profile of netupitant/palonosetron (NEPA) fixed dose combination and its potential in the treatment of chemotherapy-induced nausea and vomiting (CINV).

    PubMed

    Navari, Rudolph M

    2015-01-01

    Chemotherapy-induced nausea and vomiting (CINV) is associated with a significant deterioration in quality of life. The emetogenicity of the chemotherapeutic agents, repeated chemotherapy cycles, and patient risk factors significantly influence CINV. The use of a combination of a 5-hydroxytryptamine-3 (5-HT3) receptor antagonists, dexamethasone, and a neurokinin-1 (NK-1) receptor antagonist has significantly improved the control of acute and delayed emesis in single-day chemotherapy. Palonosetron, a second generation 5-HT3 receptor antagonist with a different half-life, different binding capacity, and a different mechanism of action than the first generation 5-HT3 receptor antagonists, appears to be the most effective agent in its class. Netupitant, is a new NK-1 receptor antagonist with a high binding affinity, a long half-life of 90 hours, is metabolized by CYP3A4, and is an inhibitor of CYP3A4. NEPA is an oral fixed-dose combination of netupitant and palonosetron which has recently been employed in Phase II and Phase III clinical trials for the prevention of CINV in patients receiving moderately and highly emetogenic chemotherapy (MEC and HEC). The clinical trials demonstrated that NEPA (300 mg of netupitant plus 0.50 mg of palonosetron) significantly improved the prevention of CINV compared to the use of palonosetron alone in patients receiving either HEC or MEC. The clinical efficacy was maintained over multiple cycles of chemotherapy. NEPA (Akynzeo(®)) has recently been approved by the Food and Drug Administration (FDA) to treat nausea and vomiting in patients undergoing cancer chemotherapy. PMID:25552904

  19. High Power Hall Thrusters

    NASA Technical Reports Server (NTRS)

    Jankovsky, Robert; Tverdokhlebov, Sergery; Manzella, David

    1999-01-01

    The development of Hall thrusters with powers ranging from tens of kilowatts to in excess of one hundred kilowatts is considered based on renewed interest in high power. high thrust electric propulsion applications. An approach to develop such thrusters based on previous experience is discussed. It is shown that the previous experimental data taken with thrusters of 10 kW input power and less can be used. Potential mass savings due to the design of high power Hall thrusters are discussed. Both xenon and alternate thruster propellant are considered, as are technological issues that will challenge the design of high power Hall thrusters. Finally, the implications of such a development effort with regard to ground testing and spacecraft intecrati'on issues are discussed.

  20. High-mix insulins

    PubMed Central

    Kalra, Sanjay; Farooqi, Mohammad Hamed; El-Houni, Ali E.

    2015-01-01

    Premix insulins are commonly used insulin preparations, which are available in varying ratios of different molecules. These drugs contain one short- or rapid-acting, and one intermediate- or long-acting insulin. High-mix insulins are mixtures of insulins that contain 50% or more than 50% of short-acting insulin. This review describes the clinical pharmacology of high-mix insulins, including data from randomized controlled trials. It suggests various ways, in which high-mix insulin can be used, including once daily, twice daily, thrice daily, hetero-mix, and reverse regimes. The authors provide a rational framework to help diabetes care professionals, identify indications for pragmatic high-mix use. PMID:26425485

  1. Hypertension (High Blood Pressure)

    MedlinePlus

    ... pressure to live. Without it, blood can't flow through our bodies and carry oxygen to our vital organs. But when blood pressure gets too high — a condition called hypertension — it can lead to ...

  2. Diamond Ranch High School.

    ERIC Educational Resources Information Center

    Betsky, Aaron

    2000-01-01

    Highlights award-winning Diamond Ranch High School (California) that was designed and built on a steep site around Los Angeles considered unsatisfactory for building due to its unstable soils. Building organization is discussed, and photos are provided. (GR)

  3. High pressure furnace

    DOEpatents

    Morris, D.E.

    1993-09-14

    A high temperature high pressure furnace has a hybrid partially externally heated construction. A metallic vessel fabricated from an alloy having a composition of at least 45% nickel, 15% chrome, and 10% tungsten is utilized (the preferred alloy including 55% nickel, 22% chrome, 14% tungsten, 2% molybdenum, 3% iron (maximum) and 5% cobalt (maximum)). The disclosed alloy is fabricated into 11/4 or 2 inch, 32 mm or 50 mm bar stock and has a length of about 22 inches, 56 cm. This bar stock has an aperture formed therein to define a closed high temperature, high pressure oxygen chamber. The opposite and closed end of the vessel is provided with a small blind aperture into which a thermocouple can be inserted. The closed end of the vessel is inserted into an oven, preferably heated by standard nickel chrome electrical elements and having a heavily insulated exterior. 19 figures.

  4. High pressure furnace

    DOEpatents

    Morris, Donald E.

    1993-01-01

    A high temperature high pressure furnace has a hybrid partially externally heated construction. A metallic vessel fabricated from an alloy having a composition of at least 45% nickel, 15% chrome, and 10% tungsten is utilized (the preferred alloy including 55% nickel, 22% chrome, 14% tungsten, 2% molybdenum, 3% iron (maximum) and 5% cobalt (maximum). The disclosed alloy is fabricated into 11/4 or 2 inch, 32 mm or 50 mm bar stock and has a length of about 22 inches, 56 cm. This bar stock has an aperture formed therein to define a closed high temperature, high pressure oxygen chamber. The opposite and closed end of the vessel is provided with a small blind aperture into which a thermocouple can be inserted. The closed end of the vessel is inserted into an oven, preferably heated by standard nickel chrome electrical elements and having a heavily insulated exterior.

  5. High blood pressure medicines

    MedlinePlus

    Hypertension - medicines ... blood vessel diseases. You may need to take medicines to lower your blood pressure if lifestyle changes ... blood pressure to the target level. WHEN ARE MEDICINES FOR HIGH BLOOD PRESSURE USED Most of the ...

  6. High-Temperature Lubricants

    NASA Technical Reports Server (NTRS)

    1984-01-01

    In the early 1980's, Lewis Research Center began a program to develop high-temperature lubricants for use on future aircraft flying at three or more times the speed of sound, which can result in vehicle skin temperatures as high as 1,600 degrees Fahrenheit. A material that emerged from this research is a plasma-sprayed, self-lubricating metal- glass-fluoride coating able to reduce oxidation at very high temperatures. Technology is now in commercial use under the trade name Surf-Kote C-800, marketed by Hohman Plating and Manufacturing Inc. and manufactured under a patent license from NASA. Among its uses are lubrication for sliding contact bearings, shaft seals for turbopumps, piston rings for high performance compressors and hot glass processing machinery; it is also widely used in missile and space applications.

  7. High Redshift Quasars

    NASA Technical Reports Server (NTRS)

    Elvis, Martin S.

