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Sample records for ii upper stage

  1. Current systems: Upper stages

    NASA Technical Reports Server (NTRS)

    Gunn, Charles R.

    1991-01-01

    The United States orbital transfer vehicles are presented: PAM-D (Payload Assist Module); PAM-D2; IUS (Inertial Upper Stage); and TOS (Transfer Orbit Stage). This presentation is represented by viewgraphs.

  2. Centaur upper stage

    NASA Astrophysics Data System (ADS)

    Groesbeck, W.

    An account is given of the design features of the LOX/LH2-fueled Centaur upper stage engine and fuel cryotankage, in order to serve as a basis for understanding the Main Engine Cut Off (MECO) system instituted. MECO follows the instant of spacecraft separation from the upper stage. The planetary launch program during 1966-1978 involved 23 Centaur launches and led to no upper stage reentry; LEO missions for HEAO and OAO satellite lofting in 1963-1979 involved nine Centaur launches and led to five reentries. GEO satellite launches in 1969-1986 saw 32 launches and three known reentries.

  3. Ares I Upper Stage Element

    NASA Technical Reports Server (NTRS)

    Chojnacki, Kent

    2009-01-01

    This slide presentation reviews the elements that make up the Ares I launch vehicle, with particular attention devoted to the upper stage of the vehicle. The upper stage elememnts, a lunar mission profile, and the upper stage objectives are reviewed. The work that Marshall Space Flight Center is doing is highlighted: work on the full scale welding process, the vertical milling machining, and the thermal protection system.

  4. Upper stage technology evaluation studies

    NASA Technical Reports Server (NTRS)

    1972-01-01

    Studies to evaluate advanced technology relative to chemical upper stages and orbit-to-orbit stages are reported. The work described includes: development of LH2/LOX stage data, development of data to indicate stage sensitivity to engine tolerance, modified thermal routines to accommodate storable propellants, added stage geometries to computer program for monopropellant configurations, determination of the relative gain obtainable through improvement of stage mass fraction, future propulsion concepts, effect of ultrahigh chamber-pressure increases, and relative gains obtainable through improved mass fraction.

  5. CRYOGENIC UPPER STAGE SYSTEM SAFETY

    NASA Technical Reports Server (NTRS)

    Smith, R. Kenneth; French, James V.; LaRue, Peter F.; Taylor, James L.; Pollard, Kathy (Technical Monitor)

    2005-01-01

    NASA s Exploration Initiative will require development of many new systems or systems of systems. One specific example is that safe, affordable, and reliable upper stage systems to place cargo and crew in stable low earth orbit are urgently required. In this paper, we examine the failure history of previous upper stages with liquid oxygen (LOX)/liquid hydrogen (LH2) propulsion systems. Launch data from 1964 until midyear 2005 are analyzed and presented. This data analysis covers upper stage systems from the Ariane, Centaur, H-IIA, Saturn, and Atlas in addition to other vehicles. Upper stage propulsion system elements have the highest impact on reliability. This paper discusses failure occurrence in all aspects of the operational phases (Le., initial burn, coast, restarts, and trends in failure rates over time). In an effort to understand the likelihood of future failures in flight, we present timelines of engine system failures relevant to initial flight histories. Some evidence suggests that propulsion system failures as a result of design problems occur shortly after initial development of the propulsion system; whereas failures because of manufacturing or assembly processing errors may occur during any phase of the system builds process, This paper also explores the detectability of historical failures. Observations from this review are used to ascertain the potential for increased upper stage reliability given investments in integrated system health management. Based on a clear understanding of the failure and success history of previous efforts by multiple space hardware development groups, the paper will investigate potential improvements that can be realized through application of system safety principles.

  6. Ares I Upper Stage Update

    NASA Technical Reports Server (NTRS)

    Davis, Daniel J.

    2010-01-01

    These presentation slides review the progress in the development of the Ares I upper stage. The development includes development of a manufacturing and processing assembly that will reduce the time required over 100 days, development of a weld tool that is a robotic tool that is the largest welder of its kind in the United States, development of avionics and software, and development of logisitics and operations systems.

  7. Upper-Stage Flight Experiment

    NASA Technical Reports Server (NTRS)

    Anderson, W. E.; Boxwell, R.; Crockett, D. V.; Ross, R.; Lewis, T.; McNeal, C.; Verdarame, K.

    1999-01-01

    For propulsion applications that require that the propellants are storable for long periods, have a high density impulse, and are environmentally clean and non-toxic, the best choice is a combination of high-concentration hydrogen peroxide (High Test Peroxide, or HTP) and a liquid hydrocarbon (LHC) fuel. The HTP/LHC combination is suitable for low-cost launch vehicles, space taxi and space maneuvering vehicles, and kick stages. Orbital Sciences Corporation is under contract with the NASA Marshall Space Flight Center in cooperation with the Air Force Research Lab to design, develop and demonstrate a new low-cost liquid upper stage based on HTP and JP-8. The Upper Stage Flight Experiment (USFE) focuses on key technologies necessary to demonstrate the operation of an inherently simple propulsion system with an innovative, state-of-the-art structure. Two key low-cost vehicle elements will be demonstrated - a 10,000 lbf thrust engine and an integrated composite tank structure. The suborbital flight test of the USFE is scheduled for 2001. Preceding the flight tests are two major series of ground tests at NASA Stennis Space Center and a subscale tank development program to identify compatible composite materials and to verify their compatibility over long periods of time. The ground tests include a thrust chamber development test series and an integrated stage test. This paper summarizes the results from the first phase of the thrust chamber development tests and the results to date from the tank material compatibility tests. Engine and tank configurations that meet the goals of the program are described.

  8. Impact of Postoperative Chemoradiotherapy versus Chemotherapy Alone on Recurrence and Survival in Patients with Stage II and III Upper Rectal Cancer: A Propensity Score-Matched Analysis

    PubMed Central

    Kim, Jae-Sung; Oh, Heung-Kwon; Kim, Duck-Woo; Lee, Keun-Wook; Kim, Jee Hyun; Eom, Keun-Yong; Kim, In Ah; Kang, Sung-Bum

    2015-01-01

    Purpose To compare the impact of postoperative chemoradiotherapy (CRT) versus adjuvant chemotherapy alone on recurrence and survival in patients with stage II and III upper rectal cancer undergoing curative resection. Materials and Methods From our institutional database, 190 patients who underwent primary curative resection between 2003 and 2010 for stage II or III upper rectal cancer were identified. None of the patients received preoperative CRT. Of these, 136 patients received postoperative chemotherapy alone (the CTx group) and 54 patients received postoperative CRT (the CRT group). The CRT group had poorer prognostic features (pT4, pN2, poor differentiation, or involved resection margin) compared with the CTx group. To reduce the impact of treatment selection bias on treatment outcomes, propensity score-matching analysis was used. Results The matched cohort consisted of 50 CRT and 50 CTx patients with a median follow-up period of 76 and 63 months, respectively. In the matched cohort, CRT resulted in an improved 5-year local control (98.0% vs. 85.2%, p = 0.024) and overall survival rate (89.9% vs. 69.8%, p = 0.021) compared with CTx. In the subgroup analysis to identify subpopulations of patients that benefit most from receiving CRT, local recurrence did not occur in patients who did not have poor prognostic features regardless of the receipt of CRT. For patients with any poor prognostic features, CRT resulted in an improved 5-year local control compared with CTx (96.4% vs. 70.7%, p = 0.013). Conclusions After adjusting for clinicopathologic factors by propensity score-matching, postoperative CRT was associated with improved local control and overall survival in stage II and III upper rectal cancer. Our results suggest that surgery followed by chemotherapy alone is acceptable for patients who did not have poor prognostic features, while additional radiotherapy should be given for patients who have any poor prognostic features. PMID:25902069

  9. [Arteriovenous malformation of the left upper limb in stage II of Schbinger: A case report in Madagascar].

    PubMed

    Raherinantenaina, F; Rajaonanahary, T M A; Randriamandrato, T A V; Rakotomena, S D; Rajaonarivony, T; Rakoto Ratsimba, H N

    2015-09-01

    Arteriovenous malformations are the most unpredictable and dangerous congenital malformations. They consist of multiple arteriovenous shunts with high flow and can progress to heart failure. They are rarely localized in the upper limb and pose therapeutic problems. We report a new case in a 27-year old woman, admitted for pulsatile pain in the left elbow. The diagnosis was made by clinical examination and ultrasonography. The surgical treatment without embolization and sclerotherapy, consisted of a large resection of the nidus without postoperative complication. PMID:24035259

  10. Orbital debris from upper-stage breakup

    NASA Technical Reports Server (NTRS)

    Loftus, Joseph P., Jr. (editor)

    1989-01-01

    The present conference on the effects of launch vehicle upper-stage breakup on the orbital debris scenario discusses an analysis of the SPOT 1 Ariane third stage, the explosive fragmentation of orbiting propellant tanks, albedo estimates for debris, Ariane-related debris in deep-space orbit, and the relationship of hypervelocity impacts to upper-stage breakups. Also discussed are the prospects for and the economics of the future removal of orbital debris, collision probabilities in GEO, current operational practices for Delta second stage breakup prevention, breakup-precluding modifications to the Ariane third stage, and the safing of the H-1 second stage after spacecraft separation.

  11. Upper stage alternatives for the shuttle era

    NASA Technical Reports Server (NTRS)

    1981-01-01

    The status and general characteristics of Space Shuttle upper stages now in use or in development, as well as new vehicle possibilities are examined. Upper stage requirements for both civil and Department of Defense missions, categorized generally into near-term (early and mid-1980's), mid-term (late 1980's to mid-1990's), and far-term (late 1990's and beyond) are discussed. Finally, the technical, schedule and cost impact of alternative ways in which these requirements could be met are examined, and a number of conclusions and recommendations are reached.

  12. Coasting Phase Propellant Management for Upper Stages

    NASA Astrophysics Data System (ADS)

    Philipp, Behruzi; Strauch, Hans; de Rose, Francesco

    The next generation of European cryogenic upper stages, namely the A5ME upper stage, is expected to perform multiple engine restarts in order to enhance the mission flexibility. The management of the propellant in the upper stage tanks under g conditions is thus a major issue with respect to the handling of these phases. A number of different tasks play a major role, e.g. the coupling of the rigid body motion and the sloshing in the tanks driven by the controller of the stage. Furthermore also thermal aspects are of importance which have to be considered. Coasting phases are not a new aspect with respect to mission scenarios of upper stages as they occur during every P/L release. Main difference in case of a restart mission is however that the tank fill level is much higher compared to past P/L separations with a nearly empty tank. The coupling between rigid body motion, controller and fluid motion is thus much stronger. Astrium therefore developed a software tool, called "FIPS", which is able evaluate the coupled closed loop rigid body motion including fluid dynamics and the control algorithm. The tool couples the high sophisticated CFD software FLOW-3D with an Astrium developed closed loop rigid body dynamics simulator. The presentation discusses details concerning the propellant behaviour in coasting phases. The impact of internal equipments such as sloshing baffles will be detailed. One conclusion of the assessment is that to a major part disturbing torques are non-negligible such that a realistic propellant behaviour can only be realized in a closed loop simulation. The impact of the upper stage controller can not be neglected.

  13. Ares I Crew Launch Vehicle Upper Stage/Upper Stage Engine Element Overview

    NASA Technical Reports Server (NTRS)

    McArthur, J. Craig

    2008-01-01

    The Ares I upper stage is an integral part of the Constellation Program transportation system. The upper stage provides guidance, navigation and control (GN and C) for the second stage of ascent flight for the Ares I vehicle. The Saturn-derived J-2X upper stage engine will provide thrust and propulsive impulse for the second stage of ascent flight for the Ares I launch vehicle. Additionally, the upper stage is responsible for the avionics system of the the entire Ares I. This brief presentation highlights the requirements, design, progress and production of the upper stage. Additionally, test facilities to support J-2X development are discussed and an overview of the operational and manufacturing flows are provided. Building on the heritage of the Apollo and Space Shuttle Programs, the Ares I Us and USE teams are utilizing extensive lessons learned to place NASA and the US into another era of space exploration. The NASA, Boeing and PWR teams are integrated and working together to make progress designing and building the Ares I upper stage to minimize cost, technical and schedule risks.

  14. Inertial Upper Stage (IUS) software analysis

    NASA Technical Reports Server (NTRS)

    Grayson, W. L.; Nickel, C. E.; Rose, P. L.; Singh, R. P.

    1979-01-01

    The Inertial Upper Stage (IUS) System, an extension of the Space Transportation System (STS) operating regime to include higher orbits, orbital plane changes, geosynchronous orbits, and interplanetary trajectories is presented. The IUS software design, the IUS software interfaces with other systems, and the cost effectiveness in software verification are described. Tasks of the IUS discussed include: (1) design analysis; (2) validation requirements analysis; (3) interface analysis; and (4) requirements analysis.

  15. Staging or upper stage reignition for GEO missions

    NASA Astrophysics Data System (ADS)

    Duret, Franois

    2002-07-01

    Geostationary orbit will remain in the near and far future one of the most frequently used for several applications including, mainly, telecommunications. For the time being the GEO satcoms are injected by intermediate, heavy or super heavy class launch vehicles, LV, using quasi standard procedures: low altitude injection on a geostationary transfer orbit, ballistic phase of at least five and a half hour, followed by an apogee manoeuvre (or boost) to reach GEO. Apogee boost is most of the time provided by the propulsive system of the satellite, if this one uses liquid propellant in an integrated system performing final injection and house-keeping for the whole life (up to 15 years) of the satellite. The current launch vehicle features generally a cryogenic (LOX/LH2) or semi-cryogenic (LOX/Kerosene) upper stage having a better Isp than the Isp of the satellite propulsive system: The possibility to provide the apogee boost by the LV upper stage seems attractive. Another possibility is to put on the top of the upper stage an other small stage, or module having the function of kick-stage, as it was done earlier when solid propellant stages were used for this apogee manoeuvre. This presentation will describe the pros and cons of this various choices for single but also dual launches in GTO/GEO, and also will address future new injection scheme, providing new transportation services to satellites featuring advanced propulsive systems such as electric, plasmic or thermo-solar thrusters, requiring other transfer orbits like MEO, GTO+ and super GTO+.

  16. Integrated Solar Upper Stage (ISUS) mission analysis

    NASA Astrophysics Data System (ADS)

    Frye, Patrick

    1997-01-01

    Solar thermal propulsion and propulsion/power systems were identified as key technologies by the Operational Effectiveness and Cost Comparison Study. These technologies were found to be pervasively cost effective with short transfer times and very good performance across a wide range of missions (Feuchter 1996). The on-going Integrated Solar Upper Stage (ISUS) Program sponsored by Phillips Laboratory represents development of one such solar thermal propulsion/power system. This paper presents conceptual designs, mission analysis results, and trade study results for a system evaluation of ISUS for future military payloads. These payloads primarily include high power communication satellites for geo-synchronous equatorial orbit (GEO) applications.

  17. Upper Stage Engine Composite Nozzle Extensions

    NASA Technical Reports Server (NTRS)

    Valentine, Peter G.; Allen, Lee R.; Gradl, Paul R.; Greene, Sandra E.; Sullivan, Brian J.; Weller, Leslie J.; Koenig, John R.; Cuneo, Jacques C.; Thompson, James; Brown, Aaron; Shigley, John K.; Dovey, Henry N.; Roberts, Robert K.

    2015-01-01

    Carbon-carbon (C-C) composite nozzle extensions are of interest for use on a variety of launch vehicle upper stage engines and in-space propulsion systems. The C-C nozzle extension technology and test capabilities being developed are intended to support National Aeronautics and Space Administration (NASA) and United States Air Force (USAF) requirements, as well as broader industry needs. Recent and on-going efforts at the Marshall Space Flight Center (MSFC) are aimed at both (a) further developing the technology and databases for nozzle extensions fabricated from specific CC materials, and (b) developing and demonstrating low-cost capabilities for testing composite nozzle extensions. At present, materials development work is concentrating on developing a database for lyocell-based C-C that can be used for upper stage engine nozzle extension design, modeling, and analysis efforts. Lyocell-based C-C behaves in a manner similar to rayon-based CC, but does not have the environmental issues associated with the use of rayon. Future work will also further investigate technology and database gaps and needs for more-established polyacrylonitrile- (PAN-) based C-C's. As a low-cost means of being able to rapidly test and screen nozzle extension materials and structures, MSFC has recently established and demonstrated a test rig at MSFC's Test Stand (TS) 115 for testing subscale nozzle extensions with 3.5-inch inside diameters at the attachment plane. Test durations of up to 120 seconds have been demonstrated using oxygen/hydrogen propellants. Other propellant combinations, including the use of hydrocarbon fuels, can be used if desired. Another test capability being developed will allow the testing of larger nozzle extensions (13.5- inch inside diameters at the attachment plane) in environments more similar to those of actual oxygen/hydrogen upper stage engines. Two C-C nozzle extensions (one lyocell-based, one PAN-based) have been fabricated for testing with the larger-scale facility.

  18. Space Launch System Upper Stage Technology Assessment

    NASA Technical Reports Server (NTRS)

    Holladay, Jon; Hampton, Bryan; Monk, Timothy

    2014-01-01

    The Space Launch System (SLS) is envisioned as a heavy-lift vehicle that will provide the foundation for future beyond low-Earth orbit (LEO) exploration missions. Previous studies have been performed to determine the optimal configuration for the SLS and the applicability of commercial off-the-shelf in-space stages for Earth departure. Currently NASA is analyzing the concept of a Dual Use Upper Stage (DUUS) that will provide LEO insertion and Earth departure burns. This paper will explore candidate in-space stages based on the DUUS design for a wide range of beyond LEO missions. Mission payloads will range from small robotic systems up to human systems with deep space habitats and landers. Mission destinations will include cislunar space, Mars, Jupiter, and Saturn. Given these wide-ranging mission objectives, a vehicle-sizing tool has been developed to determine the size of an Earth departure stage based on the mission objectives. The tool calculates masses for all the major subsystems of the vehicle including propellant loads, avionics, power, engines, main propulsion system components, tanks, pressurization system and gases, primary structural elements, and secondary structural elements. The tool uses an iterative sizing algorithm to determine the resulting mass of the stage. Any input into one of the subsystem sizing routines or the mission parameters can be treated as a parametric sweep or as a distribution for use in Monte Carlo analysis. Taking these factors together allows for multi-variable, coupled analysis runs. To increase confidence in the tool, the results have been verified against two point-of-departure designs of the DUUS. The tool has also been verified against Apollo moon mission elements and other manned space systems. This paper will focus on trading key propulsion technologies including chemical, Nuclear Thermal Propulsion (NTP), and Solar Electric Propulsion (SEP). All of the key performance inputs and relationships will be presented and discussed in light of the various missions. For each mission there are several trajectory options and each will be discussed in terms of delta-v required and transit duration. Each propulsion system will be modeled, sized, and judged based on their applicability to the whole range of beyond LEO missions. Criteria for scoring will include the resulting dry mass of the stage, resulting propellant required, time to destination, and an assessment of key enabling technologies. In addition to the larger metrics, this paper will present the results of several coupled sensitivity studies. The ultimate goals of these tools and studies are to provide NASA with the most mass-, technology-, and cost-effective in-space stage for its future exploration missions.

  19. Ares I Upper Stage Subscale Engine Test

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. The launch vehicle's first stage is a single, five-segment reusable solid rocket booster derived from the Space Shuttle Program's reusable solid rocket motor that burns a specially formulated and shaped solid propellant called polybutadiene acrylonitrile (PBAN). The second or upper stage will be propelled by a J-2X main engine fueled with liquid oxygen and liquid hydrogen. This HD video image depicts a test firing of a 40k subscale J2X injector at MSFC's test stand 115. (Highest resolution available)

  20. Commercial launch vehicles and upper stages

    NASA Technical Reports Server (NTRS)

    Mahon, J.; Wild, J.

    1984-01-01

    Since the beginning of the space age in October 1957, a family of expendable launch vehicles, capable of launching a wide range of payloads, was developed along with the Space Shuttle and a number of upper stages. A brief description is presented of selected orbits which have proved to be most useful for initial or conceptual understanding of space operations, taking into account direct injection and Hohman transfers, and synchronous and sun-synchronous orbits. Early American boosters are discussed along with current expendable launch vehicles, giving attention to the Vanguard, Redstone and Juno, Saturn 1B and Saturn V, Scout, the Atlas booster, Atlas Centaur, Delta, Titan IIIC, and Ariane. Details regarding the Space Shuttle are considered along with PAM-D, PAM-A, PAM-DII, TOS, IUS, Centaur-G, and Syncom-IV and Intelsat-VI.

  1. Integrated Solar Upper Stage Technical Support

    NASA Technical Reports Server (NTRS)

    Jaworske, Donald A.

    1998-01-01

    NASA Lewis Research Center is participating in the Integrated Solar Upper Stage (ISUS) program. This program is a ground-based demonstration of an upper stage concept that will be used to generate both solar propulsion and solar power. Solar energy collected by a primary concentrator is directed into the aperture of a secondary concentrator and further concentrated into the aperture of a heat receiver. The energy stored in the receiver-absorber-converter is used to heat hydrogen gas to provide propulsion during the orbital transfer portion of the mission. During the balance of the mission, electric power is generated by thermionic diodes. Several materials issues were addressed as part of the technical support portion of the ISUS program, including: 1) Evaluation of primary concentrator coupons; 2) Evaluation of secondary concentrator coupons; 3) Evaluation of receiver-absorber-converter coupons; 4) Evaluation of in-test witness coupons. Two different types of primary concentrator coupons were evaluated from two different contractors-replicated coupons made from graphite-epoxy composite and coupons made from microsheet glass. Specular reflectivity measurements identified the replicated graphite-epoxy composite coupons as the primary concentrator material of choice. Several different secondary concentrator materials were evaluated, including a variety of silver and rhodium reflectors. The specular reflectivity of these materials was evaluated under vacuum at temperatures up to 800 C. The optical properties of several coupons of rhenium on graphite were evaluated to predict the thermal performance of the receiver-absorber-converter. Finally, during the ground test demonstration, witness coupons placed in strategic locations throughout the thermal vacuum facility were evaluated for contaminants. All testing for the ISUS program was completed successfully in 1997. Investigations related to materials issues have proven helpful in understanding the operation of the test article, leading to a potential ISUS flight test in 2002.

  2. Technical and Operations Design of the SKYLON Upper Stage

    NASA Astrophysics Data System (ADS)

    Hempsell, Bond, M. A.

    The SKYLON spaceplane cannot reach beyond Low Earth Orbit and therefore payloads requiring higher orbits, such as geostationary transfer orbit, will require an upper stage. A concept design for a cryogenic upper stage called the SKYLON Upper Stage (SUS) is described together with its operations. It is shown that, through the use of resonant orbits, in many cases the stage can be recovered for reuse by the SKYLON that launched it.

  3. Ares I Crew Launch Vehicle Upper Stage Element Overview

    NASA Technical Reports Server (NTRS)

    McArthur, J. Craig

    2008-01-01

    This viewgraph presentation gives an overview of NASA's Ares I Crew Launch Vehicle Upper Stage Element. The topics include: 1) What is NASA s Mission?; 2) NASA s Exploration Roadmap What is our time line?; 3) Building on a Foundation of Proven Technologies Launch Vehicle Comparisons; 4) Ares I Upper Stage; 5) Upper Stage Primary Products; 6) Ares I Upper Stage Development Approach; 7) What progress have we made?; 8) Upper Stage Subsystem Highlights; 9) Structural Testing; 10) Common Bulkhead Processing; 11) Stage Installation at Stennis Space Center; 12) Boeing Producibility Team; 13) Upper Stage Low Cost Strategy; 14) Ares I and V Production at Michoud Assembly Facility (MAF); 15) Merged Manufacturing Flow; and 16) Manufacturing and Assembly Weld Tools.

  4. Integrated Solar Upper Stage (ISUS) mission trades

    SciTech Connect

    Frye, P.

    1996-12-31

    Solar thermal propulsion and propulsion/power systems were recently identified as key technologies in the Operational Effectiveness and Cost Comparison Study (OECS) sponsored by Phillips Laboratory (PL). These technologies were found to be pervasively cost effective with short transfer times and very good performance across a wide range of missions. The on-going Integrated Solar Upper Stage (ISUS) Program sponsored by PL represents development of a solar thermal propulsion/power (bimodal) system. As part of this effort, mission trades are being conducted to further define the ISUS system for geosynchronous equatorial orbit (GEO), high Earth orbit (HEO-Molniya class), and mid Earth orbit (MEO-GPS class) missions. These trades will consider launch vehicles ranging in size from a LLV3 to an Atlas IIAS that insert the ISUS into low Earth orbit (LEO). These trades will be used to define the ISUS system for the planned Engine Ground Demonstration, a space demonstration mission, and as a future operational system.

  5. Electrodynamic Tether Propulsion for Spacecraft and Upper Stages

    NASA Technical Reports Server (NTRS)

    Johnson, Les; Gilchrist, Brian; Estes, Robert D.; Lorenzini, Rnrico; Martinez-Sanchez, Manuel; Sanmartin, Juan

    1998-01-01

    Relatively short electrodynamic tethers can use solar power to 'push' against a planetary magnetic field to achieve propulsion without the expenditure of propellant. The groundwork has been laid for this type of propulsion. Important recent milestones include retrieval of a tether in space (TSS-1, 1992), successful deployment of a 20-km-long tether in space (SEDS-1, 1993), and operation of an electrodynamic tether with tether current driven in both directions (PMG, 1993). The planned Propulsive Small Expendable Deployer System (ProSEDS) experiment will use the flight-proven Small Expendable Deployer System (SEDS) to deploy a 5 km bare copper tether from a Delta II upper stage to achieve approximately 0.4 N drag thrust, thus deorbiting the stage. The experiment will use a predominantly 'bare' tether for current collection in lieu of the endmass collector and insulated tether approach used on previous missions. The flight experiment is a precursor to utilization of the technology on the International Space Station for reboost and the electrodynamic tether upper stage demonstration mission which will be capable of orbit raising, lowering and inclination changes, all using electrodynamic thrust. In addition, the use of this type of propulsion may be attractive for future missions at Jupiter.

  6. Integrated solar upper stage alternate receiver

    SciTech Connect

    Streckert, H.H.; Begg, L.L.; Heffernan, T.F.; Horner, M.H.

    1997-12-31

    The Integrated Solar Upper Stage (ISUS) receiver is a compact orbital transfer vehicle designed to generate thrust to boost transfer payloads from low earth orbit to Molniya or geosynchronous orbits. It can provide thrust by collecting and concentrating solar flux and heating hydrogen to {approximately} 2,500 K. Simultaneously, the ISUS receiver radiates heat into an array of thermionic converters to produce electrical power. The central component consists of a graphite body with rhenium lined internal passages. The alternate receiver relies on wrought rhenium that is rolled, machined and electron-beam welded to form a complex rhenium liner system within the graphite body. All machining operations were performed by molybdenum wire electron discharge machining. The tube forming procedure was performed to minimize the amount of cold work before annealing. Electron-beam welding was performed at a current density range of {approximately} 2 to 10 A/cm{sup 2} depending on material thickness, which melts the rhenium locally and results in a fine grained weld zone. A simplified Demonstration Test Assembly was fabricated and tested. The unit consisted of an inlet structure welded to a manifold with a simplified exhaust nozzle system and contained in a machined graphite body. The external graphite surfaces were coated with plasma sprayed rhenium for protection from graphite erosion. Testing included a hot hydrogen flow test to {approximately} 2,500 K. The main ISUS Alternate Receiver was designed and built according to the same procedures as the demonstration unit. However, the inlet and outlet plenums are more complex and are connected by 195 channels to efficiently transfer heat to the flowing hydrogen. An outlet tube containing a sonic orifice mates to the exhaust plenum.

  7. The IRIS-GUS Shuttle Borne Upper Stage System

    NASA Technical Reports Server (NTRS)

    Tooley, Craig; Houghton, Martin; Bussolino, Luigi; Connors, Paul; Broudeur, Steve (Technical Monitor)

    2002-01-01

    This paper describes the Italian Research Interim Stage - Gyroscopic Upper Stage (IRIS-GUS) upper stage system that will be used to launch NASA's Triana Observatory from the Space Shuttle. Triana is a pathfinder earth science mission being executed on rapid schedule and small budget, therefore the mission's upper stage solution had to be a system that could be fielded quickly at relatively low cost and risk. The building of the IRIS-GUS system wa necessary because NASA lost the capability to launch moderately sized upper stage missions fro the Space Shuttle when the PAM-D system was retired. The IRIS-GUS system restores this capability. The resulting system is a hybrid which mates the existing, flight proven IRIS (Italian Research Interim Stage) airborne support equipment to a new upper stage, the Gyroscopic Upper Stage (GUS) built by the GSFC for Triana. Although a new system, the GUS exploits flight proven hardware and design approaches in most subsystems, in some cases implementing proven design approaches with state-of-the-art electronics. This paper describes the IRIS-GUS upper stage system elements, performance capabilities, and payload interfaces.

  8. IRIS - A new Italian upper stage system

    NASA Astrophysics Data System (ADS)

    Vallerani, E.; Varesio, F.; Bussolino, L.

    1983-10-01

    IRIS (Italian Research Interim Stage) is designed to launch a satellite having a maximum weight of 900 kg from the Space Shuttle. IRIS comprises two modules. One is the Airborne Support Equivalent (ASE), which is mounted in the cargo bay of the Shuttle and supports the deployable stage module and the payload during the ground operations, the launch, and the ascent to the on-orbit separation. The other module is the IRIS Spinning State (ISS), a deployable and expendable stage carrying the payload to be launched; the ISS is spin stabilized and has a solid rocket motor whose ignition allows the payload transfer orbit insertion. The reusable ASE consists of a cradle in a truss structure for mounting the deployable stage with its payload inside the Shuttle cargo bay. The cradle has four lateral attachment fittings and one keel fitting, the latter positioned on the rear part.

  9. Upper stages using liquid propulsion and metallized propellants

    NASA Technical Reports Server (NTRS)

    Palaszewski, Bryan A.

    1992-01-01

    Metallized propellants are liquid propellants with a metal additive suspended in a gelled fuel. Typically, aluminum particles are the metal additive. These propellants increase the density and/or the specific impulse of the propulsion system. Using metallized propellants for volume- and mass-constrained upper stages can deliver modest increases in performance for low Earth orbit to geosynchronous Earth orbit (LEO-GEO) and other Earth-orbital transfer missions. However, using metallized propellants for planetary missions can deliver great reductions in flight time with a single-stage, upper-stage system. Tradeoff studies comparing metallized propellant stage performance with nonmetallized upper stages and the Inertial Upper Stage (IUS) are presented. These upper stages, launched from the STS and STS-C, are both one- and two-stage vehicles that provide the added energy to send payloads to high altitude orbits and onto interplanetary trajectories that are unattainable with only the Space Transportation System (STS) and the Space Transportation System-Cargo (STS-C). The stage designs are controlled by the volume and the mass constraints of the STS and STS-C launch vehicles. The influences of the density and specific impulse increases enabled by metallized propellants are examined for a variety of different stage and propellant combinations.

  10. Ares I Upper Stage Parachute Drop Test

    NASA Technical Reports Server (NTRS)

    2006-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. In this HD video image, the first stage reentry parachute drop test is conducted at the Yuma, Arizona proving ground. The parachute tests demonstrated a three-stage deployment sequence that included the use of an Orbiter drag chute to properly stage the unfurling of the main chute. The parachute recovery system for Orion will be similar to the system used for Apollo command module landings and include two drogue, three pilot, and three main parachutes. (Highest resolution available)

  11. Ares I Upper Stage Parachute Drop Test

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. In this HD video image, the first stage reentry parachute drop test is conducted at the Yuma, Arizona proving ground. The parachute tests demonstrated a three-stage deployment sequence that included the use of an Orbiter drag chute to properly stage the unfurling of the main chute. The parachute recovery system for Orion will be similar to the system used for Apollo command module landings and include two drogue, three pilot, and three main parachutes. (Highest resolution available)

  12. United States upper stages for the next decade

    NASA Astrophysics Data System (ADS)

    Goldstein, A.; Woods, F.

    United States (U.S.) upper stage development is approaching another crossroads. In the 1970 s the decision was made to fly all future payloads on the space shuttle. Work on high performance shuttle upper stages was halted after the Challenger accident, because of heightened safety concerns about liquid stages in the payload bay. The centaur G' was ultimately developed as the centaur upper stage for use with the Titan IV launch system. In the last two decades upper stage development decisions and requirements were driven by increased payload performance demands. As we look forward to the next decade it is apparent that the situation has changed. Significant effort is underway to downsize payloads. The best mission model projections indicate that the payload performance demands have reached a maximum with current or near-term missions, and that maximum weight requirements will generally decrease in the near future. Thus the current fleet of launch systems and upper stages are expected to be able to meet all projected performance requirements through the next one to two decades. The impetus for development of a new upper stage will have to come from somewhere other than increased performance requirements. A driving need for a new upper stage is emerging from the concept and technology development work currently underway in the U.S. on the evolved expendable vehicle (EELV) and reusable launch vehicles (RLVs). The key EELV upper stage requirements are cost, operability and reliability. Clearly the EELV presents a performance challenge for a single upper stage to operate with a booster family over the complete mission model payload weight and destination range. The design requirements and trade-off considerations are quite different for a stage to operate with an RLV. In this case, manned safety and payload bay packaging become significant additional considerations which must be addressed, and reusability, with or without space basing, is an option. This paper covers the need and prospects of U.S. upper stages for the next decade by tracing the history of development and planned improvements, and identifying new requirements and challenges expected to be imposed by emerging EELV and RLV requirements. Trade-off factors, design considerations and sensitivities, as well as cost and reliability benchmarks, are highlighted through the use of representative design solutions.

  13. Expendable solid rocket motor upper stages for the Space Shuttle

    NASA Technical Reports Server (NTRS)

    Davis, H. P.; Jones, C. M.

    1974-01-01

    A family of expendable solid rocket motor upper stages has been conceptually defined to provide the payloads for the Space Shuttle with performance capability beyond the low earth operational range of the Shuttle Orbiter. In this concept-feasibility assessment, three new solid rocket motors of fixed impulse are defined for use with payloads requiring levels of higher energy. The conceptual design of these motors is constrained to limit thrusting loads into the payloads and to conserve payload bay length. These motors are combined in various vehicle configurations with stage components derived from other programs for the performance of a broad range of upper-stage missions from spin-stabilized, single-stage transfers to three-axis stabilized, multistage insertions. Estimated payload delivery performance and combined payload mission loading configurations are provided for the upper-stage configurations.

  14. Overview of the Crew Launch Vehicle Upper Stage

    NASA Technical Reports Server (NTRS)

    Funk, Joan G.

    2006-01-01

    The overview begins with the bold vision for space exploration set out by President Bush in 2004. A brief description of the proposed systems architecture is presented along with an animation showing the various stages and phases of a mission. The overview concludes with latest roadmaps for the Upper Stage.

  15. Collaborative Stage Manual Part II

    Cancer.gov

    SEER Program Coding and Staging Manual 2004, Revision 1 Appendix C Site-Specific Coding Modules C-299 Collaborative Staging Codes Nasal Cavity C30.0 C30.0 Nasal cavity (excludes nose, NOS C76.0) Note: Laterality must be coded for this site,

  16. Collaborative Stage Manual Part II

    Cancer.gov

    SEER Program Coding and Staging Manual 2004, Revision 1 Appendix C Site-Specific Coding Modules C-469 SEER Site-Specific Coding Guidelines BREAST C500C509 Primary Site C500 Nipple (areolar) Paget disease without underlying tumor C501

  17. Collaborative Stage Manual Part II

    Cancer.gov

    Gum, Upper.......................................................................................................................................C-47 Gum, Lower and Retromolar Area Retromolar Gingiva (Trigone) ..................................................C-55 Gum, NOS ........................................................................................................................................C-63 Floor of Mouth..................................................................................................................................C-71 Hard Palate........................................................................................................................................C-83 Soft Palate, Uvula .............................................................................................................................C-91 Other Mouth....................................................................................................................................C-101 Cheek (Buccal) Mucosa, Vestibule.................................................................................................C-109 Parotid Gland ..................................................................................................................................C-119 Submandibular Gland .....................................................................................................................C-127 Other and Unspecified Major Salivary Glands ...............................................................................C-135 Tonsil, Oropharynx .........................................................................................................................C-145 Anterior Surface of Epiglottis .........................................................................................................C-155 Nasopharynx ...................................................................................................................................C-165 Pyriform Sinus, Hypopharynx, Laryngopharynx............................................................................C-173 Pharynx, NOS, and Other Ill-Defined Oral Cavity Sites ................................................................C-181 Esophagus .......................................................................................................................................C-193 Small Intestine ................................................................................................................................C-211 Colon...............................................................................................................................................C-219 Rectosigmoid, Rectum....................................................................................................................C-231 Anus Anal Canal; Anus, NOS; Other Parts of Rectum.

  18. Cluster II quartet take the stage together

    NASA Astrophysics Data System (ADS)

    1999-11-01

    This is the only occasion on which all four of ESA's Cluster II spacecraft will be on display together in Europe. Four Spacecraft, One Mission The unique event takes place near the end of the lengthy assembly and test programme, during which each individual spacecraft is being assembled in sequence, one after the other. Two have already completed their assembly and systems testing and are about to be stored in special containers at IABG prior to shipment to the Baikonur launch site in Kazakhstan next spring. In the case of the other two, flight models 5 and 8, installation of the science payloads has finished, but their exhaustive series of environmental tests at IABG have yet to begin. Following delivery to the launch site next April, the satellites will be launched in pairs in June and July 2000. Two Soyuz rockets, each with a newly designed Fregat upper stage, are being provided by the Russian-French Starsem company. This will be the first time ESA satellites have been launched from the former Soviet Union. Cluster II is a replacement for the original Cluster mission, which was lost during the maiden launch of Ariane 5 in June 1996. ESA, given the mission's importance in its overall strategy in the area of the Sun-Earth connection, decided to rebuild this unique project. ESA member states supported that proposal. On 3 April 1997, the Agency's Science Programme Committee agreed. Cluster II was born. European Teamwork Scientific institutions and industrial enterprises in almost all the 14 ESA member states and the United States are taking part in the Cluster II project. Construction of the eight Cluster / Cluster II spacecraft has been a major undertaking for European industry. Built into each 1200 kg satellite are six propellant tanks, two pressure tanks, eight thrusters, 80 metres of pipework, about 5 km of wiring, 380 connectors and more than 14 000 electrical contacts. All the spacecraft were assembled in the giant clean room at the Friedrichshafen plant of prime contractor Dornier Satellitensysteme. On completion, they were sent to IABG in Ottobrunn, near Munich, for intensive vibration, thermal, vacuum and magnetic testing. The European ground segment for the mission is just as important. A vast amount of data - equivalent to 290 million printed pages - will be returned to Earth over the mission's two-year lifetime. Signals to and from the spacecraft will be sent via a 15 metre antenna at Villafranca in Spain and processed at the European Space Operations Centre (ESOC) at Darmstadt, Germany. The main control room at ESOC will be used during the launch and early phases of the mission, with teams of operators working round the clock. About two weeks after the second Cluster II pair are placed in their operational orbits, mission operations will switch to a smaller, dedicated control room at ESOC. The Joint Science Operations Centre at Rutherford Appleton Laboratory in the UK will co-ordinate the scientific investigations. Its main task will be to combine all requirements from the 11 science instrument teams into an overall plan. The flow of information returned by the 44 instruments will be distributed to eight national data centres, six in Europe, one in the USA and the other in China. Solar Maximum Cluster II is part of an international programme to find out more about how the Sun influences the Earth. The four Cluster II satellites will join an armada of spacecraft from many countries, which are already studying the Sun and high speed wind of charged particles (mainly electrons and protons) which it continually blasts into space. Ulysses and SOHO, both joint ESA-NASA missions, and ESA's Cluster II , when it will be there, are the flagships of this armada. The timing of the mission is ideal, since it will take place during a period of peak activity in the Sun's 11-year cycle, when sunspots and solar radiation reach a maximum. Cluster II will measure the effects of this activity on near-Earth space as incoming energetic particles subject the magnetosphere - the region dominated by the Earth's magnetic field - to a buffeting. Each spacecraft carries an identical set of 11 instruments provided by scientific institutions in different countries. Formation Flying Cluster II will be the first space science mission ever to fly four identical spacecraft simultaneously. Once the quartet have been inserted into highly elliptical polar orbits, ranging from 19 000 to 119 000 km above the Earth, they will spend the next two years travelling from the magnetosphere into interplanetary space and back again. Sometimes they will be within a few hundred kilometres of each other, sometimes 20 000 kilometres apart, depending on the physical phenomena to be studied. By orbiting in a tetrahedral (triangular pyramid) formation, they will be able to make the first detailed three-dimensional study of the changes and processes taking place in near-Earth space. As the satellites orbit the Earth, they will investigate the rapid changes which occur in the Earth's magnetosphere when large numbers of electrically charged particles (electrons and protons) in the solar wind reach the Earth. Huge amounts of data will be returned which will help scientists unravel the physical processes and small-scale variations taking place in the near-Earth environment. "Cluster II will give us the best information yet on how the Sun affects the near-Earth environment," said Cluster II project scientist, Philippe Escoubet. "For the first time we will be able to study the Earth's magnetic field from four viewpoints with identical instruments." "It will be like having four cameras at a football match - one behind the goal and three others at different angles," he explained. "This is very exciting because it will help us to understand the space environment which surrounds our planet." How The Sun Affects Our Planet. Such studies are not just of academic interest. The Sun affects our world in many ways. Apart from its familiar output of light, heat and ultraviolet radiation, our nearest star also emits a continuous stream of atomic particles - the solar wind - that sweeps out into space at speeds ranging from 280 to 1 000 km/s (1 800 times faster than Concorde). Sometimes, explosions on the Sun send millions of tonnes of gas towards the Earth. These clouds of high-energy particles can travel the 150 million km between the Sun and Earth in a few days. The most energetic particles of all, created by solar flares, can reach the Earth in just 30 minutes. This activity is particularly noticeable at times of solar maximum. When charged particles from the Sun enter the Earth's upper atmosphere, they create shimmering curtains of coloured light, known as auroras, in the polar night sky. Other effects can be much more serious: * Solar storms affect the Earth's ionosphere, causing disruption of short-wave radio communications, navigation systems on ships and aircraft, and military radar systems. * Surges in electricity transmission lines can cause widespread power blackouts, as happened in Quebec, Canada, in March 1989 when 6 million people were left without electricity as a result of a huge solar-induced magnetic storm. * Damage to microchips and electrical discharges can cause satellites to stop operating, disrupting telephone, TV and data communication services. (Aware of the potential dangers, the designers of the Cluster II spacecraft have built them to survive collisions with high- energy particles from the Earth's radiation belts and the solar wind.) * Radiation levels can become hazardous to astronauts and occupants of high-flying aircraft. * Variations in solar energy output cause global climate changes which affect plant growth, crop production and food supply. * High-energy particles hitting the Earth's upper atmosphere can damage the ozone layer which protects us from harmful ultraviolet radiation.

  19. Electric Propulsion Upper-Stage for Launch Vehicle Capability Enhancement

    NASA Technical Reports Server (NTRS)

    Kemp, Gregory E.; Dankanich, John W.; Woodcock, Gordon R.; Wingo, Dennis R.

    2007-01-01

    The NASA In-Space Propulsion Technology Project Office initiated a preliminary study to evaluate the performance benefits of a solar electric propulsion (SEP) upper-stage with existing and near-term small launch vehicles. The analysis included circular and elliptical Low Earth Orbit (LEO) to Geosynchronous Earth Orbit (GEO) transfers, and LEO to Low Lunar Orbit (LLO) applications. SEP subsystem options included state-of-the-art and near-term solar arrays and electric thrusters. In-depth evaluations of the Aerojet BPT-4000 Hall thruster and NEXT gridded ion engine were conducted to compare performance, cost and revenue potential. Preliminary results indicate that Hall thruster technology is favored for low-cost, low power SEP stages, while gridded-ion engines are favored for higher power SEP systems unfettered by transfer time constraints. A low-cost point design is presented that details one possible stage configuration and outlines system limitations, in particular fairing volume constraints. The results demonstrate mission enhancements to large and medium class launch vehicles, and mission enabling performance when SEP system upper stages are mounted to low-cost launchers such as the Minotaur and Falcon 1. Study results indicate the potential use of SEP upper stages to double GEO payload mass capability and to possibly enable launch on demand capability for GEO assets. Transition from government to commercial applications, with associated cost/benefit analysis, has also been assessed. The sensitivity of system performance to specific impulse, array power, thruster size, and component costs are also discussed.

  20. Bioimpedance Spectroscopy in Detecting Lower-Extremity Lymphedema in Patients With Stage I, Stage II, Stage III, or Stage IV Vulvar Cancer Undergoing Surgery and Lymphadenectomy

    ClinicalTrials.gov

    2016-02-09

    Lymphedema; Perioperative/Postoperative Complications; Stage IA Vulvar Cancer; Stage IB Vulvar Cancer; Stage II Vulvar Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVA Vulvar Cancer; Stage IVB Vulvar Cancer

  1. ARES I Upper Stage Subsystems Design and Development

    NASA Technical Reports Server (NTRS)

    Frate, David T.; Senick, Paul F.; Tolbert, Carol M.

    2011-01-01

    From 2005 through early 2011, NASA conducted concept definition, design, and development of the Ares I launch vehicle. The Ares I was conceived to serve as a crew launch vehicle for beyond-low-Earth-orbit human space exploration missions as part of the Constellation Program Architecture. The vehicle was configured with a single shuttle-derived solid rocket booster first stage and a new liquid oxygen/liquid hydrogen upper stage, propelled by a single, newly developed J-2X engine. The Orion Crew Exploration Vehicle was to be mated to the forward end of the Ares I upper stage through an interface with fairings and a payload adapter. The vehicle design passed a Preliminary Design Review in August 2008, and was nearing the Critical Design Review when efforts were concluded as a result of the Constellation Program s cancellation. At NASA Glenn Research Center, four subsystems were developed for the Ares I upper stage. These were thrust vector control (TVC) for the J-2X, electrical power system (EPS), purge and hazardous gas (P&HG), and development flight instrumentation (DFI). The teams working each of these subsystems achieved 80 percent or greater design completion and extensive development testing. These efforts were extremely successful representing state-of-the-art technology and hardware advances necessary to achieve Ares I reliability, safety, availability, and performance requirements. This paper documents the designs, development test activity, and results.

  2. Comparative evaluation of existing expendable upper stages for space shuttle

    NASA Technical Reports Server (NTRS)

    Weyers, V. J.; Sagerman, G. D.; Borsody, J.; Lubick, R. J.

    1974-01-01

    The use of existing expendable upper stages in the space shuttle during its early years of operation is evaluated. The Burner 2, Scout, Delta, Agena, Transtage, and Centaur were each studied under contract by their respective manufacturers to determine the extent and cost of the minimum modifications necessary to integrate the stage with the shuttle orbiter. A comparative economic analysis of thirty-five different families of these stages is discussed. Results show that the overall transportation system cost differences between many of the families are quite small. However, by considering several factors in addition to cost, it is possible to select one family as being representative of the capability of the minimum modification existing stage approach. The selected family meets all of the specified mission requirements during the early years of shuttle operation.

  3. Propellant Management in Booster and Upper Stage Propulsion Systems

    NASA Technical Reports Server (NTRS)

    Fisher, Mark F.

    1997-01-01

    A summary review of some of the technical issues which surround the design of the propulsion systems for Booster and Upper Stage systems are presented. The work focuses on Propellant Geyser, Slosh, and Orientation. A brief description of the concern is given with graphics which help the reader to understand the physics of the situation. The most common solutions to these problems are given with there respective advantages and disadvantages.

  4. Crew Launch Vehicle (CLV) Upper Stage Configuration Selection Process

    NASA Technical Reports Server (NTRS)

    Davis, Daniel J.; Coook, Jerry R.

    2006-01-01

    The Crew Launch Vehicle (CLV), a key component of NASA's blueprint for the next generation of spacecraft to take humans back to the moon, is being designed and built by engineers at NASA s Marshall Space Flight Center (MSFC). The vehicle s design is based on the results of NASA's 2005 Exploration Systems Architecture Study (ESAS), which called for development of a crew-launch system to reduce the gap between Shuttle retirement and Crew Exploration Vehicle (CEV) Initial Operating Capability, identification of key technologies required to enable and significantly enhance these reference exploration systems, and a reprioritization of near- and far-term technology investments. The Upper Stage Element (USE) of the CLV is a clean-sheet approach that is being designed and developed in-house, with element management at MSFC. The USE concept is a self-supporting cylindrical structure, approximately 115' long and 216" in diameter, consisting of the following subsystems: Primary Structures (LOX Tank, LH2 Tank, Intertank, Thrust Structure, Spacecraft Payload Adaptor, Interstage, Forward and Aft Skirts), Secondary Structures (Systems Tunnel), Avionics and Software, Main Propulsion System, Reaction Control System, Thrust Vector Control, Auxiliary Power Unit, and Hydraulic Systems. The ESAS originally recommended a CEV to be launched atop a four-segment Space Shuttle Main Engine (SSME) CLV, utilizing an RS-25 engine-powered upper stage. However, Agency decisions to utilize fewer CLV development steps to lunar missions, reduce the overall risk for the lunar program, and provide a more balanced engine production rate requirement prompted engineers to switch to a five-segment design with a single Saturn-derived J-2X engine. This approach provides for single upper stage engine development for the CLV and an Earth Departure Stage, single Reusable Solid Rocket Booster (RSRB) development for the CLV and a Cargo Launch Vehicle, and single core SSME development. While the RSRB design has changed since the CLV Project's inception, the USE design has remained essentially a clean-sheet approach. Although a clean-sheet upper stage design inherently carries more risk than a modified design, it does offer many advantages: a design for increased reliability; built-in extensibility to allow for commonality/growth without major redesign; and incorporation of state-of-the-art materials, hardware, and design, fabrication, and test techniques and processes to facilitate a potentially better, more reliable system. Because consideration was given in the ESAS to both clean-sheet and modified USE designs, this paper will highlight the advantages and disadvantages of both approaches and provide a detailed discussion of trades/selections made that led to the final upper stage configuration.

  5. Risk assessment in Stage II colorectal cancer.

    PubMed

    Marshall, John L

    2010-01-01

    In the treatment of colon cancer today, the decision-making involved in the treatment of stage II disease is probably the most challenging aspect. The major question is whether or not these patients should receive postoperative adjuvant chemotherapy. Approximately 75% of stage II colon cancer is cured by surgery alone. For the remaining 25% of cases, there is great debate over whether adjuvant chemotherapy is sufficiently effective in enough patients to warrant the exposure to potentially toxic treatments. In the important QUASAR clinical trial, stage II patients were randomized to either fluorouracil (5-FU)-based therapy or observation. The results demonstrated an approximate 3% improvement in outcome for the 5-FU-treated patients. This leads to the assumption that treating all stage II patients with adjuvant chemotherapy is gross overtreatment, when essentially 97% of these patients will not benefit. Clearly the only way to approach this decision is through risk determination. In this article, I will describe the current state of defining high- and low-risk disease, which is mainly through histopathologic characteristics, as well as discuss emerging approaches such as molecular markers and genomic profiling. PMID:20225606

  6. Chemotherapy for Stage II Colon Cancer.

    PubMed

    Varghese, Anna

    2015-12-01

    The adjuvant treatment of patients with stage II colon cancer is an area of controversy in medical oncology. Adjuvant chemotherapy aims to eradicate micrometastatic disease present at the time of surgery, preventing the development of distant metastatic disease and thereby curing those patients of their cancer. National and international guidelines for the adjuvant treatment of stage II colon cancer recommend a range of treatment options from observation to chemotherapy with single-agent or combination regimens, depending on the presence or absence of high-risk features (poorly differentiated histology, presence of lymphovascular invasion, presence of perineural invasion, report of?stage II colon cancer, a small but statistically significant benefit in overall survival was seen for those patients who received adjuvant chemotherapy; however, multiple meta-analyses and retrospective subgroup analyses have called these findings into question. Though there may be a role for adjuvant chemotherapy in the treatment of patients with stage II colon cancer, its incremental benefit is small, at best, and comes with the risks of real and rarely fatal complications of chemotherapy. PMID:26648796

  7. Oblimersen Sodium and Combination Chemotherapy in Treating Patients With Newly Diagnosed Stage I, Stage II, Stage III, or Stage IV Diffuse Large B-Cell Lymphoma

    ClinicalTrials.gov

    2012-10-11

    Contiguous Stage II Adult Diffuse Large Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Stage I Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma

  8. The Malemute development program. [rocket upper stage engine design

    NASA Technical Reports Server (NTRS)

    Bolster, W. J.; Hoekstra, P. W.

    1976-01-01

    The Malemute vehicle systems are two-stage systems based on utilizing a new high performance upper stage motor with two existing military boosters. The Malmute development program is described relative to program structure, preliminary design, vehicle subsystems, and the Malemute motor. Two vehicle systems, the Nike-Malemute and Terrier-Malemute, were developed which are capable of transporting comparatively large diameter (16 in.) 200-lb payloads to altitudes of 500 and 700 km, respectively. These vehicles provide relatively low-cost transportation with two-stage reliability and launch simplicity. Flight tests of both vehicle systems revealed their performance capabilities, with the Terrier-Malemute system involving a unique Malemute motor spin sensitivity problem. It is suggested that the vehicles can be successfully flown by lowering the burnout spin rate.

  9. Experimental Enhanced Upper Stage (XEUS): An affordable large lander system

    NASA Astrophysics Data System (ADS)

    Scotkin, J.; Masten, D.; Powers, J.; O'Konek, N.; Kutter, B.; Stopnitzky, B.

    The Experimental Enhanced Upper Stage (XEUS) offers a path to reduce costs and development time to sustainable activity beyond LEO by equipping existing large cryogenic propulsion stages with MSS VTVL propulsion and GNC to create a large, multi-thrust axis lander. Conventional lander designs have been driven by the assumption that a single, highly reliable, and efficient propulsion system should conduct the entire descent, approach, and landing. Compromises in structural, propulsion, and operational efficiency result from this assumption. System reliability and safety also suffer. The result is often an iterative series of optimizations, making every subsystem mission-unique and expensive. The XEUS multi-thrust axis lander concept uniquely addresses the programmatic and technical challenges of large-mass planetary landing by taking advantage of proven technologies and decoupling the deorbit and descent propulsion system from the landing propulsion system. Precise control of distributed, multi-thrust axis landing propulsion units mounted on the horizontal axis of a Centaur stage will ultimately enable the affordable deployment of large planetary rovers, uncrewed base infrastructure and manned planetary expeditions. The XEUS lander has been designed to offer a significantly improved mass fraction and mass to surface capability over conventional lander designs, while reducing airlock/payload to surface distances and distributing plume effects by using multiple gimbaled landing thrusters. In utilizing a proven cryogenic propulsion stage, XEUS reduces development costs required for development of new cryogenic propulsion stages and fairings and builds upon the strong heritage of successful Centaur and MSS RLV flights.

  10. NASA Ares I Crew Launch Vehicle Upper Stage Overview

    NASA Technical Reports Server (NTRS)

    McArthur, J. Craig

    2008-01-01

    By incorporating rigorous engineering practices, innovative manufacturing processes and test techniques, a unique multi-center government/contractor partnership, and a clean-sheet design developed around the primary requirements for the International Space Station (ISS) and Lunar missions, the Upper Stage Element of NASA's Crew Launch Vehicle (CLV), the "Ares I," is a vital part of the Constellation Program's transportation system. Constellation's exploration missions will include Ares I and Ares V launch vehicles required to place crew and cargo in low-Earth orbit (LEO), crew and cargo transportation systems required for human space travel, and transportation systems and scientific equipment required for human exploration of the Moon and Mars. Early Ares I configurations will support ISS re-supply missions. A self-supporting cylindrical structure, the Ares I Upper Stage will be approximately 84' long and 18' in diameter. The Upper Stage Element is being designed for increased supportability and increased reliability to meet human-rating requirements imposed by NASA standards. The design also incorporates state-of-the-art materials, hardware, design, and integrated logistics planning, thus facilitating a supportable, reliable, and operable system. With NASA retiring the Space Shuttle fleet in 2010, the success of the Ares I Project is essential to America's continued leadership in space. The first Ares I test flight, called Ares I-X, is scheduled for 2009. Subsequent test flights will continue thereafter, with the first crewed flight of the Crew Exploration Vehicle (CEV), "Orion," planned for no later than 2015. Crew transportation to the ISS will follow within the same decade, and the first Lunar excursion is scheduled for the 2020 timeframe.

  11. NASA Ares I Crew Launch Vehicle Upper Stage Overview

    NASA Technical Reports Server (NTRS)

    Davis, Daniel J.

    2008-01-01

    By incorporating rigorous engineering practices, innovative manufacturing processes and test techniques, a unique multi-center government/contractor partnership, and a clean-sheet design developed around the primary requirements for the International Space Station (ISS) and Lunar missions, the Upper Stage Element of NASA's Crew Launch Vehicle (CLV), the "Ares I," is a vital part of the Constellation Program's transportation system. Constellation's exploration missions will include Ares I and Ares V launch vehicles required to place crew and cargo in low-Earth orbit (LEO), crew and cargo transportation systems required for human space travel, and transportation systems and scientific equipment required for human exploration of the Moon and Mars. Early Ares I configurations will support ISS re-supply missions. A self-supporting cylindrical structure, the Ares I Upper Stage will be approximately 84' long and 18' in diameter. The Upper Stage Element is being designed for increased supportability and increased reliability to meet human-rating requirements imposed by NASA standards. The design also incorporates state-of-the-art materials, hardware, design, and integrated logistics planning, thus facilitating a supportable, reliable, and operable system. With NASA retiring the Space Shuttle fleet in 2010, the success of the Ares I Project is essential to America's continued leadership in space. The first Ares I test flight, called Ares 1-X, is scheduled for 2009. Subsequent test flights will continue thereafter, with the first crewed flight of the Crew Exploration Vehicle (CEV), "Orion," planned for no later than 2015. Crew transportation to the ISS will follow within the same decade, and the first Lunar excursion is scheduled for the 2020 timeframe.

  12. J-2X Upper Stage Engine: Hardware and Testing 2009

    NASA Technical Reports Server (NTRS)

    Buzzell, James C.

    2009-01-01

    Mission: Common upper stage engine for Ares I and Ares V. Challenge: Use proven technology from Saturn X-33, RS-68 to develop the highest Isp GG cycle engine in history for 2 missions in record time . Key Features: LOX/LH2 GG cycle, series turbines (2), HIP-bonded MCC, pneumatic ball-sector valves, on-board engine controller, tube-wall regen nozzle/large passively-cooled nozzle extension, TEG boost/cooling . Development Philosophy: proven hardware, aggressive schedule, early risk reduction, requirements-driven.

  13. Shuttle/IUS performance for planetary missions. [Interim Upper Stage

    NASA Technical Reports Server (NTRS)

    Cork, M. J.; Driver, J. M.; Wright, J. L.

    1975-01-01

    Potential requirements for planetary missions in the 1980s, capabilities of the Interim Upper Stage (IUS) candidates to perform those missions, and Shuttle/IUS mission profile options for performance enhancement are examined. The most demanding planetary missions are the Pioneer Saturn/Uranus/Titan Probe and the Mariner-class orbiters of Mercury, Jupiter, and Saturn. Options available to designers of these missions will depend on the specific IUS selected for development and the programmatic phasing of the IUS and the NASA Tug. Use of Shuttle elliptic orbits as initial conditions for IUS ignition offers significant performance improvements; specific values are mission dependent.

  14. Chemotherapy Toxicity On Quality of Life in Older Patients With Stage I, Stage II, Stage III, or Stage IV Ovarian Epithelial, Primary Peritoneal Cavity, or Fallopian Tube Cancer

    ClinicalTrials.gov

    2016-02-09

    Stage I Ovarian Cancer; Stage IA Fallopian Tube Cancer; Stage IB Fallopian Tube Cancer; Stage IC Fallopian Tube Cancer; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIB Fallopian Tube Cancer; Stage IIC Fallopian Tube Cancer; Stage III Ovarian Cancer; Stage III Primary Peritoneal Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIC Fallopian Tube Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

  15. Pathology of upper tract urothelial carcinoma with emphasis on staging.

    PubMed

    Mazzucchelli, R; Scarpelli, M; Galosi, A B; Di Primio, R; Lopez-Beltran, A; Cheng, L; Montironi, R

    2014-01-01

    Classification of upper tract urothelial preneoplastic and neoplastic lesions mirrors that of the urinary bladder, with all lesions of the bladder urothelium being possible in the upper tract and vice versa. There are three major groups of non-invasive urothelial neoplasms: flat, papillary, and inverted. These three groups share a similar morphological spectrum of intraurothelial changes, ranging from hyperplasia to dysplasia to carcinoma in situ. However, they differ in terms of architectural growth pattern compared to the surrounding non-neoplastic mucosal surface. Infiltrating urothelial carcinoma is defined as a urothelial tumor that invades beyond the basement membrane. Unlike in non-invasive papillary urothelial neoplasms (pTa), the role of histologic grade in pT1 and higher stage tumors has been suggested to be of only relative importance. The vast majority of tumors of the upper urinary tract are urothelial carcinoma. More commonly seen, however, are foci of squamous differentiation and, less frequently, glandular differentiation. Pure urothelial carcinomas also display a wide range of variant morphologies, and recognition of these morphologies is important for diagnosis, classification, and prognosis. PMID:25572730

  16. Ares I-X Upper Stage Simulator Residual Stress Analysis

    NASA Technical Reports Server (NTRS)

    Raju, Ivatury S.; Brust, Frederick W.; Phillips, Dawn R.; Cheston, Derrick

    2008-01-01

    The structural analyses described in the present report were performed in support of the NASA Engineering and Safety Center (NESC) Critical Initial Flaw Size (CIFS) assessment for the Ares I-X Upper Stage Simulator (USS) common shell segment. An independent assessment was conducted to determine the critical initial flaw size (CIFS) for the flange-to-skin weld in the Ares I-X Upper Stage Simulator (USS). The Ares system of space launch vehicles is the US National Aeronautics and Space Administration s plan for replacement of the aging space shuttle. The new Ares space launch system is somewhat of a combination of the space shuttle system and the Saturn launch vehicles used prior to the shuttle. Here, a series of weld analyses are performed to determine the residual stresses in a critical region of the USS. Weld residual stresses both increase constraint and mean stress thereby having an important effect on fatigue and fracture life. The results of this effort served as one of the critical load inputs required to perform a CIFS assessment of the same segment.

  17. NDE for the ARES I Upper Stage Common Bulkhead

    NASA Technical Reports Server (NTRS)

    Walker, James

    2008-01-01

    The current design of the ARES 1 Upper Stage uses a common bulkhead to separate the liquid hydrogen and liquid oxygen tanks. The bulkhead consists of aluminum face sheets bonded to a Phenolic honeycomb core. The face sheets, or domes, are friction stir welded to Y-rings that connect the bulkhead to the barrel sections of the liquid hydrogen and liquid oxygen tanks. Load between the Y-rings is carried by an externally attached bolting ring. The development of nondestructive evaluation methods for the ARES I Upper Stage Common Bulkhead are outlined in this presentation. Methods for inspecting the various components of the bulkhead are covered focusing in on the dome skins, core-to-dome bond lines and friction stir welds as well as structural details like the fastener holes. Thermography, shearography and ultrasonic methods are discussed for the bond lines. Eddy current methods are discussed for the fastener holes and dome skins. A combination of phased array ultrasound, liquid penetrant and radiography are to being investigated for use on the friction stir welds. Keywords: Composite materials, NDE, Cryogenic structures

  18. Solar thermal upper stage: Economic advantage and development status

    NASA Technical Reports Server (NTRS)

    Adams, Alan M.

    1995-01-01

    A solar thermal upper stage (STUS) is envisioned as a propulsive concept for the future. The STUS will be used for low Earth orbit (LEO) to geostationary-Earth orbit (GEO) transfer and for planetary exploration missions. The STUS offers significant performance gains over conventional chemical propulsion systems. These performance gains translate into a more economical, more efficient method of placing useful payloads in space and maximizing the benefits derived from space activity. This paper will discuss the economical advantages of an STUS compared to conventional chemical propulsion systems, the potential market for an STUS, and the recent activity in the development of an STUS. The results of this assessment combined with the performance gains, will provide a strong justification for the development of an STUS.

  19. Taming Liquid Hydrogen: The Centaur Upper Stage Rocket

    NASA Technical Reports Server (NTRS)

    2004-01-01

    The Centaur is one of the most powerful rockets in the world. As an upper-stage rocket for the Atlas and Titan boosters it has been a reliable workhorse for NASA for over forty years and has played an essential role in many of NASA's adventures into space. In this CD-ROM you will be able to explore the Centaur's history in various rooms to this virtual museum. Visit the "Movie Theater" to enjoy several video documentaries on the Centaur. Enter the "Interview Booth" to hear and read interviews with scientists and engineers closely responsible for building and operating the rocket. Go to the "Photo Gallery" to look at numerous photos of the rocket throughout its history. Wander into the "Centaur Library" to read various primary documents of the Centaur program. Finally, stop by the "Observation Deck" to watch a virtual Centaur in flight.

  20. Upper Stage Tank Thermodynamic Modeling Using SINDA/FLUINT

    NASA Technical Reports Server (NTRS)

    Schallhorn, Paul; Campbell, D. Michael; Chase, Sukhdeep; Piquero, Jorge; Fortenberry, Cindy; Li, Xiaoyi; Grob, Lisa

    2006-01-01

    Modeling to predict the condition of cryogenic propellants in an upper stage of a launch vehicle is necessary for mission planning and successful execution. Traditionally, this effort was performed using custom, in-house proprietary codes, limiting accessibility and application. Phenomena responsible for influencing the thermodynamic state of the propellant have been characterized as distinct events whose sequence defines a mission. These events include thermal stratification, passive thermal control roll (rotation), slosh, and engine firing. This paper demonstrates the use of an off the shelf, commercially available, thermal/fluid-network code to predict the thermodynamic state of propellant during the coast phase between engine firings, i.e. the first three of the above identified events. Results of this effort will also be presented.

  1. Integrated solar upper stage (ISUS) space demonstration design

    NASA Astrophysics Data System (ADS)

    Frye, Patrick

    1997-01-01

    High temperature solar thermal propulsion/power systems will enable the placement of higher power satellite systems launched from smaller, less expensive launch vehicles. The on-going Integrated Solar Upper Stage (ISUS) Program sponsored by Phillips Laboratory is one such solar thermal system. A system test of an engine ground test configuration of ISUS is planned for Spring, 1997. The next step in the development of the ISUS system will be a flight demonstration mission. This paper details the conceptual designs for two potential ISUS space demonstration configurations. These designs were developed with a design-to-cost philosophy for a LEO (low Earth orbit) to GEO (geosynchronous equatorial orbit) and LEO to HEEO (highly elliptical Earth orbit) flight demonstration missions. Design considerations included packaging within the selected launch vehicle fairings (Pegasus XL and SSLV Taurus), system performance, propellant selection (H2, CH4, or NH3), and 100-150 watts of power production using thermionic diodes.

  2. Inertial upper stage - Upgrading a stopgap proves difficult

    NASA Astrophysics Data System (ADS)

    Geddes, J. P.

    The technological and project management difficulties associated with the Inertial Upper Stage's (IUS) development and performance to date are assessed, with a view to future prospects for this system. The IUS was designed for use both on the interim Titan 34D booster and the Space Shuttle Orbiter. The IUS malfunctions and cost overruns reported are substantially due to the system's reliance on novel propulsion and avionics technology. Its two solid rocket motors, which were selected on the basis of their inherent safety for use on the Space Shuttle, have the longest burn time extant. A three-dimensional carbon/carbon nozzle throat had to be developed to sustain this long burn, as were lightweight composite wound cases and shirts, insulation, igniters, and electromechanical thrust vector control.

  3. Testing for the J-2X Upper Stage Engine

    NASA Technical Reports Server (NTRS)

    Buzzell, James C.

    2010-01-01

    NASA selected the J-2X Upper Stage Engine in 2006 to power the upper stages of the Ares I crew launch vehicle and the Ares V cargo launch vehicle. Based on the proven Saturn J-2 engine, this new engine will provide 294,000 pounds of thrust and a specific impulse of 448 seconds, making it the most efficient gas generator cycle engine in history. The engine's guiding philosophy emerged from the Exploration Systems Architecture Study (ESAS) in 2005. Goals established then called for vehicles and components based, where feasible, on proven hardware from the Space Shuttle, commercial, and other programs, to perform the mission and provide an order of magnitude greater safety. Since that time, the team has made unprecedented progress. Ahead of the other elements of the Constellation Program architecture, the team has progressed through System Requirements Review (SRR), System Design Review (SDR), Preliminary Design Review (PDR), and Critical Design Review (CDR). As of February 2010, more than 100,000 development engine parts have been ordered and more than 18,000 delivered. Approximately 1,300 of more than 1,600 engine drawings were released for manufacturing. A major factor in the J-2X development approach to this point is testing operations of heritage J-2 engine hardware and new J-2X components to understand heritage performance, validate computer modeling of development components, mitigate risk early in development, and inform design trades. This testing has been performed both by NASA and its J-2X prime contractor, Pratt & Whitney Rocketdyne (PWR). This body of work increases the likelihood of success as the team prepares for testing the J-2X powerpack and first development engine in calendar 2011. This paper will provide highlights of J-2X testing operations, engine test facilities, development hardware, and plans.

  4. Upper thermal tolerances of early life stages of freshwater mussels

    USGS Publications Warehouse

    Pandolfo, Tamara J.; Cope, W. Gregory; Arellano, Consuelo; Bringolf, Robert B.; Barnhart, M. Christopher; Hammer, E

    2010-01-01

    Freshwater mussels (order Unioniformes) fulfill an essential role in benthic aquatic communities, but also are among the most sensitive and rapidly declining faunal groups in North America. Rising water temperatures, caused by global climate change, industrial discharges, drought, or land development, could further challenge imperiled unionid communities. The aim of our study was to determine the upper thermal tolerances of the larval (glochidia) and juvenile life stages of freshwater mussels. Glochidia of 8 species of mussels were tested: Lampsilis siliquoidea, Potamilus alatus, Ligumia recta, Ellipsaria lineolata,Lasmigona complanata, Megalonaias nervosa, Alasmidonta varicosa, and Villosa delumbis. Seven of these species also were tested as juveniles. Survival trends were monitored while mussels held at 3 acclimation temperatures (17, 22, and 27°C) were exposed to a range of common and extreme water temperatures (20–42°C) in standard acute laboratory tests. The average median lethal temperature (LT50) among species in 24-h tests with glochidia was 31.6°C and ranged from 21.4 to 42.7°C. The mean LT50 in 96-h juvenile tests was 34.7°C and ranged from 32.5 to 38.8°C. Based on comparisons of LT50s, thermal tolerances differed among species for glochidia, but not for juveniles. Acclimation temperature did not affect thermal tolerance for either life stage. Our results indicate that freshwater mussels already might be living close to their upper thermal tolerances in some systems and, thus, might be at risk from rising environmental temperatures.

  5. Risk Assessment Challenges in the Ares I Upper Stage

    NASA Technical Reports Server (NTRS)

    Stott, James E.; Ring, Robert W.; Elrada, Hassan A.; Hark, Frank

    2007-01-01

    NASA Marshall Space Flight Center (MSFC) is currently at work developing hardware and systems for the Ares I rocket that will send future astronauts into orbit. Built on cutting-edge launch technologies, evolved powerful Apollo and Space Shuttle propulsion elements, and decades of NASA spaceflight experience, Ares I is the essential core of a safe, reliable, cost-effective space transportation system -- one that will carry crewed missions back to the moon, on to Mars and out into the solar system. Ares I is an in-line, two-stage rocket configuration topped by the Orion crew vehicle and its launch abort system. In addition to the vehicle's primary mission -carrying crews of four to six astronauts to Earth orbit --Ares I may also use its 25-ton payload capacity to deliver resources and supplies to the International Space Station, or to "park" payloads in orbit for retrieval by other spacecraft bound for the moon or other destinations. Crew transportation to the International Space Station is planned to begin no later than 2014. The first lunar excursion is scheduled for the 2020 timeframe. This paper presents the challenges in designing the Ares I upper stage for reliability and safety while minimizing weight and maximizing performance.

  6. Stir Friction Welding Used in Ares I Upper Stage Fabrication

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts friction stir welding used in manufacturing aluminum panels that will fabricate the Ares I upper stage barrel. The panels are subjected to confidence tests in which the bent aluminum is stressed to breaking point and thoroughly examined. The panels are manufactured by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

  7. Stir Friction Welding Used in Ares I Upper Stage Fabrication

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts friction stir welding used in manufacturing aluminum panels that will fabricate the Ares I upper stage barrel. The aluminum panels are subjected to confidence panel tests during which the bent aluminum is stressed to breaking point and thoroughly examined. The panels are manufactured by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

  8. Stir Friction Welding Used in Ares I Upper Stage Fabrication

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. This HD video image depicts the preparation and placement of a confidence ring for friction stir welding used in manufacturing aluminum panels that will fabricate the Ares I upper stage barrel. The aluminum panels are manufactured and subjected to confidence tests during which the bent aluminum is stressed to breaking point and thoroughly examined. The panels are manufactured by AMRO Manufacturing located in El Monte, California. (Highest resolution available)

  9. Camera Layout Design for the Upper Stage Thrust Cone

    NASA Technical Reports Server (NTRS)

    Wooten, Tevin; Fowler, Bart

    2010-01-01

    Engineers in the Integrated Design and Analysis Division (EV30) use a variety of different tools to aid in the design and analysis of the Ares I vehicle. One primary tool in use is Pro-Engineer. Pro-Engineer is a computer-aided design (CAD) software that allows designers to create computer generated structural models of vehicle structures. For the Upper State thrust cone, Pro-Engineer was used to assist in the design of a layout for two camera housings. These cameras observe the separation between the first and second stage of the Ares I vehicle. For the Ares I-X, one standard speed camera was used. The Ares I design calls for two separate housings, three cameras, and a lighting system. With previous design concepts and verification strategies in mind, a new layout for the two camera design concept was developed with members of the EV32 team. With the new design, Pro-Engineer was used to draw the layout to observe how the two camera housings fit with the thrust cone assembly. Future analysis of the camera housing design will verify the stability and clearance of the camera with other hardware present on the thrust cone.

  10. Integrated Solar Upper Stage (ISUS) engine ground demonstration (EGD)

    NASA Astrophysics Data System (ADS)

    Kudija, Charles T.; Frye, Patrick E.

    1998-01-01

    The Integrated Solar Upper Stage (ISUS) Engine Ground Demonstration (EGD) Program sponsored by the Air Force Phillips Laboratory (PL) conducted a full-up ground demonstration of a solar thermal power and propulsion system at NASA Lewis Research Center in mid-1997. This test validated system capability in a relevant environment, bringing ISUS to a Technology Readiness Level (TRL) of 6, and paving the way for a flight demonstration by the turn of the century. The ISUS technology offers high specific impulse propulsion at moderate thrust levels and high power, radiation-tolerant electrical power generation. This bimodal system capability offers savings in launch vehicle costs and/or substantial increases in payload power and mass over present day satellite systems. The ISUS EGD consisted of the solar receiver/absorber/converter (RAC), power generation, management, and distribution subsystems, solar concentrator, and cryogen storage/feed subsystems. Simulation of a low Earth orbit (LEO)-to-Molniya orbit transfer (30-day trip time) as well as characterization of on-orbit power production was planned for this ground test. This paper describes the EGD test integration, setup and checkout, system acceptance tests, performance mapping, and exercise of the system through a mission-like series of operations. Key test data collected during the test series is reported along with a summary of technical insights achieved as a result of the experiment. Test data includes propulsion performance as derived from flowrate, temperature, and pressure measurements and the total number of thermal cycles.

  11. Seal Analysis for the Ares-I Upper Stage Fuel Tank Manhole Covers

    NASA Technical Reports Server (NTRS)

    Phillips, Dawn R.; Wingate, Robert J.

    2010-01-01

    Naflex seals have long history of use in launch vehicle components, including Saturn stages and Space Shuttle External Tank. Ares-I Upper Stage tank pressures are higher than ET pressures, requiring performance verification of heritage seal design in new manhole cover configurations. Heritage external tank analyses are reviewed for potential application to Upper Stage.

  12. NASA Ares I Crew Launch Vehicle Upper Stage Avionics and Software Overview

    NASA Technical Reports Server (NTRS)

    Nola, Charles L.; Blue, Lisa

    2008-01-01

    Building on the heritage of the Saturn and Space Shuttle Programs for the Design, Development, Test, and Evaluation (DDT and E) of avionics and software for NASA's Ares I Crew Launch Vehicle (CLV), the Ares I Upper Stage Element is a vital part of the Constellation Program's transportation system. The Upper Stage Element's Avionics Subsystem is actively proceeding toward its objective of delivering a flight-certified Upper Stage Avionics System for the Ares I CLV.

  13. Low Cost Upper Stage-Class Propulsion (LCUSP)

    NASA Technical Reports Server (NTRS)

    Vickers, John

    2015-01-01

    NASA is making space exploration more affordable and viable by developing and utilizing innovative manufacturing technologies. Technology development efforts at NASA in propulsion are committed to continuous innovation of design and manufacturing technologies for rocket engines in order to reduce the cost of NASA's journey to Mars. The Low Cost Upper Stage-Class Propulsion (LCUSP) effort will develop and utilize emerging Additive Manufacturing (AM) to significantly reduce the development time and cost for complex rocket propulsion hardware. Benefit of Additive Manufacturing (3-D Printing) Current rocket propulsion manufacturing techniques are costly and have lengthy development times. In order to fabricate rocket engines, numerous complex parts made of different materials are assembled in a way that allow the propellant to collect heat at the right places to drive the turbopump and simultaneously keep the thrust chamber from melting. The heat conditioned fuel and oxidizer come together and burn inside the combustion chamber to provide thrust. The efforts to make multiple parts precisely fit together and not leak after experiencing cryogenic temperatures on one-side and combustion temperatures on the other is quite challenging. Additive manufacturing has the potential to significantly reduce the time and cost of making rocket parts like the copper liner and Nickel-alloy jackets found in rocket combustion chambers where super-cold cryogenic propellants are heated and mixed to the extreme temperatures needed to propel rockets in space. The Selective Laser Melting (SLM) machine fuses 8,255 layers of copper powder to make a section of the chamber in 10 days. Machining an equivalent part and assembling it with welding and brazing techniques could take months to accomplish with potential failures or leaks that could require fixes. The design process is also enhanced since it does not require the 3D model to be converted to 2-D drawings. The design and fabrication process can be sped up and improved with fewer errors to be accomplished in weeks instead of months.

  14. Solar Thermal Upper Stage Cryogen System Engineering Checkout Test

    NASA Technical Reports Server (NTRS)

    Olsen, A. D; Cady, E. C.; Jenkins, D. S.

    1999-01-01

    The Solar Thermal Upper Stage technology (STUSTD) program is a solar thermal propulsion technology program cooperatively sponsored by a Boeing led team and by NASA MSFC. A key element of its technology program is development of a liquid hydrogen (LH2) storage and supply system which employs multi-layer insulation, liquid acquisition devices, active and passive thermodynamic vent systems, and variable 40W tank heaters to reliably provide near constant pressure H2 to a solar thermal engine in the low-gravity of space operation. The LH2 storage and supply system is designed to operate as a passive, pressure fed supply system at a constant pressure of about 45 psia. During operation of the solar thermal engine over a small portion of the orbit the LH2 storage and supply system propulsively vents through the enjoy at a controlled flowrate. During the long coast portion of the orbit, the LH2 tank is locked up (unvented). Thus, all of the vented H2 flow is used in the engine for thrust and none is wastefully vented overboard. The key to managing the tank pressure and therefore the H2 flow to the engine is to manage and balance the energy flow into the LH2 tank with the MLI and tank heaters with the energy flow out of the LH2 tank through the vented H2 flow. A moderate scale (71 cu ft) LH2 storage and supply system was installed and insulated at the NASA MSFC Test Area 300. The operation of the system is described in this paper. The test program for the LH2 system consisted of two parts: 1) a series of engineering tests to characterize the performance of the various components in the system: and 2) a 30-day simulation of a complete LEO and GEO transfer mission. This paper describes the results of the engineering tests, and correlates these results with analytical models used to design future advanced Solar Orbit Transfer Vehicles.

  15. Additive Manufacturing of Low Cost Upper Stage Propulsion Components

    NASA Technical Reports Server (NTRS)

    Protz, Christopher; Bowman, Randy; Cooper, Ken; Fikes, John; Taminger, Karen; Wright, Belinda

    2014-01-01

    NASA is currently developing Additive Manufacturing (AM) technologies and design tools aimed at reducing the costs and manufacturing time of regeneratively cooled rocket engine components. These Low Cost Upper Stage Propulsion (LCUSP) tasks are funded through NASA's Game Changing Development Program in the Space Technology Mission Directorate. The LCUSP project will develop a copper alloy additive manufacturing design process and develop and optimize the Electron Beam Freeform Fabrication (EBF3) manufacturing process to direct deposit a nickel alloy structural jacket and manifolds onto an SLM manufactured GRCop chamber and Ni-alloy nozzle. In order to develop these processes, the project will characterize both the microstructural and mechanical properties of the SLMproduced GRCop-84, and will explore and document novel design techniques specific to AM combustion devices components. These manufacturing technologies will be used to build a 25K-class regenerative chamber and nozzle (to be used with tested DMLS injectors) that will be tested individually and as a system in hot fire tests to demonstrate the applicability of the technologies. These tasks are expected to bring costs and manufacturing time down as spacecraft propulsion systems typically comprise more than 70% of the total vehicle cost and account for a significant portion of the development schedule. Additionally, high pressure/high temperature combustion chambers and nozzles must be regeneratively cooled to survive their operating environment, causing their design to be time consuming and costly to build. LCUSP presents an opportunity to develop and demonstrate a process that can infuse these technologies into industry, build competition, and drive down costs of future engines.

  16. Carboplatin and Paclitaxel With or Without Cisplatin and Radiation Therapy in Treating Patients With Stage I, Stage II, Stage III, or Stage IVA Endometrial Cancer

    ClinicalTrials.gov

    2016-02-09

    Endometrial Clear Cell Adenocarcinoma; Endometrial Serous Adenocarcinoma; Stage IA Uterine Corpus Cancer; Stage IB Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer

  17. Lenalidomide and Rituximab in Treating Patients With Previously Untreated Stage II, Stage III, or Stage IV Follicular Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2016-01-22

    Stage II Grade 1 Contiguous Follicular Lymphoma; Stage II Grade 1 Non-Contiguous Follicular Lymphoma; Stage II Grade 2 Contiguous Follicular Lymphoma; Stage II Grade 2 Non-Contiguous Follicular Lymphoma; Stage II Grade 3 Contiguous Follicular Lymphoma; Stage II Grade 3 Non-Contiguous Follicular Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma

  18. Changes in Brain Function in Patients With Stage I, Stage II, Stage III, or Stage IV Ovarian, Primary Peritoneal, or Fallopian Tube Cancer Who Are Receiving Chemotherapy

    ClinicalTrials.gov

    2016-02-09

    Cognitive Side Effects of Cancer Therapy; Malignant Ovarian Epithelial Tumor; Malignant Ovarian Mixed Epithelial Tumor; Ovarian Brenner Tumor; Ovarian Carcinosarcoma; Ovarian Choriocarcinoma; Ovarian Clear Cell Cystadenocarcinoma; Ovarian Dysgerminoma; Ovarian Embryonal Carcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mixed Germ Cell Tumor; Ovarian Mucinous Cystadenocarcinoma; Ovarian Polyembryoma; Ovarian Sarcoma; Ovarian Serous Cystadenocarcinoma; Ovarian Teratoma; Ovarian Yolk Sac Tumor; Stage I Ovarian Cancer; Stage IA Fallopian Tube Cancer; Stage IA Ovarian Cancer; Stage IA Ovarian Germ Cell Tumor; Stage IB Fallopian Tube Cancer; Stage IB Ovarian Cancer; Stage IB Ovarian Germ Cell Tumor; Stage IC Fallopian Tube Cancer; Stage IC Ovarian Cancer; Stage IC Ovarian Germ Cell Tumor; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Ovarian Germ Cell Tumor; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Ovarian Germ Cell Tumor; Stage IV Primary Peritoneal Cancer; Undifferentiated Ovarian Carcinoma

  19. Physics Identity Development: A Snapshot of the Stages of Development of Upper-Level Physics Students

    ERIC Educational Resources Information Center

    Irving, Paul W.; Sayre, Eleanor C.

    2013-01-01

    As part of a longitudinal study into identity development in upper-level physics students a phenomenographic research method is employed to assess the stages of identity development of a group of upper-level students. Three categories of description were discovered which indicate the three different stages of identity development for this group

  20. Two BRM promoter insertion polymorphisms increase the risk of early-stage upper aerodigestive tract cancers

    PubMed Central

    Wong, Kit Man; Qiu, Xiaoping; Cheng, Dangxiao; Azad, Abul Kalam; Habbous, Steven; Palepu, Prakruthi; Mirshams, Maryam; Patel, Devalben; Chen, Zhuo; Roberts, Heidi; Knox, Jennifer; Marquez, Stephanie; Wong, Rebecca; Darling, Gail; Waldron, John; Goldstein, David; Leighl, Natasha; Shepherd, Frances A; Tsao, Ming; Der, Sandy; Reisman, David; Liu, Geoffrey

    2014-01-01

    Brahma (BRM) has a key function in chromatin remodeling. Two germline BRM promoter insertiondeletion polymorphisms, BRM-741 and BRM-1321, have been previously associated with an increased risk of lung cancer in smokers and head and neck cancer. To further evaluate their role in cancer susceptibility particularly in early disease, we conducted a preplanned casecontrol study to investigate the association between the BRM promoter variants and stage I/II upper aerodigestive tract (UADT) cancers (i.e., lung, esophageal, head and neck), a group of early-stage malignancies in which molecular and genetic etiologic factors are poorly understood. The effects of various clinical factors on this association were also studied. We analyzed 562 cases of early-stage UADT cancers and 993 matched healthy controls. The double homozygous BRM promoter variants were associated with a significantly increased risk of early stage UADT cancers (adjusted odds ratio [aOR], 2.46; 95% confidence interval [CI], 1.73.8). This association was observed in lung (aOR, 2.61; 95% CI, 1.54.9) and head and neck (aOR, 2.75; 95% CI, 1.45.6) cancers, but not significantly in esophageal cancer (aOR, 1.66; 95% CI, 0.75.8). There was a nonsignificant trend for increased risk in the heterozygotes or single homozygotes. The relationship between the BRM polymorphisms and early-stage UADT cancers was independent of age, sex, smoking status, histology, and clinical stage. These findings suggest that the BRM promoter double insertion homozygotes may be associated with an increased risk of early-stage UADT cancers independent of smoking status and histology, which must be further validated in other populations. PMID:24519853

  1. Vorinostat, Rituximab, and Combination Chemotherapy in Treating Patients With Newly Diagnosed Stage II, Stage III, or Stage IV Diffuse Large B-Cell Lymphoma

    ClinicalTrials.gov

    2015-12-30

    Stage II Contiguous Adult Diffuse Large Cell Lymphoma; Stage II Non-Contiguous Adult Diffuse Large Cell Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma

  2. STAGING OF FUEL CELLS - PHASE II

    SciTech Connect

    Per Onnerud; Suresh Sriramulu

    2002-08-29

    TIAX has executed a laboratory-based development program aiming at the improvement of stationary fuel cell systems. The two-year long development program resulted in an improved understanding of staged fuel cells and inorganic proton conductors through evaluation of results from a number of laboratory tasks: (1) Development of a fuel cell modeling tool--Multi-scale model was developed, capable of analyzing the effects of materials and operating conditions; and this model allowed studying various ''what-if'' conditions for hypothetically staged fuel cells; (2) Study of new high temperature proton conductor--TIAX discovery of a new class of sulfonated inorganics capable of conducting protons when exposed to water; and study involved synthesis and conductivity measurements of novel compounds up to 140 C; (3) Electrochemical fuel cell measurements--the feasibility of staged fuel cells was tested in TIAX's fuel cell laboratories experimental design was based on results from modeling.

  3. Ares I Upper Stage Pressure Tests in Wind Tunnel

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Under the goals of the Vision for Space Exploration, Ares I is a chief component of the cost-effective space transportation infrastructure being developed by NASA's Constellation Program. This transportation system will safely and reliably carry human explorers back to the moon, and then onward to Mars and other destinations in the solar system. The Ares I effort includes multiple project element teams at NASA centers and contract organizations around the nation, and is managed by the Exploration Launch Projects Office at NASA's Marshall Space Flight Center (MFSC). ATK Launch Systems near Brigham City, Utah, is the prime contractor for the first stage booster. ATK's subcontractor, United Space Alliance of Houston, is designing, developing and testing the parachutes at its facilities at NASA's Kennedy Space Center in Florida. NASA's Johnson Space Center in Houston hosts the Constellation Program and Orion Crew Capsule Project Office and provides test instrumentation and support personnel. Together, these teams are developing vehicle hardware, evolving proven technologies, and testing components and systems. Their work builds on powerful, reliable space shuttle propulsion elements and nearly a half-century of NASA space flight experience and technological advances. Ares I is an inline, two-stage rocket configuration topped by the Crew Exploration Vehicle, its service module, and a launch abort system. In this HD video image, the first stage reentry 1/2% model is undergoing pressure measurements inside the wind tunnel testing facility at MSFC. (Highest resolution available)

  4. Reusable Agena study. Volume 1: Executive summary. [space shuttle Agena upper stage tug concept

    NASA Technical Reports Server (NTRS)

    1974-01-01

    The shuttle Agena upper stage interim tug concept is based on a building block approach. These building block concepts are extensions of existing ascent Agena configurations. Several current improvements, have been used in developing the shuttle/Agena upper stage concepts. High-density acid is used as the Agena upper stage oxidizer. The baffled injector is used in the main engine. The DF-224 is a fourth generation computer currently in development and will be flight proven in the near future. The Agena upper stage building block concept uses the current Agena as a baseline, adds an 8.5-inch (21.6 cm) extension to the fuel tank for optimum mixture ratio, uses monomethyl hydrazine as fuel, exchanges a 150:1 nozzle extension for the existing 45:1, exchanges an Autonetics DF-224 for the existing Honeywell computer, and adds a star sensor for guidance update. These modifications to the current Agena provide a 5-foot (1.52m) diameter shuttle/Agena upper stage that will fly all Vandenberg Air Force Base missions in the reusable mode without resorting to a kick motor. The delta V velocity of the Agena is increased by use of a strap-on propellant tank option. This option provides a shuttle/Agena upper stage with the capability to place almost 3900 pounds (1769 kg) into geosynchronous orbit (24 hour period) without the aid of kick motors.

  5. Seal Analysis for the Ares-I Upper Stage Fuel Tank Manhole Cover

    NASA Technical Reports Server (NTRS)

    Phillips, Dawn R.; Wingate, Robert J.

    2010-01-01

    Techniques for studying the performance of Naflex pressure-assisted seals in the Ares-I Upper Stage liquid hydrogen tank manhole cover seal joint are explored. To assess the feasibility of using the identical seal design for the Upper Stage as was used for the Space Shuttle External Tank manhole covers, a preliminary seal deflection analysis using the ABAQUS commercial finite element software is employed. The ABAQUS analyses are performed using three-dimensional symmetric wedge finite element models. This analysis technique is validated by first modeling a heritage External Tank liquid hydrogen tank manhole cover joint and correlating the results to heritage test data. Once the technique is validated, the Upper Stage configuration is modeled. The Upper Stage analyses are performed at 1.4 times the expected pressure to comply with the Constellation Program factor of safety requirement on joint separation. Results from the analyses performed with the External Tank and Upper Stage models demonstrate the effects of several modeling assumptions on the seal deflection. The analyses for Upper Stage show that the integrity of the seal is successfully maintained.

  6. Rituximab, Lenalidomide, and Ibrutinib in Treating Patients With Previously Untreated Stage II-IV Follicular Lymphoma

    ClinicalTrials.gov

    2016-01-12

    Stage II Grade 1 Contiguous Follicular Lymphoma; Stage II Grade 1 Non-Contiguous Follicular Lymphoma; Stage II Grade 2 Contiguous Follicular Lymphoma; Stage II Grade 2 Non-Contiguous Follicular Lymphoma; Stage II Grade 3 Contiguous Follicular Lymphoma; Stage II Grade 3 Non-Contiguous Follicular Lymphoma; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Grade 3 Follicular Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma

  7. Results of radiotherapy for stage I and II Hodgkin's disease

    SciTech Connect

    Lowery, G.S.; Ferree, C.R.; Raben, M.

    1982-06-01

    Fifty-six patients with pathologically staged I and II (A and B) Hodgkin's disease were treated with radiation therapy. Three-year relapse-free survival, total survival, and complications were analyzed. Chemotherapy was valuable as rescue treatment and as part of the initial treatment in patients with stage IIB disease. Complications were minimal.

  8. Two technicians apply insulation to S-II second stage

    NASA Technical Reports Server (NTRS)

    1964-01-01

    Two technicians apply insulation to the outer surface of the S-II second stage booster for the Saturn V moon rocket. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

  9. Assembly of 5.5-Meter Diameter Developmental Barrel Segments for the Ares I Upper Stage

    NASA Technical Reports Server (NTRS)

    Carter, Robert W.

    2011-01-01

    Full scale assembly welding of Ares I Upper Stage 5.5-Meter diameter cryogenic tank barrel segments has been performed at the Marshall Space Flight Center (MSFC). One full-scale developmental article produced under the Ares 1 Upper Stage project is the Manufacturing Demonstration Article (MDA) Barrel. This presentation will focus on the welded assembly of this barrel section, and associated lessons learned. Among the MDA articles planned on the Ares 1 Program, the Barrel was the first to be completed, primarily because the process of manufacture from piece parts (barrel panels) utilized the most mature friction stir process planned for use on the Ares US program: Conventional fixed pin Friction Stir Welding (FSW). This process is in use on other space launch systems, including the Shuttle s External Tank, the Delta IV common booster core, the Delta II, and the Atlas V rockets. The goals for the MDA Barrel development were several fold: 1) to prove out Marshall Space Flight Center s new Vertical Weld Tool for use in manufacture of cylindrical barrel sections, 2) to serve as a first run for weld qualification to a new weld specification, and 3) to provide a full size cylindrical section for downstream use in precision cleaning and Spray-on Foam Insulation development. The progression leading into the welding of the full size barrel included sub scale panel welding, subscale cylinder welding, a full length confidence weld, and finally, the 3 seamed MDA barrel processing. Lessons learned on this MDA program have been carried forward into the production tooling for the Ares 1 US Program, and in the use of the MSFC VWT in processing other large scale hardware, including two 8.4 meter diameter Shuttle External Tank barrel sections that are currently being used in structural analysis to validate shell buckling models.

  10. Cetuximab, Cisplatin, and Radiation Therapy in Treating Patients With Stage IB, Stage II, Stage III, or Stage IVA Cervical Cancer

    ClinicalTrials.gov

    2014-12-29

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Small Cell Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB Cervical Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage IVA Cervical Cancer

  11. Creation of an Upper Stage Trajectory Capability Boundary to Enable Booster System Trade Space Exploration

    NASA Technical Reports Server (NTRS)

    Walsh, Ptrick; Coulon, Adam; Edwards, Stephen; Mavris, Dimitri N.

    2012-01-01

    The problem of trajectory optimization is important in all space missions. The solution of this problem enables one to specify the optimum thrust steering program which should be followed to achieve a specified mission objective, simultaneously satisfying the constraints.1 It is well known that whether or not the ascent trajectory is optimal can have a significant impact on propellant usage for a given payload, or on payload weight for the same gross vehicle weight.2 Consequently, ascent guidance commands are usually optimized in some fashion. Multi-stage vehicles add complexity to this analysis process as changes in vehicle properties in one stage propagate to the other stages through gear ratios and changes in the optimal trajectory. These effects can cause an increase in analysis time as more variables are added and convergence of the optimizer to system closure requires more analysis iterations. In this paper, an approach to simplifying this multi-stage problem through the creation of an upper stage capability boundary is presented. This work was completed as part of a larger study focused on trade space exploration for the advanced booster system that will eventually form a part of NASA s new Space Launch System.3 The approach developed leverages Design of Experiments and Surrogate Modeling4 techniques to create a predictive model of the SLS upper stage performance. The design of the SLS core stages is considered fixed for the purposes of this study, which results in trajectory parameters such as staging conditions being the only variables relevant to the upper stage. Through the creation of a surrogate model, which takes staging conditions as inputs and predicts the payload mass delivered by the SLS upper stage to a reference orbit as the response, it is possible to identify a "surface" of staging conditions which all satisfy the SLS requirement of placing 130 metric tons into low-Earth orbit (LEO).3 This identified surface represents the 130 metric ton capability boundary for the upper stage, such that if the combined first stage and boosters can achieve any one staging point on that surface, then the design is identified as feasible. With the surrogate model created, design and analysis of advanced booster concepts is streamlined, as optimization of the upper stage trajectory is no longer required in every design loop.

  12. Study of a High-Energy Upper Stage for Future Shuttle Missions

    NASA Technical Reports Server (NTRS)

    Dressler, Gordon A.; Matuszak, Leo W.; Stephenson, David D.

    2003-01-01

    Space Shuttle Orbiters are likely to remain in service to 2020 or beyond for servicing the International Space Station and for launching very high value spacecraft. There is a need for a new STS-deployable upper stage that can boost certain Orbiter payloads to higher energy orbits, up to and including Earth-escape trajectories. The inventory of solid rocket motor Inertial Upper Stages has been depleted, and it is unlikely that a LOX/LH2-fueled upper stage can fly on Shuttle due to safety concerns. This paper summarizes the results of a study that investigated a low cost, low risk approach to quickly developing a new large upper stage optimized to fly on the existing Shuttle fleet. Two design reference missions (DRMs) were specified: the James Webb Space Telescope (JWST) and the Space Interferometry Mission (SIM). Two categories of upper stage propellants were examined in detail: a storable liquid propellant and a storable gel propellant. Stage subsystems 'other than propulsion were based largely on heritage hardware to minimize cost, risk and development schedule span. The paper presents the ground rules and guidelines for conducting the study, the preliminary conceptual designs margins, assessments of technology readiness/risk, potential synergy with other programs, and preliminary estimates of development and production costs and schedule spans. Although the Orbiter Columbia was baselined for the study, discussion is provided to show how the results apply to the remaining STS Orbiter fleet.