    1996-01-01

    The report for this period includes three papers: 'Associated Absorption at Low and High Redshift'; 'Strong X-ray Absorption in a Broad Absorption Line Quasar: PHL5200'; and 'ASCA and ROSAT X-ray Spectra of High-Redshift Radio-Loud Quasars'. The first gives examples from both low and high redshift for combining information on absorbing material in active galactic nuclei from both x-ray and the UV. The second presents ASCA observations of the z = 1.98 prototype broad absorption line quasar (BALQSO): PHL 5200, detected with both the solid-state imaging spectrometers and the gas imaging spectometers. The third paper presents results on the x-ray properties of 9 high-redshift radio-loud quasars observed by ASCA and ROSAT, including ASCA observations of S5 0014+81 (z = 3.38) and S5 0836+71 (z = 2.17) and ROSAT observations of PKS 2126-158.

  8. High-Temperature Superconductivity

    SciTech Connect

    Peter Johnson

    2008-11-05

    Like astronomers tweaking images to gain a more detailed glimpse of distant stars, physicists at Brookhaven National Laboratory have found ways to sharpen images of the energy spectra in high-temperature superconductors — materials that carry electrical c

  9. Highly Autonomous Systems Workshop

    NASA Technical Reports Server (NTRS)

    Doyle, R.; Rasmussen, R.; Man, G.; Patel, K.

    1998-01-01

    It is our aim by launching a series of workshops on the topic of highly autonomous systems to reach out to the larger community interested in technology development for remotely deployed systems, particularly those for exploration.

  10. High-Temperature Superconductivity

    ScienceCinema

    Peter Johnson

    2010-01-08

    Like astronomers tweaking images to gain a more detailed glimpse of distant stars, physicists at Brookhaven National Laboratory have found ways to sharpen images of the energy spectra in high-temperature superconductors ? materials that carry electrical c

  11. High School Parking Lots.

    ERIC Educational Resources Information Center

    Neff, Thomas G.

    2002-01-01

    Describes the reorganization of the site of Ben Davis High School in Wayne Township, Indiana as an example of improvements to school parking lot design and vehicle/pedestrian traffic flow and security. Includes design drawings. (EV)

  12. High blood cholesterol levels

    MedlinePlus

    ... gov/ency/article/000403.htm High blood cholesterol levels To use the sharing features on this page, ... called "bad" cholesterol For many people, abnormal cholesterol levels are partly due to an unhealthy lifestyle. This ...

  13. Hyperglycemia (High Blood Glucose)

    MedlinePlus Videos and Cool Tools

    ... and Learning About Prediabetes Type 2 Diabetes Risk Test Lower Your Risk Healthy Eating Overweight Smoking High ... prediabetes, and no one is excused. Take the test. Know where you stand. sticky en -- Chef Ronaldo's ...

  14. High pressure oxygen furnace

    DOEpatents

    Morris, Donald E.

    1992-01-01

    A high temperature high pressure oxygen furnace having a hybrid partially externally heated construction is disclosed. A metallic bar fabricated from an alloy having a composition of at least 45% nickel, 15% chrome, and 10% tungsten is utilized (the preferred alloy including 55% nickel, 22% chrome, 14% tungsten, 2% molybdenum, 3% iron (maximum) and 5% cobalt (maximum). The disclosed alloy is fabricated into 11/4 inch bar stock and has a length of about 17 inches. This bar stock is gun drilled for over 16 inches of its length with 0.400 inch aperture to define a closed high temperature, high pressure oxygen chamber. The opposite and closed end of the bar is provided with a small support aperture into which both a support and a thermocouple can be inserted. The closed end of the gun drilled bar is inserted into an oven, preferably heated by standard nickel chrome electrical elements and having a heavily insulated exterior.

  15. High pressure oxygen furnace

    DOEpatents

    Morris, D.E.

    1992-07-14

    A high temperature high pressure oxygen furnace having a hybrid partially externally heated construction is disclosed. A metallic bar fabricated from an alloy having a composition of at least 45% nickel, 15% chrome, and 10% tungsten is utilized, the preferred alloy including 55% nickel, 22% chrome, 14% tungsten, 2% molybdenum, 3% iron (maximum) and 5% cobalt (maximum). The disclosed alloy is fabricated into 11/4 inch bar stock and has a length of about 17 inches. This bar stock is gun drilled for over 16 inches of its length with 0.400 inch aperture to define a closed high temperature, high pressure oxygen chamber. The opposite and closed end of the bar is provided with a small support aperture into which both a support and a thermocouple can be inserted. The closed end of the gun drilled bar is inserted into an oven, preferably heated by standard nickel chrome electrical elements and having a heavily insulated exterior. 5 figs.

  16. High Velocity Gas Gun

    NASA Technical Reports Server (NTRS)

    1988-01-01

    A video tape related to orbital debris research is presented. The video tape covers the process of loading a High Velocity Gas Gun and firing it into a mounted metal plate. The process is then repeated in slow motion.

  17. High Speed Research Program

    NASA Technical Reports Server (NTRS)

    Anderson, Robert E.; Corsiglia, Victor R.; Schmitz, Frederic H. (Technical Monitor)

    1994-01-01

    An overview of the NASA High Speed Research Program will be presented from a NASA Headquarters perspective. The presentation will include the objectives of the program and an outline of major programmatic issues.

  18. High Blood Pressure

    MedlinePlus

    ... Division of Geriatrics and Clinical Gerontology Division of Neuroscience FAQs Funding Opportunities Intramural Research Program Office of ... to major health problems. Make a point of learning what blood pressure should be. And, remember: High ...

  19. High Efficiency, High Performance Clothes Dryer

    SciTech Connect

    Peter Pescatore; Phil Carbone

    2005-03-31

    This program covered the development of two separate products; an electric heat pump clothes dryer and a modulating gas dryer. These development efforts were independent of one another and are presented in this report in two separate volumes. Volume 1 details the Heat Pump Dryer Development while Volume 2 details the Modulating Gas Dryer Development. In both product development efforts, the intent was to develop high efficiency, high performance designs that would be attractive to US consumers. Working with Whirlpool Corporation as our commercial partner, TIAX applied this approach of satisfying consumer needs throughout the Product Development Process for both dryer designs. Heat pump clothes dryers have been in existence for years, especially in Europe, but have not been able to penetrate the market. This has been especially true in the US market where no volume production heat pump dryers are available. The issue has typically been around two key areas: cost and performance. Cost is a given in that a heat pump clothes dryer has numerous additional components associated with it. While heat pump dryers have been able to achieve significant energy savings compared to standard electric resistance dryers (over 50% in some cases), designs to date have been hampered by excessively long dry times, a major market driver in the US. The development work done on the heat pump dryer over the course of this program led to a demonstration dryer that delivered the following performance characteristics: (1) 40-50% energy savings on large loads with 35 F lower fabric temperatures and similar dry times; (2) 10-30 F reduction in fabric temperature for delicate loads with up to 50% energy savings and 30-40% time savings; (3) Improved fabric temperature uniformity; and (4) Robust performance across a range of vent restrictions. For the gas dryer development, the concept developed was one of modulating the gas flow to the dryer throughout the dry cycle. Through heat modulation in a