  13. Prognostic Subgroups among Patients with Stage II Colon Cancer.

    PubMed

    Boland, C Richard; Goel, Ajay

    2016-01-21

    Colon cancer has traditionally been treated surgically. However, many cases of colon cancer are systemic at the time of diagnosis, and apparently curative surgery is followed at a later date by tumor recurrence as a consequence of circulating tumor cells before the surgery. Adjuvant medical therapies are designed to prevent recurrences after surgical resection. The current standard for clinical prognostication relies principally on pathological staging. In early-stage colon cancers (stages I and II), all the tumor is contained within the wall of the colon. Less than 10% of patients with stage I disease have a recurrence, and adjuvant chemotherapy is ... PMID:26789877

  14. Omicron space habitatresearch stage II

    NASA Astrophysics Data System (ADS)

    Doule, Ond?ej; len, Vratislav; Hrin, Benot; Rousek, Tom

    2012-01-01

    The design presented in this paper is in response to the revolution in private space activities, the increasing public interest in commercial flights to space and the utilization of structures such as space hotels or private orbital habitats. The baseline for the Omicron design concept is the Russian Salyut derived space station module. Salyut was the first space station to orbit the Earth. Its unique design and technical features were what made the development of space stations Salyut 1-7, MIR and the International Space Station (ISS) Zwezda service module possible. Due to its versatility and the reliable operating launch vehicle Proton, this space module series has the potential to be adapted for space hotel development. This paper proposes a conceptual design of the space habitat called Omicron, with particular focus on interior design for the microgravity environment. The Omicron concepts address the needs of space tourism with a strong emphasis on the safety and comfort of the spaceflight participants. The Omicron habitat supports three inhabitants in nominal conditions (e.g., two passengers and one astronaut). The habitat provides a flexible interior, facilities and spaces dynamically transforming in order to accommodate various types of activities, which will be performed in an organically formed interior supporting spatial orientation and movement in microgravity. The future development potential of Omicron is also considered. The baseline version is composed solely of one rigid module with an inverted cupola for observations. An alternative version offers more space using an inflatable structure. Finally, a combination of multiple Omicron modules enables the creation of a larger orbital habitat. The Omicron's subsystems support a few days visit by trained passengers. The transport to the habitat would be provided e.g., by the Soyuz TMA spacecraft carried by the Soyuz launch vehicle in the early stage of Omicron's development, before a fully reusable spacecraft would be available.

  15. Curcumin and Cholecalciferol in Treating Patients With Previously Untreated Stage 0-II Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

    ClinicalTrials.gov

    2016-02-16

    Contiguous Stage II Small Lymphocytic Lymphoma; Noncontiguous Stage II Small Lymphocytic Lymphoma; Stage 0 Chronic Lymphocytic Leukemia; Stage I Chronic Lymphocytic Leukemia; Stage I Small Lymphocytic Lymphoma; Stage II Chronic Lymphocytic Leukemia

  16. Development of H-II rocket first stage propulsion system

    NASA Astrophysics Data System (ADS)

    Nagai, H.; Taniguchi, H.; Suzuki, A.; Yamazaki, I.

    1985-10-01

    The H-II rocket will serve as Japan's main launch vehicle in the 1990's, with the capability of placing a two-ton satellite into geostationary orbit. This paper presents the basic plan of the overall LOX/LH2 propulsion system of the H-II rocket first stage. The system description includes tank pressurization, pneumatic control, the auxiliary engine, pogo suppression, chilldown of the main engine, component development, and firing tests. The test facility is also described.

  17. TROJID: A portable software package for upper-stage trajectory optimization

    NASA Technical Reports Server (NTRS)

    Hammes, Steven M.

    1990-01-01

    Performance optimization for upper-stage exoatmospheric vehicles often is performed within the framework of a full capability trajectory simulation package requiring either a large mainframe computer or powerful work-station. Since these software packages tend to include capabilities providing for high-fidelity boost and reentry simulations, the programs usually are quite large and not very portable. The program TROJID is an attempt to provide an environment for the optimization of upper-stage trajectories within a small package capable of being run on a standard desktop microcomputer. Utilizing a state-of-the-art nonlinear programming algorithm and a trajectory simulator implementing impulsive burns and an analytic coast phase propagator, TROJID is capable of producing trajectories for optimal multi-burn upper-stage orbit transfers. The package has been designed to allow full generality in definition of both the trajectory simulator and the parameter optimization problem.

  18. NASA Ares 1 Crew Launch Vehicle Upper Stage Configuration Selection Process

    NASA Technical Reports Server (NTRS)

    Cook, Jerry R.

    2006-01-01

    The Upper Stage Element of NASA s Ares I Crew Launch Vehicle (CLV) is a "clean-sheet" approach that is being designed and developed in-house, with Element management at MSFC. The USE concept is a self-supporting cylindrical structure, approximately 115 long and 216" in diameter. While the Reusable Solid Rocket Booster (RSRB) design has changed since the CLV inception, the Upper Stage Element design has remained essentially a clean-sheet approach. Although a clean-sheet upper stage design inherently carries more risk than a modified design, it does offer many advantages: a design for increased reliability; built-in extensibility to allow for commonality/growth without major redesign; and incorporation of state-of-the-art materials, hardware, and design, fabrication, and test techniques and processes to facilitate a potentially better, more reliable system.

  19. Multiple Removal of Spent Rocket Upper Stages with an Ion Beam Shepherd

    NASA Astrophysics Data System (ADS)

    Bombardelli, C.; Herrera-Montojo, J.; Gonzalo, J. L.

    2013-08-01

    Among the many advantages of the recently proposed ion beam shepherd (IBS) debris removal technique is the capability to deal with multiple targets in a single mission. A preliminary analysis is here conducted in order to estimate the cost in terms of spacecraft mass and total mission time to remove multiple large-size upper stages of the Zenit family. Zenit-2 upper stages are clustered at 71 degrees inclination around 850 km altitude in low Earth orbit. It is found that a removal of two targets per year is feasible with a modest size spacecraft. The most favorable combinations of targets are outlined.

  20. Simulink Model of the Ares I Upper Stage Main Propulsion System

    NASA Technical Reports Server (NTRS)

    Burchett, Bradley T.

    2008-01-01

    A numerical model of the Ares I upper stage main propulsion system is formulated based on first principles. Equation's are written as non-linear ordinary differential equations. The GASP fortran code is used to compute thermophysical properties of the working fluids. Complicated algebraic constraints are numerically solved. The model is implemented in Simulink and provides a rudimentary simulation of the time history of important pressures and temperatures during re-pressurization, boost and upper stage firing. The model is validated against an existing reliable code, and typical results are shown.

  1. Subsystem Hazard Analysis Methodology for the Ares I Upper Stage Source Controlled Items

    NASA Technical Reports Server (NTRS)

    Mitchell, Michael S.; Winner, David R.

    2010-01-01

    This article describes processes involved in developing subsystem hazard analyses for Source Controlled Items (SCI), specific components, sub-assemblies, and/or piece parts, of the NASA ARES I Upper Stage (US) project. SCIs will be designed, developed and /or procured by Boeing as an end item or an off-the-shelf item. Objectives include explaining the methodology, tools, stakeholders and products involved in development of these hazard analyses. Progress made and further challenges in identifying potential subsystem hazards are also provided in an effort to assist the System Safety community in understanding one part of the ARES I Upper Stage project.

  2. Utilization of solid-propellant upper stages in STS payload orbital operations

    NASA Technical Reports Server (NTRS)

    Wilson, S. W.

    1976-01-01

    The main purpose of this report is to discuss techniques of trajectory design, maneuver execution, and stage loading that are compatible with the use of SRM's (solid rocket motors) which, once ignited, must burn to propellant depletion. It is anticipated that some shuttle payloads will use non-IUS (interim upper stage) solid propellant kick stages; therefore this subject is also pertinent to shuttle flights other than those involving the use of the IUS. The SRM utilization techniques can be divided into two major categories: (1) those in which the stage performance is adjusted to match the velocity increment magnitude requirements of a preselected trajectory, and (2) those in which the trajectory is designed to match the velocity increment magnitude capability of the stage(s).

  3. Maturation of enabling technologies for the next generation reignitable cryogenic upper stage

    NASA Astrophysics Data System (ADS)

    Mueller, Mark

    Following the ESA decision in November 2008, a pre-development phase (Phase 1) of a future evolution of the Ariane 5 launcher (named Ariane 5 Midlife Evolution, A5ME) was started under Astrium Prime leadership. This upgraded version of the Ariane 5 launcher is based on an enhanced performance Upper Stage including the cryogenic re-ignitable VINCI engine. Thanks to this reignition capability, this new Upper Stage shall be "versatile" in the sense that it shall fulfil customer needs on a broader spectrum of orbits than the "standard" orbits (i.e. Geosynchronous Transfer Orbits, GTO) typically used for commercial telecommunications satellites. In order to meet the challenges of versatility, new technologies are currently being investigated. These technologies are mainly related -but not limited-to propellant management during the extended coasting phases with the related heat transfer into the tanks and the required multiple engine re-ignitions. Within the frame of the ESA Future Launchers Preparatory Programme (Period 2 Slice 1), the Cryogenic Upper Stage Technology project (CUST) aims to mature critical technologies to such a Technology Readiness Level (TRL) that they can be integrated into the baseline A5ME Upper Stage development schedule. In addition to A5ME application, these technologies can also be used on the future next generation European launcher. This paper shows the down-selection process implemented to identify the most crucial enabling technologies for a future versatile Upper Stage and gives a description of each technology finally selected for maturation in the frame of CUST. These include -amongst others-a Sandwich Common Bulkhead for the propellant tank, an external thermal insulation kit and various propellant management devices for the coasting phase. The paper also gives an overview on the related development and maturation plan including the tests to be conducted, as well as first results of the maturation activities themselves.

  4. Individualized Treatment in Treating Patients With Stage II-IVB Nasopharyngeal Cancer Based on EBV DNA

    ClinicalTrials.gov

    2015-03-06

    Epstein-Barr Virus Infection; Stage II Nasopharyngeal Keratinizing Squamous Cell Carcinoma; Stage II Nasopharyngeal Undifferentiated Carcinoma; Stage III Nasopharyngeal Keratinizing Squamous Cell Carcinoma; Stage III Nasopharyngeal Undifferentiated Carcinoma; Stage IV Nasopharyngeal Keratinizing Squamous Cell Carcinoma; Stage IV Nasopharyngeal Undifferentiated Carcinoma

  5. Lessons Learned from Ares I Upper Stage Structures and Thermal Design

    NASA Technical Reports Server (NTRS)

    Ahmed, Rafiq

    2012-01-01

    The Ares 1 Upper Stage was part of the vehicle intended to succeed the Space Shuttle as the United States manned spaceflight vehicle. Although the Upper Stage project was cancelled, there were many lessons learned that are applicable to future vehicle design. Lessons learned that are briefly detailed in this Technical Memorandum are for specific technical areas such as tank design, common bulkhead design, thrust oscillation, control of flight and slosh loads, purge and hazardous gas system. In addition, lessons learned from a systems engineering and vehicle integration perspective are also included, such as computer aided design and engineering, scheduling, and data management. The need for detailed systems engineering in the early stages of a project is emphasized throughout this report. The intent is that future projects will be able to apply these lessons learned to keep costs down, schedules brief, and deliver products that perform to the expectations of their customers.

  6. Analytical Approach for Estimating Preliminary Mass of ARES I Crew Launch Vehicle Upper Stage Structural Components

    NASA Technical Reports Server (NTRS)

    Aggarwal, Pravin

    2007-01-01

    In January 2004, President Bush gave the National Aeronautics and Space Administration (NASA) a vision for Space Exploration by setting our sight on a bold new path to go back to the Moon, then to Mars and beyond. In response to this vision, NASA started the Constellation Program, which is a new exploration launch vehicle program. The primary mission for the Constellation Program is to carry out a series of human expeditions ranging from Low Earth Orbit to the surface of Mars and beyond for the purposes of conducting human exploration of space, as specified by the Vision for Space Exploration (VSE). The intent is that the information and technology developed by this program will provide the foundation for broader exploration activities as our operational experience grows. The ARES I Crew Launch Vehicle (CLV) has been designated as the launch vehicle that will be developed as a "first step" to facilitate the aforementioned human expeditions. The CLV Project is broken into four major elements: First Stage, Upper Stage Engine, Upper Stage (US), and the Crew Exploration Vehicle (CEV). NASA's Marshall Space Flight Center (MSFC) is responsible for the design of the CLV and has the prime responsibility to design the upper stage of the vehicle. The US is the second propulsive stage of the CLV and provides CEV insertion into low Earth orbit (LEO) after separation from the First Stage of the Crew Launch Vehicle. The fully integrated Upper Stage is a mix of modified existing heritage hardware (J-2X Engine) and new development (primary structure, subsystems, and avionics). The Upper Stage assembly is a structurally stabilized cylindrical structure, which is powered by a single J-2X engine which is developed as a separate Element of the CLV. The primary structure includes the load bearing liquid hydrogen (LH2) and liquid oxygen (LOX) propellant tanks, a Forward Skirt, the Intertank structure, the Aft Skirt and the Thrust Structure. A Systems Tunnel, which carries fluid and electrical power functions to other Elements of the CLV, is included as secondary structure. The MSFC has an overall responsibility for the integrated US element as well as structural design an thermal control of the fuel tanks, intertank, interstage, avionics, main propulsion system, Reaction Control System (RCS) for both the Upper Stage and the First Stage. MSFC's Spacecraft and Vehicle Department, Structural and Analysis Design Division is developing a set of predicted mass of these elements. This paper details the methodology, criterion and tools used for the preliminary mass predictions of the upper stage structural assembly components. In general, weight of the cylindrical barrel sections are estimated using the commercial code Hypersizer, whereas, weight of the domes are developed using classical solutions. HyperSizer is software that performs automated structural analysis and sizing optimization based on aerospace methods for strength, stability, and stiffness. Analysis methods range from closed form, traditional hand calculations repeated every day in industry to more advanced panel buckling algorithms. Margin-of-safety reporting for every potential failure provides the engineer with a powerful insight into the structural problem. Optimization capabilities include finding minimum weight panel or beam concepts, material selections, cross sectional dimensions, thicknesses, and lay-ups from a library of 40 different stiffened and sandwich designs and a database of composite, metallic, honeycomb, and foam materials. Multiple different concepts (orthogrid, isogrid, and skin stiffener) were run for multiple loading combinations of ascent design load with and with out tank pressure as well as proof pressure condition. Subsequently, selected optimized concept obtained from Hypersizer runs was translated into a computer aid design (CAD) model to account for the wall thickness tolerance, weld land etc for developing the most probable weight of the components. The flow diram summarizes the analysis steps used in developing these predicted mass.

  7. Reusable launch vehicles, enabling technology for the development of advanced upper stages and payloads

    SciTech Connect

    Metzger, John D.

    1998-01-15

    In the near future there will be classes of upper stages and payloads that will require initial operation at a high-earth orbit to reduce the probability of an inadvertent reentry that could result in a detrimental impact on humans and the biosphere. A nuclear propulsion system, such as was being developed under the Space Nuclear Thermal Propulsion (SNTP) Program, is an example of such a potential payload. This paper uses the results of a reusable launch vehicle (RLV) study to demonstrate the potential importance of a Reusable Launch Vehicle (RLV) to test and implement an advanced upper stage (AUS) or payload in a safe orbit and in a cost effective and reliable manner. The RLV is a horizontal takeoff and horizontal landing (HTHL), two-stage-to-orbit (TSTO) vehicle. The results of the study shows that an HTHL is cost effective because it implements airplane-like operation, infrastructure, and flight operations. The first stage of the TSTO is powered by Rocket-Based-Combined-Cycle (RBCC) engines, the second stage is powered by a LOX/LH rocket engine. The TSTO is used since it most effectively utilizes the capability of the RBCC engine. The analysis uses the NASA code POST (Program to Optimize Simulated Trajectories) to determine trajectories and weight in high-earth orbit for AUS/advanced payloads. Cost and reliability of an RLV versus current generation expandable launch vehicles are presented.

  8. Reusable launch vehicles, enabling technology for the development of advanced upper stages and payloads

    NASA Astrophysics Data System (ADS)

    Metzger, John D.

    1998-01-01

    In the near future there will be classes of upper stages and payloads that will require initial operation at a high-earth orbit to reduce the probability of an inadvertent reentry that could result in a detrimental impact on humans and the biosphere. A nuclear propulsion system, such as was being developed under the Space Nuclear Thermal Propulsion (SNTP) Program, is an example of such a potential payload. This paper uses the results of a reusable launch vehicle (RLV) study to demonstrate the potential importance of a Reusable Launch Vehicle (RLV) to test and implement an advanced upper stage (AUS) or payload in a safe orbit and in a cost effective and reliable manner. The RLV is a horizontal takeoff and horizontal landing (HTHL), two-stage-to-orbit (TSTO) vehicle. The results of the study shows that an HTHL is cost effective because it implements airplane-like operation, infrastructure, and flight operations. The first stage of the TSTO is powered by Rocket-Based-Combined-Cycle (RBCC) engines, the second stage is powered by a LOX/LH rocket engine. The TSTO is used since it most effectively utilizes the capability of the RBCC engine. The analysis uses the NASA code POST (Program to Optimize Simulated Trajectories) to determine trajectories and weight in high-earth orbit for AUS/advanced payloads. Cost and reliability of an RLV versus current generation expandable launch vehicles are presented.

  9. LOX/LH2 propulsion system for launch vehicle upper stage, test results

    NASA Technical Reports Server (NTRS)

    Ikeda, T.; Imachi, U.; Yuzawa, Y.; Kondo, Y.; Miyoshi, K.; Higashino, K.

    1984-01-01

    The test results of small LOX/LH2 engines for two propulsion systems, a pump fed system and a pressure fed system are reported. The pump fed system has the advantages of higher performances and higher mass fraction. The pressure fed system has the advantages of higher reliability and relative simplicity. Adoption of these cryogenic propulsion systems for upper stage of launch vehicle increases the payload capability with low cost. The 1,000 kg thrust class engine was selected for this cryogenic stage. A thrust chamber assembly for the pressure fed propulsion system was tested. It is indicated that it has good performance to meet system requirements.

  10. Upper Stage Flight Experiment 10K Engine Design and Test Results

    NASA Technical Reports Server (NTRS)

    Ross, R.; Morgan, D.; Crockett, D.; Martinez, L.; Anderson, W.; McNeal, C.

    2000-01-01

    A 10,000 lbf thrust chamber was developed for the Upper Stage Flight Experiment (USFE). This thrust chamber uses hydrogen peroxide/JP-8 oxidizer/fuel combination. The thrust chamber comprises an oxidizer dome and manifold, catalyst bed assembly, fuel injector, and chamber/nozzle assembly. Testing of the engine was done at NASA's Stennis Space Center (SSC) to verify its performance and life for future upper stage or Reusable Launch Vehicle applications. Various combinations of silver screen catalyst beds, fuel injectors, and combustion chambers were tested. Results of the tests showed high C* efficiencies (97% - 100%) and vacuum specific impulses of 275 - 298 seconds. With fuel film cooling, heating rates were low enough that the silica/quartz phenolic throat experienced minimal erosion. Mission derived requirements were met, along with a perfect safety record.

  11. Growing a Training System and Culture for the Ares I Upper Stage Project

    NASA Technical Reports Server (NTRS)

    Scott, David W.

    2009-01-01

    In roughly two years time, Marshall Space Flight Center s (MSFC) Mission Operations Laboratory (MOL) has incubated a personnel training and certification program for about 1000 learners and multiple phases of the Ares I Upper Stage (US) project. Previous MOL-developed training programs focused on about 100 learners with a focus on operations, and had enough full-time training staff to develop courseware and provide training administration. This paper discusses 1) the basics of MOL's training philosophy, 2) how creation of a broad, structured training program unfolded as feedback from more narrowly defined tasks, 3) how training philosophy, development methods, and administration are being simplified and tailored so that many Upper Stage organizations can "grow their own" training yet maintain consistency, accountability, and traceability across the project, 4) interfacing with the production contractor's training system and staff, and 5) reaping training value from existing materials and events.

  12. Infusing Training into the Documentation and Culture of Ares I Upper Stage Design and Manufacturing

    NASA Technical Reports Server (NTRS)

    Scott, David W.

    2009-01-01

    In roughly two years time, Marshall Space Flight Center's (MSFC) Mission Operations Laboratory (MOL) has incubated a personnel training and certification program for about 1000 learners and multiple phases of the Ares I Upper Stage (US) project. Previous MOL-developed training programs focused on about 100 learners with a focus on operations, and had enough full-time training staff to develop courseware and provide training administration. This paper discusses 1) how creation of a broad, structured training program unfolded as feedback from more narrowly defined tasks, 2) how training philosophy, development methods, and administration are being simplified and tailored so that many Upper Stage organizations can grow their own training yet maintain consistency, accountability, and traceability across the project, and 3) possibilities for interfacing with the production contractor's training system and staff.

  13. Overview of the Main Propulsion System for the NASA Ares I Upper Stage

    NASA Technical Reports Server (NTRS)

    Quinn, Jason E.; Swanson, Luke A.

    2009-01-01

    A functional overview of the Main Propulsion System (MPS) of the NASA Ares I Upper Stage is provided. In addition to a simple overview of the key MPS functions and design philosophies, major lessons learned are discussed. The intent is to provide a technical overview with enough detail to allow engineers outside of the MPS Integrated Product Team (IPT) to develop a rough understanding of MPS operations, components, design philosophy, and lessons learned.

  14. Waterhammer Modeling for the Ares I Upper Stage Reaction Control System Cold Flow Development Test Article

    NASA Technical Reports Server (NTRS)

    Williams, Jonathan H.

    2010-01-01

    The Upper Stage Reaction Control System provides three-axis attitude control for the Ares I launch vehicle during active Upper Stage flight. The system design must accommodate rapid thruster firing to maintain the proper launch trajectory and thus allow for the possibility to pulse multiple thrusters simultaneously. Rapid thruster valve closure creates an increase in static pressure, known as waterhammer, which propagates throughout the propellant system at pressures exceeding nominal design values. A series of development tests conducted in the fall of 2009 at Marshall Space Flight Center were performed using a water-flow test article to better understand fluid performance characteristics of the Upper Stage Reaction Control System. A subset of the tests examined waterhammer along with the subsequent pressure and frequency response in the flight-representative system and provided data to anchor numerical models. This thesis presents a comparison of waterhammer test results with numerical model and analytical results. An overview of the flight system, test article, modeling and analysis are also provided.

  15. Materials, Processes and Manufacturing in Ares 1 Upper Stage: Integration with Systems Design and Development

    NASA Technical Reports Server (NTRS)

    Bhat, Biliyar N.

    2008-01-01

    Ares I Crew Launch Vehicle Upper Stage is designed and developed based on sound systems engineering principles. Systems Engineering starts with Concept of Operations and Mission requirements, which in turn determine the launch system architecture and its performance requirements. The Ares I-Upper Stage is designed and developed to meet these requirements. Designers depend on the support from materials, processes and manufacturing during the design, development and verification of subsystems and components. The requirements relative to reliability, safety, operability and availability are also dependent on materials availability, characterization, process maturation and vendor support. This paper discusses the roles and responsibilities of materials and manufacturing engineering during the various phases of Ares IUS development, including design and analysis, hardware development, test and verification. Emphasis is placed how materials, processes and manufacturing support is integrated over the Upper Stage Project, both horizontally and vertically. In addition, the paper describes the approach used to ensure compliance with materials, processes, and manufacturing requirements during the project cycle, with focus on hardware systems design and development.

  16. Upper stage options for reusable launch vehicle {open_quotes}pop-up{close_quotes} missions

    SciTech Connect

    Eckmann, J.B.; Cotta, R.B.; Matuszak, L.W.; Perkins, D.R.

    1997-01-01

    Suborbital separation of an expendable upper stage from a small, single-stage Reusable Launch Vehicle (RLV) to transfer spacecraft into Geosynchronous Equatorial Orbit (GEO) was investigated and found to significantly increase spacecraft mass into GEO (over 400{percent}) although operational issues exist. An assessment of propulsion system options for this {open_quotes}Pop-Up{close_quotes} Mission was performed to determine the propellant combinations, stage configurations, and propulsion technologies that maximize spacecraft mass and minimize size. Propellants included earth and space storable combinations, cryogenic LH{sub 2}/LO{sub 2}, and Class 1.3 solids. Stage configurations employing cylindrical metal and overwrapped tanks, isogrid tanks, and toroidal tanks were considered. Non-toxic earth storable propellants provided comparable performance (5{endash}10{percent}) to existing storables while the use of pressure-fed engines gave about 15{percent} lower performance than pump-fed. Solid stage performance was within 5{percent} of existing storable propellants. Stages employing toroidal tanks packaged more efficiently in length constrained RLV payload bays than 4-cylindrical tank configurations, giving up to 30{percent} greater mass into GEO. The use of Extendable Exit Cones (EEC) for length constrained cases resulted in about 5{endash}10{percent} higher stage performance. {copyright} {ital 1997 American Institute of Physics.}

  17. From Paper to Production: An Update on NASA's Upper Stage Engine for Exploration

    NASA Technical Reports Server (NTRS)

    Kynard, Mike

    2010-01-01

    In 2006, NASA selected an evolved variant of the proven Saturn/Apollo J-2 upper stage engine to power the Ares I crew launch vehicle upper stage and the Ares V cargo launch vehicle Earth departure stage (EDS) for the Constellation Program. Any design changes needed by the new engine would be based where possible on proven hardware from the Space Shuttle, commercial launchers, and other programs. In addition to the thrust and efficiency requirements needed for the Constellation reference missions, it would be an order of magnitude safer than past engines. It required the J-2X government/industry team to develop the highest performance engine of its type in history and develop it for use in two vehicles for two different missions. In the attempt to achieve these goals in the past five years, the Upper Stage Engine team has made significant progress, successfully passing System Requirements Review (SRR), System Design Review (SDR), Preliminary Design Review (PDR), and Critical Design Review (CDR). As of spring 2010, more than 100,000 experimental and development engine parts have been completed or are in various stages of manufacture. Approximately 1,300 of more than 1,600 engine drawings have been released for manufacturing. This progress has been due to a combination of factors: the heritage hardware starting point, advanced computer analysis, and early heritage and development component testing to understand performance, validate computer modeling, and inform design trades. This work will increase the odds of success as engine team prepares for powerpack and development engine hot fire testing in calendar 2011. This paper will provide an overview of the engine development program and progress to date.

  18. Cisplatin and Radiation Therapy With or Without Triapine in Treating Patients With Previously Untreated Stage IB-IVA Cervical Cancer or Stage II-IVA Vaginal Cancer

    ClinicalTrials.gov

    2016-01-28

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB2 Cervical Cancer; Stage II Vaginal Cancer; Stage IIA1 Cervical Cancer; Stage IIA2 Cervical Cancer; Stage IIB Cervical Cancer; Stage III Vaginal Cancer; Stage IIIA Cervical Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Vaginal Adenocarcinoma; Vaginal Adenosquamous Carcinoma; Vaginal Squamous Cell Carcinoma

  19. CMB quadrupole suppression. II. The early fast roll stage

    SciTech Connect

    Boyanovsky, D.; Vega, H. J. de; Sanchez, N. G.

    2006-12-15

    Within the effective field theory of inflation, an initialization of the classical dynamics of the inflaton with approximate equipartition between the kinetic and potential energy of the inflaton leads to a brief fast roll stage that precedes the slow roll regime. The fast roll stage leads to an attractive potential in the wave equations for the mode functions of curvature and tensor perturbations. The evolution of the inflationary perturbations is equivalent to the scattering by this potential and a useful dictionary between the scattering data and observables is established. Implementing methods from scattering theory we prove that this attractive potential leads to a suppression of the quadrupole moment for CMB and B-mode angular power spectra. The scale of the potential is determined by the Hubble parameter during slow roll. Within the effective field theory of inflation at the grand unification (GUT) energy scale we find that if inflation lasts a total number of e-folds N{sub tot}{approx}59, there is a 10%-20% suppression of the CMB quadrupole and about 2%-4% suppression of the tensor quadrupole. The suppression of higher multipoles is smaller, falling off as 1/l{sup 2}. The suppression is much smaller for N{sub tot}>59, therefore if the observable suppression originates in the fast roll stage, there is the upper bound N{sub tot}{approx}59.

  20. Waterhammer Testing and Modeling of the Ares I Upper Stage Reaction Control System

    NASA Technical Reports Server (NTRS)

    Williams, J. Hunter; Holt, Kimberly A.

    2010-01-01

    NASA's Ares I rocket is the agency's first step in completing the goals of the Constellation Program, which plans to deliver a new generation of space explorers into low earth orbit for future missions to the International Space Station, the moon, and other destinations within the solar system. Ares I is a two-stage rocket topped by the Orion crew capsule and its service module. The launch vehicle's First Stage is a single, five-segment reusable solid rocket booster (RSRB), derived from the Space Shuttle Program's four segment RSRB. The vehicle's Upper Stage, being designed at Marshall Space Flight Center (MSFC), is propelled by a single J-2X Main Engine fueled with liquid oxygen and liquid hydrogen. During active Upper Stage flight of the Ares I launch vehicle, the Upper Stage Reaction Control System (US ReCS) will perform attitude control operations for the vehicle. The US ReCS will provide three-axis attitude control capability (roll, pitch, and yaw) for the Upper Stage while the J-2X is not firing and roll control capability while the engine is firing. Because of the requirements imposed upon the system, the design must accommodate rapid pulsing of multiple thrusters simultaneously to maintain attitude control. In support of these design activities and in preparation for Critical Design Review, analytical models of the US ReCS propellant feed system have been developed using the Thermal Hydraulic Library of MSC.EASY5 v.2008, herein referred to as EASY5. EASY5 is a commercially available fluid system modeling package with significant history of modeling space propulsion systems. In Fall 2009, a series of development tests were conducted at MSFC on a cold-flow test article for the US ReCS, herein referred to as System Development Test Article (SDTA). A subset of those tests performed were aimed at examining the effects of waterhammer on a flight-representative system and to ensure that those effects could be quantified with analytical models and incorporated into the design of the flight system. This paper presents an overview of the test article and the test approach, along with a discussion of the analytical modeling methodology. In addition, the results of that subset of development tests, along with analytical model pre-test predictions and post-test model correlations, will also be discussed in detail.

  1. Initial Assessment of the Ares I-X Launch Vehicle Upper Stage to Vibroacoustic Flight Environments

    NASA Technical Reports Server (NTRS)

    Larko, Jeffrey M.; Hughes, William O.

    2008-01-01

    The Ares I launch vehicle will be NASA s first new launch vehicle since 1981. Currently in design, it will replace the Space Shuttle in taking astronauts to the International Space Station, and will eventually play a major role in humankind s return to the Moon and eventually to Mars. Prior to any manned flight of this vehicle, unmanned test readiness flights will be flown. The first of these readiness flights, named Ares I-X, is scheduled to be launched in April 2009. The NASA Glenn Research Center is responsible for the design, manufacture, test and analysis of the Ares I-X upper stage simulator (USS) element. As part of the design effort, the structural dynamic response of the Ares I-X launch vehicle to its vibroacoustic flight environments must be analyzed. The launch vehicle will be exposed to extremely high acoustic pressures during its lift-off and aerodynamic stages of flight. This in turn will cause high levels of random vibration on the vehicle's outer surface that will be transmitted to its interior. Critical flight equipment, such as its avionics and flight guidance components are susceptible to damage from this excitation. This study addresses the modelling, analysis and predictions from examining the structural dynamic response of the Ares I-X upper stage to its vibroacoustic excitations. A statistical energy analysis (SEA) model was used to predict the high frequency response of the vehicle at locations of interest. Key to this study was the definition of the excitation fields corresponding to lift off acoustics and the unsteady aerodynamic pressure fluctuations during flight. The predicted results will be used by the Ares I-X Project to verify the flight qualification status of the Ares I-X upper stage components.

  2. ESC-B: The Cryogenic Upper Stage for Europe's Heavy Lift Launcher Ariane 5ECB

    NASA Astrophysics Data System (ADS)

    Juhls, A.

    2002-01-01

    -A. Juhls, Astrium GmbH -M. Lepelletier, Snecma Moteurs -JM. Bahu, CNES -C. Poincheval, CNES. In the year 1998 the European ministerial council decided to initiate the Ariane 5 Plus programme in order to upgrade the European heavy lift launcher Ariane 5. The market was changing more rapidly than predicted showing steadily growing satellite mass and the demand for flexible missions while strong competitors were intensifying their preparations to enter the commercial business. The answer was to improve the Ariane 5 launcher by modifying the cryogenic first (or lower ?) stage and the solid boosters and by introducing two cryogenic upper stages in two steps: In order to cope with the short term need of a significant growth of GTO lift capacity up to 10 t the first denoted ESC-A shall enter commercial service in 2002. Four years later a more powerful second version shall take over enabling a GTO performance of 12 t and providing versatile mission capability. The paper will focus on this new cryogenic upper stage denoted ESC-B giving first a general description of main characteristics and constituents. The article will highlight different challenging aspects of the ESC-B development: Ambitious economical conditions regarding both limited development budgets and the strong need to reduce production cost require improved working methods and an adjustment of the conventional development logic, in particular regarding new verification methods. Furthermore Europe is now facing the complex combination of versatile mission capability together with a powerful cryogenic upper stage. The paper will present the approach to define reasonable mission scenarios in order to cover customer demands while avoiding too stringent system requirements. Along with VINCI, Europe's first expander cycle type engine featuring an extendable nozzle dedicated subsystems will be described which allow 4 re-ignitions and 6 hours of ballistic flight. The paper concludes with the summary of the development planning aiming at a first launch of ESC-B in 2006.

  3. CDX2 as a Prognostic Biomarker in Stage II and Stage III Colon Cancer.

    PubMed

    Dalerba, Piero; Sahoo, Debashis; Paik, Soonmyung; Guo, Xiangqian; Yothers, Greg; Song, Nan; Wilcox-Fogel, Nate; Forg, Erna; Rajendran, Pradeep S; Miranda, Stephen P; Hisamori, Shigeo; Hutchison, Jacqueline; Kalisky, Tomer; Qian, Dalong; Wolmark, Norman; Fisher, George A; van de Rijn, Matt; Clarke, Michael F

    2016-01-21

    Background The identification of high-risk stage II colon cancers is key to the selection of patients who require adjuvant treatment after surgery. Microarray-based multigene-expression signatures derived from stem cells and progenitor cells hold promise, but they are difficult to use in clinical practice. Methods We used a new bioinformatics approach to search for biomarkers of colon epithelial differentiation across gene-expression arrays and then ranked candidate genes according to the availability of clinical-grade diagnostic assays. With the use of subgroup analysis involving independent and retrospective cohorts of patients with stage II or stage III colon cancer, the top candidate gene was tested for its association with disease-free survival and a benefit from adjuvant chemotherapy. Results The transcription factor CDX2 ranked first in our screening test. A group of 87 of 2115 tumor samples (4.1%) lacked CDX2 expression. In the discovery data set, which included 466 patients, the rate of 5-year disease-free survival was lower among the 32 patients (6.9%) with CDX2-negative colon cancers than among the 434 (93.1%) with CDX2-positive colon cancers (hazard ratio for disease recurrence, 3.44; 95% confidence interval [CI], 1.60 to 7.38; P=0.002). In the validation data set, which included 314 patients, the rate of 5-year disease-free survival was lower among the 38 patients (12.1%) with CDX2 protein-negative colon cancers than among the 276 (87.9%) with CDX2 protein-positive colon cancers (hazard ratio, 2.42; 95% CI, 1.36 to 4.29; P=0.003). In both these groups, these findings were independent of the patient's age, sex, and tumor stage and grade. Among patients with stage II cancer, the difference in 5-year disease-free survival was significant both in the discovery data set (49% among 15 patients with CDX2-negative tumors vs. 87% among 191 patients with CDX2-positive tumors, P=0.003) and in the validation data set (51% among 15 patients with CDX2-negative tumors vs. 80% among 106 patients with CDX2-positive tumors, P=0.004). In a pooled database of all patient cohorts, the rate of 5-year disease-free survival was higher among 23 patients with stage II CDX2-negative tumors who were treated with adjuvant chemotherapy than among 25 who were not treated with adjuvant chemotherapy (91% vs. 56%, P=0.006). Conclusions Lack of CDX2 expression identified a subgroup of patients with high-risk stage II colon cancer who appeared to benefit from adjuvant chemotherapy. (Funded by the National Comprehensive Cancer Network, the National Institutes of Health, and others.). PMID:26789870

  4. Neo-adjuvant Therapy With Anastrozole Plus Pazopanib in Stage II and III ER+ Breast Cancer

    ClinicalTrials.gov

    2015-12-02

    Estrogen Receptor-positive Breast Cancer; Human Epidermal Growth Factor 2 Negative Carcinoma of Breast; Male Breast Cancer; Recurrent Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer

  5. Characterization of the 2012-044C Briz-M Upper Stage Breakup

    NASA Technical Reports Server (NTRS)

    Matney, M. J.; Hamilton, J.; Horstman, M.; Papanyan, V.

    2013-01-01

    On 6 August, 2012, Russia launched two commercial satellites aboard a Proton rocket, and attempted to place them in geosynchronous orbit using a Briz-M upper stage (2012-044C, SSN 38746). Unfortunately, the upper stage failed early in its burn and was left stranded in an elliptical orbit with a perigee in low Earth orbit (LEO). Because the stage failed with much of its fuel on board, it was deemed a significant breakup risk. These fears were confirmed when it broke up 16 October, creating a large cloud of debris with perigees below that of the International Space Station. The debris cloud was tracked by the US Space Surveillance Network (SSN), which can reliably detect and track objects down to about 10 cm in size. Because of the unusual geometry of the breakup, there was an opportunity for NASA Orbital Debris Program Office to use specialized radar assets to characterize the extent of the debris cloud in sizes smaller than the standard debris tracked by the SSN. This paper will describe the observation campaign to measure the small particle distributions of this cloud, and presents the results of the analysis of the data. We shall compare the data to the modelled size distribution, number, and shape of the cloud, and what implications this may have for future breakup debris models. We shall conclude the paper with a discussion how this measurement process can be improved for future breakups.

  6. Characterization of the 2012-044c Briz-M Upper Stage Breakup

    NASA Technical Reports Server (NTRS)

    Matney, M. J.; Hamilton, Joseph; Papanyan, Valen

    2013-01-01

    On 6 August, 2012, Russia launched two commercial satellites aboard a Proton rocket, and attempted to place them in geosynchronous orbit using a Briz-M upper stage (2012-044C, SSN 38746). Unfortunately, the upper stage failed early in its burn and was left stranded in an elliptical orbit with a perigee in low Earth orbit (LEO). Because the stage failed with much of its fuel on board, it was deemed a significant breakup risk. These fears were confirmed when it broke up 16 October, creating a large cloud of debris with perigees below that of the International Space Station. The debris cloud was tracked by the US Space Surveillance Network (SSN), which can reliably detect and track objects down to about 10 cm in size. Because of the unusual geometry of the breakup, there was an opportunity for NASA Orbital Debris Program Office to request radar assets to characterize the extent of the debris cloud in sizes smaller than the standard debris tracked by the SSN. This paper will describe the observation campaign to measure the small particle distributions of this cloud, and presents the results of the analysis of the data. We shall compare the data to the modelled size distribution, number, and shape of the cloud, and what implications this may have for future breakup debris models. We shall conclude the paper with a discussion how this measurement process can be improved for future breakups.

  7. Non-toxic propulsion for spaceplane ``pop-up'' upper stages

    NASA Astrophysics Data System (ADS)

    Eckmann, James B.; Wiswell, Robert L.; Haberman, Eugene G.

    1998-01-01

    Military spaceplane operations scenarios envision using the ``Pop-Up'' employment profile to significantly increase the payload to orbit capability of the vehicle. Previous studies have investigated a range of propulsion system and stage design options for a pop-up upper stage (Cotta 1996). Operationally it is desirable to have the upper stage and payload stored as a wooden round that is quickly loaded on the spaceplane when needed. The current study therefore focuses on non-toxic (less-toxic), storable propellant options. These are compared to the use of conventional (toxic) storable bi-propellant, Nitrogen Tetroxide/Monomethyl Hydrazine (N2O4/MMH), and cryogenic oxidizer bi-propellant, (LO2/RP1), options. The non-toxic oxidizers investigated include Hydrogen Peroxide (H2O2) and Hydroxyammonium Nitroformate (HANF). The non-toxic fuels include hydrocarbon jet fuel (JP-4), Quadricyclane (C7H8), and Methylcubane (C9H10). The impact of H2O2 purity (90% to 100%) and various fuel blends are also evaluated. The comparison includes payload delivery performance, propellant handling issues and technology development needs. The results show that there are propellant combinations that are less toxic than N2O4/MMH and yet deliver comparable payload delivery performance. However, there are propellant handling issues and technology development needs that must be addressed. These are discussed.

  8. Characterization of the 2012-044C BRIZ-M Upper Stage Breakup

    NASA Astrophysics Data System (ADS)

    Matney, M. J.; Hamilton, J.; Horstman, M.; Papanyan, V.

    2013-08-01

    On 6 August 2012, Russia launched two commercial satellites aboard a Proton rocket, and attempted to place them in geosynchronous orbit using a Briz-M upper stage (2012-044C, SSN 38746). Unfortunately, the upper stage failed early in its burn and was left stranded in an elliptical orbit with a perigee in low Earth orbit (LEO). Because the stage failed with much of its fuel on board, it was deemed a significant breakup risk. These fears were confirmed when it broke up 16 October, creating a large cloud of debris with perigees below that of the International Space Station. The debris cloud was tracked by the U.S. Space Surveillance Network (SSN), which can reliably detect and track objects down to about 10 cm in size. Because of the unusual geometry of the breakup, there was an opportunity for the NASA Orbital Debris Program Office to use specialized radar assets to characterize the extent of the debris cloud in sizes smaller than the standard debris tracked by the SSN. This paper describes the observation campaign to measure the small particle distributions of this cloud and presents the results of the data analysis. We shall compare the data to the modelled size distribution, number, and shape of the cloud, and what implications this may have for future breakup debris models. We shall conclude the paper with a discussion about how this measurement process can be improved for future breakups.

  9. MIDDLE TO UPPER ATLANTIC REGIONAL ASSESSMENT (PHASE II)

    EPA Science Inventory

    The objective of this assessment activity is to enhance the ability of decision-makers and other stakeholders in the Middle to Upper Atlantic Region who are vulnerable to land use change and climate change to access and use the best scientific information when making decisions th...

  10. Preliminary Performance of Lithium-ion Cell Designs for Ares I Upper Stage Applications

    NASA Technical Reports Server (NTRS)

    Miller, Thomas B.; Reid, Concha M.; Kussmaul, Michael T.

    2011-01-01

    NASA's Ares I Crew Launch Vehicle (CLV) baselined lithium-ion technology for the Upper Stage (US). Under this effort, the NASA Glenn Research Center investigated three different aerospace lithium-ion cell suppliers to assess the performance of the various lithium-ion cell designs under acceptance and characterization testing. This paper describes the overall testing approaches associated with lithium-ion cells, their ampere-hour capacity as a function of temperature and discharge rates, as well as their performance limitations for use on the Ares I US vehicle.

  11. Upper stage in-flight retargeting to enhance geosynchronous satellite operations

    NASA Technical Reports Server (NTRS)

    Lee, Otto W. K.

    1990-01-01

    Real time utilization of propellant reserves that are not needed is available with the implementation of the in-flight retargeting capability for the Centaur Upper Stage. Application to a performance critical, geosynchronous mission is discussed. The operational duration of the satellite may be increased by selectively choosing the appropriate final orbit injection conditions. During ascent Centaur evaluates the amount of propellant excess available and adjusts the final orbit target to consume the excess. Typical satellite mission requirements are introduced to illustrate the mission analysis process to determine the pre-flight nominal target and the in-flight retarget function.

  12. Operations analysis (study 2.1): Shuttle upper stage software requirements

    NASA Technical Reports Server (NTRS)

    Wolfe, R. R.

    1974-01-01

    An investigation of software costs related to space shuttle upper stage operations with emphasis on the additional costs attributable to space servicing was conducted. The questions and problem areas include the following: (1) the key parameters involved with software costs; (2) historical data for extrapolation of future costs; (3) elements of the basic software development effort that are applicable to servicing functions; (4) effect of multiple servicing on complexity of the operation; and (5) are recurring software costs significant. The results address these questions and provide a foundation for estimating software costs based on the costs of similar programs and a series of empirical factors.

  13. Physicians' Beliefs About the Benefits and Risks of Adjuvant Therapies for Stage II and Stage III Colorectal Cancer

    PubMed Central

    Wong, Anthony C.; Stock, Shannon; Schrag, Deborah; Kahn, Katherine L.; Salz, Talya; Charlton, Mary E.; Rogers, Selwyn O.; Goodman, Karyn A.; Keating, Nancy L.

    2014-01-01

    Background: Adjuvant therapy plays a major role in treating colorectal cancer, and physicians' views of its effectiveness influence treatment decisions. We assessed physicians' views of the relative benefits and risks of adjuvant chemotherapy and radiotherapy for stages II and III colon and rectal cancers. Methods: The Cancer Care Outcomes Research and Surveillance Consortium surveyed a geographically dispersed population of medical oncologists, radiation oncologists, and surgeons in the United States about the benefits and risks of adjuvant therapies for colorectal cancer. We used logistic regression to assess the association of physician and practice characteristics with beliefs about adjuvant therapies. Results: Among 1,296 respondents, > 90% believed the benefits of adjuvant therapies for stage III colorectal cancer outweigh the risks. Only 21.9%, 50%, and 50.4% believed in the net benefit of chemotherapy for stage II colon cancer, chemotherapy for stage II rectal cancer, and radiation for stage II rectal cancer, respectively. Younger physicians were less likely than others to perceive adjuvant therapy for stage II colorectal cancer as beneficial. Medical oncologists were more likely than surgeons and radiation oncologists to endorse the benefits of adjuvant chemotherapy and radiation for stage II rectal cancer, but less likely for stage II colon cancer. Conclusions: Physicians largely agreed that the benefits of adjuvant chemotherapy for stage III colon cancer, as well as chemotherapy, and radiation for stage III rectal cancer, outweigh the risks, consistent with strong evidence, but were divided over the net benefit of adjuvant therapies for stage II colorectal cancer, where evidence is inconsistent. PMID:24986112

  14. Design and Analysis of a Turbopump for a Conceptual Expander Cycle Upper-Stage Engine

    NASA Technical Reports Server (NTRS)

    Dorney, Daniel J.; Rothermel, Jeffry; Griffin, Lisa W.; Thornton, Randall J.; Forbes, John C.; Skelly, Stephen E.; Huber, Frank W.

    2006-01-01

    As part of the development of technologies for rocket engines that will power spacecraft to the Moon and Mars, a program was initiated to develop a conceptual upper stage engine with wide flow range capability. The resulting expander cycle engine design employs a radial turbine to allow higher pump speeds and efficiencies. In this paper, the design and analysis of the pump section of the engine are discussed. One-dimensional meanline analyses and three-dimensional unsteady computational fluid dynamics simulations were performed for the pump stage. Configurations with both vaneless and vaned diffusers were investigated. Both the meanline analysis and computational predictions show that the pump will meet the performance objectives. Additional details describing the development of a water flow facility test are also presented.

  15. Benefits of the integrated solar upper stage (ISUS) to commercial space systems

    NASA Astrophysics Data System (ADS)

    Malloy, John; Miles, Barry

    1997-01-01

    The Integrated Solar Upper Stage (ISUS) is a solar thermal system that provides both propulsion and electric power. Using hydrogen as the propellant, ISUS can provide average specific impulses between 750 and 800 seconds. Once in final orbit, the stage uses thermionic diodes to produce electricity for the satellite payload throughout its operating lifetime. Because of its high specific impulse, ISUS can increase the total mass delivered to GEO by any launch vehicle by up to 250%. ISUS can provide benefits to commercial system in lower orbits as well. These orbits are particularly demanding on battery system because of the short orbit periods and the resulting number of battery cycles. Thermal storage in the ISUS receiver can accommodate these cycles without increasing system mass. ISUS also provide more efficient propulsion for station keeping and for separation of satellites when multiple satellites are launched for a single launch vehicle.

  16. Safety and Mission Assurance for In-House Design Lessons Learned from Ares I Upper Stage

    NASA Technical Reports Server (NTRS)

    Anderson, Joel M.

    2011-01-01

    This viewgraph presentation identifies lessons learned in the course of the Ares I Upper Stage design and in-house development effort. The contents include: 1) Constellation Organization; 2) Upper Stage Organization; 3) Presentation Structure; 4) Lesson-Importance of Systems Engineering/Integration; 5) Lesson-Importance of Early S&MA Involvement; 6) Lesson-Importance of Appropriate Staffing Levels; 7) Lesson-Importance S&MA Team Deployment; 8) Lesson-Understanding of S&MA In-Line Engineering versus Assurance; 9) Lesson-Importance of Close Coordination between Supportability and Reliability/Maintainability; 10) Lesson-Importance of Engineering Data Systems; 11) Lesson-Importance of Early Development of Supporting Databases; 12) Lesson-Importance of Coordination with Safety Assessment/Review Panels; 13) Lesson-Implementation of Software Reliability; 14) Lesson-Implementation of S&MA Technical Authority/Chief S&MA Officer; 15) Lesson-Importance of S&MA Evaluation of Project Risks; 16) Lesson-Implementation of Critical Items List and Government Mandatory Inspections; 17) Lesson-Implementation of Critical Items List Mandatory Inspections; 18) Lesson-Implementation of Test Article Safety Analysis; and 19) Lesson-Importance of Procurement Quality.

  17. Light Curve Observations of Upper Stages in the Low Earth Orbit Environment

    NASA Technical Reports Server (NTRS)

    Liou, J.-C.; Lederer, S.; Cowardin, H.; Mulrooney, M.; Read, J.; Chun, F.; Dearborn, M.; Tippets, R.

    2012-01-01

    Active debris removal (ADR) is a potential means to remediate the orbital debris environment in low Earth orbit (LEO). Massive intact objects, including spent upper stages and retired payloads, with high collision probabilities have been suggested as potential targets for ADR. The challenges to remove such objects on a routine basis are truly monumental. A key piece of information needed for any ADR operations is the tumble motion of the targets. Rapid tumble motion (in excess of one degree per second) of a multiple-ton intact object could be a major problem for proximity and docking operations. Therefore, there is a need to characterize the general tumble motion of the potential ADR targets for future ADR planning. The NASA Orbital Debris Program Office has initiated an effort to identify the global tumble behavior of potential ADR targets in LEO. The activities include optical light curve observations, imaging radar data collection, and laboratory light curve simulations and modeling. This paper provides a preliminary summary of light curve data of more than 100 upper stages collected by two telescope facilities in Colorado and New Mexico between 2011 and 2012. Analyses of the data and implications for the tumble motions of the objects are also discussed in the paper.

  18. The J-2X Upper Stage Engine: From Heritage to Hardware

    NASA Technical Reports Server (NTRS)

    Byrd, THomas

    2008-01-01

    NASA's Global Exploration Strategy requires safe, reliable, robust, efficient transportation to support sustainable operations from Earth to orbit and into the far reaches of the solar system. NASA selected the Ares I crew launch vehicle and the Ares V cargo launch vehicle to provide that transportation. Guiding principles in creating the architecture represented by the Ares vehicles were the maximum use of heritage hardware and legacy knowledge, particularly Space Shuttle assets, and commonality between the Ares vehicles where possible to streamline the hardware development approach and reduce programmatic, technical, and budget risks. The J-2X exemplifies those goals. It was selected by the Exploration Systems Architecture Study (ESAS) as the upper stage propulsion for the Ares I Upper Stage and the Ares V Earth Departure Stage (EDS). The J-2X is an evolved version ofthe historic J-2 engine that successfully powered the second stage of the Saturn I launch vehicle and the second and third stages of the Saturn V launch vehicle. The Constellation architecture, however, requires performance greater than its predecessor. The new architecture calls for larger payloads delivered to the Moon and demands greater loss of mission reliability and numerous other requirements associated with human rating that were not applied to the original J-2. As a result, the J-2X must operate at much higher temperatures, pressures, and flow rates than the heritage J-2, making it one of the highest performing gas generator cycle engines ever built, approaching the efficiency of more complex stage combustion engines. Development is focused on early risk mitigation, component and subassembly test, and engine system test. The development plans include testing engine components, including the subscale injector, main igniter, powerpack assembly (turbopumps, gas generator and associated ducting and structural mounts), full-scale gas generator, valves, and control software with hardware-in-the-loop. Testing expanded in 2007, accompanied by the refinement of the design through several key milestones. This paper discusses those 2007 tests and milestones, as well as updates key developments in 2008.

  19. BTX concentrations near a stage II implemented petrol station.

    PubMed

    Gonzalez-Flesca, Norbert; Vardoulakis, Sotiris; Cicolella, Andr

    2002-01-01

    A combined monitoring and dispersion modelling methodology was applied for assessing air quality at three different levels of proximity to the selected service station: (I) next to the fuel pumps, (II) in the surrounding environment, and (III) in the background. Continuous monitoring and passive sampling were used for achieving high temporal and spatial resolution, respectively. A Gaussian dispersion model (CALINE4) was used for assessing the road traffic contribution to the local concentrations under different meteorological conditions. It was established that Stage 2 vapour recovery reduces BTX concentrations not only near the pumps, but also in their surrounding environment. However, there is evidence that the efficiency of the system is wind speed dependent. The modelling simulation of the worst case wind scenario revealed the significance of local traffic emissions. It was shown that the traffic contribution even from a single road in the vicinity of the station can, under certain conditions, be higher than the contribution of the station itself to the local BTX levels. Finally, after comparison with previous studies, the concentrations measured near the service station (which was situated in a rural environment) appear to be lower than those observed in busy street canyons in city centres. It can be concluded, although Stage 2 recovery system effectively reduces working VOC losses in service stations, that it will only have a limited positive impact on local air quality if the service station is located in a heavily polluted area. PMID:12094529

  20. Reflections on Centaur Upper Stage Integration by the NASA Lewis (Glenn) Research Center

    NASA Technical Reports Server (NTRS)

    Graham, Scott R.

    2014-01-01

    The NASA Glenn (then Lewis) Research Center (GRC) led several expendable launch vehicle (ELV) projects from 1963 to 1998, most notably the Centaur upper stage. These major, comprehensive projects included system management, system development, integration (both payload and stage), and launch operations. The integration role that GRC pioneered was truly unique and highly successful. Its philosophy, scope, and content were not just invaluable to the missions and vehicles it supported, but also had significant Agencywide benefits. An overview of the NASA Lewis Research Center (now the NASA Glenn Research Center) philosophy on ELV integration is provided, focusing on Atlas/Centaur, Titan/Centaur, and Shuttle/Centaur vehicles and programs. The necessity of having a stable, highly technically competent in-house staff is discussed. Significant depth of technical penetration of contractor work is another critical component. Functioning as a cohesive team was more than a concept: GRC senior management, NASA Headquarters, contractors, payload users, and all staff worked together. The scope, content, and history of launch vehicle integration at GRC are broadly discussed. Payload integration is compared to stage development integration in terms of engineering and organization. Finally, the transition from buying launch vehicles to buying launch services is discussed, and thoughts on future possibilities of employing the successful GRC experience in integrating ELV systems like Centaur are explored.

  1. Reflections on Centaur Upper Stage Integration by the NASA Lewis (Glenn) Research Center

    NASA Technical Reports Server (NTRS)

    Graham, Scott R.

    2015-01-01

    The NASA Glenn (then Lewis) Research Center (GRC) led several expendable launch vehicle (ELV) projects from 1963 to 1998, most notably the Centaur upper stage. These major, comprehensive projects included system management, system development, integration (both payload and stage), and launch operations. The integration role that GRC pioneered was truly unique and highly successful. Its philosophy, scope, and content were not just invaluable to the missions and vehicles it supported, but also had significant Agency-wide benefits. An overview of the NASA Lewis Research Center (now the NASA Glenn Research Center) philosophy on ELV integration is provided, focusing on Atlas/Centaur, Titan/Centaur, and Shuttle/Centaur vehicles and programs. The necessity of having a stable, highly technically competent in-house staff is discussed. Significant depth of technical penetration of contractor work is another critical component. Functioning as a cohesive team was more than a concept: GRC senior management, NASA Headquarters, contractors, payload users, and all staff worked together. The scope, content, and history of launch vehicle integration at GRC are broadly discussed. Payload integration is compared to stage development integration in terms of engineering and organization. Finally, the transition from buying launch vehicles to buying launch services is discussed, and thoughts on future possibilities of employing the successful GRC experience in integrating ELV systems like Centaur are explored.

  2. Distribution of early life history stages of fishes in selected pools of the upper Mississippi River

    USGS Publications Warehouse

    Holland, L.E.

    1986-01-01

    Effective management of the fishery resources of the Upper Mississippi River and successful mitigation of the loss of critical habitat depend in part on an understanding of the reproductive and early life history requirements of the affected fishes. However, little is known about the use of nursery areas by fishes in the river. Of the nearly 130 species identified in the adult ichthyofauna, only a few are represented proportionally in the available data on early life stages because study designs have not included consideration of the early stages, collection gears have not adequately sampled the young, and eggs and larvae of some species are difficult to sample by conventional approaches. For the species collected, information is available on seasonal variations in total densities, composition, and catch among different habitat types. However, the data are most accurate for species with buoyant early life stages, such as freshwater drum (Aplodinotus grunniens) and gizzard shad (Dorosoma cepedianum). Eggs and larvae of freshwater drum dominate collections made in the main channel, whereas other larval fishes are usually most abundant in backwater habitats. The species found there usually deposit eggs on the substrate or on vegetation. Habitat preferences (as indicated by relative abundance) often shift as development proceeds and physical and behavioral changes occur in the larvae. Only limited information is available on the distribution of larvae within habitats, but it is clear that variations within habitats are significant.

  3. APOLLO 5 SATURN-APOLLO 204 LAUNCH VEHICLE UPPER STAGE IS ERECTED AT LAUNCH COMPLEX 37B

    NASA Technical Reports Server (NTRS)

    1967-01-01

    The Douglas-built upper stage for the Saturn-Apollo 204/Lunar Module space vehicle was erected today at Cape Kennedy's Launch Complex 37. The two-stage rocket will send an unmanned lunar module into Earth orbit later this year.

  4. Dinoflagellates: Fossil motile-stage tests from the upper cretaceous of the Northern New Jersey coastal plain

    USGS Publications Warehouse

    May, F.E.

    1976-01-01

    Fossil dinoflagellate tests have been considered to represent encysted, nonmotile stages. The discovery of flagellar porelike structures and probable trichocyst pores in the Upper Cretaceous genus Dinogymnium suggests that motile stage tests are also preserved as acid-resistant, organic-walled microfossils.

  5. System Characterization of MAHI EXO-II: A Robotic Exoskeleton for Upper Extremity Rehabilitation

    PubMed Central

    French, James A.; Rose, Chad G.; O'Malley, Marcia K.

    2015-01-01

    This paper presents the performance characterization of the MAHI Exo-II, an upper extremity exoskeleton for stroke and spinal cord injury (SCI) rehabilitation, as a means to validate its clinical implementation and to provide depth to the literature on the performance characteristics of upper extremity exoskeletons. Individuals with disabilities arising from stroke and SCI need rehabilitation of the elbow, forearm, and wrist to restore the ability to independently perform activities of daily living (ADL). Robotic rehabilitation has been proposed to address the need for high intensity, long duration therapy and has shown promising results for upper limb proximal joints. However, upper limb distal joints have historically not benefitted from the same focus. The MAHI Exo-II, designed to address this shortcoming, has undergone a static and dynamic performance characterization, which shows that it exhibits the requisite qualities for a rehabilitation robot and is comparable to other state-of-the-art designs. PMID:25984380

  6. Global distributions of upper tropospheric relative humidity derived from SAGE II observations

    NASA Technical Reports Server (NTRS)

    Chiou, E. W.; Larsen, J. C.; Mccormick, M. P.; Chu, W. P.; Rind, D.

    1992-01-01

    The global distributions of upper tropospheric relative humidity derived from the archived SAGE II water vapor data set are presented. For both summer and winter months, vertical profiles of zonal mean relative humidity are derived for each of the six 20-deg latitude bands covering 60 deg N - 60 deg S. Some examples of global maps of upper tropospheric relative humidity are shown to illustrate the relationship between moist areas and convective activity.

  7. Active Space Debris Removal using European Modified Launch Vehicle Upper Stages Equipped with Electrodynamic Tethers

    NASA Astrophysics Data System (ADS)

    Nasseri, Ali S.; Emanuelli, Matteo; Raval, Siddharth; Turconi, Andrea; Becker, Cristoph

    2013-08-01

    During the past few years, several research programs have assessed the current state and future evolution of the Low Earth Orbit region. These studies indicate that space debris density could reach a critical level such that there will be a continuous increase in the number of debris objects, primarily driven by debris-debris collision activity known as the Kessler effect. This cascade effect can be even more significant when intact objects as dismissed rocket bodies are involved in the collision. The majority of the studies until now have highlighted the urgency for active debris removal in the next years. An Active Debris Removal System (ADRS) is a system capable of approaching the debris object through a close-range rendezvous, establishing physical connection, stabilizing its attitude and finally de-orbiting the debris object using a type of propulsion system in a controlled manoeuvre. In its previous work, this group showed that a modified Fregat (Soyuz FG's 4th stage) or Breeze-M upper stage (Proton-M) launched from Plesetsk (Russian Federation) and equipped with an electro-dynamic tether (EDT) system can be used, after an opportune inclination's change, to de-orbit a Kosmos-3M second stage rocket body while also delivering an acceptable payload to orbit. In this paper, we continue our work on the aforementioned concept, presented at the 2012 Beijing Space Sustainability Conference, by comparing its performance to ADR missions using only chemical propulsion from the upper stage for the far approach and the de-orbiting phase. We will also update the EDT model used in our previous work and highlight some of the methods for creating physical contact with the object. Moreover, we will assess this concept also with European launch vehicles (Vega and Soyuz 2-1A) to remove space debris from space. In addition, the paper will cover some economic aspects, like the cost for the launches' operator in term of payload mass' loss at the launch. The entire debris removal mission from launch to de-orbiting of the target debris object will be analysed using Analytical Graphic Inc.'s Systems Tool Kit (STK).

  8. Opening a new era in space. [Space Transportation System utilizing Shuttle, Spacelab and Interim Upper Stage

    NASA Technical Reports Server (NTRS)

    Culbertson, P. E.; Bold, T. P.

    1977-01-01

    The overall payload planning aimed at initial projected use of the Space Transportation System (STS) which will establish a new capability for exploring and using space through operations of the Shuttle, Spacelab, and Interim Upper Stage (IUS) in the Eighties is reviewed, and the significance of this planning for science and technology is discussed. The first payloads will fly on the STS during Orbital Flight Tests (OFT) beginning in March 1979. Primary OFT objectives include verifying flight systems and the Shuttle's ability to accomodate various types of payloads in different mission modes. The STS schedule will build up to as many as 60 flights in 1984. The STS payloads will make contributions to the management on a global scale of the interrelationship of production, consumption, population growth, and pollution.

  9. Solar Thermal Upper Stage Liquid Hydrogen Pressure Control Testing and Analytical Modeling

    NASA Technical Reports Server (NTRS)

    Olsen, A. D.; Cady, E. C.; Jenkins, D. S.; Chandler, F. O.; Grayson, G. D.; Lopez, A.; Hastings, L. J.; Flachbart, R. H.; Pedersen, K. W.

    2012-01-01

    The demonstration of a unique liquid hydrogen (LH2) storage and feed system concept for solar thermal upper stage was cooperatively accomplished by a Boeing/NASA Marshall Space Flight Center team. The strategy was to balance thermodynamic venting with the engine thrusting timeline during a representative 30-day mission, thereby, assuring no vent losses. Using a 2 cubic m (71 cubic ft) LH2 tank, proof-of-concept testing consisted of an engineering checkout followed by a 30-day mission simulation. The data were used to anchor a combination of standard analyses and computational fluid dynamics (CFD) modeling. Dependence on orbital testing has been incrementally reduced as CFD codes, combined with standard modeling, continue to be challenged with test data such as this.

  10. IUS/TUG orbital operations and mission support study. Volume 2: Interim upper stage operations

    NASA Technical Reports Server (NTRS)

    1975-01-01

    Background data and study results are presented for the interim upper stage (IUS) operations phase of the IUS/tug orbital operations study. The study was conducted to develop IUS operational concepts and an IUS baseline operations plan, and to provide cost estimates for IUS operations. The approach used was to compile and evaluate baseline concepts, definitions, and system, and to use that data as a basis for the IUS operations phase definition, analysis, and costing analysis. Both expendable and reusable IUS configurations were analyzed and two autonomy levels were specified for each configuration. Topics discussed include on-orbit operations and interfaces with the orbiter, the tracking and data relay satellites and ground station support capability analysis, and flight control center sizing to support the IUS operations.

  11. Ares I-X Upper Stage Simulator Compartment Pressure Comparisons During Ascent

    NASA Technical Reports Server (NTRS)

    Downs. William J.; Kirchner, Robert D.; McLachlan, Blair G.; Hand, Lawrence A.; Nelson, Stuart L.

    2011-01-01

    Predictions of internal compartment pressures are necessary in the design of interstage regions, systems tunnels, and protuberance covers of launch vehicles to assess potential burst and crush loading of the structure. History has proven that unexpected differential pressure loads can lead to catastrophic failure. Pressures measured in the Upper Stage Simulator (USS) compartment of Ares I-X during flight were compared to post-flight analytical predictions using the CHCHVENT chamber-to-chamber venting analysis computer program. The measured pressures were enveloped by the analytical predictions for most of the first minute of flight but were outside of the predictions thereafter. This paper summarizes the venting system for the USS, discusses the probable reasons for the discrepancies between the measured and predicted pressures, and provides recommendations for future flight vehicles.

  12. Weld Residual Stress and Distortion Analysis of the ARES I-X Upper Stage Simulator (USS)

    NASA Technical Reports Server (NTRS)

    Raju, Ivatury; Dawicke, David; Cheston, Derrick; Phillips, Dawn

    2008-01-01

    An independent assessment was conducted to determine the critical initial flaw size (CIFS) for the flange-to-skin weld in the Ares I-X Upper Stage Simulator (USS). The Ares system of space launch vehicles is the US National Aeronautics and Space Administration s plan for replacement of the aging space shuttle. The new Ares space launch system is somewhat of a combination of the space shuttle system and the Saturn launch vehicles used prior to the shuttle. Here, a series of weld analyses are performed to determine the residual stresses in a critical region of the USS. Weld residual stresses both increase constraint and mean stress thereby having an important effect on fatigue and fracture life. While the main focus of this paper is a discussion of the weld modeling procedures and results for the USS, a short summary of the CIFS assessment is provided.

  13. Rotation of the upper first molar in Class I, II, and III patients

    PubMed Central

    de Oliveira Viganó, Cristiane; da Rocha, Viviane Ekerman; Junior, Laerte Ribeiro Menezes; Paranhos, Luiz Renato; Ramos, Adilson Luiz

    2016-01-01

    Objective: The aim of this study was to evaluate the mean rotation of the upper first molar (U1st M) in cast models from nontreated patients presenting: Class I, skeletal Class II, dental Class II, and skeletal Class III, comparing with Class I orthodontically treated patients. Materials and Methods: One hundred cast models were evaluated with five groups, composed of nontreated Class I (n = 20), dental Class II (n = 20), skeletal Class II (n = 20), skeletal Class III (n = 20), and treated Class I (n = 20). Measurements were taken from photocopies of the upper arches. The angle formed between a line crossing the mesiopalatal and the distal-buccalcusps of the U1st M and a line traced on mid palatal junction were measured in all samples. Results: One-way variance analysis showed that dental Class II group presented great mean rotation of the 1st molar (x = 78.95°, SD = 6.19) (P < 0.05), and in 85% of the patients from this group this angle was higher than 73°. Conclusions: The skeletal Class II and skeletal Class III groups showed similar mean position of the 1st molar, presenting rotation in approximately 50% of the patients. It can be concluded that upper molar rotation occurs mainly in dental Class II patients and shows higher mesial rotation angle. PMID:27011741

  14. Taming Liquid Hydrogen: The Centaur Upper Stage Rocket, 1958-2002

    NASA Technical Reports Server (NTRS)

    Dawson, Virginia P.; Bowles, Mark D.

    2004-01-01

    During its maiden voyage in May 1962, a Centaur upper stage rocket, mated to an Atlas booster, exploded 54 seconds after launch, engulfing the rocket in a huge fireball. Investigation revealed that Centaur's light, stainless-steel tank had split open, spilling its liquid-hydrogen fuel down its sides, where the flame of the rocket exhaust immediately ignited it. Coming less than a year after President Kennedy had made landing human beings on the Moon a national priority, the loss of Centaur was regarded as a serious setback for the National Aeronautics and Space Administration (NASA). During the failure investigation, Homer Newell, Director of Space Sciences, ruefully declared: "Taming liquid hydrogen to the point where expensive operational space missions can be committed to it has turned out to be more difficult than anyone supposed at the outset." After this failure, Centaur critics, led by Wernher von Braun, mounted a campaign to cancel the program. In addition to the unknowns associated with liquid hydrogen, he objected to the unusual design of Centaur. Like the Atlas rocket, Centaur depended on pressure to keep its paper-thin, stainless-steel shell from collapsing. It was literally inflated with its propellants like a football or balloon and needed no internal structure to give it added strength and stability. The so-called "pressure-stabilized structure" of Centaur, coupled with the light weight of its high- energy cryogenic propellants, made Centaur lighter and more powerful than upper stages that used conventional fuel. But, the critics argued, it would never become the reliable rocket that the United States needed.

  15. Seal Joint Analysis and Design for the Ares-I Upper Stage LOX Tank

    NASA Technical Reports Server (NTRS)

    Phillips, Dawn R.; Wingate, Robert J.

    2011-01-01

    The sealing capability of the Ares-I Upper Stage liquid oxygen tank-to-sump joint is assessed by analyzing the deflections of the joint components. Analyses are performed using three-dimensional symmetric wedge finite element models and the ABAQUS commercial finite element software. For the pressure loads and feedline interface loads, the analyses employ a mixed factor of safety approach to comply with the Constellation Program factor of safety requirements. Naflex pressure-assisted seals are considered first because they have been used successfully in similar seal joints in the Space Shuttle External Tank. For the baseline sump seal joint configuration with a Naflex seal, the predicted joint opening greatly exceeds the seal design specification. Three redesign options of the joint that maintain the use of a Naflex seal are studied. The joint openings for the redesigned seal joints show improvement over the baseline configuration; however, these joint openings still exceed the seal design specification. RACO pressure-assisted seals are considered next because they are known to also be used on the Space Shuttle External Tank, and the joint opening allowable is much larger than the specification for the Naflex seals. The finite element models for the RACO seal analyses are created by modifying the models that were used for the Naflex seal analyses. The analyses show that the RACO seal may provide sufficient sealing capability for the sump seal joint. The results provide reasonable data to recommend the design change and plan a testing program to determine the capability of RACO seals in the Ares-I Upper Stage liquid oxygen tank sump seal joint.

  16. Radiation Therapy and Cisplatin With or Without Triapine in Treating Patients With Newly Diagnosed Stage IB2, II, or IIIB-IVA Cervical Cancer or Stage II-IVA Vaginal Cancer

    ClinicalTrials.gov

    2016-03-29

    Cervical Adenocarcinoma; Cervical Adenosquamous Carcinoma; Cervical Squamous Cell Carcinoma; Stage IB2 Cervical Cancer; Stage II Vaginal Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Vaginal Cancer; Stage IIIB Cervical Cancer; Stage IVA Cervical Cancer; Stage IVA Vaginal Cancer; Stage IVB Vaginal Cancer

  17. Epistaxis in end stage liver disease masquerading as severe upper gastrointestinal hemorrhage

    PubMed Central

    Camus, Marine; Jensen, Dennis M; Matthews, Jason D; Ohning, Gordon V; Kovacs, Thomas O; Jutabha, Rome; Ghassemi, Kevin A; Machicado, Gustavo A; Dulai, Gareth S

    2014-01-01

    AIM: To describe the prevalence, diagnosis, treatment, and outcomes of end stage liver disease (ESLD) patients with severe epistaxis thought to be severe upper gastrointestinal hemorrhage (UGIH). METHODS: This observational single center study included all consecutive patients with ESLD and epistaxis identified from consecutive subjects hospitalized with suspected UGIH and prospectively enrolled in our databases of severe UGIH between 1998 and 2011. RESULTS: A total of 1249 patients were registered for severe UGIH in the data basis, 461 (36.9%) were cirrhotics. Epistaxis rather than UGIH was the bleeding source in 20 patients. All patients had severe coagulopathy. Epistaxis was initially controlled in all cases. Fifteen (75%) subjects required posterior nasal packing and 2 (10%) embolization in addition to correction of coagulopathy. Five (25%) patients died in the hospital, 12 (60%) received orthotopic liver transplantation (OLT), and 3 (15%) were discharged without OLT. The mortality rate was 63% in patients without OLT. CONCLUSION: Severe epistaxis in patients with ESLD is (1) a diagnosis of exclusion that requires upper endoscopy to exclude severe UGIH; and (2) associated with a high mortality rate in patients not receiving OLT. PMID:25320538

  18. Modeling and Simulation of the ARES UPPER STAGE Transportation, Lifting, Stacking and Mating Operations Within the Vehicle Assembly Building at KSC

    NASA Technical Reports Server (NTRS)

    Kromis, Phillip A.

    2010-01-01

    This viewgraph presentation describes the modeling and simulation of the Ares Upper Stage Transportation, lifting, stacking, and mating operations within the Vehicle Assembly Building (VAB) at Kennedy Space Center (KSC). An aerial view of KSC Launch Shuttle Complex, two views of the Delmia process control layout, and an upper stage move subroutine and breakdown are shown. An overhead image of the VAB and the turning basin along with the Pegasus barge at the turning basin are also shown. This viewgraph presentation also shows the actual design and the removal of the mid-section spring tensioners, the removal of the AFT rear and forward tensioners tie downs, and removing the AFT hold down post and mount. US leaving the Pegasus Barge, the upper stage arriving at transfer aisle, upper stage receiving/inspection in transfer aisle, and an overhead view of upper stage receiving/inspection in transfer aisle are depicted. Five views of the actual connection of the cabling to the upper stage aft lifting hardware are shown. The upper stage transporter forward connector, two views of the rotation horizontal to vertical, the disconnection of the rear bolt ring cabling, the lowering of the upper stage to the inspection stand, disconnection of the rear bolt ring from the upper stage, the lifting of the upper stage and inspection of AFT fange, and the transfer of upper stage in an integrated stack are shown. Six views of the mating of the upper stage to the first stage are depicted. The preparation, inspection, and removal of the forward dome are shown. The upper stage mated on the integrated stack and crawler is also shown. This presentation concludes with A Rapid Upper Limb Assessment (RULA) utilizing male and female models for assessing risk factors to the upper extremities of human beings in an actual physical environment.

  19. Study of the anabranch dynamics for different sinuosity stages in the Upper Amazon River Basin

    NASA Astrophysics Data System (ADS)

    Frias, C. E.; Mendoza, A.; Dauer, K.; Abad, J. D.; Montoro, H.; Paredes, J.; Vizcarra, J.

    2013-12-01

    The Upper Peruvian Amazon River is characterized by a sequence of anabranching structures, which are composed by several channels behaving as non-developed and quasy-freely meandering channels. The widest channel in these anabranching structures is considered as the main channel or main anabranch while the other channels are secondary anabranches. Based on satellite imagery, it is observed that the main channels show different sinuosities along the Upper Peruvian Amazon River valley. Little is known about the effects of the planform characteristics of the main channel into the morphodynamics of the secondary anabranches. Thus, two study sites were selected to characterize anabranching structures with low and medium-high sinuosity main channels. For the low sinuosity main channel case, an area at the tri-point boundary between Colombia-Brazil and Peru was selected. For the medium-high sinuosity main channel case, an area upstream of Iquitos City (the largest city in the Peruvian Amazon Rainforest) was selected. A field campaign was carried out on 2010 and 2011 for the medium-high and low sinuosity stages respectively. On this field campaign velocity measurement, bathymetry and water surface elevations were obtained. With the field data it was possible to develop and validate a two dimensional shallow water numerical model to study the hydrodynamics on both sites. This allows us to discuss the effects of the current planform configuration of the anabranching structures into the short-term behavior of individual channels. In past studies, temporal analysis of the Amazon River planform have been carried out using satellite imagery with special focus into the floodplain, main channel, number of islands and valley slope. However, the dynamics in these anabranching structures containing multiple channels have not been studied in detailed. The metrics obtained for this study were sinuosity, channel width and annual migration rates. It was confirmed that in a medium to high sinuosity stage, the secondary anabranches behave as non-developed meanders. Also, it was concluded that the planform for secondary anabranches in all main channel sinuosity stages are controlled by the main anabranch migration.

  20. Shuttle program standard maneuver sequences for orbiter/upper-stage separation SSUS-A, SSUS-D, and IUS

    NASA Technical Reports Server (NTRS)

    Wilson, S. W.

    1980-01-01

    Descriptions of standard post-ejection maneuver sequences for the deployment of IUS, SSUS-A, and SSUS-D upper stages from the space shuttle orbiter are presented. The sequences were designed to satisfy requirements for limiting the damage inflicted on the orbiter by upper-stage exhaust particles, subject to a further requirement for minimizing the impingement of orbiter thruster plumes on the deployed payload. In all cases it was assumed that the orbital maneuvering system engines would be used to apply the orbiter's major separation velocity increment.

  1. Operations analysis (study 2.1). Contingency analysis. [of failure modes anticipated during space shuttle upper stage planning

    NASA Technical Reports Server (NTRS)

    1974-01-01

    Future operational concepts for the space transportation system were studied in terms of space shuttle upper stage failure contingencies possible during deployment, retrieval, or space servicing of automated satellite programs. Problems anticipated during mission planning were isolated using a modified 'fault tree' technique, normally used in safety analyses. A comprehensive space servicing hazard analysis is presented which classifies possible failure modes under the catagories of catastrophic collision, failure to rendezvous and dock, servicing failure, and failure to undock. The failure contingencies defined are to be taken into account during design of the upper stage.

  2. Reusable Centaur study. Volume 1: Executive summary. [development costs of Centaur launch vehicle as upper stage for space shuttle orbiter

    NASA Technical Reports Server (NTRS)

    Heald, D. A.

    1974-01-01

    A study of the Reusable Centaur for use as an initial upper stage with the space shuttle was conducted. The currently operative Centaur stage, with modifications for space shuttle orbiter compatibility and for improved performance, represents a cost effective development solution. The performance needs and available development funds are discussed. The main features of three Reusable Centaur configurations with increasing capability at increasing development costs are summarized.

  3. Flight Results of the Chandra X-ray Observatory Inertial Upper Stage Space Mission

    NASA Technical Reports Server (NTRS)

    Tillotson, R.; Walter, R.

    2000-01-01

    Under contract to NASA, a specially configured version of the Boeing developed Inertial Upper Stage (IUS) booster was provided by Boeing to deliver NASA's 1.5 billion dollar Chandra X-Ray Observatory satellite into a highly elliptical transfer orbit from a Shuttle provided circular park orbit. Subsequently, the final orbit of the Chandra satellite was to be achieved using the Chandra Integral Propulsion System (IPS) through a series of IPS burns. On 23 July 1999 the Shuttle Columbia (STS-93) was launched with the IUS/Chandra stack in the Shuttle payload bay. Unfortunately, the Shuttle Orbiter was unexpectantly inserted into an off-nominal park orbit due to a Shuttle propulsion anomaly occurring during ascent. Following the IUS/Chandra on-orbit deployment from the Shuttle, at seven hours from liftoff, the flight proven IUS GN&C system successfully injected Chandra into the targeted transfer orbit, in spite of the off-nominal park orbit. This paper describes the IUS GN&C system, discusses the specific IUS GN&C mission data load development, analyses and testing for the Chandra mission, and concludes with a summary of flight results for the IUS part of the Chandra mission.

  4. Effect of gimbal friction modelling technique on control stability and performance for Centaur upper stage

    NASA Astrophysics Data System (ADS)

    Graham, Ronald E.

    The powered-phase autopilot for the Centaur upper stage rocket uses an autopilot forward loop gain scheduler that decreases the proportional gain as propellant mass is depleted. Nonlinear time response simulation studies revealed that Centaur vehicles with low-gain autopilots would have large attitude error limit cycles. These limit cycles were due to the assumed presence of Coulomb friction in the engine gimbals. This situation could be corrected through the use of an harmonic dither, programmed into the on-board digital computer and added to the engine command signal. This would introduce impending motion to the engines, allowing control of the engines even under small commands. Control authority was found to be restored when dither was used. A concern arose that the Centaur could be unacceptably excited at resonances near the dither frequency, if the dither amplitude was to be chosen on the basis of friction level present, a test was conducted to measure this level. Dither characteristics were to be based on the test results. The test results showed that the gimbal friction characteristic was actually hysteretic rather than the assumed Coulomb friction. The simulation results showed that, using this new model of gimbal friction, dither would no longer be necessary.

  5. Effect of Gimbal friction modeling technique on control stability and performance for Centaur upper-stage

    NASA Astrophysics Data System (ADS)

    Graham, Ronald E.

    The powered-phase autopilot for the Centaur upper stage rocket uses an autopilot forward loop gain scheduler that decreases the proportional gain as propellant mass is depleted. Nonlinear time response simulation studies revealed that Centaur vehicles with low-gain autopilots would have large attitude error limit cycles. These limit cycles were due to the assumed presence of Coulomb friction in the engine gimbals. This situation could be corrected through the use of an harmonic dither, programmed into the on-board digital computer and added to the engine command signal. This would introduce impending motion to the engines, allowing control of the engines even under small commands. Control authority was found to be restored when dither was used. A concern arose that the Centaur could be unacceptably excited at resonances near the dither frequency, if the dither amplitude was to be chosen on the basis of friction level present, a test was conducted to measure this level. Dither characteristics were to be based on the test results. The test results showed that the gimbal friction characteristic was actually hysteretic rather than the assumed Coulomb friction. The simulation results showed that, using this new model of gimbal friction, dither would no longer be necessary.

  6. Advanced transportation system studies technical area 3: Alternate propulsion system concepts. SSME upper stage use

    NASA Astrophysics Data System (ADS)

    Strangeland, Eric; Levak, Daniel

    1993-04-01

    The main objective was to determine viable methods for starting the Space Shuttle Main Engine (SSME) in an altitude environment and restarting it in an orbit environment with minimum changes in utilization of the engine system or hardware. The study concluded that the use of the SSME in an upper stage is feasible with minimal changes to the engine systems. The altitude start case requires only a change in the valve sequencing during start and reorificing of the ASI lines. Inlet pressures can be moderately low at 40 psia for the LOX and 32 psia for the H2. The orbital restart case adds the need to recirculate propellant and thermal control paint (to keep the turbomachinery inlets cold to minimize the tank pressures needed), and the need to heat two small components (to maintain acceptable mixture ratios during the early part of the start). These actions allow start anytime after approximately 120 minutes. Earlier starts (approximately one hour) are also possible but would require additional component heating for mixture ratio control during the early portion of the start sequence.

  7. Breast-Conserving Surgery Followed by Radiation Therapy With MRI-Detected Stage I or Stage II Breast Cancer

    ClinicalTrials.gov

    2011-12-07

    Ductal Breast Carcinoma in Situ; Estrogen Receptor-negative Breast Cancer; Estrogen Receptor-positive Breast Cancer; HER2-negative Breast Cancer; HER2-positive Breast Cancer; Invasive Ductal Breast Carcinoma; Invasive Lobular Breast Carcinoma; Male Breast Cancer; Medullary Ductal Breast Carcinoma With Lymphocytic Infiltrate; Mucinous Ductal Breast Carcinoma; Papillary Ductal Breast Carcinoma; Progesterone Receptor-negative Breast Cancer; Progesterone Receptor-positive Breast Cancer; Stage I Breast Cancer; Stage II Breast Cancer; Tubular Ductal Breast Carcinoma

  8. Second Stage (S-II) Arrives at Marshall Space Flight Center For Testing

    NASA Technical Reports Server (NTRS)

    2004-01-01

    The business end of a Second Stage (S-II) slowly emerges from the shipping container as workers prepare to transport the Saturn V component to the testing facility at MSFC. The Second Stage (S-II) underwent vibration and engine firing tests. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

  9. Fulvestrant and/or Anastrozole in Treating Postmenopausal Patients With Stage II-III Breast Cancer Undergoing Surgery

    ClinicalTrials.gov

    2015-09-09

    Estrogen Receptor-positive Breast Cancer; HER2-negative Breast Cancer; Invasive Ductal Breast Carcinoma; Invasive Lobular Breast Carcinoma; Recurrent Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

  10. Orbital evolution of the first upper stages used for the new European and Chinese navigation satellite systems

    NASA Astrophysics Data System (ADS)

    Anselmo, Luciano; Pardini, Carmen

    2011-06-01

    The solutions adopted for the disposal of the upper stages used to put in orbit the first satellites of the new European (Galileo) and Chinese (Beidou) navigation constellations were analyzed. The orbit evolution of the rocket bodies was modeled for 200 years, taking into account all relevant perturbations, and the chosen disposal options were evaluated in terms of their long-term consequences for the debris environment. The results obtained, when applicable, were also discussed in the context of the eccentricity instability problem, pointed out in previous studies. In addition, the long-term evolution of the fragments resulting from a Beidou rocket body breakup, and of simulated high area-to-mass ratio objects released in the disposal orbits of the first two Galileo upper stages, was investigated. Eight out of ten Beidou upper stages were found to have an orbital lifetime <25 years and the other two resulted in a dwell time of approximately 6 years below 2000 km. It was also found that the perigee heights of the two upper stages used to deploy the first Galileo test spacecraft will remain more than 169 km above the constellation nominal altitude, never crossing the existing or planned navigation systems. In spite of an inclination resonance possibly leading to the exponential growth of the eccentricity over several decades, the optimal choice of the disposal orbital elements was able to prevent such an outcome, by maintaining the orbit nearly circular. Therefore, the upper stage disposal strategies used so far for Beidou and Galileo have generally been quite successful in averting the long-term interference of such rocket bodies with the navigation constellations, provided that accidental breakups are prevented.

  11. Assessment of upper airways measurements in patients with mandibular skeletal Class II malocclusion

    PubMed Central

    Silva, Nayanna Nadja e; Lacerda, Rosa Helena Wanderley; Silva, Alexandre Wellos Cunha; Ramos, Tania Braga

    2015-01-01

    Objective: Mandibular Class II malocclusions seem to interfere in upper airways measurements. The aim of this study was to assess the upper airways measurements of patients with skeletal Class II malocclusion in order to investigate the association between these measurements and the position and length of the mandible as well as mandibular growth trend, comparing the Class II group with a Class I one. Methods: A total of 80 lateral cephalograms from 80 individuals aged between 10 and 17 years old were assessed. Forty radiographs of Class I malocclusion individuals were matched by age with forty radiographs of individuals with mandibular Class II malocclusion. McNamara Jr., Ricketts, Downs and Jarabak's measurements were used for cephalometric evaluation. Data were submitted to descriptive and inferential statistical analysis by means of SPSS 20.0 statistical package. Student's t-test, Pearson correlation and intraclass correlation coefficient were used. A 95% confidence interval and 5% significance level were adopted to interpret the results. Results: There were differences between groups. Oropharynx and nasopharynx sizes as well as mandibular position and length were found to be reduced in Class II individuals. There was a statistically significant positive correlation between the size of the oropharynx and Xi-Pm, Co-Gn and SNB measurements. In addition, the size of the nasopharynx was found to be correlated with Xi-Pm, Co-Gn, facial depth, SNB, facial axis and FMA. Conclusion: Individuals with mandibular Class II malocclusion were shown to have upper airways measurements diminished. There was a correlation between mandibular length and position and the size of oropharynx and nasopharynx. PMID:26560826

  12. NASA Ares I Launch Vehicle Upper Stage Reaction Control System (ReCS) Cold Flow Development Test Overview

    NASA Technical Reports Server (NTRS)

    Dervan, Melanie; Williams, Hunter; Holt, Kim; Sivak, Amy; Morris, Jon D.

    2010-01-01

    NASA s Ares I launch vehicle, consisting of a five segment solid rocket booster first stage and a liquid bi-propellant J2-X engine Upper Stage, is the vehicle that s been chosen to launch the Orion Crew Module, which will return humans to the Moon, Mars, and beyond. After First Stage booster separation, the Reaction Control System (ReCS), a monopropellant hydrazine system, will provide the Upper Stage element with three degrees of freedom control as needed. This paper provides an overview of the system level development testing that has taken place on the Ares I launch vehicle Upper Stage ReCS. The ReCS System Development Test Article (SDTA) was built as a flight representative water flow test article whose primary test objective was to obtain fluid system performance data to evaluate the integrate system performance characteristics and verify analytical models. Water is the industry standard for cold flow testing of hydrazine systems, because the densities are very close and the speeds of sound are well characterized. The completion of this development level test program was considered necessary to support the ReCS Critical Design Review. This paper will address the design approach taken in building the test article, the objectives of the test program, types of testing completed, general results, the ability of the program to meet the test objectives, and lessons learned

  13. Development of an innovative sandwich common bulkhead for cryogenic upper stage propellant tank

    NASA Astrophysics Data System (ADS)

    Szelinski, B.; Lange, H.; Röttger, C.; Sacher, H.; Weiland, S.; Zell, D.

    2012-12-01

    In the frame of the Future Launcher Preparatory Program (FLPP) investigating advancing technologies for the Next Generation of Launchers (NGL) a number of novel key technologies are presently under development for significantly improving vehicle performance in terms of payload capacity and mission versatility. As a respective ESA guided technology development program, Cryogenic Upper Stage Technologies (CUST) has been launched within FLPP that hosts among others the development of a common bulkhead to separate liquid hydrogen from the liquid oxygen compartment. In this context, MT Aerospace proposed an advanced sandwich design concept which is currently in the development phase reaching for TRL4 under MT Aerospace responsibility. Key components of this sandwich common bulkhead are a specific core material, situated in-between two thin aluminum face sheets, and an innovative thermal decoupling element at the equatorial region. The combination of these elements provides excellent thermal insulation capabilities and mechanical performance at a minimum weight, since mechanical and thermal functions are merged in the same component. This improvement is expressed by substantial performance figures of the proposed concept that include high resistance against reverse pressure, an optimized heat leak and minimized mass, involving the sandwich dome structure and the adjacent interface rings. The development of single sub-technologies, all contributing to maturate the sandwich common bulkhead towards the desired technology readiness level (TRL), is described in the context of the given design constraints as well as technical, functional and programmatic requirements, issued from the stage level. This includes the thermal and mechanical characterization of core materials, manufacturing issues as well as non-destructive testing and the thermal and structural analyses and dimensioning of the complete common bulkhead system. Dedicated TRL assessments in the Ariane 5 Mid-life Evolution (A5-ME) program track the progress of these technology developments and analyze their applicability in time for A5-ME. In order to approximate A5-ME concerned preconditions, activities are initiated aiming at harmonization of the available specifications. Hence, a look-out towards a further technology step approaching TRL6 in a subsequent phase is given, briefly addressing topics of full scale manufacture and appropriate thermo-mechanical testing of an entire sandwich common bulkhead.

  14. The Integrated Solar Upper Stage engine ground demonstration power management and distribution subsystem design

    NASA Astrophysics Data System (ADS)

    Baez, Anastacio N.; Kimnach, Greg L.

    1997-01-01

    The National Aeronautics and Space Administration (NASA), the Air Force Phillips Laboratory (PL), and the Defense Special Weapons Agency (DSWA) in a joint effort are developing technologies for a solar bimodal system. A solar bimodal system combines thermal propulsion and electric power generation in a single integrated system. A spacecraft Integrated Solar Upper Stage (ISUS) bimodal system combines orbital transfer propulsion, electric power generation, and on-board propulsion into one overall system. A key benefit of such integrated system is the augmentation of payload to spacecraft mass ratio thus resulting in lower launch vehicle requirements. Scaling down to smaller launch vehicles increases space access by reducing overall mission cost. The NASA/PL/DSWA ISUS program is concentrating efforts on a near-term ground test demonstration of the bimodal concept. A successful ground demonstration of the ISUS various technologies will enable a full system flight demonstration of the bimodal concept. NASA Lewis Research Center in Cleveland Ohio will be the site for the engine ground demonstrator (EGD). The ISUS bimodal system uses solar concentrators to focus solar energy into an integrated receiver, absorber, and converter (RAC) power plant. The power plant main body is a graphite blackbody that stores thermal energy within a cavity in its main core. During the propulsion phase of the bimodal system a propellant flows into the graphite main core and is distributed uniformly through axial flow channels in the heated cavity. The blackbody core heats the propellant that is then discharged into an output tube thus creating thrust. An array of thermionic generators encircles the graphite core cavity and provides electrical energy conversion functions during the power generation phase. The power management and distribution subsystem's main functions are to condition raw electrical power generated by the RAC power plant and deliver it to the spacecraft payloads. This paper presents a detail description of the power management and distribution subsystem design for the ISUS ground demonstration program.

  15. The J-2X Upper Stage Engine: From Design to Hardware

    NASA Technical Reports Server (NTRS)

    Byrd, Thomas

    2010-01-01

    NASA is well on its way toward developing a new generation of launch vehicles to support of national space policy to retire the Space Shuttle fleet, complete the International Space Station, and return to the Moon as the first step in resuming this nation s exploration of deep space. The Constellation Program is developing the launch vehicles, spacecraft, surface systems, and ground systems to support those plans. Two launch vehicles will support those ambitious plans the Ares I and Ares V. (Figure 1) The J-2X Upper Stage Engine is a critical element of both of these new launchers. This paper will provide an overview of the J-2X design background, progress to date in design, testing, and manufacturing. The Ares I crew launch vehicle will lift the Orion crew exploration vehicle and up to four astronauts into low Earth orbit (LEO) to rendezvous with the space station or the first leg of mission to the Moon. The Ares V cargo launch vehicle is designed to lift a lunar lander into Earth orbit where it will be docked with the Orion spacecraft, and provide the thrust for the trans-lunar journey. While these vehicles bear some visual resemblance to the 1960s-era Saturn vehicles that carried astronauts to the Moon, the Ares vehicles are designed to carry more crew and more cargo to more places to carry out more ambitious tasks than the vehicles they succeed. The government/industry team designing the Ares rockets is mining a rich history of technology and expertise from the Shuttle, Saturn and other programs and seeking commonality where feasible between the Ares crew and cargo rockets as a way to minimize risk, shorten development times, and live within the budget constraints of its original guidance.

  16. Measurements of lower stratospheric/upper tropospheric water vapor by the SAGE II instrument

    NASA Technical Reports Server (NTRS)

    Larsen, J. C.; Mcmaster, L. R.; Mccormick, M. P.; Chu, W. P.

    1986-01-01

    Preliminary, unvalidated data are discussed from early measurements of water vapor profiles in the upper troposphere/lower stratosphere by means of SAGE II satellite sensors. Zonal means for April 1985 are discussed and compared with previous, separate data sets for water vapor profiles for the 100 mbar and 300 mbar levels determined from space-based IR and rawinsonde data. Techniques employed to correct for noisy measurements due to the presence of clouds in the SAGE II scenes are described, noting the slant path transmission methods applied to generate the water vapor profiles.

  17. SAGE II long-term measurements of stratospheric and upper tropospheric aerosols

    SciTech Connect

    Wang, P.H.; Kent, G.S.; McCormick, M.P.; Thomason, L.W.

    1995-12-31

    The Stratospheric Aerosol and Gas Experiment (SAGE) II solar occultation instrument has been making measurements on stratospheric aerosols and gases continually since October 1984. Observations from the SAGE II instrument provide a valuable long-term data set for study of the aerosol in the stratosphere and aerosol and cloud in the upper troposphere. The period of observation covers the decay phase of material injected by the El Chichon volcanic eruption in 1982, the years 1988--1990 when stratospheric aerosol levels approached background levels, and the period after the eruption of Mount Pinatubo in 1991. The Mount Pinatubo eruption caused the largest perturbation in stratospheric aerosol loading in this century, with effects on stratospheric dynamics and chemistry. The SAGE II data sequence shows the global dispersion of aerosols following the Mount Pinatubo eruption, as well as the changes occurring in stratospheric aerosol mass and surface area. The downward transfer of stratospheric aerosols into the upper troposphere following the earlier eruption of El Chichon is clearly visible. Estimates have been made of the amount of volcanic material lying in the upper troposphere and the way in which this varies with latitude and season.

  18. Family Caregiver Palliative Care Intervention in Supporting Caregivers of Patients With Stage II-IV Gastrointestinal, Gynecologic, and Urologic Cancers

    ClinicalTrials.gov

    2015-10-30

    Healthy, no Evidence of Disease; Localized Transitional Cell Cancer of the Renal Pelvis and Ureter; Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter; Psychosocial Effects of Cancer and Its Treatment; Recurrent Bladder Cancer; Recurrent Cervical Cancer; Recurrent Colon Cancer; Recurrent Gastric Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Ovarian Germ Cell Tumor; Recurrent Pancreatic Cancer; Recurrent Rectal Cancer; Recurrent Renal Cell Cancer; Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter; Recurrent Urethral Cancer; Recurrent Uterine Sarcoma; Regional Transitional Cell Cancer of the Renal Pelvis and Ureter; Stage II Bladder Cancer; Stage II Renal Cell Cancer; Stage II Urethral Cancer; Stage IIA Cervical Cancer; Stage IIA Colon Cancer; Stage IIA Gastric Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIA Pancreatic Cancer; Stage IIA Rectal Cancer; Stage IIA Uterine Sarcoma; Stage IIB Cervical Cancer; Stage IIB Colon Cancer; Stage IIB Gastric Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIB Pancreatic Cancer; Stage IIB Rectal Cancer; Stage IIB Uterine Sarcoma; Stage IIC Colon Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIC Rectal Cancer; Stage III Bladder Cancer; Stage III Pancreatic Cancer; Stage III Renal Cell Cancer; Stage III Urethral Cancer; Stage IIIA Cervical Cancer; Stage IIIA Colon Cancer; Stage IIIA Gastric Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Rectal Cancer; Stage IIIA Uterine Sarcoma; Stage IIIB Cervical Cancer; Stage IIIB Colon Cancer; Stage IIIB Gastric Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Rectal Cancer; Stage IIIB Uterine Sarcoma; Stage IIIC Colon Cancer; Stage IIIC Gastric Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Ovarian Germ Cell Tumor; Stage IIIC Rectal Cancer; Stage IIIC Uterine Sarcoma; Stage IV Bladder Cancer; Stage IV Gastric Cancer; Stage IV Ovarian Epithelial Cancer; Stage IV Ovarian Germ Cell Tumor; Stage IV Pancreatic Cancer; Stage IV Renal Cell Cancer; Stage IV Urethral Cancer; Stage IVA Cervical Cancer; Stage IVA Colon Cancer; Stage IVA Rectal Cancer; Stage IVA Uterine Sarcoma; Stage IVB Cervical Cancer; Stage IVB Colon Cancer; Stage IVB Rectal Cancer; Stage IVB Uterine Sarcoma; Ureter Cancer

  19. Three Orbital Burns to Molniya Orbit Via Shuttle_Centaur G Upper Stage

    NASA Technical Reports Server (NTRS)

    Williams, Craig H.