  20. Fulminant high altitude blindness.

    PubMed

    Mashkovskiy, Evgeny; Szawarski, Piotr; Ryzhkov, Pavel; Goslar, Tomaz; Mrak, Irena

    2016-06-01

    Prolonged altitude exposure even with acclimatization continues to present a physiological challenge to all organ systems including the central nervous system. We describe a case of a 41-year-old Caucasian female climber who suffered severe visual loss that was due to possible optic nerve pathology occurring during a high altitude expedition in the Himalayas. This case is atypical of classic high altitude cerebral oedema and highlights yet another danger of prolonged sojourn at extreme altitudes. PMID:27601532

  1. High-temperature electronics

    NASA Technical Reports Server (NTRS)

    Matus, Lawrence G.; Seng, Gary T.

    1990-01-01

    To meet the needs of the aerospace propulsion and space power communities, the high temperature electronics program at the Lewis Research Center is developing silicon carbide (SiC) as a high temperature semiconductor material. This program supports a major element of the Center's mission - to perform basic and developmental research aimed at improving aerospace propulsion systems. Research is focused on developing the crystal growth, characterization, and device fabrication technologies necessary to produce a family of SiC devices.

  2. HIGH TEMPERATURE THERMOCOUPLE

    DOEpatents

    Eshayu, A.M.

    1963-02-12

    This invention contemplates a high temperature thermocouple for use in an inert or a reducing atmosphere. The thermocouple limbs are made of rhenium and graphite and these limbs are connected at their hot ends in compressed removable contact. The rhenium and graphite are of high purity and are substantially stable and free from diffusion into each other even without shielding. Also, the graphite may be thick enough to support the thermocouple in a gas stream. (AEC)

  3. High-temperature sensor

    DOEpatents

    Not Available

    1981-01-29

    A high temperature sensor is described which includes a pair of electrical conductors separated by a mass of electrical insulating material. The insulating material has a measurable resistivity within the sensor that changes in relation to the temperature of the insulating material within a high temperature range (1000 to 2000/sup 0/K). When required, the sensor can be encased within a ceramic protective coating.

  4. High efficiency incandescent lighting

    SciTech Connect

    Bermel, Peter; Ilic, Ognjen; Chan, Walker R.; Musabeyoglu, Ahmet; Cukierman, Aviv Ruben; Harradon, Michael Robert; Celanovic, Ivan; Soljacic, Marin

    2014-09-02

    Incandescent lighting structure. The structure includes a thermal emitter that can, but does not have to, include a first photonic crystal on its surface to tailor thermal emission coupled to, in a high-view-factor geometry, a second photonic filter selected to reflect infrared radiation back to the emitter while passing visible light. This structure is highly efficient as compared to standard incandescent light bulbs.

  5. High conductivity composite metal

    DOEpatents

    Zhou, Ruoyi; Smith, James L.; Embury, John David

    1998-01-01

    Electrical conductors and methods of producing them, where the conductors possess both high strength and high conductivity. Conductors are comprised of carbon steel and a material chosen from a group consisting of copper, nickel, silver, and gold. Diffusion barriers are placed between these two materials. The components of a conductor are assembled and then the assembly is subjected to heat treating and mechanical deformation steps.

  6. High conductivity composite metal

    DOEpatents

    Zhou, R.; Smith, J.L.; Embury, J.D.

    1998-01-06

    Electrical conductors and methods of producing them are disclosed, where the conductors possess both high strength and high conductivity. Conductors are comprised of carbon steel and a material chosen from a group consisting of copper, nickel, silver, and gold. Diffusion barriers are placed between these two materials. The components of a conductor are assembled and then the assembly is subjected to heat treating and mechanical deformation steps. 10 figs.

  7. High pressure gas target

    NASA Astrophysics Data System (ADS)

    Gelbart, W.; Johnson, R. R.; Abeysekera, B.

    2012-12-01

    Compact, high pressure, high current gas target features all metal construction and semi-automatic window assembly change. The unique aspect of this target is the domed-shaped window. The Havar alloy window is electron beam welded to a metal ring, thus forming one, interchangeable assembly. The window assembly is sealed by knife-edges locked by a pneumatic toggle allowing a quick, in situ window change.

  8. High beta multipoles

    SciTech Connect

    Prager, S C

    1982-05-01

    Multipoles are being employed as devices to study fusion issues and plasma phenomena at high values of beta (plasma pressure/magnetic pressure) in a controlled manner. Due to their large volume, low magnetic field (low synchrotron radiation) region, they are also under consideration as potential steady state advanced fuel (low neutron yield) reactors. Present experiments are investigating neoclassical (bootstrap and Pfirsch-Schlueter) currents and plasma stability at extremely high beta.

  9. High temperature pressure gauge

    DOEpatents

    Echtler, J. Paul; Scandrol, Roy O.

    1981-01-01

    A high temperature pressure gauge comprising a pressure gauge positioned in fluid communication with one end of a conduit which has a diaphragm mounted in its other end. The conduit is filled with a low melting metal alloy above the diaphragm for a portion of its length with a high temperature fluid being positioned in the remaining length of the conduit and in the pressure gauge.

  10. High Performance Polymers

    NASA Technical Reports Server (NTRS)

    Venumbaka, Sreenivasulu R.; Cassidy, Patrick E.

    2003-01-01

    This report summarizes results from research on high performance polymers. The research areas proposed in this report include: 1) Effort to improve the synthesis and to understand and replicate the dielectric behavior of 6HC17-PEK; 2) Continue preparation and evaluation of flexible, low dielectric silicon- and fluorine- containing polymers with improved toughness; and 3) Synthesis and characterization of high performance polymers containing the spirodilactam moiety.

  11. High performance polymeric foams

    SciTech Connect

    Gargiulo, M.; Sorrentino, L.; Iannace, S.

    2008-08-28

    The aim of this work was to investigate the foamability of high-performance polymers (polyethersulfone, polyphenylsulfone, polyetherimide and polyethylenenaphtalate). Two different methods have been used to prepare the foam samples: high temperature expansion and two-stage batch process. The effects of processing parameters (saturation time and pressure, foaming temperature) on the densities and microcellular structures of these foams were analyzed by using scanning electron microscopy.

  12. High-temperature electronics

    NASA Astrophysics Data System (ADS)

    Matus, Lawrence G.; Seng, Gary T.

    1990-02-01

    To meet the needs of the aerospace propulsion and space power communities, the high temperature electronics program at the Lewis Research Center is developing silicon carbide (SiC) as a high temperature semiconductor material. This program supports a major element of the Center's mission - to perform basic and developmental research aimed at improving aerospace propulsion systems. Research is focused on developing the crystal growth, characterization, and device fabrication technologies necessary to produce a family of SiC devices.