    2015-01-01

    An unclassified analytical trajectory design, performance, and mission study was done for the 1982 to 1986 joint National Aeronautics and Space Administration (NASA)-United States Air Force (USAF) Shuttle/Centaur G upper stage development program to send performance-demanding payloads to high orbits such as Molniya using an unconventional orbit transfer. This optimized three orbital burn transfer to Molniya orbit was compared to the then-baselined two burn transfer. The results of the three dimensional trajectory optimization performed include powered phase steering data and coast phase orbital element data. Time derivatives of the orbital elements as functions of thrust components were evaluated and used to explain the optimization's solution. Vehicle performance as a function of parking orbit inclination was given. Performance and orbital element data was provided for launch windows as functions of launch time. Ground track data was given for all burns and coasts including variation within the launch window. It was found that a Centaur with fully loaded propellant tanks could be flown from a 37 deg inclination low Earth parking orbit and achieve Molniya orbit with comparable performance to the baselined transfer which started from a 57 deg inclined orbit: 9,545 versus 9,552 lb of separated spacecraft weight, respectively. There was a significant reduction in the need for propellant launch time reserve for a 1 hr window: only 78 lb for the three burn transfer versus 320 lb for the two burn transfer. Conversely, this also meant that longer launch windows over more orbital revolutions could be done for the same amount of propellant reserve. There was no practical difference in ground tracking station or airborne assets needed to secure telemetric data, even though the geometric locations of the burns varied considerably. There was a significant adverse increase in total mission elapsed time for the three versus two burn transfer (12 vs. 1-1/4 hr), but could be accommodated by modest modifications to Centaur systems. Future applications were discussed. The three burn transfer was found to be a viable, arguably preferable, alternative to the two burn transfer.

  20. Three Orbital Burns to Molniya Orbit via Shuttle Centaur G Upper Stage

    NASA Technical Reports Server (NTRS)

    Williams, Craig H.

    2014-01-01

    An unclassified analytical trajectory design, performance, and mission study was done for the 1982-86 joint NASA-USAF Shuttle/Centaur G upper stage development program to send performance-demanding payloads to high orbits such as Molniya using an unconventional orbit transfer. This optimized three orbital burn transfer to Molniya orbit was compared to the then-baselined two burn transfer. The results of the three dimensional trajectory optimization performed include powered phase steering data and coast phase orbital element data. Time derivatives of the orbital elements as functions of thrust components were evaluated and used to explain the optimization's solution. Vehicle performance as a function of parking orbit inclination was given. Performance and orbital element data was provided for launch windows as functions of launch time. Ground track data was given for all burns and coasts including variation within the launch window. It was found that a Centaur with fully loaded propellant tanks could be flown from a 37deg inclination low Earth parking orbit and achieve Molniya orbit with comparable performance to the baselined transfer which started from a 57deg inclined orbit: 9,545 lb vs. 9,552 lb of separated spacecraft weight respectively. There was a significant reduction in the need for propellant launch time reserve for a one hour window: only 78 lb for the three burn transfer vs. 320 lb for the two burn transfer. Conversely, this also meant that longer launch windows over more orbital revolutions could be done for the same amount of propellant reserve. There was no practical difference in ground tracking station or airborne assets needed to secure telemetric data, even though the geometric locations of the burns varied considerably. There was a significant adverse increase in total mission elapsed time for the three vs. two burn transfer (12 vs. 11/4 hrs), but could be accommodated by modest modifications to Centaur systems. Future applications were discussed. The three burn transfer was found to be a viable, arguably preferable, alternative to the two burn transfer.

  1. Deletion of Chromosome 4q Predicts Outcome in Stage II Colon Cancer Patients

    PubMed Central

    Brosens, R. P. M.; Belt, E. J. T. H.; Haan, J. C.; Buffart, T. E.; Carvalho, B.; Grabsch, H.; Quirke, P.; Cuesta, M. A.; Engel, A. F.; Ylstra, B.; Meijer, G. A.

    2010-01-01

    Background: Around 30% of all stage II colon cancer patients will relapse and die of their disease. At present no objective parameters to identify high-risk stage II colon cancer patients, who will benefit from adjuvant chemotherapy, have been established. With traditional histopathological features definition of high-risk stage II colon cancer patients is inaccurate. Therefore more objective and robust markers for prediction of relapse are needed. DNA copy number aberrations have proven to be robust prognostic markers, but have not yet been investigated for this specific group of patients. The aim of the present study was to identify chromosomal aberrations that can predict relapse of tumor in patients with stage II colon cancer. Materials and Methods: DNA was isolated from 40 formaldehyde fixed paraffin embedded stage II colon cancer samples with extensive clinicopathological data. Samples were hybridized using Comparative Genomic Hybridization (CGH) arrays to determine DNA copy number changes and microsatellite stability was determined by PCR. To analyze differences between stage II colon cancer patients with and without relapse of tumor a Wilcoxon rank-sum test was implemented with multiple testing correction. Results: Stage II colon cancers of patients who had relapse of disease showed significantly more losses on chromosomes 4, 5, 15q, 17q and 18q. In the microsatellite stable (MSS) subgroup (n=28), only loss of chromosome 4q22.14q35.2 was significantly associated with disease relapse (p < 0.05, FDR < 0.15). No differences in clinicopathological characteristics between patients with and without relapse were observed. Conclusion: In the present series of MSS stage II colon cancer patients losses on 4q22.14q35.2 were associated with worse outcome and these genomic alterations may aid in selecting patients for adjuvant therapy. PMID:20966546

  2. Proton Beam Therapy of Stage II and III Non-Small-Cell Lung Cancer

    SciTech Connect

    Nakayama, Hidetsugu; Satoh, Hiroaki; Sugahara, Shinji; Kurishima, Koichi; Tsuboi, Koji; Sakurai, Hideyuki; Ishikawa, Shigemi; Tokuuye, Koichi

    2011-11-15

    Purpose: The present retrospective study assessed the role of proton beam therapy (PBT) in the treatment of patients with Stage II or III non-small-cell lung cancer who were inoperable or ineligible for chemotherapy because of co-existing disease or refusal. Patients and Methods: Between November 2001 and July 2008, PBT was given to 35 patients (5 patients with Stage II, 12 with Stage IIIA, and 18 with Stage IIIB) whose median age was 70.3 years (range, 47.4-85.4). The median proton dose given was 78.3 Gy (range, 67.1-91.3) (relative biologic effectiveness). Results: Local progression-free survival for Stage II-III patients was 93.3% at 1 year and 65.9% at 2 years during a median observation period of 16.9 months. Four patients (11.4%) developed local recurrence, 13 (37.1%) developed regional recurrence, and 7 (20.0%) developed distant metastases. The progression-free survival rate for Stage II-III patients was 59.6% at 1 year and 29.2% at 2 years. The overall survival rate of Stage II-III patients was 81.8% at 1 year and 58.9% at 2 years. Grade 3 or greater toxicity was not observed. A total of 15 patients (42.9%) developed Grade 1 and 6 (17.1%) Grade 2 toxicity. Conclusion: PBT for Stage II-III non-small-cell lung cancer without chemotherapy resulted in good local control and low toxicity. PBT has a definite role in the treatment of patients with Stage II-III non-small-cell lung cancer who are unsuitable for surgery or chemotherapy.

  3. A 20k Payload Launch Vehicle Fast Track Development Concept Using an RD-180 Engine and a Centaur Upper Stage

    NASA Technical Reports Server (NTRS)

    Toelle, Ronald (Compiler)

    1995-01-01

    A launch vehicle concept to deliver 20,000 lb of payload to a 100-nmi orbit has been defined. A new liquid oxygen/kerosene booster powered by an RD-180 engine was designed while using a slightly modified Centaur upper stage. The design, development, and test program met the imposed 40-mo schedule by elimination of major structural testing by increased factors of safety and concurrent engineering concepts. A growth path to attain 65,000 lb of payload is developed.

  4. Results of the first 2-stage diode experiments on PBFA II

    SciTech Connect

    Lockner, T.; Slutz, S.; Johnson, D.J.; Desjarlais, M.; Poukey, J.

    1994-08-01

    A series of experiments have been performed on the PBFA II accelerator in a 2-Stage diode configuration. These experiments have demonstrated the generation and post acceleration of both proton and lithium beams. The second stage was also used to measure the ion current injected from the first stage. The ion current was found to be larger than the inferred current from Faraday cup measurements as is seen in single stage experiments. This result suggests that the current difference (known as parasitic load) is carried by ions. A straightforward modification to the poor magnetic field geometry in the second stage is shown to improve transport to the axis.

  5. Brentuximab Vedotin and Combination Chemotherapy in Treating Older Patients With Previously Untreated Stage II-IV Hodgkin Lymphoma

    ClinicalTrials.gov

    2015-09-18

    Adult Lymphocyte Depletion Hodgkin Lymphoma; Adult Lymphocyte Predominant Hodgkin Lymphoma; Adult Mixed Cellularity Hodgkin Lymphoma; Adult Nodular Sclerosis Hodgkin Lymphoma; Stage II Adult Hodgkin Lymphoma; Stage III Adult Hodgkin Lymphoma; Stage IV Adult Hodgkin Lymphoma

  6. Second Stage (S-II) Plays Key Role in Apollo missions

    NASA Technical Reports Server (NTRS)

    1970-01-01

    This photograph of the Saturn V Second Stage (S-II) clearly shows the cluster of five powerful J-2 engines needed to boost the Apollo spacecraft into earth orbit following first stage separation. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

  7. Supporting collaboration through a nursing informatics curriculum stage II.

    PubMed Central

    Travis, L. L.; Hoehn, B.; Spees, C.; Hribar, K.; Youngblut, J.

    1992-01-01

    Collaboration is at the center of the process used to design, implement and evaluate an integrated informatics curriculum in a baccalaureate nursing program. This paper describes the second stage of a process to design the informatics nursing courses. The challenges to foster faculty collaborative relationships as well as to enhance the course content of all nursing informatics curriculum. A number of strategies were used to develop the collaborative efforts between the faculty and nursing staff in the clinical agencies. Information technology was incorporated into the didactic and clinical portions of courses through the use of creative teaching strategies. Therefore, the faculty have ensured a blend of information, technology, and the clinical care process throughout the curriculum. PMID:1482910

  8. Stages of Acquisition of Gateway Drug Use in Upper Elementary School Children.

    ERIC Educational Resources Information Center

    Kelley, R. Mark; And Others

    This study examines the stages of acquisition of "gateway" drug use among fourth, fifth, and sixth grade students at 11 elementary schools in Arkansas. A 109-item questionnaire, administered in the classrooms by the classroom teachers, solicited information about the stages of acquisition and the subjects' use of alcohol, smokeless tobacco,

  9. A phase II trial of RCHOP followed by radioimmunotherapy for early stage (stages I/II) diffuse large B-cell non-Hodgkin lymphoma: ECOG3402.

    PubMed

    Witzig, Thomas E; Hong, Fangxin; Micallef, Ivana N; Gascoyne, Randy D; Dogan, Ahmet; Wagner, Henry; Kahl, Brad S; Advani, Ranjana H; Horning, Sandra J

    2015-09-01

    Patients with early stage diffuse large B-cell lymphoma (DLBCL) receive RCHOP (rituximab cyclophosphamide, doxorubicin, vincristine, prednisone) alone or with involved field radiotherapy (IFRT). Anti-CD20 radioimmunotherapy (RIT) delivers radiation to microscopic sites outside of known disease. This phase II study aimed to achieve a functional complete response (CR) rate of ?75% to RCHOP and (90) Yttrium-ibritumomab tiuxetan RIT. Patients with stages I/II DLBCL received 4-6 cycles of RCHOP followed by RIT [148MBq/kg (04mCi/kg)]; patients with positron emission tomographypositive sites of disease after RCHOP/RIT received 30Gy IFRT. Of the 62 patients enrolled; 53 were eligible. 42% (22/53) had stage I/IE; 58% (31/53) stage II/IIE. After RCHOP, 79% (42/53) were in CR/unconfirmed CR. Forty-eight patients proceeded to RIT. One partial responder after RIT received IFRT and achieved a CR. The best response after RCHOP+RIT in all 53 patients was a functional CR rate of 89% (47/53; 95% confidence interval: 77-96%). With a median follow-up of 59years, 7 (13%) patients have progressed and 4 (8%) have died (2 with DLBCL). At 5years, 78% of patients remain in remission and 94% are alive. Chemoimmunotherapy and RIT is an active regimen for early stage DLBCL patients. Eighty-nine percent of patients achieved functional CR without the requirement of IFRT. This regimen is worthy of further study for early stage DLBCL in a phase III trial. PMID:25974212

  10. Upper-stage space shuttle propulsion by means of separate scramjet and rocket engines

    NASA Technical Reports Server (NTRS)

    Franciscus, L. C.; Allen, J. L.

    1972-01-01

    A preliminary mission study of a reusable vehicle from staging to orbit indicates payload advantages for a dual-propulsion system consisting of separate scramjet and rocket engines. In the analysis the scramjet operated continuously and the initiation of rocket operation was varied. For a stage weight of 500,000 lb the payload was 10.4 percent of stage weight or 70 percent greater than that of a comparable all-rocket-powered stage. When compared with a reusable two-state rocket vehicle having 50,000 lb payload, the use of the dual propulsion system for the second stage resulted in significant decreases in lift-off weight and empty weight, indicating possible lower hardware costs.

  11. Evolutionary stages of a mid-Proterozoic carbonate basin as inferred from the upper marble, Adirondack Lowlands, New York

    SciTech Connect

    Hauer, K.L.; Grant, N.K. . Dept. of Geology)

    1992-01-01

    Mineral abundances for Upper Marble protoliths, obtained through least-squares multiple regression calculations, and trace element concentrations for 112 samples from two drill cores, exhibit stratigraphic variations that are interpretable in terms of stages in the development of the original carbonate basin. Factor analysis with varimax rotation reveals three dominant factors; dolomite, calcite + Sr, and quartz; and five minor factors: clastics, anhydrite + Sr, magnesite, ore + Sr, and illite. When the factor affiliations of samples are considered with respect to their stratigraphic arrangement, the result can be interpreted in terms of a seven-stage model of basin evolution that possesses elements common to both Proterozoic and Phanerozoic carbonate basins. According to this model, stage 1 was dominated by widespread penecontemporaneous dolomitization punctuated by brief periods of increased basin restriction. Stage 2 involved increasing basin restriction during which dolomitization was progressively inhibited by increasing Ca[sup 2+] and/or sulfate levels. Stage 3 was characterized by further basin restriction and episodes of anhydrite precipitation during which dolomitization resumed briefly because of lowered Ca[sup 2+] and/or sulfate levels. Stage 4 and 5 involved decreasing restriction and brine concentrations which allowed large-scale dolomitization to resume during stage 5, and abundant chert was formed in these sediments subsequent to dolomitization. Stage 6 was characterized by increasing restriction and progressive inhibition of dolomitization. Finally, stage 7 saw rapid increases in aluminosilicate sedimentation that ended further carbonate deposition. Sr abundances throughout the cores reflect control by carbonate mineralogy, which was in turn controlled by the degree of basin restriction.

  12. Decadal-Scale Responses in Middle and Upper Stratospheric Ozone From SAGE II Version 7 Data

    NASA Technical Reports Server (NTRS)

    Remsberg, E. E.

    2014-01-01

    Stratospheric Aerosol and Gas Experiment (SAGE II) version 7 (v7) ozone profiles are analyzed for their decadal-scale responses in the middle and upper stratosphere for 1991 and 1992-2005 and compared with those from its previous version 6.2 (v6.2). Multiple linear regression (MLR) analysis is applied to time series of its ozone number density vs. altitude data for a range of latitudes and altitudes. The MLR models that are fit to the time series data include a periodic 11 yr term, and it is in-phase with that of the 11 yr, solar UV (Ultraviolet)-flux throughout most of the latitude/ altitude domain of the middle and upper stratosphere. Several regions that have a response that is not quite in-phase are interpreted as being affected by decadal-scale, dynamical forcings. The maximum minus minimum, solar cycle (SClike) responses for the ozone at the low latitudes are similar from the two SAGE II data versions and vary from about 5 to 2.5% from 35 to 50 km, although they are resolved better with v7. SAGE II v7 ozone is also analyzed for 1984-1998, in order to mitigate effects of end-point anomalies that bias its ozone in 1991 and the analyzed results for 1991-2005 or following the Pinatubo eruption. Its SC-like ozone response in the upper stratosphere is of the order of 4%for 1984-1998 vs. 2.5 to 3%for 1991-2005. The SAGE II v7 results are also recompared with the responses in ozone from the Halogen Occultation Experiment (HALOE) that are in terms of mixing ratio vs. pressure for 1991-2005 and then for late 1992- 2005 to avoid any effects following Pinatubo. Shapes of their respective response profiles agree very well for 1992-2005. The associated linear trends of the ozone are not as negative in 1992-2005 as in 1984-1998, in accord with a leveling off of the effects of reactive chlorine on ozone. It is concluded that the SAGE II v7 ozone yields SC-like ozone responses and trends that are of better quality than those from v6.2.

  13. Upper Stratospheric Temperature Climatology Derived from SAGE II Observations: Preliminary Results

    NASA Technical Reports Server (NTRS)

    Wang, P.-H.; Cunnold, D. M.; Wang, H. J.; Chu, W. P.; Thomason, L. W.

    2002-01-01

    This study shows that the temperature information in the upper stratosphere can be derived from the SAGE II 385-mn observations. The preliminary results indicate that the zonal mean temperature increases with altitude below 50 km and decreases above 50 km. At 50 km, a regional maximum of 263 K is located in the tropics, and a minimum of 261 K occurs in the subtropics in both hemispheres. The derived long-term temperature changes from 1985 to 1997 reveal a statistically significant negative trend of -2 to -2.5 K/decade in the tropical upper stratosphere and about -2 K/decade in the subtropics near the stratopause. At latitudes poleward of 50, the results show a statistically significant positive trend of about 1 K/decade in the upper stratosphere. The preliminary results also show large annual temperature oscillations in the extratropics with a maximum amplitude of approx. 8 K located at about 44 km near 50 in both hemispheres during local summer. In addition, the semiannual oscillation is found to be a maximum in the tropics with a peak amplitude of approx. 3.3 K located at about 42 km during the equinox.

  14. Carcinoma of the uterine cervix stage IB and early stage II. Prognostic value of the histological tumor regression after initial brachytherapy

    SciTech Connect

    Calais, G.; Le Floch, O.; Chauvet, B.; Reynaud-Bougnoux, A.; Bougnoux, P. )

    1989-12-01

    In our center limited centro pelvic invasive carcinomas of the uterine cervix (less than 4 cm) are treated with brachytherapy and surgery. With these therapeutic modalities no residual carcinoma was observed for 80% of the patients. The purpose of this study was to evaluate our results with this treatment, and to evaluate the prognostic value of the pathological status of the cervix. From 1976 to 1987 we have treated 115 patients with these modalities. Staging system used was the FIGO classification modified for Stage II (divided in early Stage II and late Stage II). Patients were Stage IB (70 cases) and early Stage II (45 cases); 60 Gy were delivered with utero vaginal brachytherapy before any treatment. Six weeks later a radical hysterectomy with pelvic lymphadenectomy was performed. Twenty-one patients with positive nodes received a pelvic radiotherapy (45 to 55 Gy). Local control rate was 97% (100% for Stage IB and 93% for early Stage II). Uncorrected 10-year actuarial survival rate was 96% for Stage IB and 80% for early Stage II patients. No treatment failure was observed for Stage IB patients. Ninety-two patients (80%) had no residual carcinoma in the cervix (group 1) and 23 patients (20%) had a residual tumor (group 2). The sterilization rate of the cervix was 87% for Stage IB tumors versus 69% for early Stage II, and was 82% for N- patients versus 68% for N+ patients. Ten year actuarial survival rate was 92% for group 1 and 78% for group 2 (p = 0, 1). Grade 3 complications rate was 6%. We conclude that brachytherapy + surgery is a safe treatment for limited centro pelvic carcinomas of the uterine cervix (especially Stage IB) and that pathological status of the cervix after brachytherapy is not a prognostic factor.

  15. Large-Scale Liquid Hydrogen Tank Rapid Chill and Fill Testing for the Advanced Shuttle Upper Stage Concept

    NASA Technical Reports Server (NTRS)

    Flachbart, R. H.; Hedayat, A.; Holt, K. A.; Sims, J.; Johnson, E. F.; Hastings, L. J.; Lak, T.

    2013-01-01

    Cryogenic upper stages in the Space Shuttle program were prohibited primarily due to a safety risk of a 'return to launch site' abort. An upper stage concept addressed this concern by proposing that the stage be launched empty and filled using shuttle external tank residuals after the atmospheric pressure could no longer sustain an explosion. However, only about 5 minutes was allowed for tank fill. Liquid hydrogen testing was conducted within a near-ambient environment using the multipurpose hydrogen test bed 638.5 ft3 (18m3) cylindrical tank with a spray bar mounted longitudinally inside. Although the tank was filled within 5 minutes, chilldown of the tank structure was incomplete, and excessive tank pressures occurred upon vent valve closure. Elevated tank wall temperatures below the liquid level were clearly characteristic of film boiling. The test results have substantial implications for on-orbit cryogen transfer since the formation of a vapor film would be much less inhibited due to the reduced gravity. However, the heavy tank walls could become an asset in normal gravity testing for on-orbit transfer, i.e., if film boiling in a nonflight weight tank can be inhibited in normal gravity, then analytical modeling anchored with the data could be applied to reduced gravity environments with increased confidence.

  16. Rituximab, Combination Chemotherapy, and 90-Yttrium Ibritumomab Tiuxetan for Patients With Stage I or II Non-Hodgkin's Lymphoma

    ClinicalTrials.gov

    2015-02-17

    Contiguous Stage II Adult Diffuse Large Cell Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Nodal Marginal Zone B-cell Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Splenic Marginal Zone Lymphoma; Stage I Adult Diffuse Large Cell Lymphoma; Testicular Lymphoma; Waldenström Macroglobulinemia

  17. Large Scale Testing of a Foam/Multilayer Insulation Thermal Control System (TCS) for Cryogenic Upper Stages

    NASA Technical Reports Server (NTRS)

    Hastings, Leon; Martin, James

    1998-01-01

    The development of high energy cryogenic upper stages is essential for the efficient delivery of large payloads to various destinations envisioned in future programs. A key element in such upper stages is cryogenic fluid management (CFM) advanced development/technology. Due to the cost of and limited opportunities for orbital experiments, ground testing must be employed to the fullest extent possible. Therefore, a system level test bed termed the Multipurpose Hydrogen Test Bed (MHTB), which is representative in size and shape (3 meter diameter by 3 meter long with a volume of 18 cubic meters) of a fully integrated space transportation vehicle liquid hydrogen propellant tank has been established. To date, upper stage studies have often baselined the foam/multilayer insulation (FMLI) combination concept; however, hardware experience with the concept is minimal and was therefore selected for the MHTB. The foam element (isofoam SS-1 171 with an average thickness of 3.5 centimeters) is designed to protect against ground hold/ascent flight environments, and allows for the use of a dry nitrogen purge as opposed to the more complex/heavy helium purge subsystem normally required with MLI in cryogenic applications. The MLI (45 layers of Double Aluminized Mylar with Dacron spacers) provides protection in the vacuum environment of space and is designed for an on-orbit storage period of 45 days. Several unique features were incorporated in the MLI concept and included: variable density MLI (reduces weight and radiation losses by changing the layer density), larger but fewer DAM perforations for venting during ascent to orbit (reduces radiation losses), and roll wrap installation of the MLI with a commercially established process to lower assembly man-hours and reduce seam heat leak. Thermal performance testing of the MHTB TCS was conducted during three test series conducted between September 1995 and May 1996. Results for the ground hold portion of the tests were as expected producing an average heat leak of 63 WattS/M2 at an average foam surface temperature of 170 K. The results of the simulated orbit hold test interval produced heat leaks ranging from 0.085 to 0.22 Watts/squareM at warm boundary temperatures of 164K and 305K, respectively. When compared to the performance for a traditional MLI system, a 60% reduction in orbital heat leak or boiloff was measured. Overall, the MHTB TCS demonstrated satisfactory performance for all mission phases required of a cryogenic upper stage.

  18. Prediction of damage by high velocity impact on the pressurised propellant tanks of launch vehicle upper stage

    NASA Astrophysics Data System (ADS)

    Balamurali, A.; Kulkarni, A.; Elayathu, M.

    Before finalising the launch window for a particular satellite launch vehicle mission, Collision Avoidance (COLA) studies are carried out to assess the risk of collision between the catalogued space objects and the launch vehicle. However at altitudes where the effect of atmospheric drag is less pronounced, the population of debris that are too small (less than 100mm size) to be tracked are enormously large. In Low Earth Orbit (LEO) the average relative velocity between two orbiting objects is about 10 km/s. At this velocity if these objects strike the launch vehicle before injection of the satellite, the consequence can be detrimental to the mission. After injection of the satellite the spent stage, which will be in orbit, if struck by these high velocity particles may result in fragmentation and aggravate the problem of space debris. LEO missions of satellite launch vehicles usually have an upper stage of lightweight pressurised tanks for fuel and oxidiser. Effect of high velocity impact on heset structures need to be considered for the design. This paper presents the results of the analysis of high velocity impact of space debris objects on a pressurised Titanium fuel/oxidiser tank of the upper stage of a launch vehicle. The analysis is carried out using the Finite Element Method. A three dimensional model of the tank is generated using shell elements. The internal pressure is accounted in the model by introducing the pre-stress effects. Debris is modelled as rigid bodies with initial velocities. The transient dynamic problem is solved using explicit integration technique. The study focuses on the effect of impact by particles of a variety of size, shape and velocities. The effect of different angle and location of impact on the tanks are also studied to assess the extent of damage and zone of safe operation of the stage before and after injection of satellite.

  19. Three-dimensional transient thermal analysis of a receiver-absorber-converter system in the Integrated Solar Upper Stage Unit

    SciTech Connect

    Tong, W.

    1999-12-01

    The Integrated Solar Upper Stage (ISUS) program is directing its efforts at solving endemic national spacecraft architecture problems. The ISUS is an advanced, integrated upper stage concept that would permit payload realignment, allowing large payloads to be moved by smaller and less expensive boosters. A receiver-absorber-converter (RAC) system in the ISUS unit is designed to convert solar energy to kinetic energy in the propulsion phase or electrical energy in the power generation phase for spacecraft control and operation. In this study a three-dimensional, transient, turbulent hydrogen gas flow through the RAC system was simulated using a finite element thermal-hydraulic model. With this model, transient temperature, pressure, and flow fields in the RAC system were obtained. Numerical results of the mass flow rate distribution through hydrogen heating channels reveal that higher mass flow rates occur through those channels near either the hydrogen channels reveal that higher mass flow rates occur through those channels near either the hydrogen inlet or exit. It takes about 18.5 min for the hydrogen exhaust temperature to drop below 2,000 K. The results obtained from this work have been applied for validating and optimizing the present RAC design, as well as for performing the thermal stress analysis.

  20. C/C and C/SiC Nozzle Extensions - A Breakthrough to Improve Upper and Lower Stage Engines Performance

    NASA Astrophysics Data System (ADS)

    Pichon, T.; /Lacombe, A.; Mercier, A.; Ferrey, A.

    2002-01-01

    The need to increase the payload capacity of the current launchers drives rocket engine manufacturers to seek higher thrust level, specific impulse and thrust to weight ratio. A particularly efficient way to do this is the use of increased expansion ratio nozzle extensions for upper stage engines, and using thermostructural composite materials in order to allow higher temperature material limitations and to decrease mass. The latter is applicable to both upper and lower stage engines. Up to the mid 90s, the use of composite nozzles has been limited to solid rocket nozzles, but recent developments led to flight qualification on liquid rocket engines, on the RL10-B2 engine of the DELTA III launcher. This engine is equipped with a large extendible Carbon/Carbon Novoltex Sepcarb nozzle developed by Snecma Propulsion Solide under a contract from Pratt &Whitney San Jose. This paper describes the technological background of Snecma Propulsion Solide concerning the design and manufacturing of large size composite nozzles for liquid rocket engines. It provides an up-to-date status of the demonstrations already performed on different engines (HM7, RL10-B2 in particular) and details all the recent progress on technical and manufacturing performance. The manufacturing process has also been improved and simplified in order to allow the manufacturing of larger scale nozzles, at lower cost. Finally, this paper evidences that this technology is today mature and is ready to be implemented on existing or future liquid rocket engines being developed.

  1. Research-based course materials and assessments for upper-division electrodynamics (E&M II)

    NASA Astrophysics Data System (ADS)

    Baily, Charles; Dubson, Michael; Pollock, Steven J.

    2013-01-01

    Favorable outcomes from ongoing research at the University of Colorado Boulder on student learning in junior-level electrostatics (E&M I) have led us to extend this work to upper-division electrodynamics (E&M II). We describe here our development of a set of research-based instructional materials designed to actively engage students during lecture (including clicker questions and other in-class activities); and an instrument for assessing whether our faculty-consensus learning goals are being met. We also discuss preliminary results from several recent implementations of our transformed curriculum, plans for the dissemination and further refinement of these materials, and offer some insights into student difficulties in advanced undergraduate electromagnetism.

  2. 76 FR 41731 - Air Quality: Widespread Use for Onboard Refueling Vapor Recovery and Stage II Waiver

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... nonattainment areas after EPA promulgated ORVR standards on April 6, 1994, 59 FR 16262, codified at 40 CFR parts... promulgated ORVR standards on April 6, 1994, 59 FR 16262. \\8\\ Unlike Stage II, which is a requirement only in... Executive Order (EO) 12866 (58 FR 51735, October 4, 1993), this action is a ``significant regulatory...

  3. 78 FR 28776 - Approval and Promulgation of Implementation Plans; Kentucky; Stage II Requirements for Enterprise...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ... standards (NAAQS) as part of the Cincinnati/Northern Kentucky Area. See 56 FR 56694, effective January 6... 63 FR 67586. Under this regulation, gasoline dispensing facilities with a monthly throughput of 25... by EPA, effective June 19, 2000 (65 FR 37879). Since the Kentucky Stage II program was already...

  4. 78 FR 34303 - Approval and Promulgation of Implementation Plans; North Carolina; Removal of Stage II Gasoline...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-07

    ...EPA is proposing to approve changes to the North Carolina State Implementation Plan (SIP) submitted by the State of North Carolina Department of Environment and Natural Resources (NC DENR), Division of Air Quality on September 18, 2009, for the purpose of removing Stage II vapor control requirements for new and upgraded gasoline dispensing facilities in the State. The September 18, 2009, SIP......

  5. Development of Weld Inspection of the Ares I Crew Launch Vehicle Upper Stage

    NASA Technical Reports Server (NTRS)

    Russell, Sam; Ezell, David

    2010-01-01

    NASA is designing a new crewed launch vehicle called Ares I to replace the Space Shuttle after its scheduled retirement in 2010. This new launch vehicle will build on the Shuttle technology in many ways including using a first stage based upon the Space Shuttle Solid Rocket Booster, advanced aluminum alloys for the second stage tanks, and friction stir welding to assemble the second stage. Friction stir welding uses a spinning pin that is inserted in the joint between two panels that are to be welded. The pin mechanically mixes the metal together below the melting temperature to form the weld. Friction stir welding allows high strength joints in metals that would otherwise lose much of their strength as they are melted during the fusion welding process. One significant change from the Space Shuttle that impacts NDE is the implementation of self-reacting friction stir welding for non-linear welds on the primary metallic structure. The self-reacting technique differs from the conventional technique because the load of the pin tool pressing down on the metal being joined is reacted by a nut on the end of the tool rather than an anvil behind the part. No spacecraft has ever flown with a self-reacting friction stir weld, so this is a major advancement in the manufacturing process, bringing with it a whole new set of challenges for NDE to overcome. The metal microstructure and possible defects are different from other weld processes. Friction plug welds will be used to close out the hole remaining in the radial welds when friction stir welded. This plug welding also has unique challenges in inspection. The current state of development of these inspections will be presented, along with other information pertinent to NDE of the Ares I.

  6. Upper Sternal Cleft With a Complex Congenital Heart Defect: Repair in a Single Stage.

    PubMed

    Al-Yamani, Mohammed; Lavrand, Frederic; Thambo, Jean-Benoit; Roubertie, Franois

    2016-02-01

    Sternal clefts are extremely rare in association with complex congenital heart defects, and their management can be challenging. Complete surgical repair in early infancy, of both anomalies in a single stage, is advocated. Different surgical techniques exist for isolated sternal cleft repair, but they do not consider the difficulties of combining sternal defect closure and a cardiac operation with the unavoidable postoperative cardiac edema. We describe a successful surgical technique to repair a sternal cleft in a 3-month-old infant in a concomitant cardiac operation using an absorbable polyglactin 910 mesh plate and sternal osseous autografting to avoid postoperative cardiac distention. PMID:26777935

  7. Preoperative Serum Interleukin-6 Is a Potential Prognostic Factor for Colorectal Cancer, including Stage II Patients

    PubMed Central

    Shiga, Kazuyoshi; Hara, Masayasu; Nagasaki, Takaya; Sato, Takafumi; Takahashi, Hiroki; Sato, Mikinori; Takeyama, Hiromitsu

    2016-01-01

    Aims. To evaluate the prognostic significance of serum interleukin-6 (IL-6) in colorectal cancer (CRC). Patients and Methods. Preoperative serum IL-6 was measured in 233 CRC patients and 13 healthy controls. Relationships between IL-6 and various clinicopathological factors were evaluated, and the overall survival (OS) and disease-free survival (DFS) rates according to IL-6 status were calculated for all patients and according to disease stage. Results. The mean IL-6 level was 6.6?pg/mL in CRC patients and 2.6?pg/mL in healthy controls. Using a cutoff of 6.3?pg/mL, obtained using receiver operating characteristic curve analysis, 57 patients had a high IL-6 level. The mean value was higher for stage II disease than for stage III disease. IL-6 status correlated with C-reactive protein (CRP) and carcinoembryonic antigen levels, obstruction, and pT4 disease. The OS differed according to the IL-6 status for all patients, whereas the DFS differed for all patients and for those with stage II disease. The Cox proportional hazards model showed that pT4 disease was an independent risk factor for recurrence in all CRC patients; IL-6, CRP, and pT4 were significant risk factors in stage II patients. Conclusions. The preoperative IL-6 level influences the risk of CRC recurrence. PMID:26858756

  8. Biopsy and definitive radiation therapy in stages I and II carcinoma of the female breast

    SciTech Connect

    Ray, G.R.; Fish, V.J.; Lee, R.H.; Marzoni, F.A. Jr.; Trollope, M.L.; Hews, M.; Gribble, M.

    1983-01-01

    One hundred-twenty patients with Stages I and II carcinoma of the female breast were biopsied followed by definitive radiation therapy without mastectomy. The breast received 4500-5000 cGy (rad) using a 6 MV linear accelerator followed by a supplement to the area of the primary tumor of 2000 cGy (rad) using electrons in 99 patients (83%) and interstitial implanation in 21 patients (17%). Local recurrence was not recorded in the 43 patients with Stage I disease, while three of 77 patients (4%) with Stage II disease suffered a local recurrence. The actuarial five-year relapse-free survival was 91% and 60% in Stages I and II respectively. Cosmetic results were considered excellent by both physician and patient in the majority of cases. Axillary dissection was the recommended method of staging the axilla but was noted to be more morbid than axillary sampling. Electrons may be as effective as interstitial implanation as a means of supplementation following external beam therapy if specific guidelines are followed.

  9. Propulsion and aerodynamic analysis of the Beta II two-stage-to-orbit vehicle

    NASA Astrophysics Data System (ADS)

    Davic, James R.; Midea, Anthony C.

    1992-08-01

    A study of a revised version of the Beta II two-stage-to-orbit vehicle has been undertaken. The goal of the study was to modify and refine critical components of the NASA/Boeing/Wright Laboratory Beta II booster design to better define a successful baseline vehicle that can provide routine access to space. The vehicle geometry was modified and corresponding aerodynamics were predicted. The propulsion system was improved by refining the nacelle design which included incorporating a variable capture area inlet, replacing the five High Speed Civil Transport derived turbine bypass turbojet engines with four variable cycle turbofan engines per nacelle, and removing the bypass duct system. The ramjet performance was adjusted for the change in airflow due to the variable capture area inlet. The second stage wing-body orbiter design was not modified for this study. The total Beta II takeoff weight which resulted was approximately 1.0 million pounds.

  10. Vaccine Therapy and Cyclophosphamide in Treating Patients With Stage II-III Breast or Stage II-IV Ovarian, Primary Peritoneal, or Fallopian Tube Cancer

    ClinicalTrials.gov

    2016-01-07

    Recurrent Breast Carcinoma; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma; Stage IIA Breast Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIB Breast Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIIA Breast Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Breast Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Breast Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

  11. Stage II surgical resection of hepatocellular carcinoma after TAE: a report of 38 cases

    PubMed Central

    Wang, Jian-Hua; Lin, Gui; Yan, Zhi-Ping; Wang, Xiao-Lin; Cheng, Jie-Ming; Li, Mao-Quan

    1998-01-01

    AIM: To evaluate the curative effect of stage II surgical resection of hepatocellular carcinoma after TAE. METHODS: Thirty-eight patients with unresectable hepatocellular carcinoma were treated by transcatheter arterial embolization (TAE). When the sizes of tumors were markedly reduced after TAE, stage II surgical resections were performed. RESULTS: Before TAE, the diameters of tumors were 12.84 cm 4.87 cm (x s), but reduced to 5.12 cm 1.82 cm (x s) after TAE (P < 0.001). Pathologic examination of the resected specimens revealed obvious necrosis in most cases. After surgery, 26 patients were alive, with the longest survival of 96 months, twelve died and 10 had tumor recurrence. CONCLUSION: Patients in moderate and advanced stages of hepatocellular carcinoma after TAE should be treated surgically, but the indication must be controlled strictly. PMID:11819256

  12. Impact of variable river water stage on the simulation of groundwater-river interactions over the Upper Rhine Graben hydrosystem

    NASA Astrophysics Data System (ADS)

    Habets, F.; Vergnes, J.

    2013-12-01

    The Upper Rhine alluvial aquifer is an important transboundary water resource which is particularly vulnerable to pollution from the rivers due to anthropogenic activities. A realistic simulation of the groundwater-river exchanges is therefore of crucial importance for effective management of water resources, and hence is the main topic of the NAPROM project financed by the French Ministry of Ecology. Characterization of these fluxes in term of quantity and spatio-temporal variability depends on the choice made to represent the river water stage in the model. Recently, a couple surface-subsurface model has been applied to the whole aquifer basin. The river stage was first chosen to be constant over the major part of the basin for the computation of the groundwater-river interactions. The present study aims to introduce a variable river water stage to better simulate these interactions and to quantify the impact of this process over the simulated hydrological variables. The general modeling strategy is based on the Eau-Dyssée modeling platform which couples existing specialized models to address water resources and quality in regional scale river basins. In this study, Eau-Dyssée includes the RAPID river routing model and the SAM hydrogeological model. The input data consist in runoff and infiltration coming from a simulation of the ISBA land surface scheme covering the 1986-2003 period. The QtoZ module allows to calculate river stage from simulated river discharges, which is then used to calculate the exchanges between aquifer units and river. Two approaches are compared. The first one uses rating curves derived from observed river discharges and river stages. The second one is based on the Manning's formula. Manning's parameters are defined with geomorphological parametrizations and topographic data based on Digital Elevation Model (DEM). First results show a relatively good agreement between observed and simulated river water height. Taking into account a variable river stage seems to increase the amount of water exchanged between groundwater and river. Systematic biases are nevertheless found between simulated and observed mean river stage elevation. They show that the primary source of errors when simulating river stage - and hence groundwater-river interactions - is the uncertainties associated with the topographic data used to define the riverbed elevation. Thus, this study confirms the need to access to more accurate DEM for estimating riverbed elevation and studying groundwater-river interactions, at least at regional scale.

  13. On prediction of re-entry time of an upper stage from GTO

    NASA Astrophysics Data System (ADS)

    Mutyalarao, M.; Sharma, Ram Krishan

    2011-06-01

    The evolution of objects in geostationary transfer orbit (GTO) is determined by a complex interplay of atmospheric drag and luni-solar gravity. These orbits are highly eccentric (eccentricity >0.7) and have large variations in velocity and perturbations during a revolution. The periodic changes in the perigee altitudes of these orbits are mainly due to the gravitational perturbations of the Sun and the Moon. The re-entry time of the objects in such orbits is sensitive to the initial conditions. The aim of this paper is to study the re-entry time of the cryogenic stage of the Indian geo-synchronous launch vehicle, GSLV-F04/CS, which has been decaying since 2 September 2007 from initial orbit with eccentricity equal to 0.706. Two parameters, initial eccentricity and ballistic coefficient, are chosen for optimal estimation. It is known that the errors are more in eccentricity for the observations based on two line elements (TLEs). These two parameters are computed with response surface method using a genetic algorithm for the selected eight different zones, based on rough linear variation of the mean apogee altitude during 200 days orbit evolution. The study shows that the GSLV-F04/CS will re-enter between 5 December 2010 and 7 January 2011. The methodology is also applied to study the re-entry of six decayed objects (cryogenic stages of GSLV and Molniya satellites). Good agreement is noticed between the actual and the predicted re-entry times. The absolute percentage error in re-entry prediction time for all the six objects is found to be less than 7%. The present methodology is being adopted at Vikram Sarabhai Space Centre (VSSC) to predict the re-entry time of GSLV-F04/CS.

  14. Optimal adaptive two-stage designs for early phase II clinical trials.

    PubMed

    Shan, Guogen; Wilding, Gregory E; Hutson, Alan D; Gerstenberger, Shawn

    2016-04-15

    Simon's optimal two-stage design has been widely used in early phase clinical trials for Oncology and AIDS studies with binary endpoints. With this approach, the second-stage sample size is fixed when the trial passes the first stage with sufficient activity. Adaptive designs, such as those due to Banerjee and Tsiatis (2006) and Englert and Kieser (2013), are flexible in the sense that the second-stage sample size depends on the response from the first stage, and these designs are often seen to reduce the expected sample size under the null hypothesis as compared with Simon's approach. An unappealing trait of the existing designs is that they are not associated with a second-stage sample size, which is a non-increasing function of the first-stage response rate. In this paper, an efficient intelligent process, the branch-and-bound algorithm, is used in extensively searching for the optimal adaptive design with the smallest expected sample size under the null, while the type I and II error rates are maintained and the aforementioned monotonicity characteristic is respected. The proposed optimal design is observed to have smaller expected sample sizes compared to Simon's optimal design, and the maximum total sample size of the proposed adaptive design is very close to that from Simon's method. The proposed optimal adaptive two-stage design is recommended for use in practice to improve the flexibility and efficiency of early phase therapeutic development. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26526165

  15. CD44v6 expression in patients with stage II or stage III sporadic colorectal cancer is superior to CD44 expression for predicting progression

    PubMed Central

    Zhao, LH; Lin, QL; Wei, J; Huai, YL; Wang, KJ; Yan, HY

    2015-01-01

    Background: Currently, it is difficult to predict the prognosis of patients exhibiting stage II or stage III colorectal cancer (CRC) and to identify those patients most likely to benefit from aggressive treatment. The current study was performed to examine the clinicopathological significance of CD44 and CD44v6 protein expression in these patients. Study design: We retrospectively investigated 187 consecutive patients who underwent surgery with curative intent for stage II to III CRC from 2007 to 2013 in the Beijing Civil Aviation Hospital. CD44 and CD44v6 protein expression levels were determined using immunohistochemistry and compared to the clinicopathological data. Results: Using immunohistochemical detection, CD44 expression was observed in 108 (57.75%) of the CRC patients; and its detection was significantly associated with greater invasion depth, lymph node metastasis, angiolymphatic invasion, and a more advanced pathological tumor-lymph node-metastasis (TNM) stage. CD44v6 expression was observed in 135 (72.19%) of the CRC patients; and its expression was significantly associated with a poorly differentiated histology, greater invasion depth, lymph node metastasis, angiolymphatic invasion, and a more advanced pathological TNM stage. Expression of CD44v6 was higher than that of CD44 in stage II and stage III sporadic CRC. Conclusion: CD44v6 is a more useful marker for predicting a poor prognosis in stage II and stage III sporadic CRC as compared to CD44. PMID:25755763

  16. Perceived partner adaptation and psychosocial outcomes for newly diagnosed stage I and stage II breast cancer patients.

    PubMed

    Brusilovskiy, Eugene; Mitstifer, Meredith; Salzer, Mark S

    2009-01-01

    The current study examines the relationship between a woman's perception of her partner's emotional, behavioral, and intimate adaptation to her breast cancer and her levels of distress, well-being, and social support. Sixty-six women diagnosed with Stage I or II breast cancer within the previous year completed distress, well-being and social support measures and answered open-ended questions describing their partners' adaptation to their cancer. Women whose partners' intimate adaptation is positive had significantly lower distress, and positive emotional and intimate adaptation was related to higher well-being and social support. These results suggest that efforts to address women's psychosocial needs during their initial treatment of breast cancer should include a focus on their relationships and, possibly, interventions aimed at assisting the adjustment of their spouse or significant other. PMID:19197678

  17. Fundamental two-stage formulation for Bayesian system identification, Part II: Application to ambient vibration data

    NASA Astrophysics Data System (ADS)

    Zhang, Feng-Liang; Au, Siu-Kui

    2016-01-01

    A fundamental theory has been developed for a general two-stage Bayesian system identification problem in the companion paper (Part I). This paper applies the theory to the particular case of structural system identification using ambient vibration data. In Stage I, the modal properties are identified using the Fast Bayesian FFT method. Given the data, their posterior distribution can be well approximated by a Gaussian distribution whose mean and covariance matrix can be computed efficiently. In Stage II, the structural model parameters (e.g., stiffness, mass) are identified incorporating the posterior distribution of the natural frequencies and mode shapes in Stage I and their conditional distribution based on the theoretical structural finite element model. Synthetic and experimental data are used to illustrate the proposed theory and applications. A number of factors commonly relevant to structural system identification are studied, including the number of measured degrees of freedom, the number of identifiable modes and sensor alignment error.

  18. Combined modality treatment for stage I-II non-Hodgkin's lymphomas: CVP versus BACOP chemotherapy

    SciTech Connect

    Bajetta, E.; Valagussa, P.; Bonadonna, G.; Lattuada, A.; Buzzoni, R.; Rilke, F.; Banfi, A.

    1988-07-01

    This paper reports the 5-year results of a prospective randomized study beginning in 1976 on 177 evaluable patients with pathologic Stage I-IE and II-IIE non-Hodgkin's lymphomas with diffuse histology according to the Rappaport classification. Treatment consisted of either CVP or BACOP chemotherapy (3 cycles) followed by regional radiotherapy (40 to 50 Gy) and further cycles of either combination. In both arms, complete remission at the end of combined treatment was high (CVP 93%, BACOP 98%) regardless of age, stage or bulky disease. At 5 years, the comparative freedom from first progression was 62% for CVP vs 78% for BACOP (p = 0.02), respectively. Clinically relevant differences favoring BACOP chemotherapy were essentially documented in patients with large cell lymphomas (International Working Formulation), those with Stage II having more than three involved anatomical sites, bulky disease and age over 60 years. Recurrence within radiation fields was documented in only 5% of complete responders. Combined treatment was, in general, well tolerated particularly when BACOP was used. In only 2 patients given CVP post radiation cutaneous fibrosis was documented. Second solid tumors were detected in 4 patients. One patient started on CVP died because of brain stem necrosis after 45 Gy. We conclude that in Stage I-II patients with nodal and extranodal diffuse non-Hodgkin's lymphomas, particularly large cell lymphomas, combined modality approach with primary Adriamycin and bleomycin containing regimen, such as BACOP, followed by adjuvant radiotherapy offers high chances of cure with minimal toxicity.

  19. Thrust-vector control of a three-axis stabilized upper-stage rocket with fuel slosh dynamics

    NASA Astrophysics Data System (ADS)

    Rubio Hervas, Jaime; Reyhanoglu, Mahmut

    2014-05-01

    This paper studies the thrust vector control problem for an upper-stage rocket with fuel slosh dynamics. The dynamics of a three-axis stabilized spacecraft with a single partially-filled fuel tank are formulated and the sloshing propellant is modeled as a multi-mass-spring system, where the oscillation frequencies of the mass-spring elements represent the prominent sloshing modes. The equations of motion are expressed in terms of the three-dimensional spacecraft translational velocity vector, the attitude, the angular velocity, and the internal coordinates representing the slosh modes. A Lyapunov-based nonlinear feedback control law is proposed to control the translational velocity vector and the attitude of the spacecraft, while attenuating the sloshing modes characterizing the internal dynamics. A simulation example is included to illustrate the effectiveness of the control law.

  20. An Updated Zero Boil-Off Cryogenic Propellant Storage Analysis Applied to Upper Stages or Depots in a LEO Environment

    NASA Technical Reports Server (NTRS)

    Plachta, David; Kittel, Peter

    2003-01-01

    Previous efforts have shown the analytical benefits of zero boil-off (ZBO) cryogenic propellant storage in launch vehicle upper stages of Mars transfer vehicles for conceptual Mars Missions. However, recent NASA mission investigations have looked at a different and broad array of missions, including a variety of orbit transfer vehicle (OTV) propulsion concepts, some requiring cryogenic storage. For many of the missions, this vehicle will remain for long periods (greater than one week) in low earth orbit (LEO), a relatively warm thermal environment. Under this environment, and with an array of tank sizes and propellants, the performance of a ZBO cryogenic storage system is predicted and compared with a traditional, passive-only storage concept. The results show mass savings over traditional, passive-only cryogenic storage when mission durations are less than one week in LEO for oxygen, two weeks for methane, and roughly 2 months for LH2. Cryogenic xenon saves mass over passive storage almost immediately.

  1. ARIANE 5 upper-stage ignition conditions improvement, and return to operation with ''Envisat'' payload

    NASA Astrophysics Data System (ADS)

    Dutheil, J. Ph.; Langel, G.