  13. High power density targets

    NASA Astrophysics Data System (ADS)

    Pellemoine, Frederique

    2013-12-01

    In the context of new generation rare isotope beam facilities based on high-power heavy-ion accelerators and in-flight separation of the reaction products, the design of the rare isotope production targets is a major challenge. In order to provide high-purity beams for science, high resolution is required in the rare isotope separation. This demands a small beam spot on the production target which, together with the short range of heavy ions in matter, leads to very high power densities inside the target material. This paper gives an overview of the challenges associated with this high power density, discusses radiation damage issues in targets exposed to heavy ion beams, and presents recent developments to meet some of these challenges through different projects: FAIR, RIBF and FRIB which is the most challenging. Extensive use of Finite Element Analysis (FEA) has been made at all facilities to specify critical target parameters and R&D work at FRIB successfully retired two major risks related to high-power density and heavy-ion induced radiation damage.

  14. High Energy Continuum of High Redshift Quasars

    NASA Technical Reports Server (NTRS)

    Elvis, Martin

    2000-01-01

    Discussion with the RXTE team at GSFC showed that a sufficiently accurate background subtraction procedure had now, been derived for sources at the flux level of PKS 2126-158. However this solution does not apply to observations carried out before April 1997, including our observation. The prospect of an improved solution becoming available soon is slim. As a result the RXTE team agreed to re-observe PKS2126-158. The new observation was carried out in April 1999. Quasi-simultaneous optical observations were obtained, as Service observing., at the 4-meter Anglo-Australian Telescope, and ftp-ed from the AAT on 22April. The RXTE data was processed in late June, arriving at SAO in early July. Coincidentally, our collaborative Beppo-SAX observation of PKS2126-158 was made later in 1999, and a GTO Chandra observation (with which we are involved) was made on November 16. Since this gives us a unique monitoring data for a high redshift quasar over a broad pass-band we are now combining all three observations into a single comprehensive study Final publication of the RXTE data will thus take place under another grant.

  15. High Performance Arcjet Engines

    NASA Technical Reports Server (NTRS)

    Kennel, Elliot B.; Ivanov, Alexey Nikolayevich; Nikolayev, Yuri Vyacheslavovich

    1994-01-01

    This effort sought to exploit advanced single crystal tungsten-tantalum alloy material for fabrication of a high strength, high temperature arcjet anode. The use of this material is expected to result in improved strength, temperature resistance, and lifetime compared to state of the art polycrystalline alloys. In addition, the use of high electrical and thermal conductivity carbon-carbon composites was considered, and is believed to be a feasible approach. Highly conductive carbon-carbon composite anode capability represents enabling technology for rotating-arc designs derived from the Russian Scientific Research Institute of Thermal Processes (NIITP) because of high heat fluxes at the anode surface. However, for US designs the anode heat flux is much smaller, and thus the benefits are not as great as in the case of NIITP-derived designs. Still, it does appear that the tensile properties of carbon-carbon can be even better than those of single crystal tungsten alloys, especially when nearly-single-crystal fibers such as vapor grown carbon fiber (VGCF) are used. Composites fabricated from such materials must be coated with a refractory carbide coating in order to ensure compatibility with high temperature hydrogen. Fabrication of tungsten alloy single crystals in the sizes required for fabrication of an arcjet anode has been shown to be feasible. Test data indicate that the material can be expected to be at least the equal of W-Re-HfC polycrystalline alloy in terms of its tensile properties, and possibly superior. We are also informed by our colleagues at Scientific Production Association Luch (NP0 Luch) that it is possible to use Russian technology to fabricate polycrystalline W-Re-HfC or other high strength alloys if desired. This is important because existing engines must rely on previously accumulated stocks of these materials, and a fabrication capability for future requirements is not assured.

  16. High Beta Tokamaks

    SciTech Connect

    Cowley, S.

    1998-11-14

    Perhaps the ideal tokamak would have high {beta} ({beta} {approx}> 1) and classical confinement. Such a tokamak has not been found, and we do not know if one does exist. We have searched for such a possibility, so far without success. In 1990, we obtained analytic equilibrium solutions for large aspect ratio tokamaks at {beta} {approx} {Omicron}(1) [1]. These solutions and the extension at high {beta} poloidal to finite aspect ratio [2] provided a basis for the study of high {beta} tokamaks. We have shown that these configurations can be stable to short scale MHD modes [3], and that they have reduced neoclassical transport [4]. Microinstabilities (such as the {del}T{sub i} mode) seem to be stabilized at high {beta} [5] - this is due to the large local shear [3] and the magnetic well. We have some concerns about modes associated with the compressional branch which may appear at high {beta}. Bill Dorland and Mike Kotschenreuther have studied this issue and our concerns may be unfounded. It is certainly tantalizing, especially given the lowered neoclassical transport values, that these configurations could have no microinstabilities and, one could assume, no anomalous transport. Unfortunately, while this work is encouraging, the key question for high {beta} tokamaks is the stability to large scale kink modes. The MHD {beta} limit (Troyon limit) for kink modes at large aspect ratio is problematically low. There is ample evidence from computations that the limit exists. However, it is not known if stable equilibria exist at much higher {beta}--none have been found. We have explored this question in the asymptotic high {beta} poloidal limit. Unfortunately, we are unable to find stable equilibrium and also unable to show that they don't exist. The results of these calculations will be published when a more definitive answer is found.

  17. High Temperature Capacitor Development

    SciTech Connect

    John Kosek

    2009-06-30

    The absence of high-temperature electronics is an obstacle to the development of untapped energy resources (deep oil, gas and geothermal). US natural gas consumption is projected to grow from 22 trillion cubic feet per year (tcf) in 1999 to 34 tcf in 2020. Cumulatively this is 607 tcf of consumption by 2020, while recoverable reserves using current technology are 177 tcf. A significant portion of this shortfall may be met by tapping deep gas reservoirs. Tapping these reservoirs represents a significant technical challenge. At these depths, temperatures and pressures are very high and may require penetrating very hard rock. Logistics of supporting 6.1 km (20,000 ft) drill strings and the drilling processes are complex and expensive. At these depths up to 50% of the total drilling cost may be in the last 10% of the well depth. Thus, as wells go deeper it is increasingly important that drillers are able to monitor conditions down-hole such as temperature, pressure, heading, etc. Commercial off-the-shelf electronics are not specified to meet these operating conditions. This is due to problems associated with all aspects of the electronics including the resistors and capacitors. With respect to capacitors, increasing temperature often significantly changes capacitance because of the strong temperature dependence of the dielectric constant. Higher temperatures also affect the equivalent series resistance (ESR). High-temperature capacitors usually have low capacitance values because of these dielectric effects and because packages are kept small to prevent mechanical breakage caused by thermal stresses. Electrolytic capacitors do not operate at temperatures above 150oC due to dielectric breakdown. The development of high-temperature capacitors to be used in a high-pressure high-temperature (HPHT) drilling environment was investigated. These capacitors were based on a previously developed high-voltage hybridized capacitor developed at Giner, Inc. in conjunction with a

  18. High Altitude Medical Problems

    PubMed Central

    Hultgren, Herbert N.