    2003-08-01

    ARIANE 5 experienced a flight anomaly with the 10 th model mission (F 510), having placed its both satellites in a lower orbit than the planned GTO. Only one satellite (Artemis) could be retrieved due to its own propulsion systems. Arianespace, CNES and Astrium-GmbH (former DaimlerChrysler Aerospace Dasa) immediately set up a recovery team, combining forces for carrying deep and schedule-driven investigations, and later qualifying recovery measures. A failure in such an important program: is immediately triggering a large "post-shock" reaction from the ARIANE community implied in the relevant business and technology. The investigation fields are summarised in the following chapters, showing how failure analysis, engineering investigations and basic research have been combined in order to have a schedule and methodic efficient approach. The combination of all available European resources in space vehicle design has been implemented, involving industry, agency technical centers and research laboratories. The investigation methodology applied has been driven by the particular situation of a flight anomaly investigation, which has to take into account the reduced amount of measurement available in flight and the necessary combination with ground test data for building a strategy to reach identification of possible failure scenario. From the investigations and from extensive sensitivity characterisation test of EPS engine (AESTUS) ignition transient, stability margins have been deeply investigated and introduced in the post-anomaly upgraded stage design. The identification and implementation of recovery measures, extended as well to - potential ignition margin reduction factors even beyond the observed flight anomaly allowed to establish a robust complementary qualification status, thus allowing resuming of operational flight, starting with the valuable "Envisat" payload of European Space Agency, dedicated to earth and climate monitoring, on flight 511, the 28/02/2002, from Kourou Spaceport.

  2. Stage II Chronic Maxillary Atelectasis Associated with Subclinical Visual Field Defect

    PubMed Central

    Mangussi-Gomes, Joo; Nakanishi, Mrcio; Chalita, Maria Regina; Damasco, Fabiana; De Oliveira, Carlos Augusto Costa Pires

    2013-01-01

    Introduction?Chronic maxillary atelectasis (CMA) is characterized by a persistent decrease in the maxillary sinus volume due to inward bowing of its walls. According to its severity, it may be classified into three clinical-radiological stages. Objective?To report a case of stage II CMA associated with subclinical visual field defect. Case Report?A 34-year-old woman presented with a 15-year history of recurrent episodes of sinusitis and intermittent right facial discomfort for the past 5 years. She denied visual complaints, and no facial deformities were observed on physical examination. Paranasal sinus computed tomography (CT) demonstrated a completely opacified right maxillary sinus with inward bowing of its walls, suggesting the diagnosis of stage II CMA. A computerized campimetry (CC) disclosed a scotoma adjacent to the blind spot of the right eye, indicating a possible damage to the optic nerve. The patient was submitted to functional endoscopic sinus surgery, with drainage of a thick mucous fluid from the sinus. She did well after surgery and has been asymptomatic since then. Postoperative CT was satisfactory and CC was normal. Discussion?CMA occurs because of a persistent ostiomeatal obstruction, which creates negative pressure inside the sinus. It is associated with nasosinusal symptoms but had never been described in association with any visual field defect. It can be divided into stage I (membranous deformity), stage II (bony deformity), and stage III (clinical deformity). The silent sinus syndrome is a special form of CMA. This term should only be used to describe those cases with spontaneous enophthalmos, hypoglobus, and/or midfacial deformity in the absence of nasosinusal symptoms. PMID:25992047

  3. Radiotherapy for Stage II and Stage III Breast Cancer Patients With Negative Lymph Nodes After Preoperative Chemotherapy and Mastectomy

    SciTech Connect

    Le Scodan, Romuald; Selz, Jessica; Stevens, Denise; Bollet, Marc A.; Lande, Brigitte de la; Daveau, Caroline; Lerebours, Florence; Labib, Alain; Bruant, Sarah

    2012-01-01

    Purpose: To evaluate the effect of postmastectomy radiotherapy (PMRT) in Stage II-III breast cancer patients with negative lymph nodes (pN0) after neoadjuvant chemotherapy (NAC). Patients and Materials: Of 1,054 breast cancer patients treated with NAC at our institution between 1990 and 2004, 134 had pN0 status after NAC and mastectomy. The demographic data, tumor characteristics, metastatic sites, and treatments were prospectively recorded. The effect of PMRT on locoregional recurrence-free survival and overall survival (OS) was evaluated by multivariate analysis, including known prognostic factors. Results: Of the 134 eligible patients, 78 (58.2%) received PMRT and 56 (41.8%) did not. At a median follow-up time of 91.4 months, the 5-year locoregional recurrence-free survival and OS rate was 96.2% and 88.3% with PMRT and 92.5% and 94.3% without PMRT, respectively (p = NS). The corresponding values at 10 years were 96.2% and 77.2% with PMRT and 86.8% and 87.7% without PMRT (p = NS). On multivariate analysis, PMRT had no effect on either locoregional recurrence-free survival (hazard ratio, 0.37; 95% confidence interval, 0.09-1.61; p = .18) or OS (hazard ratio, 2.06; 95% confidence interval, 0.71-6; p = .18). This remained true in the subgroups of patients with clinical Stage II or Stage III disease at diagnosis. A trend was seen toward poorer OS among patients who had not had a pathologic complete in-breast tumor response after NAC (hazard ratio, 6.65; 95% confidence interval, 0.82-54.12; p = .076). Conclusions: The results from the present retrospective study showed no increase in the risk of distant metastasis, locoregional recurrence, or death when PMRT was omitted in breast cancer patients with pN0 status after NAC and mastectomy. Whether the omission of PMRT is acceptable for these patients should be addressed prospectively.

  4. FISH COMMUNITIES IN LAKE IN SUBREGION 2B (UPPER PENINSULA OF MICHIGAN) IN RELATION TO LAKE ACIDITY: VOLUME II. APPENDICES

    EPA Science Inventory

    Surveys of fish community status were conducted in summer 1987 in 49 lakes in Subregion 20, the Upper Peninsula of Michigan, as part of Phase II of the Eastern Lake Survey. Lake selection involved a variable probability sampling design. Fish communities were surveyed using gill n...

  5. Saturn V Second Stage (S-II) Ready for Static Test

    NASA Technical Reports Server (NTRS)

    1965-01-01

    Two workers are dwarfed by the five J-2 engines of the Saturn V second stage (S-II) as they make final inspections prior to a static test firing by North American Space Division. These five hydrogen -fueled engines produced one million pounds of thrust, and placed the Apollo spacecraft into earth orbit before departing for the moon. The towering 363-foot Saturn V was a multi-stage, multi-engine launch vehicle standing taller than the Statue of Liberty. Altogether, the Saturn V engines produced as much power as 85 Hoover Dams.

  6. Paclitaxel and Carboplatin With or Without Bevacizumab in Treating Patients With Stage II, Stage III, or Stage IV Ovarian Epithelial Cancer, Primary Peritoneal Cancer, or Fallopian Tube Cancer

    ClinicalTrials.gov

    2015-12-21

    Fallopian Tube Endometrioid Adenocarcinoma; Fallopian Tube Mucinous Adenocarcinoma; Fallopian Tube Transitional Cell Carcinoma; Malignant Ovarian Mixed Epithelial Tumor; Ovarian Brenner Tumor; Ovarian Clear Cell Adenocarcinofibroma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mucinous Adenocarcinoma; Ovarian Serous Adenocarcinoma; Ovarian Transitional Cell Carcinoma; Primary Peritoneal Serous Adenocarcinoma; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer; Undifferentiated Ovarian Carcinoma

  7. Empirical impact evaluation of the energy savings resulting from BPA's Stage II irrigation system retrofit program: Final report

    SciTech Connect

    Harrer, B.J.; Tawil, J.W.; Lyke, A.J.; Nieves, L.A.; Edin, E.S.; Bailey, B.M.

    1987-07-01

    This report documents the results of an evaluation of the impacts on irrigation system energy consumption of conservation measures installed under the Bonneville Power Administration's Stage II retrofit program. Historical billing data and other farm records provided the basis for this evaluation. A number of different statistical techniques were used to estimate the actual energy savings resulting from the Stage II conservation measures. Results of the study reveal that the methodology used in predicting energy savings resulting from the Stage II program is accurate. The basis for energy savings predictions in the Stage II program are changes in brake horsepower, and, in this study, a 1% change in brake horsepower was found to result in slightly more than a 1% change in energy consumption. Overall, Stage II program conservation measures were found to reduce irrigation system energy use by an average of 34%. The average costs of obtaining these savings were 6 mills (.6 cents) per kWh saved.

  8. Carboplatin and Paclitaxel With or Without Bevacizumab Compared to Docetaxel, Carboplatin, and Paclitaxel in Treating Patients With Stage II, Stage III, or Stage IV Ovarian Epithelial, Fallopian Tube, or Primary Peritoneal Cavity Carcinoma (Cancer)

    ClinicalTrials.gov

    2013-03-18

    Brenner Tumor; Fallopian Tube Cancer; Ovarian Carcinosarcoma; Ovarian Clear Cell Cystadenocarcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mixed Epithelial Carcinoma; Ovarian Mucinous Cystadenocarcinoma; Ovarian Serous Cystadenocarcinoma; Ovarian Undifferentiated Adenocarcinoma; Primary Peritoneal Cavity Cancer; Stage II Ovarian Epithelial Cancer; Stage III Ovarian Epithelial Cancer; Stage IV Ovarian Epithelial Cancer

  9. Paclitaxel, Bevacizumab And Adjuvant Intraperitoneal Carboplatin in Treating Patients Who Had Initial Debulking Surgery for Stage II, Stage III, or Stage IV Ovarian Epithelial, Primary Peritoneal, or Fallopian Tube Cancer

    ClinicalTrials.gov

    2014-06-18

    Brenner Tumor; Fallopian Tube Cancer; Ovarian Clear Cell Cystadenocarcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mixed Epithelial Carcinoma; Ovarian Mucinous Cystadenocarcinoma; Ovarian Serous Cystadenocarcinoma; Ovarian Undifferentiated Adenocarcinoma; Primary Peritoneal Cavity Cancer; Stage II Ovarian Epithelial Cancer; Stage III Ovarian Epithelial Cancer; Stage IV Ovarian Epithelial Cancer

  10. Advanced space engine preliminary design. [liquid hydrogen/liquid oxygen upper stage engine for space tug application

    NASA Technical Reports Server (NTRS)

    Zachary, A. T.

    1973-01-01

    Analysis and design of an optimum LO2/LH2, combustion topping cycle, 88,964 Newtons (20,000-pound) thrust, liquid rocket engine was conducted. The design selected is well suited to high-energy, upper-stage engine applications such as the Space Tug and embodies features directed toward optimization of vehicle performance. A configuration selection was conducted based on prior Air Force Contracts, and additional criteria for optimum stage performance. Following configuration selection, analyses and design of the major components and engine systems were conducted to sufficient depth to provide layout drawings suitable for subsequent detailing. In addition, engine packaging to a common interface and a retractable nozzle concept were defined. Alternative development plans and related costs were also established. The design embodies high-performance, low-weight, low NPSH requirements (saturated propellant inlet conditions at start), idle-mode operation, and autogenous pressurization. The design is the result of the significant past and current LO2/LH2 technology efforts of the NASA centers and the Air Force, as well as company-funded programs.

  11. Computer program for post-flight evaluation of a launch vehicle upper-stage on-off reaction control system

    NASA Technical Reports Server (NTRS)

    Knauber, R. N.

    1982-01-01

    This report describes a FORTRAN IV coded computer program for post-flight evaluation of a launch vehicle upper stage on-off reaction control system. Aerodynamic and thrust misalignment disturbances are computed as well as the total disturbing moments in pitch, yaw, and roll. Effective thrust misalignment angle time histories of the rocket booster motor are calculated. Disturbing moments are integrated and used to estimate the required control system total inpulse. Effective control system specific inpulse is computed for the boost and coast phases using measured control fuel useage. This method has been used for more than fifteen years for analyzing the NASA Scout launch vehicle second and third-stage reaction control system performance. The computer program is set up in FORTRAN IV for a CDC CYBER 175 system. With slight modification it can be used on other machines having a FORTRAN compiler. The program has optional CALCOMP plotting output. With this option the program requires 19K words of memory and has 786 cards. Running time on a CDC CYBER 175 system is less than three (3) seconds for a typical problem.

  12. Upper Water Column Structure During Marine Isotope Stage 11.3 and the Holocene on the Portuguese Margin

    NASA Astrophysics Data System (ADS)

    Salgueiro, E.; Martin, P. A.; Voelker, A.; Rodrigues, T.; Abrantes, F.; Grimalt, J.

    2008-12-01

    Most paleoceanographic studies have focused on reconstructing past surface water conditions by applying global trace metal calibrations of surface dwelling planktonic foraminifera (PF) from tropical - subtropical regions, and little attention has been paid to deep dwelling species and trace metal calibrations that include coastal upwelling samples. We have generated regional core-top PF trace element ratio (Mg/Ca, Ba/Ca, Cd/Ca) and stable isotope (?18O, ?13C) calibrations for the Portuguese margin upper water column temperature and nutrient content. Three species with different depth habitats were are explored in this seasonal upwelling region: G. bulloides an upper water column species; G. ruber (white), a surface dwelling species; and G. inflata, a deep dwelling species. Mg/Ca and ?18O values, and the derived sea surface temperature (SST), of the three PF species mirror seasonal temperatures in the water column as well as different depth habitats: (1) G. ruber (white) reflects surface conditions (~10 m water depth) in the warm winter-time Portugal Coastal Countercurrent (PCCC); (2) G. inflata indicates the winter mixed layer but is also present in the PCCC; (3) G. bulloides records the summer upwelling species lives in the upper 100 m water depth, but appears to migrate during the upwelling into waters closer to the surface (~10 m). The Ba/Ca, Cd/Ca and ?13C imply a complex relationship between nutrient tracers and the nutrient content of water masses on the Portuguese margin. Taken at face value, each of the nutrient proxies and the three foraminifera species seem to record different nutrient information. G. bulloides data, for example, suggest higher nutrients related with the upwelling waters whereas G. inflata imply higher nutrients at the base of the thermocline during winter. The insights gained from this study are being applied to reconstruct the upper water column structure on this seasonal upwelling margin during Marine Isotope Stage 11.3 and the Holocene, the most similar interglacial periods in terms of orbital parameters and greenhouse gas concentrations, with the MD03-2699 core (recovered off Lisbon: 39 N; 10.7 W). Additionally, these shell geochemistry data are compared with alkenone abundance and derived SST data.

  13. IGFBP-3 Gene Methylation in Primary Tumor Predicts Recurrence of Stage II Colorectal Cancers

    PubMed Central

    Fu, Tao; Pappou, Emmanouil P.; Guzzetta, Angela A.; de Freitas Calmon, Marilia; Sun, Lifeng; Herrera, Alexander; Li, Fan; Wolfgang, Christopher L.; Baylin, Stephen B.; Iacobuzio-Donahue, Christine A.; Tong, Weidong; Ahuja, Nita

    2015-01-01

    Objectives To evaluate the influence of IGFBP-3 methylation on recurrence in patients with stage II colorectal cancer (CRC) from 2 independent cohorts. Background The relationship between IGFBP-3 methylation in primary tumors (PTs) or lymph nodes (LNs) and risk of recurrence in patients with stage II CRC treated with surgery alone is unknown. Methods IGFBP-3 methylation of DNA from 115 PTs and 1641 LNs in patients with stage II CRC from 2 independent cohorts was analyzed. Forty patients developed recurrence, whereas 75 matched patients remained recurrence free for more than 2 years after surgery. Cox proportional hazard models were used to calculate hazard ratios (HRs) of recurrence, adjusted for patient and tumor characteristics. Results Methylation of IGFBP-3 in PTs was identified to be significantly associated with risk of recurrence in the training set. The signature was tested in a validation set and classified 40.7% of patients as high risk. Five-year recurrence-free survival rates were 76.4% and 58.3% for low- and high-risk patients, respectively, with an HR of 2.21 (95% confidence interval, 1.04–4.68; P = 0.039). In multivariate analysis, the signature remained the most significant prognostic factor, with an HR of 2.40 (95% confidence interval, 1.10–5.25; P = 0.029). A combined analysis of 1641 LNs from the 2 sets identified IGFBP-3 methylation in LNs was not associated with risk of recurrence. Conclusions Detection of IGFBP-3 methylation in PTs, but not in LNs, provides a powerful tool for the identification of patients with stage II CRC at high risk of recurrence. PMID:25822686

  14. Prognostic Value of Stem Cell Quantification in Stage II Colon Cancer

    PubMed Central

    Vaz, Maria Angeles; Martinez, Juan Carlos; Devesa, Jos Manuel; Trill, Javier Die; Abraira, Victor; Riquelme, Alejandro; Carrato, Alfredo

    2014-01-01

    Background Cancer stem cells (CSCs) are a subset of tumor cells with capacity to self-renew and generate the diverse cells that make up the tumor. The aim of this study is to evaluate the prognostic value of CSCs in a highly homogeneous population of stage II colon cancer. Methods One hundred stage II colon cancer patients treated by the same surgical team between 1977 and 2005 were retrospectively analyzed. None of the patients received adjuvant chemotherapy. Inmunohistochemistry expression of CD133, NANOG and CK20 was scored, using four levels: <10%, 1125%, 2650% and >50% positivity. Kaplan-Meier analysis and log rank test were used to compare survival. Results The average patient age was 68 years (patients were between 4592 years of age) and median follow up was 5.8 years. There was recurrent disease in 17 (17%); CD133 expression (defined by >10% positivity) was shown in 60% of the tumors, in 95% for NANOG and 78% for CK20. No correlation was found among expression levels of CD133, NANOG or CK20 and relapse-free survival (RFS) or overall survival (OS). However, a statistical significant correlation was found between established pathological prognostic factors and RFS and OS. Conclusions Stem Cell quantification defined by CD133 and NANOG expression has no correlation with RFS or OS in this cohort of Stage II colon cancer. PMID:24586330

  15. Activity monitoring reflects cardiovascular and metabolic variations in COPD patients across GOLD stages II to IV.

    PubMed

    Kortianou, E A; Louvaris, Z; Vasilopoulou, M; Nasis, I; Kaltsakas, G; Koulouris, N G; Vogiatzis, I

    2013-12-01

    We investigated whether activity monitoring reliably reflects variations in oxygen transport and utilization during walking in COPD patients. Forty-two patients (14 in each GOLD stage II, III and IV) performed an incremental treadmill protocol to the limit of tolerance. Breath-by-breath gas exchange, central hemodynamic variables and activity monitoring were simultaneously recorded. Physiological variables and accelerometer outputs rose linearly with walking speeds. Strong correlations (r[interquartile range, IQR]) were found between treadmill walking intensity (WI: range 0.8-2.0 ms(-2)) and oxygen consumption (0.95 [IQR 0.87-0.97]), (range 7.6-15.5 ml kg(-1)min(-1)); minute ventilation (0.95 [IQR 0.86-0.98]), (range 20-37 l min(-1)); cardiac output (0.89 [IQR 0.73-0.94]), (range 6.8-11.5 l min(-1)) and arteriovenous oxygen concentration difference (0.84 [IQR 0.76-0.90]), (range 7.7-12.1 ml O2100 ml(-1)). Correlations between WI and gas exchange or central hemodynamic parameters were not different across GOLD stages. In conclusion, central hemodynamic, respiratory and muscle metabolic variations during incremental treadmill exercise are tightly associated to changes in walking intensity as recorded by accelerometry across GOLD stages II to IV. Interestingly, the magnitude of these associations is not different across GOLD stages. PMID:24013005

  16. Adjuvant chemotherapy for stages II, III and IV of colon cancer.

    PubMed

    Grvalos, Cristina; Garca-Escobar, Ignacio; Garca-Alfonso, Pilar; Cassinello, Javier; Maln, Diego; Carrato, Alfredo

    2009-08-01

    Colorectal cancer is the third most frequent malignant neoplasm in Western countries. After complete resection, 5-year overall survival varies according to the initial stage. Adjuvant chemotherapy (CT) is indicated in patients with colon cancer at high-risk stage II, stage III and after complete resection of metastases. 5-Fluorouracil (5FU), alone or modulated with levamisol or leucovorin (LV), oral fluoropyrimidines, raltitrexed, irinotecan and oxaliplatin have been studied as adjuvant therapy for colon cancer. Nowadays, oxaliplatin-based regimens, FOLFOX or FLOX, are considered as the standard adjuvant CT. If there are contraindications for oxaliplatin, the best alternatives are capecitabine or continuous infusion of 5FU/LV. The role of monoclonal antibodies, cetuximab and bevacizumab, combined with oxaliplatin/fluoropyrimidine-based CT is under investigation in clinical trials. This article reviews the state of the art and the future perspectives of adjuvant therapy in colon cancer. Prognostic and predictive factors are also commented on. PMID:19661027

  17. Dinosaur Census Reveals Abundant Tyrannosaurus and Rare Ontogenetic Stages in the Upper Cretaceous Hell Creek Formation (Maastrichtian), Montana, USA

    PubMed Central

    Horner, John R.; Goodwin, Mark B.; Myhrvold, Nathan

    2011-01-01

    Background A dinosaur census recorded during the Hell Creek Project (19992009) incorporates multiple lines of evidence from geography, taphohistory, stratigraphy, phylogeny and ontogeny to investigate the relative abundance of large dinosaurs preserved in the Upper Cretaceous Hell Creek Formation of northeastern Montana, USA. Overall, the dinosaur skeletal assemblages in the Hell Creek Formation (excluding lag-influenced records) consist primarily of subadult or small adult size individuals. Small juveniles and large adults are both extremely rare, whereas subadult individuals are relatively common. We propose that mature individuals of at least some dinosaur taxa either lived in a separate geographic locale analogous to younger individuals inhabiting an upland environment where sedimentation rates were relatively less, or these taxa experienced high mortality before reaching terminal size where late stage and often extreme cranial morphology is expressed. Methodology/Principal Findings Tyrannosaurus skeletons are as abundant as Edmontosaurus, an herbivore, in the upper Hell Creek Formation and nearly twice as common in the lower third of the formation. Smaller, predatory dinosaurs (e.g., Troodon and dromaeosaurids) are primarily represented by teeth found in microvertebrate localities and their skeletons or identifiable lag specimens were conspicuously absent. This relative abundance suggests Tyrannosaurus was not a typical predator and likely benefited from much wider food choice opportunities than exclusively live prey and/or specific taxa. Tyrannosaurus adults may not have competed with Tyrannosaurus juveniles if the potential for selecting carrion increased with size during ontogeny. Conclusions/Significance Triceratops is the most common dinosaur and isolated skulls contribute to a significant portion of this census. Associated specimens of Triceratops consisting of both cranial and postcranial elements remain relatively rare. This rarity may be explained by a historical collecting bias influenced by facies and taphonomic factors. The limited discovery of postcranial elements may also depend on how extensive a fossil quarry is expanded after a skull is collected. PMID:21347420

  18. DETERMINANTS OF ADJUVANT OXALIPLATIN RECEIPT AMONG OLDER STAGE II AND III COLORECTAL CANCER PATIENTS

    PubMed Central

    Lund, Jennifer L; Strmer, Til; Sanoff, Hanna K; Brookhart, Alan; Sandler, Robert S; Warren, Joan L

    2013-01-01

    Purpose Controversy exists regarding adjuvant oxaliplatin treatment among older stage II and III colorectal cancer (CRC) patients. We sought to identify patient/tumor, physician, hospital, and geographic factors associated with oxaliplatin use among older patients. Methods Individuals diagnosed at age>65 with stage II/III CRC from 20042007 undergoing surgical resection and receiving adjuvant chemotherapy were identified using the Surveillance, Epidemiology and End Results program (SEER)-Medicare, a database including patient/tumor and hospital characteristics. Physician information was obtained from the American Medical Association. We used Poisson regression to identify independent predictors of oxaliplatin receipt. The discriminatory ability of each category of characteristics to predict oxaliplatin receipt was assessed by comparing the area under the receiver operating curve (AUC) from logistic regression models. Results We identified 4,388 individuals who underwent surgical resection at 773 hospitals and received chemotherapy from 1,517 physicians. Adjuvant oxaliplatin use was higher among stage III (colon=56%, rectum=51%) compared to stage II patients (colon=37%, rectum=35%). Overall, patients who were older, diagnosed before 2006, separated, divorced or widowed, living in a higher poverty census tract or in the East or Midwest, or with higher levels of comorbidity were less likely to receive oxaliplatin. Patient factors and calendar year accounted for most of the variation in oxaliplatin receipt (AUC=75.8%). Conclusion Adjuvant oxaliplatin use increased rapidly from 20042007 despite uncertainties regarding its effectiveness in older patients. Physician and hospital characteristics had little influence on adjuvant oxaliplatin receipt among older patients. PMID:23512326

  19. Adjuvant Therapy for Stage II and III Colon Cancer: Consensus Report of the International Society of Gastrointestinal Oncology

    PubMed Central

    Marshall, John L.; Haller, Daniel G.; de Gramont, Aimery; Hochster, Howard S.; Lenz, Heinz-Josef; Ajani, Jaffer A.; Goldberg, Richard M.

    2007-01-01

    Chemotherapy agents available for the treatment of stage II and stage III colon cancer have changed substantially since the 1992 National Institutes of Health consensus report recommended that all stage III patients routinely receive adjuvant treatment with 5-fluorouracil/levamisole. Subsequent trials demonstrated superiority of 5-fluorouracil/leucovorin over 5-fluorouracil/levamisole in the adjuvant setting, and the recent addition of oxaliplatin to this regimen has further improved disease-free survival. While stage III colon cancer patients are routinely treated, the use of adjuvant chemotherapy in patients with stage II disease is still a subject of debate. Many trials that are assessing the potential role of biologics in the adjuvant setting will soon be completed. However, identifying molecular prognostic markers that accurately select patients with stage II or III cancers who are at risk of recurrence would be essential to select and individualize therapy. PMID:19262703

  20. Stage II Adenocarcinoma of the Endometrium: Adjuvant Radiotherapy and Recurrence Patterns

    SciTech Connect

    Cozad, Scott C.

    2008-05-01

    Purpose: Review patterns of recurrence for Stage II endometrial cancer in a community practice. Methods and Materials: A retrospective review of patients with endometrial cancer diagnosed between 1985-2002. Patients were excluded for Stages I, III, or IV or treatment with preoperative pelvic radiation (external beam radiation therapy [EBRT]). Results: Eighty-six patients with a mean follow-up of 70 months are reported. Higher risk patients were selected for adjuvant radiation with no apparent differences for those receiving only EBRT compared with EBRT with brachytherapy. Five-year actuarial vaginal, pelvic sidewall/nodal, and metastatic control rates were 100% and 100%, 96.9% and 100%, and 79% and 84.2% for patients receiving EBRT or EBRT with brachytherapy. Overall survival rates were 70.5% and 75.8%, and cause-specific survival rates were 78.8% and 82.9% for those receiving EBRT or EBRT with brachytherapy. A select group was observed and experienced one vaginal recurrence with overall and cause-specific survival rates of 100%. Conclusion: In higher risk patients with Stage II, adjuvant EBRT achieves excellent vaginal and pelvic sidewall/nodal control without apparent benefit from additional brachytherapy. Select patients may not require adjuvant treatment.

  1. Morphological and molecular effects of cortisol and ACTH on zebrafish stage I and II follicles.

    PubMed

    Sousa, Maria Lgia; Figueiredo, Francisco; Pinheiro, Catarina; Silva, Ana; Malho, Fernanda; Rocha, Maria Joo; Rocha, Eduardo; Urbatzka, Ralph

    2015-11-01

    Oogenesis in zebrafish (Danio rerio) is controlled by the hypothalamus-pituitary-gonadal axis and reproductive hormones. In addition, an interference of stress hormones is known with reproductive biology. In the presented work, we aimed to explore the hypothesis that cortisol (Cort) and ACTH may affect early oogenesis in zebrafish, given the presence of the specific receptors for glucocorticoids and ACTH in the zebrafish ovary. Follicles at stages I and II were exposed in vitro to 1 ??M Cort and ACTH for 48 h, then ultrastructural and molecular effects were analyzed. The comet assay demonstrated increased tail moments for Cort and ACTH treatment indicative of DNA damage. The mRNA expression of apoptotic genes (bax, bcl-2) was not altered by both treatments, but Cort increased significantly the expression of the ACTH receptor (mc2r). Cort stimulated the presence of the endoplasmic reticulum, predominantly at stage II, while ACTH induced a strong vacuolization. Viability of oocytes was not affected by both treatments and fluorescent staining (monodansylcadaverine/acridine orange) indicated a reduced quantity of autophagosomes for ACTH, and lower presence of nucleic acids in ooplasm for Cort and ACTH. Concluding, different responses were observed for stress hormones on early stages of zebrafish oocytes, which suggest a role for both hormones in the stress-mediated adverse effects on female gametogenesis. PMID:26316549

  2. Closed-Loop Simulation Study of the Ares I Upper Stage Thrust Vector Control Subsystem for Nominal and Failure Scenarios

    NASA Technical Reports Server (NTRS)

    Chicatelli, Amy; Fulton, Chris; Connolly, Joe; Hunker, Keith

    2010-01-01

    As a replacement to the current Shuttle, the Ares I rocket and Orion crew module are currently under development by the National Aeronautics and Space Administration (NASA). This new launch vehicle is segmented into major elements, one of which is the Upper Stage (US). The US is further broken down into subsystems, one of which is the Thrust Vector Control (TVC) subsystem which gimbals the US rocket nozzle. Nominal and off-nominal simulations for the US TVC subsystem are needed in order to support the development of software used for control systems and diagnostics. In addition, a clear and complete understanding of the effect of off-nominal conditions on the vehicle flight dynamics is desired. To achieve these goals, a simulation of the US TVC subsystem combined with the Ares I vehicle as developed. This closed-loop dynamic model was created using Matlab s Simulink and a modified version of a vehicle simulation, MAVERIC, which is currently used in the Ares I project and was developed by the Marshall Space Flight Center (MSFC). For this report, the effects on the flight trajectory of the Ares I vehicle are investigated after failures are injected into the US TVC subsystem. The comparisons of the off-nominal conditions observed in the US TVC subsystem with those of the Ares I vehicle flight dynamics are of particular interest.

  3. Computer program for prediction of capture maneuver probability for an on-off reaction controlled upper stage

    NASA Technical Reports Server (NTRS)

    Knauber, R. N.

    1982-01-01

    A FORTRAN coded computer program which computes the capture transient of a launch vehicle upper stage at the ignition and/or separation event is presented. It is for a single degree-of-freedom on-off reaction jet attitude control system. The Monte Carlo method is used to determine the statistical value of key parameters at the outcome of the event. Aerodynamic and booster induced disturbances, vehicle and control system characteristics, and initial conditions are treated as random variables. By appropriate selection of input data pitch, yaw and roll axes can be analyzed. Transient response of a single deterministic case can be computed. The program is currently set up on a CDC CYBER 175 computer system but is compatible with ANSI FORTRAN computer language. This routine has been used over the past fifteen (15) years for the SCOUT Launch Vehicle and has been run on RECOMP III, IBM 7090, IBM 360/370, CDC6600 and CDC CYBER 175 computers with little modification.

  4. Ares I-X Upper Stage Simulator Structural Analyses Supporting the NESC Critical Initial Flaw Size Assessment

    NASA Technical Reports Server (NTRS)

    Knight, Norman F., Jr.; Phillips, Dawn R.; Raju, Ivatury S.

    2008-01-01

    The structural analyses described in the present report were performed in support of the NASA Engineering and Safety Center (NESC) Critical Initial Flaw Size (CIFS) assessment for the ARES I-X Upper Stage Simulator (USS) common shell segment. The structural analysis effort for the NESC assessment had three thrusts: shell buckling analyses, detailed stress analyses of the single-bolt joint test; and stress analyses of two-segment 10 degree-wedge models for the peak axial tensile running load. Elasto-plastic, large-deformation simulations were performed. Stress analysis results indicated that the stress levels were well below the material yield stress for the bounding axial tensile design load. This report also summarizes the analyses and results from parametric studies on modeling the shell-to-gusset weld, flange-surface mismatch, bolt preload, and washer-bearing-surface modeling. These analyses models were used to generate the stress levels specified for the fatigue crack growth assessment using the design load with a factor of safety.

  5. Prognostic and Predictive Model for Stage II Colon Cancer Patients With Nonemergent Surgery

    PubMed Central

    Zhang, Chun-Dong; Wang, Ji-Nan; Sui, Bai-Qiang; Zeng, Yong-Ji; Chen, Jun-Qing; Dai, Dong-Qiu

    2016-01-01

    Abstract No ideal prognostic model has been applied to clearly identify which suitable high-risk stage II colon cancer patients with negative margins undergoing nonemergent surgery should receive adjuvant chemotherapy routinely. Clinicopathologic and prognostic data of 333 stage II colon cancer patients who underwent D2 or D3 lymphadenectomy during nonemergent surgery were retrospectively analyzed. Four pathologically determined factors, including adjacent organ involvement (RR 2.831, P = 0.001), histologic differentiation (RR 2.151, P = 0.009), lymphovascular invasion (RR 4.043, P < 0.001), and number of lymph nodes retrieved (RR 2.161, P = 0.011), were identified as independent prognostic factors on multivariate analysis. Importantly, a simple cumulative scoring system clearly categorizing prognostic risk groups was generated: risk score = ∑ coefficient’ × status (AOI + histological differentiated + lymphovascular invasion + LNs retrieved). Our new prognostic model may provide valuable information on the impact of lymphovascular invasion, as well as powerfully and reliably predicting prognosis and recurrence for this particular cohort of patients. This model may identify suitable patients with an R0 resection who should receive routine postoperative adjuvant therapy and may help clinicians to facilitate individualized treatment. In this study, we aim to provide an ideal and quantifiable method for clinical decision making in the nonemergent surgical treatment of stage II colon cancer. Our prognostic and predictive model should be applied in multicenter, prospective studies with large sample sizes, in order to obtain a more reliable clinical recommendation. PMID:26735527

  6. Role of Adjuvant Radiotherapy for Stage II Thymoma After Complete Tumor Resection

    SciTech Connect

    Chen Yidong

    2010-12-01

    Purpose: To determine whether patients with Masaoka stage II thymoma benefit from adjuvant radiation therapy after complete tumor resection. Methods and Materials: A total of 107 patients with stage II thymoma who underwent complete resection of their tumors between September 1964 and October 2006 were retrospectively analyzed. Sixty-six patients were treated with adjuvant radiotherapy, and 41 patients received surgery alone. Results: Eight patients (7.5%) had a relapse of their disease, including two patients (4.5%) who had surgery alone, and 6 patients (9.5%) who had adjuvant radiation therapy. Disease-free survival rates at 5 and 10 years were 92.3% and 82.6%, respectively, for the surgery-plus-radiation group, and 97.6% and 93.1%, respectively, for the group that underwent surgery alone (p = 0.265). Disease-specific survival rates at 5 and 10 years were 96.4% and 89.3%, respectively, for the surgery-plus-radiation group and 97.5% and 97.5% for the surgery group (p = 0.973). On univariate analysis, patients with type B3 thymomas had the lowest disease-free survival rates among all subtypes (p = 0.001), and patients with large thymomas (>7 cm) had lower disease-specific survival rates than those with small tumors (<7 cm) (p = 0.017). On multivariate analysis, histological type (type B3) thymoma was a significant independent prognostic factor. Conclusions: Adjuvant radiotherapy after complete tumor resection for patients with stage II thymoma did not significantly reduce recurrence rates or improve survival rates. Histological type (type B3) thymoma was a significant independent prognostic factor. Further investigation should be carried out using a multicenter randomized or controlled study.

  7. Developmental ability of porcine in vitro matured oocytes at the meiosis II stage after vitrification.

    PubMed

    Ogawa, Buko; Ueno, Satoshi; Nakayama, Naoki; Matsunari, Hitomi; Nakano, Kazuaki; Fujiwara, Tsukasa; Ikezawa, Yuka; Nagashima, Hiroshi

    2010-06-01

    The aim of the present study was to investigate whether a combination of cytoplasmic lipid removal (delipation) and treatment by a microtubule stabilizer, paclitaxel, would lead to efficient cryopreservation of porcine in vitro matured (IVM) oocytes at the meiosis II (MII) stage. Vitrification and subsequent re-warming and culture of 109 untreated oocytes produced only 9 blastocysts (8.3%). On the other hand, the post-vitrification blastocyst rate was significantly improved (21/113, 18.6%, P<0.05) when oocytes were treated with 1 microM paclitaxel. Oocyte delipation also significantly increased the post-vitrification blastocyst rate compared with the untreated group (15/37, 40.5%, P<0.05). The delipation-and-paclitaxel group exhibited a significantly higher blastocyst rate (34/75, 45.3%, P<0.05) than the paclitaxel group, although it was not significantly higher than that for the delipation group. In transfer experiment, a total of 109 (18.6%) parthenogenetic blastocysts were obtained from 586 oocytes vitrified with the delipation-and-paclitaxel treatment. Transfer of 72 blastocysts to two recipients resulted in 14 (19.4%) somite stage fetuses. In conclusion, we demonstrated for the first time that by removing cytoplasmic lipid droplets from oocytes and performing a microtubule stabilization procedure, vitrified porcine IVM MII-stage oocytes could efficiently develop to the blastocyst stage while retaining the ability to develop into fetuses. PMID:20332589

  8. First-line ifosfamide, methotrexate, etoposide and prednisolone chemotherapy +/- radiotherapy is active in stage I/II extranodal NK/T-cell lymphoma.

    PubMed

    Lee, Keun-Wook; Yun, Tak; Kim, Dong-Wan; Im, Seock-Ah; Kim, Tae-You; Yoon, Sung-Soo; Heo, Dae Seog; Bang, Yung-Jue; Park, Seonyang; Kim, Byoung Kook; Kim, Noe Kyeong

    2006-07-01

    Although most patients diagnosed with extranodal NK/T-cell lymphoma (NTCL) have localized disease, radiotherapy alone is unsatisfactory because of frequent systemic failure and conventional doxorubicin-based chemotherapy has low efficacy. Twenty-six patients with NTCL received ifosfamide, methotrexate, etoposide and prednisolone (IMEP) chemotherapy as first-line treatment [ifosfamide 1.5 g/m2 (days 1 - 3), methotrexate 30 mg/m2 (days 3 and 10), etoposide 100 mg/m2 (days 1 - 3) and prednisolone 120 mg (days 1 - 5)]. Radiotherapy was administered only to patients with Ann Arbor stage I/II that had not achieved complete remission (CR) or to those that developed local failure after completing chemotherapy. Sixteen patients (group A) had nasal or upper aerodigestive tract localization (stage I/II) and 10 (group B) had extranasal or disseminated disease. Of the 14 evaluable patients in group A, 11 (79%) achieved CR after IMEP alone and 13 (93%) after chemotherapy +/- additional radiotherapy. Although, out of the 11 patients who achieved CR with chemotherapy alone, seven developed recurrence, all recurrences were local failure and successfully treated by additional curative radiotherapy. However, patients in group B responded poorly (CR 13%). IMEP regimen was active in NTCL patients with nasal or upper aerodigestive tract localization. Considering local failure rate after IMEP alone, initial IMEP chemotherapy followed by radiotherapy may be a promising treatment strategy in this subset of NTCL. PMID:16923557

  9. Upper bound on the effective error coefficient of two-stage decoding, and good two-level decompositions of some Reed-Muller codes

    NASA Astrophysics Data System (ADS)

    Wu, Jiantian; Lin, Shu; Fujiwara, Toru; Takata, Toyoo

    1994-02-01

    In this letter, an upper bound on the effective error coefficient of a two-level code with two-stage decoding is presented. This bound provides a guideline for constructing two-level codes to achieve a good trade-off between the error performance and decoding complexity. Based on this bound, good two-level decompositions of some Reed-Muller codes for two-stage decoding are found. Simulation results on the error performances of some Reed-Muller codes of lengths up to 64 with two-stage soft-decision suboptimum decoding based on their two-level decompositions are given.

  10. Performance of the Spacecraft Propulsion Research Facility During Altitude Firing Tests of the Delta 3 Upper Stage

    NASA Technical Reports Server (NTRS)

    Meyer, Michael L.; Dickens, Kevin W.; Skaff, Tony F.; Cmar, Mark D.; VanMeter, Matthew J.; Haberbusch, Mark S.

    1998-01-01

    The Spacecraft Propulsion Research Facility at the NASA Lewis Research Center's Plum Brook Station was reactivated in order to conduct flight simulation ground tests of the Delta 3 cryogenic upper stage. The tests were a cooperative effort between The Boeing Company, Pratt and Whitney, and NASA. They included demonstration of tanking and detanking of liquid hydrogen, liquid oxygen and helium pressurant gas as well as 12 engine firings simulating first, second, and third burns at altitude conditions. A key to the success of these tests was the performance of the primary facility systems and their interfaces with the vehicle. These systems included the structural support of the vehicle, propellant supplies, data acquisition, facility control systems, and the altitude exhaust system. While the facility connections to the vehicle umbilical panel simulated the performance of the launch pad systems, additional purge and electrical connections were also required which were unique to ground testing of the vehicle. The altitude exhaust system permitted an approximate simulation of the boost-phase pressure profile by rapidly pumping the test chamber from 13 psia to 0.5 psia as well as maintaining altitude conditions during extended steady-state firings. The performance of the steam driven ejector exhaust system has been correlated with variations in cooling water temperature during these tests. This correlation and comparisons to limited data available from Centaur tests conducted in the facility from 1969-1971 provided insight into optimizing the operation of the exhaust system for future tests. Overall, the facility proved to be robust and flexible for vehicle space simulation engine firings and enabled all test objectives to be successfully completed within the planned schedule.

  11. Identification and characterization of ANO9 in stage II and III colorectal carcinoma

    PubMed Central

    Li, Chunxiang; Cai, Sanjun; Wang, Xishan; Jiang, Zheng

    2015-01-01

    Background and Objectives: The precise role and potential underlying mechanisms of anoctamin 9 (ANO9) remain largely unknown. This study aims to characterize the role and oncogenic mechanisms of ANO9 in stage II and III colorectal cancer (CRC). Methods: We examined the expression of ANO9 in colorectal cancerous tissues and cells using real-time quantitative PCR and immunohistochemistry, respectively. Multiple cellular and molecular approaches such as gene transfection, CCK-8 assay, flow cytometry, and invasion assay were also performed to explore its oncogenic mechanisms. Furthermore, the clinical significance of ANO9 in clinical CRC specimens was assessed by clinical correlation and survival analyses. Results: Lower expression of ANO9 messenger RNA (mRNA) was frequently detected both in CRC tissues with recurrence and metastasis-derived cell lines. Compared with matched nontumorous tissues, lower expression of ANO9 protein was observed in tumors, which was significantly correlated with tumorigenesis (p < 0.05). In vitro functional studies showed that ANO9 contributed to tumor cell proliferation, apoptosis, and invasion. Moreover, investigation of clinical CRC specimens showed that ANO9 were markedly overexpressed in metastatic tissue compared with primary tissue. Decreased expression of ANO9 was correlated with poor prognostic outcomes. Conclusions: This study highlighted the role of ANO9 in progression and metastasis of stage II and III CRC. These findings suggested that up-regulation of ANO9, as a metastasis-related gene, could be a novel approach for inhibiting CRC progression. PMID:26317553

  12. Stage II endometrial carcinoma. Results and complications of a combined radiotherapeutic-surgical approach

    SciTech Connect

    Larson, D.M.; Copeland, L.J.; Gallager, H.S.; Kong, J.P.; Wharton, J.T.; Stringer, C.A.

    1988-04-15

    Since one third of the patients with Stage II endometrial carcinoma have occult extrauterine pelvic metastases at diagnosis, adequate treatment must include the pelvic lymph nodes and parametria. Eighty-three patients with Stage II endometrial carcinoma were treated between January 1964 and December 1983. Sixty-nine patients (83%) received combined whole-pelvic irradiation and surgery, five (6%) had surgery alone and nine (11%) had radiotherapy alone. Five-year actuarial survival rates were 67%, 60%, and 38%, respectively. No pelvic recurrence occurred in the 69 patients who received the combined therapy, and there was no vaginal recurrence in the 80 patients treated with intracavity radium. There was a significantly lower incidence of pelvic lymph node metastases (P = 0.03) in patients treated with preoperative irradiation. The median time to recurrence was 17 months, with 67% of the recurrences diagnosed before 2 years, and 88% within 5 years. Ten patients (12%) incurred severe complications and three died as a result. Whole-pelvic irradiation, intracavity radium, and hysterectomy are effective treatment for occult pelvic and vaginal disease.

  13. Dose-Escalated Robotic SBRT for Stage III Prostate Cancer

    PubMed Central

    Meier, Robert

    2015-01-01

    Stereotactic body radiotherapy (SBRT) is the precise external delivery of very high-dose radiotherapy to targets in the body, with treatment completed in one to five fractions. SBRT should be an ideal approach for organ-confined prostate cancer because (I) dose-escalation should yield improved rates of cancer control; (II) the unique radiobiology of prostate cancer favors hypofractionation; and (III) the conformal nature of SBRT minimizes high-dose radiation delivery to immediately adjacent organs, potentially reducing complications. This approach is also more convenient for patients, and is cheaper than intensity-modulated radiotherapy (IMRT). Several external beam platforms are capable of delivering SBRT for early-stage prostate cancer, although most of the mature reported series have employed a robotic non-coplanar platform (i.e., CyberKnife). Several large studies report 5-year biochemical relapse rates which compare favorably to IMRT. Rates of late GU toxicity are similar to those seen with IMRT, and rates of late rectal toxicity may be less than with IMRT and low-dose rate brachytherapy. Patient-reported quality of life (QOL) outcomes appear similar to IMRT in the urinary domain. Bowel QOL may be less adversely affected by SBRT than with other radiation modalities. After 5?years of follow-up, SBRT delivered on a robotic platform is yielding outcomes at least as favorable as IMRT, and may be considered appropriate therapy for stage III prostate cancer. PMID:25905037

  14. Stage II endometrial carcinoma treated with external-beam radiotherapy, intracavitary application of cesium, and surgery

    SciTech Connect

    Podczaski, E.S.; Kaminski, P.; Manetta, A.; Louk, D.; Andrews, C.; Larson, J.; DeGeest, K.; Mortel, R. )

    1989-11-01

    From September 1972 to September 1987, thirty-six patients with stage II carcinoma of the endometrium were treated with external-beam radiotherapy to the pelvis, a single intracavitary application of cesium-137, and extrafascial hysterectomy with adnexectomy. Patients were followed for a median of 54.4 months. Overall 2- and 5-year actuarial survival rates were 83 and 58%, respectively. Survival was analyzed in terms of the independent variables surgical stage, presence of a gross cervical lesion, and residual disease within the myometrium or cervix. Factors contributing to patients survival were analyzed by the log-rank method. The 12 patients with a gross cervical lesion had an adverse prognosis, as compared to those without such a lesion (P less than 0.05). Seven of the twelve patients (58%) with a cervical lesion at clinical staging demonstrated persistent or recurrent disease. The presence of extrauterine disease at surgery was a major prognostic factor in patient survival (P less than 0.01). All six patients with extrauterine disease expired 2.3 to 53.0 months after hysterectomy. Two patients with persistence of disease expired 2.3 and 7.5 months after hysterectomy. Eleven patients developed recurrent disease 2.1 to 56.5 months after hysterectomy. All presented with distant metastases. Four of the thirteen patients with persistent or recurrent disease had no residual tumor within the myometrium.

  15. Combination Chemotherapy and Lenalidomide in Treating Patients With Newly Diagnosed Stage II-IV Peripheral T-cell Non-Hodgkin's Lymphoma

    ClinicalTrials.gov

    2015-10-02

    Anaplastic Large Cell Lymphoma, ALK-Negative; Anaplastic Large Cell Lymphoma, ALK-Positive; Hepatosplenic T-Cell Lymphoma; Peripheral T-Cell Lymphoma, Not Otherwise Specified; Stage II Angioimmunoblastic T-cell Lymphoma; Stage II Enteropathy-Associated T-Cell Lymphoma; Stage III Angioimmunoblastic T-cell Lymphoma; Stage III Enteropathy-Associated T-Cell Lymphoma; Stage IV Angioimmunoblastic T-cell Lymphoma; Stage IV Enteropathy-Associated T-Cell Lymphoma

  16. Combination Chemotherapy With or Without Bortezomib in Treating Younger Patients With Newly Diagnosed T-Cell Acute Lymphoblastic Leukemia or Stage II-IV T-Cell Lymphoblastic Lymphoma

    ClinicalTrials.gov

    2016-03-29

    Adult T Acute Lymphoblastic Leukemia; Childhood T Acute Lymphoblastic Leukemia; Stage II Childhood Lymphoblastic Lymphoma; Stage II Contiguous Adult Lymphoblastic Lymphoma; Stage II Non-Contiguous Adult Lymphoblastic Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Childhood Lymphoblastic Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Childhood Lymphoblastic Lymphoma; Untreated Adult Acute Lymphoblastic Leukemia; Untreated Childhood Acute Lymphoblastic Leukemia

  17. Designing the Ares I Crew Launch Vehicle Upper Stage Element and Integrating the Stack at NASA's Marshall Space Flight Center

    NASA Technical Reports Server (NTRS)

    Lyles, Garry; Otte, Neil E.

    2008-01-01

    Fielding an integrated launch vehicle system entails many challenges, not the least of which is the fact that it has been over 30 years since the United States has developed a human-rated vehicle - the venerable Space Shuttle. Over time, whole generations of rocket scientists have passed through the aerospace community without the opportunity to perform such exacting, demanding, and rewarding work. However, with almost 50 years of experience leading the design, development, and end-to-end systems engineering and integration of complex launch vehicles, NASA's Marshall Space Flight Center offers the in-house talent - both junior- and senior-level personnel - to shape a new national asset to meet the requirements for safe, reliable, and affordable space exploration solutions.' These personnel are housed primarily in Marshall's Engineering Directorate and are matrixed into the programs and projects that reside at the rocket center. Fortunately, many Apollo era and Shuttle engineers, as well as those who gained valuable hands-on experience in the 1990s by conducting technology demonstrator projects such as the Delta-Clipper Experimental Advanced, X-33, X-34, and X-37, as well as the short-lived Orbital Space Plane, work closely with industry partners to advance the nation's strategic capability for human access to space. Currently, only three spacefaring nations have this distinction, including the United States, Russia, and, more recently, China. The U.S. National Space Policy of2006 directs that NASA provide the means to travel to space, and the NASA Appropriations Act of2005 provided the initial funding to begin in earnest to replace the Shuttle after the International Space Station construction is complete in 20 IO? These and other strategic goals and objectives are documented in NASA's 2006 Strategic Plan.3 In 2005, a team of NASA aerospace experts conducted the Exploration Systems Architecture Study, which recommended a two-vehicle approach to America's next space transportation system for missions to the International Space Station in the next decade and to explore the Moon and establish an outpost around the 2020 timeframe.4 Based on this extensive study, NASA selected the Ares I crew launch vehicle configuration and the heavy-lift Ares V cargo launch vehicle (fig 1). This paper will give an overview of NASA's approach to integrating the Ares I vehicle stack using capabilities and assets that are resident in Marshall's Engineering Directorate, working in partnership with other NASA Centers and the U.S. aerospace industry. It also will provide top-level details on the progress of the in-house design of the Ares I vehicle's upper stage element.