    1979-01-01

    Increased travel to high altitude areas by mountaineers and nonclimbing tourists has emphasized the clinical problems associated with rapid ascent. Acute mountain sickness affects most sojourners at elevations above 10,000 feet. Symptoms are usually worse on the second or third day after arrival. Gradual ascent, spending one to three days at an intermediate altitude, and the use of acetazolamide (Diamox) will prevent or ameliorate symptoms in most instances. Serious and potentially fatal problems, such as high altitude pulmonary edema or cerebral edema, occur in approximately 0.5 percent to 1.0 percent of visitors to elevations above 10,000 feet—especially with heavy physical exertion on arrival, such as climbing or skiing. Early recognition, high flow oxygen therapy and prompt descent are crucially important in management. Our knowledge of the causes of these and other high altitude problems, such as retinal hemorrhage, systemic edema and pulmonary hypertension, is still incomplete. Even less is known of the effect of high altitudes on medical conditions common at sea level or on the action of commonly used drugs. ImagesFigure 2. PMID:483805

  19. Palonosetron: in the prevention of nausea and vomiting.

    PubMed

    Yang, Lily P H; Scott, Lesley J

    2009-11-12

    Palonosetron is a second-generation serotonin 5-HT3 receptor antagonist, with a distinct pharmacological profile that differs from first-generation 5-HT3 receptor antagonists. Intravenous palonosetron is widely indicated for the prevention of chemotherapy-induced nausea and vomiting (CINV) in the acute and delayed phases following moderately emetogenic chemotherapy (MEC) and the prevention of CINV in the acute phase following highly emetogenic chemotherapy (HEC). In the US, oral palonosetron is approved for the prevention of CINV in the acute phase following MEC (although this formulation is not currently available), and intravenous palonosetron is indicated for the prevention of postoperative nausea and vomiting (PONV) in the first 24 hours following surgery. All indications are currently limited to adult patients. Intravenous palonosetron was noninferior to intravenous ondansetron (with statistically greater efficacy than ondansetron) or dolasetron in preventing CINV following MEC, or to intravenous ondansetron or granisetron in preventing CINV following HEC, in the acute phase. Statistically greater efficacy was seen with intravenous palonosetron than ondansetron or dolasetron in preventing CINV following MEC in the delayed phase. Oral palonosetron was noninferior to intravenous palonosetron in preventing CINV in the acute phase in patients receiving MEC. Intravenous palonosetron was superior to placebo in preventing PONV in the first 24 hours following surgery. Palonosetron was generally well tolerated in clinical trials. Intravenous palonosetron is a valuable option in the prevention of acute- and delayed-phase CINV in adult patients receiving MEC, and of acute-phase CINV in patients receiving HEC. Oral palonosetron is likely to be a useful addition to oral formulations of other 5-HT3 receptor antagonists in preventing CINV in patients receiving MEC. Intravenous palonosetron is a useful alternative to currently recommended agents in PONV prevention. PMID

  20. Chemotherapy-induced nausea and vomiting: incidence and characteristics of persistent symptoms and future directions NCCTG N08C3 (Alliance)

    PubMed Central

    Kottschade, Lisa; Novotny, Paul; Lyss, Alan; Mazurczak, Miroslaw; Loprinzi, Charles

    2016-01-01

    Background Despite newer agents, chemotherapy-induced nausea and vomiting (CINV) continues to remain a distressing side effect to a proportion of patients undergoing systemic anti-cancer therapy. Methods We recently performed an unplanned secondary analysis on a previously reported negative phase III trial (N08C3) looking at the efficacy of gabapentin/placebo in combination with dexamethasone and a 5HT3 receptor antagonist in the prevention of CINV for 413 patients undergoing regimens with highly emetogenic chemotherapy (HEC). In the current study, we attempted to better understand the higher than expected rate of overall patient satisfaction, despite a low complete response rate in both arms. Additionally, we looked at patient variables and their relationship to rates of CINV. Results Approximately one third of patients experienced more than mild nausea and reported scores on the Functional Living Index–Emesis that indicated interference with activities. Thirty-five percent reported nausea greater than 2.5 on a scale of 0 to 10 (0 being none), 19 % reported at least one emetic episode, and 49 % reported taking rescue medication. Nausea and vomiting on day 1, cisplatin therapy, and history of motion sickness significantly predicted delayed CINV. Age, combination chemotherapy (HEC with moderately emetogenic), and getting treatment for breast cancer predicted CINVon day 1. Discussion These data confirm previous reports that subgroups of patients may be more prone to acute and delayed CINV. Future CINV study design may benefit from a more individualized approach to CINV management, targeting those patients who are truly at risk for CINV despite continued drug development efforts. PMID:26768436

  1. HIGH POWER PULSED OSCILLATOR

    DOEpatents

    Singer, S.; Neher, L.K.

    1957-09-24

    A high powered, radio frequency pulse oscillator is described for generating trains of oscillations at the instant an input direct voltage is impressed, or immediately upon application of a light pulse. In one embodiment, the pulse oscillator comprises a photo-multiplier tube with the cathode connected to the first dynode by means of a resistor, and adjacent dynodes are connected to each other through adjustable resistors. The ohmage of the resistors progressively increases from a very low value for resistors adjacent the cathode to a high value adjacent the plate, the last dynode. Oscillation occurs with this circuit when a high negative voltage pulse is applied to the cathode and the photo cathode is bombarded. Another embodiment adds capacitors at the resistor connection points of the above circuit to increase the duration of the oscillator train.

  2. Bioremediation of high explosives

    SciTech Connect

    Kitts, C.L.; Alvarez, M.A.; Hanners, J.L.; Ogden, K.L.; Vanderberg-Twary, L.; Unkefer, P.J.

    1995-09-01

    Manufacture and use of high explosives has resulted in contamination of ground water and soils throughout the world. The use of biological methods for remediation of high explosives contamination has received considerable attention in recent years. Biodegradation is most easily studied using organisms in liquid cultures. Thus, the amount of explosive that can be degraded in liquid culture is quite small. However, these experiments are useful for gathering basic information about the biochemical pathways of biodegradation, identifying appropriate organisms and obtaining rates of degradation. The authors` laboratory has investigated all three major areas of explosives bioremediation: explosives in solution, explosives in soil, and the disposal of bulk explosives from demilitarization operations. They investigated the three explosives most commonly used in modern high explosive formulations: 2,4,6-trinitrotoluene (TNT), hexahydro 1,3,5-trinitro-1,3,5-triazine (RDX) and octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine (HMX).

  3. Highly Thermal Conductive Nanocomposites

    NASA Technical Reports Server (NTRS)

    Sun, Ya-Ping (Inventor); Connell, John W. (Inventor); Veca, Lucia Monica (Inventor)

    2015-01-01

    Disclosed are methods for forming carbon-based fillers as may be utilized in forming highly thermal conductive nanocomposite materials. Formation methods include treatment of an expanded graphite with an alcohol/water mixture followed by further exfoliation of the graphite to form extremely thin carbon nanosheets that are on the order of between about 2 and about 10 nanometers in thickness. Disclosed carbon nanosheets can be functionalized and/or can be incorporated in nanocomposites with extremely high thermal conductivities. Disclosed methods and materials can prove highly valuable in many technological applications including, for instance, in formation of heat management materials for protective clothing and as may be useful in space exploration or in others that require efficient yet light-weight and flexible thermal management solutions.

  4. High level nuclear waste

    SciTech Connect

    Crandall, J L

    1980-01-01

    The DOE Division of Waste Products through a lead office at Savannah River is developing a program to immobilize all US high-level nuclear waste for terminal disposal. DOE high-level wastes include those at the Hanford Plant, the Idaho Chemical Processing Plant, and the Savannah River Plant. Commercial high-level wastes, for which DOE is also developing immobilization technology, include those at the Nuclear Fuel Services Plant and any future commercial fuels reprocessing plants. The first immobilization plant is to be the Defense Waste Processing Facility at Savannah River, scheduled for 1983 project submission to Congress and 1989 operation. Waste forms are still being selected for this plant. Borosilicate glass is currently the reference form, but alternate candidates include concretes, calcines, other glasses, ceramics, and matrix forms.

  5. High brightness electron accelerator

    DOEpatents

    Sheffield, Richard L.; Carlsten, Bruce E.; Young, Lloyd M.

    1994-01-01

    A compact high brightness linear accelerator is provided for use, e.g., in a free electron laser. The accelerator has a first plurality of acclerating cavities having end walls with four coupling slots for accelerating electrons to high velocities in the absence of quadrupole fields. A second plurality of cavities receives the high velocity electrons for further acceleration, where each of the second cavities has end walls with two coupling slots for acceleration in the absence of dipole fields. The accelerator also includes a first cavity with an extended length to provide for phase matching the electron beam along the accelerating cavities. A solenoid is provided about the photocathode that emits the electons, where the solenoid is configured to provide a substantially uniform magnetic field over the photocathode surface to minimize emittance of the electons as the electrons enter the first cavity.

  6. High voltage power supply

    NASA Technical Reports Server (NTRS)

    Ruitberg, A. P.; Young, K. M. (Inventor)

    1985-01-01

    A high voltage power supply is formed by three discrete circuits energized by a battery to provide a plurality of concurrent output signals floating at a high output voltage on the order of several tens of kilovolts. In the first two circuits, the regulator stages are pulse width modulated and include adjustable ressistances for varying the duty cycles of pulse trains provided to corresponding oscillator stages while the third regulator stage includes an adjustable resistance for varying the amplitude of a steady signal provided to a third oscillator stage. In the first circuit, the oscillator, formed by a constant current drive network and a tuned resonant network included a step up transformer, is coupled to a second step up transformer which, in turn, supplies an amplified sinusoidal signal to a parallel pair of complementary poled rectifying, voltage multiplier stages to generate the high output voltage.

  7. High resolution data acquisition

    DOEpatents

    Thornton, Glenn W.; Fuller, Kenneth R.

    1993-01-01

    A high resolution event interval timing system measures short time intervals such as occur in high energy physics or laser ranging. Timing is provided from a clock (38) pulse train (37) and analog circuitry (44) for generating a triangular wave (46) synchronously with the pulse train (37). The triangular wave (46) has an amplitude and slope functionally related to the time elapsed during each clock pulse in the train. A converter (18, 32) forms a first digital value of the amplitude and slope of the triangle wave at the start of the event interval and a second digital value of the amplitude and slope of the triangle wave at the end of the event interval. A counter (26) counts the clock pulse train (37) during the interval to form a gross event interval time. A computer (52) then combines the gross event interval time and the first and second digital values to output a high resolution value for the event interval.

  8. High resolution data acquisition

    DOEpatents

    Thornton, G.W.; Fuller, K.R.

    1993-04-06

    A high resolution event interval timing system measures short time intervals such as occur in high energy physics or laser ranging. Timing is provided from a clock, pulse train, and analog circuitry for generating a triangular wave synchronously with the pulse train (as seen in diagram on patent). The triangular wave has an amplitude and slope functionally related to the time elapsed during each clock pulse in the train. A converter forms a first digital value of the amplitude and slope of the triangle wave at the start of the event interval and a second digital value of the amplitude and slope of the triangle wave at the end of the event interval. A counter counts the clock pulse train during the interval to form a gross event interval time. A computer then combines the gross event interval time and the first and second digital values to output a high resolution value for the event interval.

  9. High temperature electronics technology

    NASA Astrophysics Data System (ADS)

    Dening, J. C.; Hurtle, D. E.

    1984-03-01

    This report summarizes the barrier metallization developments accomplished in a program intended to develop 300 C electronic controls capability for potential on-engine aircraft engine application. In addition, this report documents preliminary life test results at 300 C and above and discusses improved design practices required for high temperature integrated injection logic semiconductors. Previous Phase 1 activities focused on determining the viability of operating silicon semiconductor devices over the -55 C to +300 C temperature range. This feasibility was substantiated but the need for additional design work and process development was indicated. Phase 2 emphasized the development of a high temperature metallization system as the primary development need for high temperature silicon semiconductor applications.

  10. High temperature interface superconductivity

    NASA Astrophysics Data System (ADS)

    Gozar, A.; Bozovic, I.

    2016-02-01

    High-Tc superconductivity at interfaces has a history of more than a couple of decades. In this review we focus our attention on copper-oxide based heterostructures and multi-layers. We first discuss the technique, atomic layer-by-layer molecular beam epitaxy (ALL-MBE) engineering, that enabled High-Tc Interface Superconductivity (HT-IS), and the challenges associated with the realization of high quality interfaces. Then we turn our attention to the experiments which shed light on the structure and properties of interfacial layers, allowing comparison to those of single-phase films and bulk crystals. Both 'passive' hetero-structures as well as surface-induced effects by external gating are discussed. We conclude by comparing HT-IS in cuprates and in other classes of materials, especially Fe-based superconductors, and by examining the grand challenges currently laying ahead for the field.