  18. Results of radiotherapy alone in 581 patients with Stage II carcinoma of the uterine cervix

    SciTech Connect

    Combes, P.F.; Daly, N.J.; Horiot, J.C.; Achille, E.; Keiling, R.; Pigneux, J.; Pourquier, H.; Rozan, R.; Schraub, S.; Vrousos, C.

    1985-03-01

    From January 1976 to December 1978, 581 previously untreated patients with Stage II carcinoma of the uterine cervix were treated by radiotherapy alone in nine departments of radiotherapy in France. This retrospective analysis was undertaken in an attempt to evaluate the therapeutic results and prognostically significant factors. The overall locoregional control rate was 83.2%, with total disease control of 74.5%. Uncorrected actuarial survival rates are 76% at 3 years and 68% at 5 years. The incidence of severe postherapeutic complications is 7.2%. Clinical substaging, patient's age at the time of the diagnosis, lymphangiogram findings, and tolerance to external irradiation were all found to have prognostic significance. According to those findings, the possibilities of improving the results are discussed.

  19. Inhaled cisplatin deposition and distribution in lymph nodes in stage II lung cancer patients.

    PubMed

    Zarogoulidis, Paul; Darwiche, Kaid; Krauss, Leslie; Huang, Haidong; Zachariadis, George A; Katsavou, Anna; Hohenforst-Schmidt, Wolfgang; Papaiwannou, Antonis; Vogl, Thomas J; Freitag, Lutz; Stamatis, George; Zarogoulidis, Konstantinos

    2013-09-01

    Lung cancer therapies during the last decade have focused on targeting the genome of cancer cells, and novel routes for administering lung cancer therapies have been investigated for decades. Aerosol therapies for several systematic diseases and systemic infections were introduced into the market a decade ago. One of the main issues of aerosol therapies has been the ability to investigate the deposition of a drug compound throughout the systematic circulation and lymph node circulation. Until now, none of the published studies have efficiently shown the deposition of a chemotherapy pharmaceutical within the lymph node tissue. In our current work we present, for the first time, with the novel CytoViva() (AL, USA) technique, the deposition of cisplatin aerosol therapy in surgically resected stage II lymph nodes from lung cancer patients. Finally, we present the distribution of cisplatin in correlation with the cisplatin concentration in different lymph stations and comment on the possible mechanisms of distribution. PMID:23980678

  20. Ecological continuity between Lower and Upper Bed II, Olduvai Gorge, Tanzania.

    PubMed

    Kovarovic, Kris; Slepkov, Rebecca; McNulty, Kieran P

    2013-06-01

    The sediments of Bed II at Olduvai Gorge, Tanzania, have received less scientific scrutiny than Bed I strata, likely due to the lower density of fossil hominins in the younger layers. Nevertheless, Bed II provides important contextual information about changes over time in early hominin environments. Mammal fossils from Bed II are separated into older and younger faunas by a regional disconformity under which lies an aeolian tuff, the Lemuta Member, dated to ∼1.74 Ma (millions of years ago). Differences between the faunal communities above and below the Lemuta Member have been previously noted and interpreted as evidence for distinct environmental change. Here, we investigate the palaeoecological conditions that characterised the transition between older and younger Bed II sites via analysis of their mammalian community ecological niche exploitation profiles, comparing these to known modern habitats. We present a comprehensive species list for both Bed II faunas. An initial correspondence analysis points to palaeoecological differences in pre- and post-Lemuta Member assemblages, although neither is representative of a forest habitat. When taphonomic differences in body mass profiles are taken into account, however, ecological differences appear far less important. Based on a resampling procedure to generate modern locality data with body mass profiles similar to the Bed II faunas, discriminant correspondence analyses liken both fossil assemblages to modern woodland habitats, with Lower Bed II having some affinity to floodplain and marshy woodlands, likely related to the presence of the Olduvai palaeolake in this stratigraphic interval. A comparison of the Bed II faunas to each other suggests that their differences could reasonably be sampled from within a single modern habitat. Although additional evidence points to an increase in aridity subsequent to the Lemuta Member, the importance of woodland habitats throughout Bed II is clear. PMID:23566459

  1. Isolated tumor cells and micrometastases in regional lymph nodes in stage I to II endometrial cancer

    PubMed Central

    Minobe, Shinichiro

    2016-01-01

    Objective The aim of this study was to clarify the clinical significance of isolated tumor cells (ITCs) or micrometastasis (MM) in regional lymph nodes in patients with International Federation of Gynecology and Obstetrics (FIGO) stage I to II endometrial cancer. Methods In this study, a series of 63 patients with FIGO stage I to II were included, who had at least one of the following risk factors for recurrence: G3 endometrioid/serous/clear cell adenocarcinomas, deep myometrial invasion, cervical involvement, lympho-vascular space invasion, and positive peritoneal cytology. These cases were classified as intermediate-risk endometrial cancer. Ultrastaging by multiple slicing, staining with hematoxylin and eosin and cytokeratin, and microscopic examination was performed on regional lymph nodes that had been diagnosed as negative for metastases. Results Among 61 patients in whom paraffin-embedded block was available, ITC/MM was identified in nine patients (14.8%). Deep myometrial invasion was significantly associated with ITC/MM (p=0.028). ITC/MM was an independent risk factor for extrapelvic recurrence (hazard ratio, 17.9; 95% confidence interval [CI], 1.4 to 232.2). The 8-year overall survival (OS) and recurrence-free survival (RFS) rates were more than 20% lower in the ITC/MM group than in the node-negative group (OS, 71.4% vs. 91.9%; RFS, 55.6% vs. 84.0%), which were statistically not significant (OS, p=0.074; RFS, p=0.066). Time to recurrence tended to be longer in the ITC/MM group than in the node-negative group (median, 49 months vs. 16.5 months; p=0.080). Conclusions It remains unclear whether ITC/MM have an adverse influence on prognosis of intermediate-risk endometrial cancer. A multicenter cooperative study is needed to clarify the clinical significance of ITC/MM. PMID:25925293

  2. Clinicopathologic Presentation of Asian-Indian American (AIA) Women with Stage 0, I & II Breast Cancer

    PubMed Central

    Rao, Malay; Khan, Atif J.; Moran, Meena S.; Hirshfield, Kim M.; Ganesan, Shridar; Haffty, Bruce G.

    2013-01-01

    Although numerous studies have looked at cancer incidence and survival in Asian Indian-American (AIA) patients, there is a paucity of data regarding clinicopathologic presentation of cancer in this ethnically diverse population. After receiving IRB approval, AIA patients of Indian and Pakistani descent who presented with Stage 0, I, & II breast cancer to our facility were identified. Charts were extracted for clinical and pathologic variables in addition to outcomes data. Standard statistical analyses were performed using SAS (v 9.1). The population (n = 50) consisted of 86% Indian (n = 43) and 14% Pakistani (n = 7). The median age at diagnosis was 52 (range 25–79). Sixty-three percent of tumors were detected after discovery of a palpable mass while 36% had a mammographically detected mass. Stage 0, I & II distribution was 14, 42 and 44%, respectively. The median tumor size was 1.5 cm (range 0.2–4.5 cm). ER, PR, and HER2 were positive in 69, 67, and 24% of AIA patients, respectively; 21% were triple-negative. Treatment data shows that 60% underwent lumpectomy (n = 29), 39% underwent mastectomy (n = 19), 74% received hormonal therapy (n = 26) and 55% received chemotherapy (n = 30). To our knowledge, this is the first detailed report of the clinicopathologic presentation of Asian-Indian American women with breast cancer at a single institution. Of note, AIA women were more likely to present with palpable masses and at a younger age. This differs from Caucasian women and may indicate a social or cultural barrier to routine screening mammograms and possibly a biologically more aggressive tumor. PMID:20563645

  3. INSTRUCTIONAL TELEVISION FOR THE UPPER PRIMARY. A TEACHER GUIDE, SEMESTER II.

    ERIC Educational Resources Information Center

    DELIKAN, ALFRED; AND OTHERS

    TELECAST PROGRAMS FOR THE UPPER PRIMARY GRADES WERE IN ART, MUSIC, PHYSICAL EDUCATION AND SCIENCE. A PREVIEW OF THE CONTENT OF EACH UNIT WAS GIVEN, TOGETHER WITH DETAILED INFORMATION FOR FOLLOWUP ACTIVITY. IN THE ART SERIES, IT WAS RECOMMENDED THAT PUPIL PARTICIPATION TAKE PLACE AS SOON AS POSSIBLE AFTER THE TELECAST. INDIVIDUAL CREATIVITY WAS

  4. INSTRUCTIONAL TELEVISION FOR THE UPPER PRIMARY. A TEACHER GUIDE, SEMESTER II.

    ERIC Educational Resources Information Center

    DELIKAN, ALFRED; AND OTHERS

    TELECAST PROGRAMS FOR THE UPPER PRIMARY GRADES WERE IN ART, MUSIC, PHYSICAL EDUCATION AND SCIENCE. A PREVIEW OF THE CONTENT OF EACH UNIT WAS GIVEN, TOGETHER WITH DETAILED INFORMATION FOR FOLLOWUP ACTIVITY. IN THE ART SERIES, IT WAS RECOMMENDED THAT PUPIL PARTICIPATION TAKE PLACE AS SOON AS POSSIBLE AFTER THE TELECAST. INDIVIDUAL CREATIVITY WAS…

  5. Experience of curing serious obstruction of advanced-stage upper digestive tract tumor using laser under endoscope

    NASA Astrophysics Data System (ADS)

    Mu, Hai-Bin; Zhang, Man-Ling; Zhang, Xiao-Qiang; Zhang, Feng-Qiu; Kong, De-Jia; Tang, Li-Bin

    1998-11-01

    The patients who suffer from upper digestive tract tumor, such as cancer of esophagus, cancer of cardia, all have serious obstruction and fail to get nutrition and can not bear the strike of the radiotherapy and chemotherapy. In order to reduce the obstruction symptom and suffering of the patients and to prolong their life time, since 1989, our hospital used the laser to cure the upper digestive tract tumor 11 cases with serious obstruction and got remarkable curative effect.

  6. Prognostic Significance of DNA Cytometry in Carcinoma of the Uterine Cervix FIGO Stage IB and II

    PubMed Central

    Grote, Hans Jrgen; Friedrichs, Nicolaus; Pomjanski, Natalia; Guhde, Helen Friderike; Reich, Olaf; Bcking, Alfred

    2001-01-01

    Objective: To assess the prognostic value of DNA?image cytometry in cervical carcinoma of the uterus and its relation to other established prognostic factors. Study design: The study included 116 cases of cervical carcinoma FIGO stages IB and II which were treated with radical abdominal hysterectomy. The median follow?up was 55 months (range 1162 months). DNA image cytometry was performed on cytologic specimens prepared by enzymatic cell separation from formalin?fixed, paraffin?embedded tissues. DNA stemline ploidy, DNA stemline aneuploidy, 5c exceeding rate, 9c exceeding rate, 2c deviation index, and DNA malignancy grade were computed. DNA?variables as well as various clinical and histological variables were related to survival rates. Results: In multivariate statistical analysis DNA stemline ploidy using 2.2c as a cut?off value and FIGO stage showed to be statistically significant available presurgery predictors of survival, whereas the postsurgical parameters lymphonodal status, tumor size and parametrial involvement were significantly correlated with survival. The synopsis of all parameters in a multivariate Cox model indicated that with declining relevance the number of positive pelvic lymph nodes, DNA stemline ploidy using a cut?off level at a modal value of 2.2c, largest pelvic lymph node, 5c exceeding rate, and ratio of carcinoma area to cervix area, were of predictive value for survival. Conclusions: Our results suggest that prognostic information deducted from classical staging parameters is successfully complemented by DNA image cytometry which can be applied pretherapeutically. PMID:12082291

  7. Validated Competing Event Model for the Stage I-II Endometrial Cancer Population

    SciTech Connect

    Carmona, Ruben; Gulaya, Sachin; Murphy, James D.; Rose, Brent S.; Wu, John; Noticewala, Sonal; McHale, Michael T.; Yashar, Catheryn M.; Vaida, Florin; Mell, Loren K.

    2014-07-15

    Purpose/Objectives(s): Early-stage endometrial cancer patients are at higher risk of noncancer mortality than of cancer mortality. Competing event models incorporating comorbidity could help identify women most likely to benefit from treatment intensification. Methods and Materials: 67,397 women with stage I-II endometrioid adenocarcinoma after total hysterectomy diagnosed from 1988 to 2009 were identified in Surveillance, Epidemiology, and End Results (SEER) and linked SEER-Medicare databases. Using demographic and clinical information, including comorbidity, we sought to develop and validate a risk score to predict the incidence of competing mortality. Results: In the validation cohort, increasing competing mortality risk score was associated with increased risk of noncancer mortality (subdistribution hazard ratio [SDHR], 1.92; 95% confidence interval [CI], 1.60-2.30) and decreased risk of endometrial cancer mortality (SDHR, 0.61; 95% CI, 0.55-0.78). Controlling for other variables, Charlson Comorbidity Index (CCI) = 1 (SDHR, 1.62; 95% CI, 1.45-1.82) and CCI >1 (SDHR, 3.31; 95% CI, 2.74-4.01) were associated with increased risk of noncancer mortality. The 10-year cumulative incidences of competing mortality within low-, medium-, and high-risk strata were 27.3% (95% CI, 25.2%-29.4%), 34.6% (95% CI, 32.5%-36.7%), and 50.3% (95% CI, 48.2%-52.6%), respectively. With increasing competing mortality risk score, we observed a significant decline in omega (ω), indicating a diminishing likelihood of benefit from treatment intensification. Conclusion: Comorbidity and other factors influence the risk of competing mortality among patients with early-stage endometrial cancer. Competing event models could improve our ability to identify patients likely to benefit from treatment intensification.

  8. A Three Dimensional Study of Upper Airway in Adult Skeletal Class II Patients with Different Vertical Growth Patterns

    PubMed Central

    Yang, Fang; Zhang, Mingye; Zhao, Jinlong; Chen, Jinwu; Li, Yongming

    2014-01-01

    Objective The study was performed to compare the 3D pharyngeal airway dimensions in adult skeletal Class II patients with different vertical growth patterns (low, normal, and high angle) and to investigate whether the upper airway dimensions of untreated skeletal Class II adults were affected by vertical skeletal variables. Methods Cone-beam computed tomography (CBCT) records of 64 untreated adult skeletal Class II patients (34 male and 30 female) were collected to evaluate the pharyngeal airway dimensions. Subjects were divided into three subgroups according to the GoGn-SN angle (low angle, normal angle or high angle). All subgroups were matched for sex. ANOVA and SNK - q tests were used to identify differences within and among groups (p<0.05). Coefficient of product-moment correlation (Pearson correlation coefficient) was used to analyze the association between pharyngeal airway dimensions and vertical growth patterns. Results The results showed that pharyngeal airway measurements were statistically significantly less (p<0.05) in high angle group as compared to normal angle or low angle group. Conclusions Adult skeletal Class II subjects with vertical growth patterns have significantly narrower pharyngeal airways than those with normal or horizontal growth patterns, confirming an association between pharyngeal airway measurements and a vertical skeletal pattern. PMID:24755893

  9. Normal and sonographic anatomy of selected peripheral nerves. Part II: Peripheral nerves of the upper limb.

    PubMed

    Kowalska, Berta; Sudo?-Szopi?ska, Iwona

    2012-06-01

    The ultrasonographic examination is frequently used for imaging peripheral nerves. It serves to supplement the physical examination, electromyography, and magnetic resonance imaging. As in the case of other USG imaging studies, the examination of peripheral nerves is non-invasive, well-tolerated by patients, and relatively inexpensive. Part I of this article series described in detail the characteristic USG picture of peripheral nerves and the proper examination technique, following the example of the median nerve. This nerve is among the most often examined peripheral nerves of the upper limb. This part presents describes the normal anatomy and ultrasound picture of the remaining large nerve branches in the upper extremity and neck - the spinal accessory nerve, the brachial plexus, the suprascapular, axillary, musculocutaneous, radial and ulnar nerves. Their normal anatomy and ultrasonographic appearance have been described, including the division into individual branches. For each of them, specific reference points have been presented, to facilitate the location of the set trunk and its further monitoring. Sites for the application of the ultrasonographic probe at each reference point have been indicated. In the case of the ulnar nerve, the dynamic component of the examination was emphasized. The text is illustrated with images of probe positioning, diagrams of the normal course of the nerves as well as a series of ultrasonographic pictures of normal nerves of the upper limb. This article aims to serve as a guide in the ultrasound examination of the peripheral nerves of the upper extremity. It should be remembered that a thorough knowledge of the area's topographic anatomy is required for this type of examination. PMID:26674017

  10. Normal and sonographic anatomy of selected peripheral nerves. Part II: Peripheral nerves of the upper limb

    PubMed Central

    Sudo?-Szopi?ska, Iwona

    2012-01-01

    The ultrasonographic examination is frequently used for imaging peripheral nerves. It serves to supplement the physical examination, electromyography, and magnetic resonance imaging. As in the case of other USG imaging studies, the examination of peripheral nerves is non-invasive, well-tolerated by patients, and relatively inexpensive. Part I of this article series described in detail the characteristic USG picture of peripheral nerves and the proper examination technique, following the example of the median nerve. This nerve is among the most often examined peripheral nerves of the upper limb. This part presents describes the normal anatomy and ultrasound picture of the remaining large nerve branches in the upper extremity and neck the spinal accessory nerve, the brachial plexus, the suprascapular, axillary, musculocutaneous, radial and ulnar nerves. Their normal anatomy and ultrasonographic appearance have been described, including the division into individual branches. For each of them, specific reference points have been presented, to facilitate the location of the set trunk and its further monitoring. Sites for the application of the ultrasonographic probe at each reference point have been indicated. In the case of the ulnar nerve, the dynamic component of the examination was emphasized. The text is illustrated with images of probe positioning, diagrams of the normal course of the nerves as well as a series of ultrasonographic pictures of normal nerves of the upper limb. This article aims to serve as a guide in the ultrasound examination of the peripheral nerves of the upper extremity. It should be remembered that a thorough knowledge of the area's topographic anatomy is required for this type of examination. PMID:26674017

  11. Stratospheric Aerosol and Gas Experiment (SAGE) II and III Aerosol Extinction Measurements in the Arctic Middle and Upper Troposphere

    NASA Technical Reports Server (NTRS)

    Treffeisen, R. E.; Thomason, L. W.; Strom, J.; Herber, A. B.; Burton, S. P.; Yamanouchi, T.

    2006-01-01

    In recent years, substantial effort has been expended toward understanding the impact of tropospheric aerosols on Arctic climate and chemistry. A significant part of this effort has been the collection and documentation of extensive aerosol physical and optical property data sets. However, the data sets present significant interpretive challenges because of the diverse nature of these measurements. Among the longest continuous records is that by the spaceborne Stratospheric Aerosol and Gas Experiment (SAGE) II. Although SAGE tropospheric measurements are restricted to the middle and upper troposphere, they may be able to provide significant insight into the nature and variability of tropospheric aerosol, particularly when combined with ground and airborne observations. This paper demonstrates the capacity of aerosol products from SAGE II and its follow-on experiment SAGE III to describe the temporal and vertical variations of Arctic aerosol characteristics. We find that the measurements from both instruments are consistent enough to be combined. Using this combined data set, we detect a clear annual cycle in the aerosol extinction for the middle and upper Arctic troposphere.

  12. Intraoperative Radiotherapy in Early-Stage Breast Cancer: Results of the Montpellier Phase II Trial

    SciTech Connect

    Lemanski, Claire; Azria, David; Gourgon-Bourgade, Sophie; Gutowski, Marian; Rouanet, Phillippe; Saint-Aubert, Bernard; Ailleres, Norbert; Fenoglietto, Pascal; Dubois, Jean-Bernard

    2010-03-01

    Purpose: We recently presented the intraoperative radiotherapy (IORT) technique given as a reliable alternative to conventional boost radiation after breast-conserving surgery. The low crude numbers of recurrence in elderly patients led us to investigate the feasibility and the efficacy of this procedure as a sole treatment. Methods and Materials: We included 94 patients older than 65 years in this phase II trial. Among them, 42 patients presented with all the inclusion criteria, i.e., stages pT0 to pT1 and pN0, ductal invasive unifocal carcinoma, and tumor-free margin of >2 mm. IORT was delivered using a dedicated linear accelerator. One 21-Gy fraction was prescribed and specified at the 90% isodose, using electrons. In vivo dosimetry was performed for all patients. The primary endpoint was the quality index. Secondary endpoints were quality of life, local recurrences, cosmetic results, and specific and overall rates of survival. Results: The median follow-up was 30 months (range, 12-49 months), and median age was 72 years (range, 66-80 years). The median tumor diameter was 10 mm. All patients received the total prescribed dose. No acute grade 3 toxicities were observed. Endpoints for all but one patient corresponded to acceptable quality index criteria. Pretreatment quality-of-life scores were maximal, and no significant decrease was observed during follow-up. Cosmesis was good to excellent at 6 months. Two patients experienced recurrence but underwent salvage mastectomy. Conclusion: Our results confirm that exclusive partial-breast IORT is feasible for treating early-stage breast cancer in the elderly. IORT may be considered an alternative treatment for a selected population and offers a safe one-step treatment.

  13. Role of Postmastectomy Radiation After Neoadjuvant Chemotherapy in Stage II-III Breast Cancer

    SciTech Connect

    Fowble, Barbara L.; Einck, John P.; Kim, Danny N.; McCloskey, Susan; Mayadev, Jyoti; Yashar, Catheryn; Chen, Steven L.; Hwang, E. Shelley

    2012-06-01

    Purpose: To identify a cohort of women treated with neoadjuvant chemotherapy and mastectomy for whom postmastectomy radiation therapy (PMRT) may be omitted according to the projected risk of local-regional failure (LRF). Methods and Materials: Seven breast cancer physicians from University of California cancer centers created 14 hypothetical clinical case scenarios, identified, reviewed, and abstracted the available literature (MEDLINE and Cochrane databases), and formulated evidence tables with endpoints of LRF, disease-free survival, and overall survival. Using the American College of Radiology appropriateness criteria methodology, appropriateness ratings for postmastectomy radiation were assigned for each scenario. Finally, an overall summary risk assessment table was developed. Results: Of 24 sources identified, 23 were retrospective studies from single institutions. Consensus on the appropriateness rating, defined as 80% agreement in a category, was achieved for 86% of the cases. Distinct LRF risk categories emerged. Clinical stage II (T1-2N0-1) patients, aged >40 years, estrogen receptor-positive subtype, with pathologic complete response or 0-3 positive nodes without lymphovascular invasion or extracapsular extension, were identified as having {<=}10% risk of LRF without radiation. Limited data support stage IIIA patients with pathologic complete response as being low risk. Conclusions: In the absence of randomized trial results, existing data can be used to guide the use of PMRT in the neoadjuvant chemotherapy setting. Using available studies to inform appropriateness ratings for clinical scenarios, we found a high concordance of treatment recommendations for PMRT and were able to identify a cohort of women with a low risk of LRF without radiation. These low-risk patients will form the basis for future planned studies within University of California Athena Breast Health Network.

  14. Non-Surgical Breast-Conserving Treatment (KORTUC-BCT) Using a New Radiosensitization Method (KORTUC II) for Patients with Stage I or II Breast Cancer

    PubMed Central

    Ogawa, Yasuhiro; Kubota, Kei; Aoyama, Nobutaka; Yamanishi, Tomoaki; Kariya, Shinji; Hamada, Norihiko; Nogami, Munenobu; Nishioka, Akihito; Onogawa, Masahide; Miyamura, Mitsuhiko

    2015-01-01

    The purpose of the present study was to establish a non-surgical breast-conserving treatment (BCT) using KORTUC II radiosensitization treatment. A new radiosensitizing agent containing 0.5% hydrogen peroxide and 0.83% sodium hyaluronate (a CD44 ligand) has been developed for intra-tumoral injection into various tumors. This new method, named KORTUC II, was approved by our local ethics committee for the treatment of breast cancer and metastatic lymph nodes. A total of 72 early-stage breast cancer patients (stage 0, 1 patient; stage I, 23; stage II, 48) were enrolled in the KORTUC II trial after providing fully informed consent. The mean age of the patients was 59.7 years. A maximum of 6 mL (usually 3 mL for tumors of less than approximately 3 cm in diameter) of the agent was injected into breast tumor tissue twice a week under ultrasonographic guidance. For radiotherapy, hypofraction radiotherapy was administered using a tangential fields approach including an ipsilateral axillary region and field-in-field method; the energy level was 4 MV, and the total radiation dose was 44 Gy administered as 2.75 Gy/fraction. An electron boost of 3 Gy was added three times. Treatment was well tolerated with minimal adverse effects in all 72 patients. No patients showed any significant complications other than mild dermatitis. A total of 24 patients under 75 years old with stage II breast cancer underwent induction chemotherapy (EC and/or taxane) prior to KORTUC II treatment, and 58 patients with estrogen receptor-positive tumors also received hormonal therapy following KORTUC II. The mean duration of follow-up as of the end of September 2014 was 51.1 months, at which time 68 patients were alive without any distant metastases. Only one patient had local recurrence and died of cardiac failure at 6.5 years. Another one patient had bone metastases. For two of the 72 patients, follow-up ended after several months following KORTUC II treatment. In conclusion, non-surgical BCT can be performed using KORTUC II, which has three major characteristics: imaging guidance; enzyme-targeting; and targeting of breast cancer stem cells via the CD44 receptor. PMID:26593948

  15. Single Nucleotide Polymorphisms as Prognostic and Predictive Factors of Adjuvant Chemotherapy in Colorectal Cancer of Stages I and II

    PubMed Central

    Horvat, Matej; Potočnik, Uroš; Repnik, Katja; Kavalar, Rajko; Štabuc, Borut

    2016-01-01

    Colorectal cancer (CRC) is a highly heterogeneous disease regarding the stage at time of diagnosis and there is special attention regarding adjuvant chemotherapy in unselected patients with stage I and stage II. The clinicohistologically based TNM staging system with emphasis on histological evaluation of primary tumor and resected regional lymph nodes remains the standard of staging, but it has restricted sensitivity resulting in false downward stage migration. Molecular characteristics might predispose tumors to a worse prognosis and identification of those enables identifying patients with high risk of disease recurrence. Suitable predictive markers also enable choosing the most appropriate therapy. The current challenge facing adjuvant chemotherapy in stages I and II CRC is choosing patients with the highest risk of disease recurrence who are going to derive most benefit without facing unnecessary adverse effects. Single nucleotide polymorphisms (SNPs) are one of the potential molecular markers that might help us identify patients with unfavorable prognostic factors regarding disease initiation and recurrence and could determine selection of an appropriate chemotherapy regimen in the adjuvant and metastatic setting. In this paper, we discuss SNPs of genes involved in the multistep processes of cancerogenesis, metastasis, and the metabolism of chemotherapy that might prove clinically significant. PMID:26884752

  16. Hypoalbuminaemia A Marker of Cardiovascular Disease in Patients with Chronic Kidney Disease Stages II - IV

    PubMed Central

    Shah, Nehal Rachit; Dumler, Francis

    2008-01-01

    Cardiovascular disease (CVD) is a major cause of morbidity and mortality in patients with chronic kidney disease (CKD) patients. Serum albumin, a negative acute-phase reactant and marker for underlying inflammation and/or malnutrition, is an independent predictor of CVD and mortality in CKD VI patients. Such an association in patients with less severe CKD is not well established. We conducted a cross sectional study of all CKD II - IV patients attending the nephrology clinic (N=376; mean age: 5717 years; GFR: 4720 mL/min/1.73m2; females 48%; blacks 15%; diabetics 27%; hypertensive 79%). Laboratory and clinical data including risk factors and evidence of CVD were obtained at the point of the most recent visit. The association between risk factors and CVD was evaluated by logistic regression. In the simple logistic regression model, age (p<0.0001), sex (P= 0.02), hypertension (P<0.0001), diabetes (P<.0001), dyslipidemia (p=.01), and serum albumin (p<.0001) were found to be statistically significant. Serum albumin was found to be an independent predictor (p=0.04) of CVD by multiple logistic regression analysis using the above risk factor variables. In conclusion: a) hypoalbuminaemia is an independent predictor of CVD in early CKD stages; b) hypoalbuminaemia may be used to identify the population at higher risk for CVD. PMID:19015744

  17. Outcomes following watchful waiting for stage II-IV follicular lymphoma patients in the modern era.

    PubMed

    Nastoupil, Loretta J; Sinha, Rajni; Byrtek, Michelle; Ziemiecki, Ryan; Zhou, Xiaolei; Taylor, Michael; Friedberg, Jonathan W; Link, Brian K; Cerhan, James R; Dawson, Keith; Flowers, Christopher R

    2016-03-01

    To examine the effectiveness of an initial management strategy of watchful waiting for follicular lymphoma (FL) in clinical practice, we compared outcomes for patients diagnosed 2004-2007 in the United States initially managed with watchful waiting with outcomes following initial rituximab monotherapy and chemoimmunotherapy. In total, 1754 stage II-IV patients in the National LymphoCare Study underwent watchful waiting (n=386), rituximab monotherapy (n=296) or rituximab plus chemotherapy (n=1072) as initial management strategy. Female patients and those who received treatment in the Northeast or in an academic setting more commonly underwent watchful waiting versus initial chemoimmunotherapy; whereas patients with grade 3 histology, anaemia, elevated lactate dehydrogenase, extranodal involvement, B symptoms or performance status ?1 more commonly received chemoimmunotherapy. Although time to new treatment and progression-free survival following first- and second-line therapy were improved with chemoimmunotherapy, and time to chemotherapy was improved with rituximab monotherapy, there were no differences in overall survival between watchful waiting and chemoimmunotherapy or rituximab monotherapy. With 8-year overall survival estimates of 74%, initial management with watchful waiting in the context of sequential therapy remains a viable option for FL patients in the modern era. This trial was registered at www.clinicaltrials.gov (NCT00097565). PMID:26729445

  18. Haematological toxicity: a marker of adjuvant chemotherapy efficacy in stage II and III breast cancer.

    PubMed Central

    Saarto, T.; Blomqvist, C.; Rissanen, P.; Auvinen, A.; Elomaa, I.

    1997-01-01

    Two hundred and eleven patients with node-positive stage II and III breast cancer were treated with eight cycles of adjuvant chemotherapy comprising cyclophosphamide, doxorubicin and oral ftorafur (CAFt), with and without tamoxifen. All patients had undergone radical surgery, and 148 patients were treated with post-operative radiotherapy in two randomized studies. The impact of haematological toxicity of CAFt on distant disease-free (DDFS) and overall survival (OS) was recorded. Dose intensity of all given cycles (DI), dose intensity of the two initial cycles (DI2) and total dose (TD) were calculated separately for all chemotherapy drugs and were correlated with DDFS and OS. Patients with a lower leucocyte nadir during the chemotherapy had significantly better DDFS and OS (P = 0.01 and 0.04 respectively). Dose intensity of the two first cycles also correlated significantly with DDFS (P = 0.05) in univariate but not in multivariate analysis, while the leucocyte nadir retained its prognostic value. These results indicate that the leucocyte nadir during the adjuvant chemotherapy is a biological marker of chemotherapy efficacy; this presents the possibility of establishing an optimal dose intensity for each patient. The initial dose intensity of adjuvant chemotherapy also seems to be important in assuring the optimal effect of adjuvant chemotherapy. PMID:9010042

  19. Dislocation mechanism based model for stage II fatigue crack propagation rate

    NASA Technical Reports Server (NTRS)

    Mazumdar, P. K.

    1986-01-01

    Repeated plastic deformation, which of course depends on dislocation mechanism, at or near the crack tip leads to the fatigue crack propagation. By involving the theory of thermally activated flow and the cumulative plastic strain criterion, an effort is made here to model the stage II fatigue crack propagation rate in terms of the dislocation mechanism. The model, therefore, provides capability to ascertain: (1) the dislocation mechanism (and hence the near crack tip microstructures) assisting the crack growth, (2) the relative resistance of dislocation mechanisms to the crack growth, and (3) the fracture surface characteristics and its interpretation in terms of the dislocation mechanism. The local microstructure predicted for the room temperature crack growth in copper by this model is in good agreement with the experimental results taken from the literature. With regard to the relative stability of such dislocation mechanisms as the cross-slip and the dislocation intersection, the model suggests an enhancement of crack growth rate with an ease of cross-slip which in general promotes dislocation cell formation and is common in material which has high stacking fault energy (produces wavy slips). Cross-slip apparently enhances crack growth rate by promoting slip irreversibility and fracture surface brittleness to a greater degree.

  20. Stage I posterior osteotomy and instrumentation and stage II anterior debridement and bone grafting for lumbar spinal tuberculosis with severe kyphosis

    PubMed Central

    Deng, Qiang; Zhang, Yalou; Sheng, Weibin

    2015-01-01

    The purpose of this study was to determine the efficacy of stage I posterior osteotomy and instrumentation followed by stage II anterior debridement and bone grafting in patients with lumbar spinal tuberculosis (TB) with severe kyphosis. The records of patients with lumbar spinal TB and severe kyphosis treated with 2-stage surgery at our hospital from 2005 to 2010 were retrospectively reviewed. Outcome measures were kyphosis correction rate, visual analogue scale (VAS) pain scores, and American Spinal Injury Association (ASIA) spinal cord injury and sensation function scores. A total of 53 patients (34 male, 19 female; mean age 32 years) were included. The number of involved kyphosis segments ranged from 7 to 14, and the average preoperative kyphosis angle was 107.3 ± 18.1°. All procedures were performed without serious complications. The average follow-up time was 42 months. Bone fusion occurred at a range of 6 to 9 months after surgery, and none of the patients had internal fixation failure, position change, or pseudoarthrosis. The mean postoperative kyphosis angle was 29.4 ± 12.4°, with a mean improvement of 77.9°, and the correction rate was 72.6% (P < 0.001). At final follow-up, average correction loss was 1.35°. The mean postoperative VAS pain score was 2.4 ± 0.8, and the change from the preoperative value was significant (P < 0.001). ASIA spinal injury scores were increased postoperatively. Stage I posterior osteotomy and instrumentation followed by stage II anterior debridement and bone grafting can achieve good results in patients with lumbar TB and severe kyphosis. PMID:26885015

  1. Statistical methods for astronomical data with upper limits. II - Correlation and regression

    NASA Technical Reports Server (NTRS)

    Isobe, T.; Feigelson, E. D.; Nelson, P. I.

    1986-01-01

    Statistical methods for calculating correlations and regressions in bivariate censored data where the dependent variable can have upper or lower limits are presented. Cox's regression and the generalization of Kendall's rank correlation coefficient provide significant levels of correlations, and the EM algorithm, under the assumption of normally distributed errors, and its nonparametric analog using the Kaplan-Meier estimator, give estimates for the slope of a regression line. Monte Carlo simulations demonstrate that survival analysis is reliable in determining correlations between luminosities at different bands. Survival analysis is applied to CO emission in infrared galaxies, X-ray emission in radio galaxies, H-alpha emission in cooling cluster cores, and radio emission in Seyfert galaxies.

  2. Is There a Role of Postoperative Radiation Therapy in Completely Resected Stage I/II Thymic Epithelial Tumor?

    PubMed Central

    Oh, Dongryul; Kim, Kwhanmien; Kim, Jhingook; Shim, Young Mog; Han, Jungho

    2012-01-01

    Purpose Retrospective analyses of patients with stage I-II thymic epithelial tumors (TET) who were treated with either surgery alone (S) or surgery plus postoperative radiation therapy (SRT) were conducted to evaluate the role of adjuvant radiation therapy (RT). Materials and Methods A total of 110 stage I-II TET patients following complete resection were included in this study. Postoperative radiation therapy was recommended for those with aggressive histologic type and/or invasive features according to the surgeons' judgment during the operation. A median dose of 54.0 Gy (range, 44 to 60 Gy) focused on the primary tumor bed was administered to 57 patients (51.8%). Results In all patients, the rates of overall survival, disease-specific survival, and disease-free survival at 10 years were 91.7%, 97.1%, and 95.8%, respectively. No significant differences in disease-specific survival (100% in the S group and 93.5% in the SRT group at 10 years, p=0.12) and disease-free survival (98.1% in the S group and 94.5% in the SRT group at 10 years, p=0.41) were observed between the treatment groups, although a significantly larger number of World Health Organization (WHO)-type B2-C (p<0.001) and Masaoka stage II (p=0.03) tumors were observed in the SRT group than in the S group. No local recurrence was observed in the SRT group. No grade 2 or greater RT-related toxicities were observed in the SRT group. Conclusion Excellent outcomes were achieved in patients with stage I-II TET who underwent complete resection. Considering excellent local control and low morbidity, adjuvant RT may be considered in high risk patients with WHO-type B2-C histology and Masaoka stage II. PMID:23091442

  3. The Role of Type II Spicules in the Upper Solar Atmosphere

    NASA Technical Reports Server (NTRS)

    Klimchuk, James A.

    2012-01-01

    We examine the suggestion that most of the hot plasma in the Sun's co rona comes from type II spicule material that is heated as it is ejected from the chromosphere. This contrasts with the traditional view th at the corona is filled via chromospheric evaporation that results fr om coronal heating. We explore the observational consequences of a hy pothetical spicule dominated corona and conclude from the large discr epancy between predicted and actual observations that only a small fraction of the hot plasma can be supplied by spicules (<2% in active regions and <5% in the quiet Sun). The red- blue asymmetries of EUV spec tral lines and the ratio of lower transition region (LTR; T< or =0.1 MK) to coronal emission measures are both predicted to be 2 orders of magnitude larger than observed. Furthermore, hot spicule material would cool dramatically by adiabatic expansion as it rises into the corona, so coronal heating would be required to maintain the high temperatu res that are seen at all altitudes. The necessity of coronal heating is inescapable. Traditional coronal heating models predict far too little emission from the LTR, and we suggest that this emission comes pr imarily from the bulk of the spicule material that is heated to < or =0.1 MK and is visible in He II (304 ?A) as it falls back to the surf ace.

  4. ELLERMAN BOMBS AT HIGH RESOLUTION. II. TRIGGERING, VISIBILITY, AND EFFECT ON UPPER ATMOSPHERE

    SciTech Connect

    Vissers, Gregal J. M.; Rouppe van der Voort, Luc H. M.; Rutten, Robert J.

    2013-09-01

    We use high-resolution imaging spectroscopy with the Swedish 1-m Solar Telescope (SST) to study the transient brightenings of the wings of the Balmer H{alpha} line in emerging active regions that are called Ellerman bombs. Simultaneous sampling of Ca II 8542 A with the SST confirms that most Ellerman bombs also occur in the wings of this line, but with markedly different morphology. Simultaneous images from the Solar Dynamics Observatory (SDO) show that Ellerman bombs are also detectable in the photospheric 1700 A continuum, again with differing morphology. They are also observable in 1600 A SDO images, but with much contamination from C IV emission in transition-region features. Simultaneous SST spectropolarimetry in Fe I 6301 A shows that Ellerman bombs occur at sites of strong-field magnetic flux cancellation between small bipolar strong-field patches that rapidly move together over the solar surface. Simultaneous SDO images in He II 304 A, Fe IX 171 A, and Fe XIV 211 A show no clear effect of the Ellerman bombs on the overlying transition region and corona. These results strengthen our earlier suggestion, based on H{alpha} morphology alone, that the Ellerman bomb phenomenon is a purely photospheric reconnection phenomenon.

  5. Non-muscle myosin II takes centre stage in cell adhesion and migration

    PubMed Central

    Vicente-Manzanares, Miguel; Ma, Xuefei; Adelstein, Robert S.; Horwitz, Alan Rick

    2010-01-01

    Non-muscle myosin II (NM II) is an actin-binding protein that has actin cross-linking and contractile properties and is regulated by the phosphorylation of its light and heavy chains. The three mammalian NM II isoforms have both overlapping and unique properties. Owing to its position downstream of convergent signalling pathways, NM II is central in the control of cell adhesion, cell migration and tissue architecture. Recent insight into the role of NM II in these processes has been gained from loss-of-function and mutant approaches, methods that quantitatively measure actin and adhesion dynamics and the discovery of NM II mutations that cause monogenic diseases. PMID:19851336

  6. Computer program for prediction of fuel consumption statistical data for an upper stage three-axes stabilized on-off control system

    NASA Technical Reports Server (NTRS)

    1982-01-01

    A FORTRAN coded computer program and method to predict the reaction control fuel consumption statistics for a three axis stabilized rocket vehicle upper stage is described. A Monte Carlo approach is used which is more efficient by using closed form estimates of impulses. The effects of rocket motor thrust misalignment, static unbalance, aerodynamic disturbances, and deviations in trajectory, mass properties and control system characteristics are included. This routine can be applied to many types of on-off reaction controlled vehicles. The pseudorandom number generation and statistical analyses subroutines including the output histograms can be used for other Monte Carlo analyses problems.

  7. Brunnstrom Recovery Stage and Motricity Index for the Evaluation of Upper Extremity in Stroke: Analysis for Correlation and Responsiveness

    ERIC Educational Resources Information Center

    Safaz, Ismail; Ylmaz, Bilge; Yasar, Evren; Alaca, Rdvan

    2009-01-01

    The aim of this study was to find out first whether Brunnstrom recovery stage (BRS) and motricity index (MI) were correlated with each other and second to observe whether the two assessment tools were sensitive to changes regarding the rehabilitation outcome. Forty-six stroke patients who were admitted to the Stroke Rehabilitation Unit at our

  8. β-Catenin Expression Pattern in Stage I and II Ovarian Carcinomas

    PubMed Central

    Gamallo, Carlos; Palacios, José; Moreno, Gema; Calvo de Mora, Jorge; Suárez, Asunción; Armas, Alvaro

    1999-01-01

    The immunohistochemical expression pattern of β-catenin has been correlated with β-catenin gene mutations, clinicopathological features, and disease outcome in 69 stage I and II ovarian carcinomas. β-Catenin expression was localized in the nuclei, in addition to the cytoplasm and membrane, in 11 tumors (16%): nine endometrioid carcinomas with widespread nuclear expression and two serous carcinomas with focal nuclear expression. The remaining 58 carcinomas (84%) only had membranous β-catenin expression. All but one of the endometrioid carcinomas with nuclear β-catenin expression had considerable squamous metaplasia, and five of these cases had large areas of endometrioid tumor of low malignant potential. In addition, β-catenin nuclear expression was observed in atypical epithelial cells in endometriotic glands adjacent to an endometrioid carcinoma. Sequencing was performed on 25 tumors and corresponding normal tissue: all 13 endometrioid tumors as well as 12 carcinomas of other histological types (four serous, two clear cell, two mucinous, and two mixed). There were oncogenic mutations in the phosphorylation sequence for GSK-3β in exon 3 of the β-catenin gene in seven endometrioid carcinomas with β-catenin nuclear expression. Three mutations affected codon 32 (D32G, D32Y, and D32Y), one affected codon 33 (S33C), two affected codon 37 (S37C and S37F), and one affected codon 41 (T41A). No mutations were observed in the other 18 carcinomas analyzed, comprising two endometrioid and two serous carcinomas with β-catenin nuclear expression, and 14 carcinomas of different histological types with only membranous expression. In the univariate and multivariate survival analyses, β-catenin nuclear expression was selected as an indicator of good prognosis, because no patient whose tumor expressed β-catenin in the nuclei showed relapses or died, in contrast to the 19 relapses and deaths among patients with tumors that only had β-catenin membranous expression, including three of the four patients with endometrioid carcinomas. Oncogenic β-catenin mutation is characteristic of a group of endometrioid carcinomas with a good prognosis, most of which originate from previous benign or borderline lesions. Endometrioid carcinomas with exclusively membranous expression of β-catenin seem to represent a different subgroup of carcinomas that probably have a worse prognosis. In early-stage ovarian cancer, determination of the β-catenin expression pattern could prove to be a useful marker for selecting low-risk patients. PMID:10433945

  9. Organic metamorphism in the Lower Mississippian-Upper Devonian Bakken shales-II: Soxhlet extraction.

    USGS Publications Warehouse

    Price, L.C.; Ging, T.; Love, A.; Anders, D.

    1986-01-01

    We report on Soxhlet extraction (and subsequent related analyses) of 39 Lower Mississippian-Upper Devonian Bakken shales from the North Dakota portion of the Williston Basin, and analyses of 28 oils from the Basin. Because of the influence of primary petroleum migration, no increase in the relative or absolute concentrations of hydrocarbons or bitumen was observed at the threshold of intense hydrocarbon generation (TIHG), or during mainstage hydrocarbon generation in the Bakken shales. Thus, the maturation indices that have been so useful in delineating the TIHG and mainstage hydrocarbon generation in other studies were of no use in this study, where these events could clearly be identified only by Rock-Eval pyrolysis data. The data of this study demonstrate that primary petroleum migration is a very efficient process. Four distinctive classes of saturated hydrocarbon gas chromatograms from the Bakken shales arose from facies, maturation, and primary migration controls. As a consequence of maturation, the % of saturated hydrocarbons increased in the shale extract at the expense of decreases in the resins and asphaltenes. Measurements involving resins and asphaltenes appear to be excellent maturation indices in the Bakken shales. Two different and distinct organic facies were present in immature Bakken shales. -from Authors

  10. Cancer Stem Cell Gene Profile as Predictor of Relapse in High Risk Stage II and Stage III, Radically Resected Colon Cancer Patients

    PubMed Central

    Giampieri, Riccardo; Scartozzi, Mario; Loretelli, Cristian; Piva, Francesco; Mandolesi, Alessandra; Lezoche, Giovanni; Prete, Michela Del; Bittoni, Alessandro; Faloppi, Luca; Bianconi, Maristella; Cecchini, Luca; Guerrieri, Mario; Bearzi, Italo; Cascinu, Stefano

    2013-01-01

    Clinical data indicate that prognostic stratification of radically resected colorectal cancer based on disease stage only may not be always be adequate. Preclinical findings suggest that cancer stem cells may influence the biological behaviour of colorectal cancer independently from stage: objective of the study was to assess whether a panel of stemness markers were correlated with clinical outcome in resected stage II and III colon cancer patients. A panel of 66 markers of stemness were analysed and thus patients were divided into two groups (A and B) with most patients clustering in a manner consistent with different time to relapse by using a statistical algorithm. A total of 62 patients were analysed. Thirty-six (58%) relapsed during the follow-up period (range 1.6386.5 months). Twelve (19%) and 50 (81%) patients were allocated into group A and B, respectively. A significantly different median relapse-free survival was observed between the 2 groups (22.18 vs 42.85 months, p?=?0.0296). Among of all genes tested, those with the higher weight in determining different prognosis were CD44, ALCAM, DTX2, HSPA9, CCNA2, PDX1, MYST1, COL1A1 and ABCG2. This analysis supports the idea that, other than stage, biological variables, such as expression levels of colon cancer stem cell genes, may be relevant in determining an increased risk of relapse in resected colorectal cancer patients. PMID:24023782

  11. [Risk factors influencing lymph nodes metastasis in lung cancer with stage I, II or IIIA].

    PubMed

    Hirayama, T; Kaneda, Y; Nawata, S; Tanaka, S; Esato, K

    1990-10-01

    The purpose of this study was to assess the risk factors involved in the intrapulmonary, hilar and mediastinal lymph nodes metastases in seventy-eight patients with stage I, II or IIIA lung cancer postoperatively, which were resected from 1978 to 1988. In the histological type, the incidence of the mediastinal lymph nodes metastases in adenocarcinoma was higher than that in other types, such as squamous cell carcinoma and large cel carcinoma. In addition, the incidence of mediastinal lymph nodes metastases in the papillary type was significantly higher than that in the tubular type (p less than 0.05). The incidence of mediastinal lymph nodes metastases increased as invasion into the lymphatic duct and/or vessel was demonstrated (p less than 0.01, p less than 0.05). The proximal type, in which the cancer spread to the secondary segmental bronchus, metastasized to the hilar lymph nodes more frequently than the distal type, in which the cancer was located in the bronchus distal to the third segmental one. Although there was no significant relationship between the site of the cancer and the incidence of the metastatic lymph nodes, the hilar and superior mediastinal lymph nodes (#1-4, 3a, 3p) metastases were demonstrated regardless of the lobe in which the cancer was located. The primary tumor located in the left lower lobe of the lung tended to metastasize to the inferior mediastinal lymph nodes (#8, 9). Twenty-five out of 33 patients with the lymph nodes metastases had hilar metastatic lymph nodes. However, the mediastinal lymph nodes metastases were proved in 5 patients without any intrapulmonary and hilar lymph nodes metastases. No relationship between the histological differentiation, size of tumor, pT factor and the incidence of lymph nodes metastases was found. PMID:2176232

  12. Durable Long-Term Remission With Chemotherapy Alone for Stage II to IV Laryngeal Cancer

    PubMed Central

    Holsinger, F. Christopher; Kies, Merrill S.; Diaz, Eduardo M.; Gillenwater, Ann M.; Lewin, Jan S.; Ginsberg, Lawrence E.; Glisson, Bonnie S.; Garden, Adam S.; Ark, Nebil; Lin, Heather Y.; Lee, J. Jack; El-Naggar, Adel K.; Ki Hong, Waun; Shin, Dong M.; Khuri, Fadlo R.