  11. High Performance, Dependable Multiprocessor

    NASA Technical Reports Server (NTRS)

    Ramos, Jeremy; Samson, John R.; Troxel, Ian; Subramaniyan, Rajagopal; Jacobs, Adam; Greco, James; Cieslewski, Grzegorz; Curreri, John; Fischer, Michael; Grobelny, Eric; George, Alan; Aggarwal, Vikas; Patel, Minesh; Some, Raphael

    2006-01-01

    With the ever increasing demand for higher bandwidth and processing capacity of today's space exploration, space science, and defense missions, the ability to efficiently apply commercial-off-the-shelf (COTS) processors for on-board computing is now a critical need. In response to this need, NASA's New Millennium Program office has commissioned the development of Dependable Multiprocessor (DM) technology for use in payload and robotic missions. The Dependable Multiprocessor technology is a COTS-based, power efficient, high performance, highly dependable, fault tolerant cluster computer. To date, Honeywell has successfully demonstrated a TRL4 prototype of the Dependable Multiprocessor [I], and is now working on the development of a TRLS prototype. For the present effort Honeywell has teamed up with the University of Florida's High-performance Computing and Simulation (HCS) Lab, and together the team has demonstrated major elements of the Dependable Multiprocessor TRLS system.

  12. High-conflict divorce.

    PubMed

    Johnston, J R

    1994-01-01

    This article reviews available research studies of high-conflict divorce and its effects on children. Interparental conflict after divorce (defined as verbal and physical aggression, overt hostility, and distrust) and the primary parent's emotional distress are jointly predictive of more problematic parent-child relationships and greater child emotional and behavioral maladjustment. As a group, children of high-conflict divorce as defined above, especially boys, are two to four times more likely to be clinically disturbed in emotions and behavior compared with national norms. Court-ordered joint physical custody and frequent visitation arrangements in high-conflict divorce tend to be associated with poorer child outcomes, especially for girls. Types of intervention programs and social policy appropriate for these kinds of families are presented. PMID:7922278

  13. High temperature interface superconductivity

    DOE PAGESBeta

    Gozar, A.; Bozovic, I.

    2016-01-20

    High-Tc superconductivity at interfaces has a history of more than a couple of decades. In this review we focus our attention on copper-oxide based heterostructures and multi-layers. We first discuss the technique, atomic layer-by-layer molecular beam epitaxy (ALL-MBE) engineering, that enabled High-Tc Interface Superconductivity (HT-IS), and the challenges associated with the realization of high quality interfaces. Then we turn our attention to the experiments which shed light on the structure and properties of interfacial layers, allowing comparison to those of single-phase films and bulk crystals. Both ‘passive’ hetero-structures as well as surface-induced effects by external gating are discussed. Here, wemore » conclude by comparing HT-IS in cuprates and in other classes of materials, especially Fe-based superconductors, and by examining the grand challenges currently laying ahead for the field.« less

  14. High-energy detector

    DOEpatents

    Bolotnikov, Aleksey E.; Camarda, Giuseppe; Cui, Yonggang; James, Ralph B.

    2011-11-22

    The preferred embodiments are directed to a high-energy detector that is electrically shielded using an anode, a cathode, and a conducting shield to substantially reduce or eliminate electrically unshielded area. The anode and the cathode are disposed at opposite ends of the detector and the conducting shield substantially surrounds at least a portion of the longitudinal surface of the detector. The conducting shield extends longitudinally to the anode end of the detector and substantially surrounds at least a portion of the detector. Signals read from one or more of the anode, cathode, and conducting shield can be used to determine the number of electrons that are liberated as a result of high-energy particles impinge on the detector. A correction technique can be implemented to correct for liberated electron that become trapped to improve the energy resolution of the high-energy detectors disclosed herein.

  15. High School Principals and the High School Journalism Program.

    ERIC Educational Resources Information Center

    Peterson, Jane W.

    A study asked selected high school principals to respond to statements about the value of high school journalism to the high school student and about the rights and responsibilities of the high school journalist. These responses were then checked against such information as whether or not the high school principal had worked on a high school…

  16. High temperature electronics

    NASA Astrophysics Data System (ADS)

    Seng, Gary T.

    1991-03-01

    In recent years, the aerospace propulsion and space power communities have acknowledged a growing need for electronic devices that are capable of sustained high-temperature operation. Aeropropulsion applications for high-temperature electronic devices include engine ground test instrumentation such as multiplexers, analog-to-digital converters, and telemetry systems capable of withstanding hot section engine temperatures in excess of 600 C. Uncooled operation of control and condition monitoring systems in advanced supersonic aircraft would subject the electronics to temperatures in excess of 300 C. Similarly, engine-mounted integrated electronic sensors could reach temperatures which exceed 500 C. In addition to aeronautics, there are many other areas that could benefit from the existence of high-temperature electronic devices. Space applications include power electronic devices for space platforms and satellites. Since power electronics require radiators to shed waste heat, electronic devices that operate at higher temperatures would allow a reduction in radiator size. Terrestrial applications include deep-well drilling instrumentation, high power electronics, and nuclear reactor instrumentation and control. To meet the needs of the applications mentioned previously, the high-temperature electronics (HTE) program at the Lewis Research Center is developing silicon carbide (SiC) as a high-temperature semiconductor material. Research is focused on developing the crystal growth, growth modeling, characterization, and device fabrication technologies necessary to produce a family of SiC devices. Interest in SiC has grown dramatically in recent years due to solid advances in the technology. Much research remains to be performed, but SiC appears ready to emerge as a useful semiconductor material.

  17. High Performance FORTRAN

    NASA Technical Reports Server (NTRS)

    Mehrotra, Piyush

    1994-01-01

    High performance FORTRAN is a set of extensions for FORTRAN 90 designed to allow specification of data parallel algorithms. The programmer annotates the program with distribution directives to specify the desired layout of data. The underlying programming model provides a global name space and a single thread of control. Explicitly parallel constructs allow the expression of fairly controlled forms of parallelism in particular data parallelism. Thus the code is specified in a high level portable manner with no explicit tasking or communication statements. The goal is to allow architecture specific compilers to generate efficient code for a wide variety of architectures including SIMD, MIMD shared and distributed memory machines.

  18. High Brightness Test Stand

    SciTech Connect

    Birx, D.L.; Caporaso, G.J.; Boyd, J.K.; Hawkins, S.A.; Poor, S.E.; Reginato, L.L.; Rogers, D. Jr.; Smith, M.W.

    1985-08-07

    The High Brightness Test Stand is a 2 MeV, less than or equal to 10 kA electron accelerator module. This accelerator module, designed as an upgrade prototype for the Advanced Test Accelerator (ATA), combines solid state nonlinear magnetic drives with state-of-the-art induction linac technology. The facility serves a dual role, as it not only provides a test bed for this new technology, but is used to develop high brightness electron optics. We will both further describe the accelerator, as well as present some of the preliminary electron optics measurements.

  19. Highly compliant transparent electrodes

    NASA Astrophysics Data System (ADS)

    Shian, Samuel; Diebold, Roger M.; McNamara, Alena; Clarke, David R.

    2012-08-01

    Adaptive optical devices based on electric field induced deformation of dielectric elastomers require transparent and highly compliant electrodes to conform to large shape changes. Electrical, optical, and actuation properties of acrylic elastomer electrodes fabricated with single-walled carbon nanotubes (SWCNTs) and silver nanowires (AgNWs) have been evaluated. Based on these properties, a figure of merit is introduced for evaluating the overall performance of deformable transparent electrodes. This clearly indicates that SWCNTs outperform AgNWs. Under optimal conditions, optical transparency as high as 91% at 190% maximum actuation strain is readily achievable using SWCNT electrodes.

  20. High Availability Electronics Standards

    SciTech Connect

    Larsen, R.S.; /SLAC

    2006-12-13

    Availability modeling of the proposed International Linear Collider (ILC) predicts unacceptably low uptime with current electronics systems designs. High Availability (HA) analysis is being used as a guideline for all major machine systems including sources, utilities, cryogenics, magnets, power supplies, instrumentation and controls. R&D teams are seeking to achieve total machine high availability with nominal impact on system cost. The focus of this paper is the investigation of commercial standard HA architectures and packaging for Accelerator Controls and Instrumentation. Application of HA design principles to power systems and detector instrumentation are also discussed.

  1. High Energy Astrophysics Program

    NASA Technical Reports Server (NTRS)

    1996-01-01

    This report reviews activities performed by members of the USRA (Universities Space Research Association) contract team during the six months during the reporting period (10/95 - 3/96) and projected activities during the coming six months. Activities take place at the Goddard Space Flight Center, within the Laboratory for High Energy Astrophysics. Developments concern instrumentation, observation, data analysis, and theoretical work in Astrophysics. Missions supported include: Advanced Satellite for Cosmology and Astrophysics (ASCA), X-ray Timing Experiment (XTE), X-ray Spectrometer (XRS), Astro-E, High Energy Astrophysics Science, Archive Research Center (HEASARC), and others.

  2. High Energy Astrophysics Program

    NASA Technical Reports Server (NTRS)

    1996-01-01

    This report reviews activities performed-by members of the USRA contract team during the six months of the reporting period and projected activities during the coming six months. Activities take place at the Goddard Space Flight Center, visiting the Laboratory for High Energy Astrophysics. Developments concern instrumentation, observation, data analysis, and theoretical work in Astrophysics. Missions supported include: Advanced Satellite for Cosmology and Astrophysics (ASCA); X-ray Timing Experiment (XTE); X-ray Spectrometer (XRS); Astro-E; High Energy Astrophysics Science Archive Research Center (HEASARC), and others.

  3. High strength alloys

    SciTech Connect

    Maziasz, Phillip James; Shingledecker, John Paul; Santella, Michael Leonard; Schneibel, Joachim Hugo; Sikka, Vinod Kumar; Vinegar, Harold J.; John, Randy Carl; Kim, Dong Sub

    2012-06-05

    High strength metal alloys are described herein. At least one composition of a metal alloy includes chromium, nickel, copper, manganese, silicon, niobium, tungsten and iron. System, methods, and heaters that include the high strength metal alloys are described herein. At least one heater system may include a canister at least partially made from material containing at least one of the metal alloys. At least one system for heating a subterranean formation may include a tublar that is at least partially made from a material containing at least one of the metal alloys.

  4. High strength alloys

    SciTech Connect

    Maziasz, Phillip James; Shingledecker, John Paul; Santella, Michael Leonard; Schneibel, Joachim Hugo; Sikka, Vinod Kumar; Vinegar, Harold J; John, Randy Carl; Kim, Dong Sub

    2010-08-31

    High strength metal alloys are described herein. At least one composition of a metal alloy includes chromium, nickel, copper, manganese, silicon, niobium, tungsten and iron. System, methods, and heaters that include the high strength metal alloys are described herein. At least one heater system may include a canister at least partially made from material containing at least one of the metal alloys. At least one system for heating a subterranean formation may include a tubular that is at least partially made from a material containing at least one of the metal alloys.

  5. Delirium at high altitude.

    PubMed

    Basnyat, Buddha

    2002-01-01

    A 35-year-old man on a trek to the Mount Everest region of Nepal presented with a sudden, acute confusional state at an altitude of about 5000 m. Although described at higher altitudes, delirium presenting alone has not been documented at 5000 m or at lower high altitudes. The differential diagnosis which includes acute mountain sickness and high altitude cerebral edema is discussed. Finally, the importance of travelling with a reliable partner and using proper insurance is emphasized in treks to the Himalayas. PMID:12006167

  6. High intensity hadron accelerators

    SciTech Connect

    Teng, L.C.

    1989-05-01

    This rapporteur report consists mainly of two parts. Part I is an abridged review of the status of all High Intensity Hadron Accelerator projects in the world in semi-tabulated form for quick reference and comparison. Part II is a brief discussion of the salient features of the different technologies involved. The discussion is based mainly on my personal experiences and opinions, tempered, I hope, by the discussions I participated in in the various parallel sessions of the workshop. In addition, appended at the end is my evaluation and expression of the merits of high intensity hadron accelerators as research facilities for nuclear and particle physics.

  7. High Median Nerve Injuries.

    PubMed

    Isaacs, Jonathan; Ugwu-Oju, Obinna

    2016-08-01

    The median nerve serves a crucial role in extrinsic and intrinsic motor and sensory function to the radial half of the hand. High median nerve injuries, defined as injuries proximal to the anterior interosseous nerve origin, therefore typically result in significant functional loss prompting aggressive surgical management. Even with appropriate recognition and contemporary nerve reconstruction, however, motor and sensory recovery may be inadequate. With isolated persistent high median nerve palsies, a variety of available tendon transfers can improve key motor functions and salvage acceptable use of the hand. PMID:27387077

  8. Prevention of High Blood Pressure

    MedlinePlus

    ... page from the NHLBI on Twitter. Prevention of High Blood Pressure Healthy lifestyle habits, proper use of medicines, and ... prevent high blood pressure or its complications. Preventing High Blood Pressure Onset Healthy lifestyle habits can help prevent high ...

  9. High Blood Pressure in Pregnancy

    MedlinePlus

    ... The Health Information Center High Blood Pressure in Pregnancy What Is High Blood Pressure? Blood pressure is ... Are the Effects of High Blood Pressure in Pregnancy? Although many pregnant women with high blood pressure ...

  10. High speed door assembly

    DOEpatents

    Shapiro, Carolyn

    1993-01-01

    A high speed door assembly, comprising an actuator cylinder and piston rods, a pressure supply cylinder and fittings, an electrically detonated explosive bolt, a honeycomb structured door, a honeycomb structured decelerator, and a structural steel frame encasing the assembly to close over a 3 foot diameter opening within 50 milliseconds of actuation, to contain hazardous materials and vapors within a test fixture.