    2009-01-01

    Purpose For patients with stage II to IV laryngeal cancer, radiation therapy (RT) either alone or with concurrent chemotherapy provides the highest rate of organ preservation but can be associated with functional impairment. Thus, we studied the use of induction chemotherapy with or without conservation laryngeal surgery (CLS). Our objectives were to study the sensitivity of laryngeal cancer to platinum-based chemotherapy alone and to highlight the efficacy of CLS in this setting. Patients and Methods Thirty-one previously untreated patients with laryngeal cancer (T2-4, N0-1, M0), who were resectable with CLS, were enrolled. Patients received three to four cycles of paclitaxel, ifosfamide, and cisplatin (TIP) chemotherapy, and response was assessed histologically. Patients with partial response (PR) proceeded to CLS. Patients achieving pathologic complete response (pCR) received an additional three cycles of TIP and no other treatment. Results Thirty patients were assessable for response. With TIP chemotherapy alone, 11 patients (37%) achieved pCR, 10 of whom (33%) remain alive with durable disease remission and no evidence of recurrence over a median follow-up time of 5 years. Nineteen patients (63%) treated with TIP alone achieved PR. The overall laryngeal preservation (LP) rate was 83%, and only five patients (16%) required postoperative RT. No patient required a gastrostomy tube or tracheotomy. Conclusion Chemotherapy alone in selected patients with T2-4, N0-1 laryngeal cancer can provide durable disease remission at 5 years. For patients with PR, CLS provides a high rate of LP. This prospective study suggests that chemotherapy alone may cure selected patients with laryngeal cancer, warranting further prospective investigation. PMID:19289628

  13. Geochemical make-up of oceanic peridotites from NW Turkey and the multi-stage melting history of the Tethyan upper mantle

    NASA Astrophysics Data System (ADS)

    Uysal, ?brahim; ?en, A. Dndar; Ersoy, E. Yal?n; Dilek, Yildirim; Saka, Samet; Zaccarini, Federica; Escayola, Monica; Karsl?, Orhan

    2014-02-01

    We present the whole-rock and the mineral chemical data for upper mantle peridotites from the Harmanc?k region in NW Turkey and discuss their petrogenetic-tectonic origin. These peridotites are part of a Tethyan ophiolite belt occurring along the ?zmir-Ankara-Ercincan suture zone in northern Turkey, and include depleted lherzolites and refractory harzburgites. The Al2O3 contents in orthopyroxene and clinopyroxene from the depleted lherzolite are high, and the Cr-number in the coexisting spinel is low falling within the abyssal field. However, the orthopyroxene and clinopyroxene in the harzburgites have lower Al2O3 contents for a given Cr-number of spinel, and plot within the lower end of the abyssal field. The whole-rock geochemical and the mineral chemistry data imply that the Harmanc?k peridotites formed by different degrees of partial melting (~%10-27) of the mantle. The depleted lherzolite samples have higher MREE and HREE abundances than the harzburgitic peridotites, showing convex-downward patterns. These peridotites represent up to ~16 % melting residue that formed during the initial seafloor spreading stage of the Northern Neotethys. On the other hand, the more refractory harzburgites represent residues after ~4-11 % hydrous partial melting of the previously depleted MOR mantle, which was metasomatized by slab-derived fluids during the early stages of subduction. The Harmanc?k peridotites, hence, represent the fragments of upper mantle rocks that formed during different stages of the tectonic evolution of the Tethyan oceanic lithosphere in Northern Neotethys. We infer that the multi-stage melting history of the Harmanc?k peridotites reflect the geochemically heterogeneous character of the Tethyan oceanic lithosphere currently exposed along the ?zmir-Ankara-Erzincan suture zone.

  14. Validating NEXRAD MPE and Stage III precipitation products for uniform rainfall on the Upper Guadalupe River Basin of the Texas Hill Country

    NASA Astrophysics Data System (ADS)

    Wang, Xianwei; Xie, Hongjie; Sharif, Hatim; Zeitler, Jon

    2008-01-01

    SummaryThis study examines the performance of the Next Generation Weather Radar (NEXRAD) Multisensor Precipitation Estimator (MPE) and Stage III precipitation products, using a high-density rain gauge network located on the Upper Guadalupe River Basin of the Texas Hill Country. As point-area representativeness error of gauge rainfall is a major concern in assessment of radar rainfall estimation, this study develops a new method to automatically select uniform rainfall events based on coefficient of variation criterion of 3 by 3 radar cells. Only gauge observations of those uniform rainfall events are used as ground truth to evaluate radar rainfall estimation. This study proposes a new parameter probability of rain detection (POD) instead of the conditional probability of rain detection (CPOD) commonly used in previous studies to assess the capability that a radar or gauge detects rainfall. Results suggest that: (1) gauge observations of uniform rainfall better represent ground truth of a 4 × 4 km 2 radar cell than non-uniform rainfall; (2) the MPE has higher capability of rain detection than either gauge-only or Stage III; (3) the MPE has much higher linear correlation and lower mean relative difference with gauge measurements than the Stage III does; (4) the Stage III tends to overestimate precipitation (20%), but the MPE tends to underestimate (7%).

  15. Expression of PAT and NPT II proteins during the developmental stages of a genetically modified pepper developed in Korea.

    PubMed

    Kim, Hyo Jin; Lee, Si Myung; Kim, Jae Kwang; Ryu, Tae Hun; Suh, Seok Cheol; Cho, Hyun Suk

    2010-10-27

    Estimation of the protein levels introduced in a biotechnology-derived product is conducted as part of an overall safety assessment. An enzyme-linked immunosorbent assay (ELISA) was used to analyze phosphinothricin acetyltransferase (PAT) and neomycin phosphotransferase II (NPT II) protein expression in a genetically modified (GM) pepper plant developed in Korea. PAT and NPT II expression levels, based on both dry weight and fresh weight, were variable among different plant generations and plant sections from isolated genetically modified organism (GMO) fields at four developmental stages. PAT expression was highest in leaves at anthesis (11.44 ?g/gdw and 2.17 ?g/gfw) and lowest in roots (0.12 ?g/gdw and 0.01 ?g/gfw). NPT II expression was also highest in leaves at anthesis (17.31 ?g/gdw and 3.41 ?g/gfw) and lowest in red pepper (0.65 ?g/gdw and 0.12 ?g/gfw). In pollen, PAT expression was 0.59-0.62 ?g/gdw, while NPT II was not detected. Both PAT and NPT II showed a general pattern of decreased expression with progression of the growing season. As expected, PAT and NPT II protein expression was not detectable in control pepper plants. PMID:20873787

  16. Phase II Study of Chemoradiotherapy With 5-Fluorouracil and Cisplatin for Stage II-III Esophageal Squamous Cell Carcinoma: JCOG Trial (JCOG 9906)

    SciTech Connect

    Kato, Ken; Muro, Kei; Minashi, Keiko; Ohtsu, Atsushi; Ishikura, Satoshi; Boku, Narikazu; Takiuchi, Hiroya; Komatsu, Yoshito; Miyata, Yoshinori; Fukuda, Haruhiko

    2011-11-01

    Purpose: In this Phase II study, we evaluated the efficacy and toxicity of chemoradiotherapy (CRT) with cisplatin (CDDP) and 5-fluorouracil (5-FU) for Stage II-III esophageal squamous cell carcinoma (ESCC). Patients and Methods: Patients with clinical Stage II-III (T1N1M0 or T2-3N0-1M0) thoracic ESCC were enrolled between April 2000 and March 2002. Chemotherapy comprised two courses of protracted infusion of 5-FU (400 mg/m{sup 2}/day) on Days 1-5 and 8-12, and 2-h infusion of CDDP (40 mg/m{sup 2}) on Days 1 and 8; this regimen was repeated every 5 weeks. Concurrent radiotherapy involved 60-Gy irradiation (30 fractions) for 8 weeks with a 2-week break. Responders received two courses of 5-FU (800 mg/m{sup 2}/day) on Days 1-5 and CDDP (80 mg/m{sup 2}) on Day 1. Final analysis was conducted in March 2007. Survival and late toxicities were monitored for 5 years. Results: The characteristics of the 76 patients enrolled were as follows: median age, 61 years; male/female, 68/8; performance status 0/1, 59/17 patients; Stage IIA/IIB/III, 26/12/38 patients. Of the 74 eligible patients, 46 (62.2%) achieved complete response. Median survival time was 29 months, with 3- and 5-year survival rates of 44.7% and 36.8%, respectively. Acute toxicities included Grade 3/4 esophagitis (17%), nausea (17%), hyponatremia (16%), and infection without neutropenia (12%). Late toxicities comprised Grade 3/4 esophagitis (13%), pericardial (16%) and pleural (9%) effusion, and radiation pneumonitis (4%), causing 4 deaths. Conclusions: CRT is effective for Stage II-III ESCC with manageable acute toxicities and can provide a nonsurgical treatment option. However, further improvement is required for reduction in late toxicity.

  17. 40 CFR 51.126 - Determination of widespread use of ORVR and waiver of CAA section 182(b)(3) Stage II gasoline...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 2 2012-07-01 2012-07-01 false Determination of widespread use of ORVR and waiver of CAA section 182(b)(3) Stage II gasoline vapor recovery requirements. 51.126 Section 51... Determination of widespread use of ORVR and waiver of CAA section 182(b)(3) Stage II gasoline vapor...

  18. 2-Octadecynoic acid as a dual life stage inhibitor of Plasmodium infections and plasmodial FAS-II enzymes

    PubMed Central

    Carballeira, Nstor M.; Bwalya, Angela Gono; Itoe, Maurice Ayamba; Andricopulo, Adriano D.; Cordero-Maldonado, Mara Lorena; Kaiser, Marcel; Mota, Maria M.; Crawford, Alexander D.; Guido, Rafael V. C.; Tasdemir, Deniz

    2014-01-01

    The malaria parasite Plasmodium goes through two life stages in the human host, a non-symptomatic liver stage (LS) followed by a blood stage with all clinical manifestation of the disease. In this study, we investigated a series of 2-alkynoic fatty acids (2-AFAs) with chain lengths between 14 and 18 carbon atoms for dual in vitro activity against both life stages. 2-Octadecynoic acid (2-ODA) was identified as the best inhibitor of P. berghei parasites with ten times higher potency (IC50 = 0.34 ?g/ml) than the control drug. In target determination studies, the same compound inhibited three P. falciparum FAS-II (PfFAS-II) elongation enzymes PfFabI, PfFabZ, and PfFabG with the lowest IC50 values (0.280.80 ?g/mL, respectively). Molecular modeling studies provided insights into the molecular aspects underlying the inhibitory activity of this series of 2-AFAs and a likely explanation for the considerably different inhibition potentials. Blood stages of P. falciparum followed a similar trend where 2-ODA emerged as the most active compound, with 20 times less potency. The general toxicity and hepatotoxicity of 2-AFAs were evaluated by in vitro and in vivo methods in mammalian cell lines and zebrafish models, respectively. This study identifies 2-ODA as the most promising antiparasitic 2-AFA, particularly towards P. berghei parasites. PMID:25103602

  19. 2-Octadecynoic acid as a dual life stage inhibitor of Plasmodium infections and plasmodial FAS-II enzymes.

    PubMed

    Carballeira, Nstor M; Bwalya, Angela Gono; Itoe, Maurice Ayamba; Andricopulo, Adriano D; Cordero-Maldonado, Mara Lorena; Kaiser, Marcel; Mota, Maria M; Crawford, Alexander D; Guido, Rafael V C; Tasdemir, Deniz

    2014-09-01

    The malaria parasite Plasmodium goes through two life stages in the human host, a non-symptomatic liver stage (LS) followed by a blood stage with all clinical manifestation of the disease. In this study, we investigated a series of 2-alkynoic fatty acids (2-AFAs) with chain lengths between 14 and 18 carbon atoms for dual in vitro activity against both life stages. 2-Octadecynoic acid (2-ODA) was identified as the best inhibitor of Plasmodium berghei parasites with ten times higher potency (IC50=0.34 ?g/ml) than the control drug. In target determination studies, the same compound inhibited three Plasmodium falciparum FAS-II (PfFAS-II) elongation enzymes PfFabI, PfFabZ, and PfFabG with the lowest IC50 values (0.28-0.80 ?g/ml, respectively). Molecular modeling studies provided insights into the molecular aspects underlying the inhibitory activity of this series of 2-AFAs and a likely explanation for the considerably different inhibition potentials. Blood stages of P. falciparum followed a similar trend where 2-ODA emerged as the most active compound, with 20 times less potency. The general toxicity and hepatotoxicity of 2-AFAs were evaluated by in vitro and in vivo methods in mammalian cell lines and zebrafish models, respectively. This study identifies 2-ODA as the most promising antiparasitic 2-AFA, particularly towards P. berghei parasites. PMID:25103602

  20. Serial Assessment of Therapeutic Response to a New Radiosensitization Treatment, Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas, Type II (KORTUC II), in Patients with Stage I/II Breast Cancer Using Breast Contrast-Enhanced Magnetic Resonance Imaging

    PubMed Central

    Yaogawa, Shin; Ogawa, Yasuhiro; Morita-Tokuhiro, Shiho; Tsuzuki, Akira; Akima, Ryo; Itoh, Kenji; Morio, Kazuo; Yasunami, Hiroaki; Onogawa, Masahide; Kariya, Shinji; Nogami, Munenobu; Nishioka, Akihito; Miyamura, Mitsuhiko

    2015-01-01

    Background: We have developed a new radiosensitization treatment called Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas, Type II (KORTUC II). Using KORTUC II, we performed breast-conserving treatment (BCT) without any surgical procedure for elderly patients with breast cancer in stages I/II or patients refusing surgery. Since surgery was not performed, histological confirmation of the primary tumor region following KORTUC II treatment was not possible. Therefore, to precisely evaluate the response to this new therapy, a detailed diagnostic procedure is needed. The goal of this study was to evaluate the therapeutic response to KORTUC II treatment in patients with stage I/II breast cancer using annual breast contrast-enhanced (CE) magnetic resonance imaging (MRI). Methods: Twenty-one patients with stage I/II breast cancer who were elderly and/or refused surgery were enrolled in this study. All patients underwent MRI prior to and at 3 to 6 months after KORTUC II, and then approximately biannually thereafter. Findings from MRI were compared with those from other diagnostic modalities performed during the same time period. Results: KORTUC II was well tolerated, with minimal adverse effects. All of 21 patients showed a clinically complete response (cCR) on CE MRI. The mean period taken to confirm cCR on the breast CE MRI was approximately 14 months. The mean follow-up period for the patients was 61.9 months at the end of October 2014. Conclusions: The therapeutic effect of BCT using KORTUC II without surgery could be evaluated by biannual CE MRI evaluations. Approximately 14 months were required to achieve cCR in response to this therapy. PMID:26703733

  1. Gamma-Secretase/Notch Signalling Pathway Inhibitor RO4929097, Paclitaxel, and Carboplatin Before Surgery in Treating Patients With Stage II or Stage III Triple-Negative Breast Cancer

    ClinicalTrials.gov

    2015-09-03

    Estrogen Receptor Negative; HER2/Neu Negative; Progesterone Receptor Negative; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Triple-Negative Breast Carcinoma

  2. Extra- and intra-cellular ice formation in Stage I and II Xenopus laevis oocytes.

    PubMed

    Guenther, James F; Seki, Shinsuke; Kleinhans, F W; Edashige, Keisuke; Roberts, Daniel M; Mazur, Peter

    2006-06-01

    We are currently investigating factors that influence intracellular ice formation (IIF) in mouse oocytes and oocytes of the frog Xenopus. A major reason for choosing these two species is that while their eggs normally do not possess aquaporin channels in their plasma membranes, these channels can be made to express. We wish to see whether IIF is affected by the presence of these channels. The present Xenopus study deals with control eggs not expressing aquaporins. The main factor studied has been the effect of a cryoprotective agent [ethylene glycol (EG) or glycerol] and its concentration. The general procedure was to (a) cool the oocytes on a cryostage to slightly below the temperatures at which extracellular ice formation occurs, (b) warm them to just below the melting point, and (c) then re-cool them to -50 degrees C at 10 degrees C/min. In the majority of cases, IIF occurs well into step (c), but a sizeable minority undergo IIF in steps (a) or (b). The former group we refer to as low-temperature flashers; the latter as high-temperature flashers. IIF is manifested as abrupt blackening of the egg, which we refer to as "flashing." Observations on the Linkam cryostage are restricted to Stage I and II oocytes, which have diameters of 200 300 microm. In the absence of a cryoprotective agent, that is in frog Ringers, the mean flash temperature for the low-temperature freezers is -11.4 degrees C, although a sizeable percentage flash at temperatures much closer to that of the EIF (-3.9 degrees C). When EG is present, the flash temperature for the low-temperatures freezers drops significantly to approximately -20 degrees C for EG concentrations ranging from 0.5 to 1.5 M. The presence of 1.5 M glycerol also substantially reduces the IIF temperature of the low-temperature freezers; namely, to -29 degrees C, but 0.5 and 1 M glycerol exert little or no effect. The IIF temperatures observed using the Linkam cryostage agree well with those estimated by calorimetry [F.W. Kleinhans, J.F. Guenther, D.M. Roberts, P. Mazur, Analysis of intracellular ice nucleation in Xenopus oocytes by differential scanning calorimetry, Cryobiology 52 (2006) 128-138]. The IIF temperatures in Xenopus are substantially higher than those observed in mouse oocytes [P. Mazur, S. Seki, I.L. Pinn, F.W. Kleinhans, K. Edashige, Extra- and intracellular ice formation in mouse oocytes, Cryobiology 51 (2005) 29-53]. Perhaps that is a reflection of their much larger size. PMID:16600207

  3. Total body irradiation for stage II-IV non-Hodgkin's lymphoma: ten-year follow-up

    SciTech Connect

    Mendenhall, N.P.; Noyes, W.D.; Million, R.R.

    1989-01-01

    Between 1972 and 1977, a prospective study was conducted at the University of Florida on the role of total body irradiation (TBI) in the management of stage II-IV non-Hodgkin's lymphoma (NHL). Forty-four consecutive de novo (DN) patients (including ten stage II, 18 stage III, and 16 stage IV), as well as 16 previously treated (PT) patients, were accrued. Twenty of the 44 DN patients were symptomatic at presentation. Complete clinical responses were obtained in 20 of the 27 DN patients with favorable histologies (FH), and six of the 17 with unfavorable histologies (UH). Partial responses were obtained in six patients with FH and 11 patients with UH; only one patient showed no response to TBI. By univariate analysis, PT patients showed a trend for decreased relapse-free survival (P = .066) and decreased survival (P = .093). Multivariate analysis identified the best predictors of response rate to be histology (P = .0146) and marrow involvement (P = .0854); of relapse-free survival, histology (P = .0035), and TBI dose (P = .002); and of absolute survival, age (P = .0012), histology (P = .012), and TBI dose (P = .029). Thirty of the 41 patients who relapsed underwent salvage treatment with either chemotherapy or radiation. Twenty-three of the 30 undergoing salvage therapy obtained a second complete clinical response. There were no treatment-related deaths. The most common complication was thrombocytopenia. The major late complications were myeloproliferative disorders in four patients, which occurred only after cumulative TBI doses in excess of 200 cGy.

  4. Potential of lichen secondary metabolites against Plasmodium liver stage parasites with FAS-II as the potential target.

    PubMed

    Lauinger, Ina L; Vivas, Livia; Perozzo, Remo; Stairiker, Christopher; Tarun, Alice; Zloh, Mire; Zhang, Xujie; Xu, Hua; Tonge, Peter J; Franzblau, Scott G; Pham, Duc-Hung; Esguerra, Camila V; Crawford, Alexander D; Maes, Louis; Tasdemir, Deniz

    2013-06-28

    Chemicals targeting the liver stage (LS) of the malaria parasite are useful for causal prophylaxis of malaria. In this study, four lichen metabolites, evernic acid (1), vulpic acid (2), psoromic acid (3), and (+)-usnic acid (4), were evaluated against LS parasites of Plasmodium berghei. Inhibition of P. falciparum blood stage (BS) parasites was also assessed to determine stage specificity. Compound 4 displayed the highest LS activity and stage specificity (LS IC50 value 2.3 μM, BS IC50 value 47.3 μM). The compounds 1-3 inhibited one or more enzymes (PfFabI, PfFabG, and PfFabZ) from the plasmodial fatty acid biosynthesis (FAS-II) pathway, a potential drug target for LS activity. To determine species specificity and to clarify the mechanism of reported antibacterial effects, 1-4 were also evaluated against FabI homologues and whole cells of various pathogens (S. aureus, E. coli, M. tuberculosis). Molecular modeling studies suggest that lichen acids act indirectly via binding to allosteric sites on the protein surface of the FAS-II enzymes. Potential toxicity of compounds was assessed in human hepatocyte and cancer cells (in vitro) as well as in a zebrafish model (in vivo). This study indicates the therapeutic and prophylactic potential of lichen metabolites as antibacterial and antiplasmodial agents. PMID:23806111

  5. Prognostic value of BRAF and KRAS mutation status in stage II and III microsatellite instable colon cancers.

    PubMed

    de Cuba, E M V; Snaebjornsson, P; Heideman, D A M; van Grieken, N C T; Bosch, L J W; Fijneman, R J A; Belt, E; Bril, H; Stockmann, H B A C; Hooijberg, E; Punt, C J A; Koopman, M; Nagtegaal, I D; Coupé, V H M; Carvalho, B; Meijer, G A

    2016-03-01

    Microsatellite instability (MSI) has been associated with favourable survival in early stage colorectal cancer (CRC) compared to microsatellite stable (MSS) CRC. The BRAF V600E mutation has been associated with worse survival in MSS CRC. This mutation occurs in 40% of MSI CRC and it is unclear whether it confers worse survival in this setting. The prognostic value of KRAS mutations in both MSS and MSI CRC remains unclear. We examined the effect of BRAF and KRAS mutations on survival in stage II and III MSI colon cancer patients. BRAF exon 15 and KRAS exon 2-3 mutation status was assessed in 143 stage II (n = 85) and III (n = 58) MSI colon cancers by high resolution melting analysis and sequencing. The relation between mutation status and cancer-specific (CSS) and overall survival (OS) was analyzed using Kaplan-Meier and Cox regression analysis. BRAF V600E mutations were observed in 51% (n = 73) and KRAS mutations in 16% of cases (n = 23). Patients with double wild-type cancers (dWT; i.e., BRAF and KRAS wild-type) had a highly favourable survival with 5-year CSS of 93% (95% CI 84-100%), while patients with cancers harbouring mutations in either BRAF or KRAS, had 5-year CSS of 76% (95% CI 67-85%). In the subgroup of stage II patients with dWT cancers no cancer-specific deaths were observed. On multivariate analysis, mutation in either BRAF or KRAS vs. dWT remained significantly prognostic. Mutations in BRAF as well as KRAS should be analyzed when considering these genes as prognostic markers in MSI colon cancers. PMID:26376292

  6. Evaluation of the dosimetric impact of applying flattening filter-free beams in intensity-modulated radiotherapy for early-stage upper thoracic carcinoma of oesophagus

    PubMed Central

    Zhang, Wuzhe; Lin, Zhixiong; Yang, Zhining; Fang, Weisheng; Lai, Peibo; Lu, Jiayang; Wu, Vincent WC

    2015-01-01

    Introduction Flattening filter-free (FFF) radiation beams have recently become clinically available on modern linear accelerators in radiation therapy. This study aimed to evaluate the dosimetric impact of using FFF beams in intensity-modulated radiotherapy (IMRT) for early-stage upper thoracic oesophageal cancer. Methods Eleven patients with primary stage upper thoracic oesophageal cancer were recruited. For each patient, two IMRT plans were computed using conventional beams (Con-P) and FFF beams (FFF-P), respectively. Both plans employed a five-beam arrangement and were prescribed with 64Gy to (planning target volume) PTV1 and 54Gy to PTV2 in 32 fractions using 6MV photons. The dose parameters of the target volumes and organs at risks (OARs), and treatment parameters including the monitor units (MU) and treatment time (TT) for Con-P and FFF-P were recorded and compared. Results The mean D5 of PTV1 and PTV2 were higher in FFF-P than Con-P by 0.4Gy and 0.3Gy, respectively. For the OARs, all the dose parameters did not show significant difference between the two plans except the mean V5 and V10 of the lung in which the FFF-P was lower (46.7% vs. 47.3% and 39.1% vs. 39.6%, respectively). FFF-P required 54% more MU but 18.4% less irradiation time when compared to Con-P. Conclusion The target volume and OARs dose distributions between the two plans were comparable. However, FFF-P was more effective in sparing the lung from low dose and reduced the mean TT compared with Con-P. Long-term clinical studies are suggested to evaluate the radiobiological effects of FFF beams. PMID:26229675

  7. Evaluation of the dosimetric impact of applying flattening filter-free beams in intensity-modulated radiotherapy for early-stage upper thoracic carcinoma of oesophagus

    SciTech Connect

    Zhang, Wuzhe; Lin, Zhixiong; Yang, Zhining; Fang, Weisheng; Lai, Peibo; Lu, Jiayang; Wu, Vincent WC

    2015-06-15

    Flattening filter-free (FFF) radiation beams have recently become clinically available on modern linear accelerators in radiation therapy. This study aimed to evaluate the dosimetric impact of using FFF beams in intensity-modulated radiotherapy (IMRT) for early-stage upper thoracic oesophageal cancer. Eleven patients with primary stage upper thoracic oesophageal cancer were recruited. For each patient, two IMRT plans were computed using conventional beams (Con-P) and FFF beams (FFF-P), respectively. Both plans employed a five-beam arrangement and were prescribed with 64 Gy to (planning target volume) PTV1 and 54 Gy to PTV2 in 32 fractions using 6 MV photons. The dose parameters of the target volumes and organs at risks (OARs), and treatment parameters including the monitor units (MU) and treatment time (TT) for Con-P and FFF-P were recorded and compared. The mean D{sub 5} of PTV1 and PTV2 were higher in FFF-P than Con-P by 0.4 Gy and 0.3 Gy, respectively. For the OARs, all the dose parameters did not show significant difference between the two plans except the mean V{sub 5} and V{sub 10} of the lung in which the FFF-P was lower (46.7% vs. 47.3% and 39.1% vs. 39.6%, respectively). FFF-P required 54% more MU but 18.4% less irradiation time when compared to Con-P. The target volume and OARs dose distributions between the two plans were comparable. However, FFF-P was more effective in sparing the lung from low dose and reduced the mean TT compared with Con-P. Long-term clinical studies are suggested to evaluate the radiobiological effects of FFF beams.

  8. Role of Surgery in Stages II and III Pediatric Abdominal Non-Hodgkin Lymphoma: A 5-Years Experience

    PubMed Central

    Ali, Amany M.; Sayd, Heba A.; Hamza, Hesham M.; Salem, Mohamed A.

    2011-01-01

    Abdominal Non-Hodgkin lymphomas (NHL) are the most common extra nodal presentation of pediatric NHL. Our aim is to assess the role of surgery as a risk factor and to evaluate the impact of risk-adjusted systemic chemotherapy on survival of patients with stages II and III disease. This study included 35 pediatric patients with abdominal NHL treated over five years at South Egypt Cancer Institute (SECI), Assiut University, between January 2005 and January 2010. The data of every patient included: Age, sex, and presentation, staging work up to determine extent of the disease and the type of resection performed, histopathological examination, details of chemotherapy, disease free survival and overall survival. The study included 25 boys and 10 girls with a median age of six years (range: 2.5:15). Thirty patients (86%) presented with abdominal pain, 23 patients (66%) presented with abdominal mass and distention, 13 patients (34%) presented with weight loss, and intestinal obstruction occurred in six patients (17%). The ileo-cecal region and abdominal lymph nodes were the commonest sites (48.5%, 21% respectively). Burkitt's lymphoma was the most common histological type in 29 patients (83%). Ten (28.5%) stage II (group A) and 25 (71.5%) stage III (group B). Complete resections were performed in 10 (28.5%), debulking in 6 (17%) and imaging guided biopsy in 19 (54%). A11 patients received systemic chemotherapy. The median follow up duration was 63 months (range 51-78 months). The parameters that significantly affect the overall survival were stage at presentation complete resection for localized disease. In conclusion, the extent of disease at presentation is the most important prognostic factor in pediatric abdominal NHL. Surgery is restricted to defined situations such as; abdominal emergencies, diagnostic biopsy and total tumor extirpation in localized disease. Chemotherapy is the cornerstone in the management of pediatric abdominal NHL. PMID:24212775

  9. Comparison of NEXRAD Stage III and MPE precipitation products with constraints from high quality and density of raingauge networks in the Upper Guadalupe River Basin, Central Texas

    NASA Astrophysics Data System (ADS)

    Xie, H.; Wang, X.

    2006-05-01

    NEXRAD's Multisensor Precipitation Estimator (MPE) product replaced the Stage III product started in October 2003 at the West Gulf River Forecast Center (WGRFC) where includes most of the Texas and New Mexico. The MPE is an integrated product of rain gauge, NEXRAD, and satellite (GOES) precipitation estimates. The main objective of MPE is to reduce both areal-mean bias error and local bias error. The overall improved quality of MPE over Stage 3 is evident at the WGRFC. However, so far, there is no quantitative evaluation in a relative long period (one year or more) of a large area. In this study, high quality and density of 50 raingauge networks (6 minutes temporal resolution) in the Upper Guadalupe River Basin, Central Texas are used to evaluate both the Stage III (years 2001 and 2002) and MPE (year 2004) products. In this study, we propose two types of comparison (1) directly compare collocated radar cell and gauge of all rainfall events and (2) only compare collocated radar cell and gauge of homogeneous/uniform rainfall events. To find uniform rainfall events, 6-mintutes raingauge rainfall were used to calculate the correlation coefficient (CC) and coefficient of variation (CV) of a hour among one central gauge and its surrounding gauges (>= 4). For a particular rainfall hour, when CV is < 0.5 and CC is > 0.5, or CV is <0.1, the rainfall event of this hour is thus selected as a uniform or homogeneous rainfall event. Our preliminary results of CC from all rainfall events and homogeneous rainfall events for year 2004 (MPE) are 0.79 and 0.96, respectively. This indicates an overall good quality of MPE product in comparison with raingauge rainfall, especially for the homogeneous rainfall events. Work is in progress.

  10. Tumour-infiltrating CD68+ and CD57+ cells predict patient outcome in stage IIIII colorectal cancer

    PubMed Central

    Chaput, N; Svrcek, M; Auprin, A; Locher, C; Drusch, F; Malka, D; Taeb, J; Gor, D; Ducreux, M; Boige, V

    2013-01-01

    Background: The aim of our study was to evaluate the prognostic role of immunological microenvironnement in stage IIIII CRC patients. Methods: We constructed a tissue microarray from 196 consecutive patients with stage IIIII CRC and compared CD3, CD4, CD8, CD57, CD68, CXCL9/MIG, CXCL13, and PPAR? immunoreactivity in tumour samples and their matched non-tumour tissue. We assessed their association with relapse-free survival (RFS; primary endpoint) and overall survival (OS) in multivariate Cox models. Results: Low densities of CD57+ and CD68+ tumour-infiltrating cells (TIC) independently predicted worse outcomes. A prognostic score combining CD57 (+, > vs ?, ?2 cells per spot) and CD68 (+, >0 vs ?, =0 cells per spot) TIC density discriminated CRC patients at low (CD68+/CD57+), intermediate (CD68+/CD57?), or high (CD68?/CD57?) risk, with hazard ratios for the intermediate-risk and high-risk groups of 2.7 (95% confidence interval (CI): 1.35.8) and 9.0 (3.225.4) for RFS, and 2.5 (1.25.1) and 10.6 (3.829.2) for OS, respectively, as compared with the low-risk group. Corresponding 5-year survival rates (95% CI) in the low-, moderate- and high-risk groups were 84% (7191), 65% (5474), and 12% (247), respectively, for RFS, and 91% (8096), 76% (6684), and 25% (759), respectively, for OS. Conclusion: Tumour CD57+ and CD68+ TIC density assessment independently predicts survival in patients with stage IIIII CRC. If validated, our score based on a quick, inexpensive, and well-established method such as point counting on diagnostic tissue sections could be used routinely as a prognostic tool in CRC patients. PMID:23868006

  11. Brentuximab Vedotin and Combination Chemotherapy in Treating Patients With Stage II-IV HIV-Associated Hodgkin Lymphoma

    ClinicalTrials.gov

    2016-01-18

    AIDS-Related Hodgkin Lymphoma; Classical Hodgkin Lymphoma; HIV Infection; Stage IIA Hodgkin Lymphoma; Stage IIB Hodgkin Lymphoma; Stage IIIA Hodgkin Lymphoma; Stage IIIB Hodgkin Lymphoma; Stage IVA Hodgkin Lymphoma; Stage IVB Hodgkin Lymphoma

  12. Bevacizumab, Fluorouracil, Leucovorin Calcium, and Oxaliplatin Before Surgery in Treating Patients With Stage II-III Rectal Cancer

    ClinicalTrials.gov

    2015-10-24

    Mucinous Adenocarcinoma of the Rectum; Signet Ring Adenocarcinoma of the Rectum; Stage IIA Rectal Cancer; Stage IIB Rectal Cancer; Stage IIC Rectal Cancer; Stage IIIA Rectal Cancer; Stage IIIB Rectal Cancer; Stage IIIC Rectal Cancer

  13. 77 FR 35279 - Approval and Promulgation of Implementation Plans; Arizona; Update to Stage II Gasoline Vapor...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-13

    ...'s Submittal On October 3, 2011 (76 FR 61062), we proposed to approve a revision to the Arizona State... FR 41731, at 41734 (July 15, 2011). \\2\\ By letter dated April 12, 2011, ADEQ substituted the statutes.... See 61 FR 3578 (February 1, 1996). MCAQDM's stage I vapor recovery program and related rule are...

  14. 78 FR 58884 - Approval and Promulgation of Implementation Plans; Kentucky; Stage II Requirements for Enterprise...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-25

    .../Northern Kentucky Area. See 56 FR 56694, effective January 6, 1992. The designation was based on the Area's..., 1998, and approved by EPA into the SIP on December 8, 1998. See 63 FR 67586. Under this regulation... maintenance plan were approved by EPA, effective June 19, 2000 (65 FR 37879). Since the Kentucky Stage...

  15. The first stage of a Boeing Delta II rocket is lifted into place at pad 17A, CCAS

    NASA Technical Reports Server (NTRS)

    1999-01-01

    The first stage of a Boeing Delta II rocket is raised off a truck bed before being lifted into place on the tower at Launch Complex 17, Cape Canaveral Air Station. The rocket will carry the Stardust spacecraft into space for a close encounter with the comet Wild 2 in January 2004. Using a medium called aerogel, it will capture comet particles flying off the nucleus of the comet, plus collect interstellar dust for later analysis. The collected samples will return to Earth in a Sample Return Capsule to be jettisoned as Stardust swings by Earth in January 2006. Stardust is scheduled to be launched on Feb. 6, 1999.

  16. The first stage of a Boeing Delta II rocket is lifted into place at pad 17A, CCAS

    NASA Technical Reports Server (NTRS)

    1999-01-01

    The first stage of a Boeing Delta II rocket is lifted to its vertical position on the tower at Launch Complex 17, Cape Canaveral Air Station. The rocket will carry the Stardust spacecraft into space for a close encounter with the comet Wild 2 in January 2004. Using a medium called aerogel, it will capture comet particles flying off the nucleus of the comet, plus collect interstellar dust for later analysis. The collected samples will return to Earth in a Sample Return Capsule to be jettisoned as Stardust swings by Earth in January 2006. Stardust is scheduled to be launched on Feb. 6, 1999.

  17. The first stage of a Boeing Delta II rocket is lifted into place at pad 17A, CCAS

    NASA Technical Reports Server (NTRS)

    1999-01-01

    The first stage of a Boeing Delta II rocket is guided to its vertical position on the tower at Launch Complex 17, Cape Canaveral Air Station. The rocket will carry the Stardust spacecraft into space for a close encounter with the comet Wild 2 in January 2004. Using a medium called aerogel, it will capture comet particles flying off the nucleus of the comet, plus collect interstellar dust for later analysis. The collected samples will return to Earth in a Sample Return Capsule to be jettisoned as Stardust swings by Earth in January 2006. Stardust is scheduled to be launched on Feb. 6, 1999.

  18. The first stage of a Boeing Delta II rocket is lifted into place at pad 17A, CCAS

    NASA Technical Reports Server (NTRS)

    1999-01-01

    The first stage of a Boeing Delta II rocket is in position on the mobile tower (at right) at Launch Complex 17. At left is the launch tower. The rocket will carry the Stardust spacecraft into space for a close encounter with the comet Wild 2 in January 2004. Using a medium called aerogel, it will capture comet particles flying off the nucleus of the comet, plus collect interstellar dust for later analysis. The collected samples will return to Earth in a Sample Return Capsule to be jettisoned as Stardust swings by Earth in January 2006. Stardust is scheduled to be launched on Feb. 6, 1999.

  19. The first stage of a Boeing Delta II rocket is lifted into place at pad 17A, CCAS

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Workers at Cape Canaveral Air Station help guide the first stage of a Boeing Delta II rocket to its vertical position on the tower at Launch Complex 17. The rocket will carry the Stardust spacecraft into space for a close encounter with the comet Wild 2 in January 2004. Using a medium called aerogel, it will capture comet particles flying off the nucleus of the comet, plus collect interstellar dust for later analysis. The collected samples will return to Earth in a Sample Return Capsule to be jettisoned as Stardust swings by Earth in January 2006. Stardust is scheduled to be launched on Feb. 6, 1999.

  20. Predictors of timing of adjuvant chemotherapy in older women with hormone receptor-negative, stages II-III breast cancer.

    PubMed

    Wheeler, Stephanie B; Carpenter, William R; Peppercorn, Jeffrey; Schenck, Anna P; Weinberger, Morris; Biddle, Andrea K

    2012-01-01

    Adherence to consensus guidelines for cancer care may vary widely across health care settings and contribute to differences in cancer outcomes. For some women with breast cancer, omission of adjuvant chemotherapy or delays in its initiation may contribute to differences in cancer recurrence and mortality. We studied adjuvant chemotherapy use among women with stage II or stage III, hormone receptor-negative breast cancer to understand health system and socio-demographic correlates of underuse and delayed adjuvant chemotherapy. We used Surveillance Epidemiology and End Results (SEER)-Medicare linked data to examine the patterns of care for 6,678 women aged 65 and older diagnosed with stage II or stage III hormone receptor-negative breast cancer in 1994-2002, with claims data through 2007. Age-stratified logistic regression was employed to examine the potential role of socio-demographic and structural/organizational health services characteristics in explaining differences in adjuvant chemotherapy initiation. Overall utilization of guideline-recommended adjuvant chemotherapy peaked at 43% in this population. Increasing age, higher co-morbidity burden, and low-income status were associated with lower odds of chemotherapy initiation within 4 months, whereas having positive lymph nodes, more advanced disease, and being married were associated with higher odds (P < 0.05). Health system-related structural/organizational characteristics and race/ethnicity offered little explanatory insight. Timely initiation of guideline-recommended adjuvant chemotherapy was low, with significant variation by age, income, and co-morbidity status. Based on these findings, future studies should seek to explore the more nuanced reasons why older women do not receive chemotherapy and why delays in care occur. PMID:21842244

  1. The CYP19 RS4646 Polymorphism IS Related to the Prognosis of Stage III and Operable Stage III Breast Cancer

    PubMed Central

    Shao, Xiying; Guo, Yong; Xu, Xiaohong; Zheng, Yabing; Wang, Jiwen; Chen, Zhanhong; Huang, Jian; Huang, Ping; Cai, Jufen; Wang, Xiaojia

    2015-01-01

    Purpose Aromatase, encoded by the CYP19 gene, catalyzes the final step of the conversion of androgens to estrogens. Given the critical role of CYP19 in estrogen synthesis, the potential influence of CYP19 rs4646 polymorphism on breast cancer survival, deserves further study. Methods Genotyping for CYP19 rs4646 variants was performed on 406 Chinese women with stage III and operable stage III breast cancer. Associations were evaluated between CYP19 rs4646 genotypes and disease-free survival (DFS). Results In premenopausal patients, women who are homozygous for the minor allele (AA) have a longer DFS compared with those carrying the major allele (CC or AC) (87 months versus 48.7 months; Hazard ratio (HR) = 0.56, 95 % CI = 0.318-0.985, P = 0.041). These differences were further demonstrated by a multivariate analysis (HR = 0.456, 95 % CI = 0.249-0.836, P = 0.011). Conversely, the same variant (AA) was estimated to be associated with a poorer DFS in postmenopausal women (AA versus AC or CC: 13.7 months versus 56.3 months; HR = 2.758, 95 % CI = 1.432-5.313, P = 0.002). Furthermore, the differences were confirmed by the COX proportional hazards model (HR = 2.983, 95% CI =1.494-5.955, P = 0.002). Conclusions The present study indicates that CYP19 rs4646 polymorphism is related to DFS in early breast cancer and that the prognosis index of the homozygous for the minor allele (AA) may depend on menopause status. The findings are novel, if confirmed, rs4646 genotypes may provide useful information for routine management in breast cancer. PMID:25793413

  2. CBCT Evaluation of the Upper Airway Morphological Changes in Growing Patients of Class II Division 1 Malocclusion with Mandibular Retrusion Using Twin Block Appliance: A Comparative Research

    PubMed Central

    Li, Liang; Liu, Hong; Cheng, Huijuan; Han, Yanzhao; Wang, Chunling; Chen, Yu

    2014-01-01

    Objective The purpose of this study was to evaluate the morphological changes of upper airway after Twin Block (TB) treatment in growing patients with Class II division 1 malocclusion and mandibular retrusion compared with untreated Class II patients by cone beam computed tomography (CBCT). Materials and Methods Thirty growing patients who have completed TB treatment were recruited into TB group. The control group (n?=?30) was selected from the patients with the same diagnosis and without TB treatment. CBCT scans of the pre-treatment (T1) and post-treatment (T2) data of TB group and control data were collected. After three-dimensional (3D) reconstruction and registration of T1 and T2 data, the morphological changes of upper airway during TB treatment were measured. The statistical differences between T1 and T2 data of TB group as well as T2 and control data were accessed by t-test. Results During the TB treatment, the mandible moved advanced by 3.522.14 mm in the horizontal direction and 3.772.10 mm in the vertical direction. The hyoid bone was in a more forward and inferior place. The upper airway showed a significant enlargement in nasopharynx, oropharynx and hypopharynx. In addition, the nasopharynx turned more circular, and the oropharynx became more elliptic in transverse shape. However, the transverse shape of the hypopharynx showed no significant difference. After comparison between T2 and control data, only the horizontal movement of the hyoid bone, the volumetric expansion of the oropharynx and hypopharynx, and changes of the oropharyngeal transverse shape showed significant difference. Conclusion Compared to the untreated Class II patients, the upper airway of growing patients with Class II division 1 malocclusion and mandibular retrusion showed a significant enlargement in the oropharynx and hypopharynx as well as a more elliptic transverse shape in the oropharynx, and the hyoid bone moved to an anterior position after TB treatment. PMID:24705466

  3. Type II epithelial keratin 6hf (K6hf) is expressed in the companion layer, matrix, and medulla in anagen-stage hair follicles.

    PubMed

    Wang, Zhiling; Wong, Pauline; Langbein, Lutz; Schweizer, Jrgen; Coulombe, Pierre A

    2003-12-01

    More than half of the known keratin genes (n approximately 50) are expressed in the hair follicle. An in-depth knowledge of their differential expression in this organ will help us to understand the mechanisms of its formation and cycling, and the etiology of inherited hair disorders. Keratin 6hf is a type II keratin recently shown to occur in the companion layer. We cloned the mouse ortholog and characterized its expression in skin and oral mucosa. The mK6hf gene is 9.1 kb long and located in the cluster of type II keratin genes on mouse chromosome 15, between the keratin 6 (mK6alpha/mK6beta) and hair keratin genes. In situ hybridization and protein immunolocalization showed that, in addition to the companion layer, mK6hf is expressed in the upper matrix and medulla of the anagen-stage hair. This distribution is seen for all types of mouse hairs and medullated human hairs. The distribution of keratin 6hf protein in the hair shaft mirrors that of keratin 17, and the observation of reduced levels of keratin 6hf in keratin 17 null hair argues for a direct interaction between them. mK6hf is also expressed in the nail bed epithelium and fungiform papillae of dorsal tongue epithelium. Our findings provide an additional marker for the hair matrix and medulla, and suggest that the cellular precursors for the medulla, cortex, and cuticle compartments are already spatially segregated within the hair matrix. They also have obvious implications for the epithelial alterations associated with defects in keratin 6 genes. PMID:14675170

  4. The upper Tortonian-lower Messinian at Monte dei Corvi (Northern Apennines, Italy): Completing a Mediterranean reference section for the Tortonian Stage

    NASA Astrophysics Data System (ADS)

    Hsing, S. K.; Kuiper, K. F.; Link, W.; Hilgen, F. J.; Krijgsman, W.

    2009-05-01

    A high-resolution integrated stratigraphy including biostratigraphy, magnetostratigraphy, tephrostratigraphy and cyclostratigraphy is presented for the upper Tortonian and lower Messinian (Upper Miocene) at Monte dei Corvi. Numerical age control comes from a combination of magnetobiostratigrapic dating and astronomical tuning, while radioisotope dating of ash layers produced less reliable ages. The deep marine succession is characterized by large-scale non-repetitive stratigraphic changes allowing the discrimination between a Lower, Brownish, Rossini and Euxinic Shale Interval. The sedimentary cycles, which occur superimposed on these large-scale changes, are related to astronomical climate forcing. Astronomical tuning of the sedimentary cycles provides not only absolute ages for biostratigraphic events, reversal boundaries and volcanic ash layers, but also for the observed non-cyclic changes. These can be linked to environmental and geodynamic changes in the Mediterranean region preceding the Messinian Salinity Crisis. The beginning of the Brownish Interval marked by tripartite cycles at 8.017 Ma coincides with tectonic re-arrangements in the Mediterranean, such as compression in the Betics and opening of the Rifian corridor. At 7.616 Ma the change to the calcareous Rossini Interval can be linked to tectonic uplift in the northern Apennines and the deepening of the Rifian corridor, while the Betic corridor became restricted coinciding with the end of evaporite deposition in the eastern Betics. The change to euxinic shales at 7.168 Ma reflects basin-wide restriction marked by diatomite and sapropel formation in the Mediterranean basin related to the severely constricted Betic and Rifian corridors. The occurrence of a tripartite construction of cycles in the euxinic shales at 6.719 Ma coincides with diatomite formation in the eastern Mediterranean, uplift and shallowing in the Northern Apennines and further constriction of the Atlantic gateways. We conclude that late Tortonian-early Messinian tectonic and environmental events occur remarkably synchronously in the Mediterranean basin and most likely result from a combination of geodynamic processes and eccentricity-controlled climatic changes. In combination with the upper Serravallian and lower Tortonian interval, which includes the formal Tortonian Global Stratotype Section and Point (GSSP), the Monte dei Corvi is the only complete section in the Mediterranean covering the entire Tortonian Stage. We therefore propose the Monte dei Corvi section as Tortonian reference section, particularly for the Mediterranean region. In addition, it may serve as a unit-stratotype for the Tortonian.

  5. Upper stages utilizing electric propulsion

    NASA Technical Reports Server (NTRS)

    Byers, D. C.

    1980-01-01

    The payload characteristics of geocentric missions which utilize electron bombardment ion thruster systems are discussed. A baseline LEO to GEO orbit transfer mission was selected to describe the payload capabilities. The impacts on payloads of both mission parameters and electric propulsion technology options were evaluated. The characteristics of the electric propulsion thrust system and the power requirements were specified in order to predict payload mass. This was completed by utilizing a previously developed methodology which provides a detailed thrust system description after the final mass on orbit, the thrusting time, and the specific impulse are specified. The impact on payloads of total mass in LEO, thrusting time, propellant type, specific impulse, and power source characteristics was evaluated.

  6. ColoFinder: a prognostic 9-gene signature improves prognosis for 871 stage II and III colorectal cancer patients

    PubMed Central

    He, Jianmin

    2016-01-01

    Colorectal cancer (CRC) is a heterogeneous disease with a high mortality rate and is still lacking an effective treatment. Our goal is to develop a robust prognosis model for predicting the prognosis in CRC patients. In this study, 871 stage II and III CRC samples were collected from six gene expression profilings. ColoFinder was developed using a 9-gene signature based Random Survival Forest (RSF) prognosis model. The 9-gene signature recurrence score was derived with a 5-fold cross validation to test the association with relapse-free survival, and the value of AUC was gained with 0.87 in GSE39582(95% CI [0.83–0.91]). The low-risk group had a significantly better relapse-free survival (HR, 14.8; 95% CI [8.17–26.8]; P < 0.001) than the high-risk group. We also found that the 9-gene signature recurrence score contributed more information about recurrence than standard clinical and pathological variables in univariate and multivariate Cox analyses when applied to GSE17536(p = 0.03 and p = 0.01 respectively). Furthermore, ColoFinder improved the predictive ability and better stratified the risk subgroups when applied to CRC gene expression datasets GSE14333, GSE17537, GSE12945and GSE24551. In summary, ColoFinder significantly improves the risk assessment in stage II and III CRC patients. The 9-gene prognostic classifier informs patient prognosis and treatment response. PMID:26989635

  7. Comparative analyses of postoperative complications and prognosis of different surgical procedures in stage II endometrial carcinoma treatment

    PubMed Central

    Yin, Hongmei; Gui, Ting

    2016-01-01

    Objective To investigate the impact of surgical resection extent on the postoperative complications and the prognosis in patients with stage II endometrial cancer. Methods A total of 54 patients were retrospectively reviewed, 35 patients underwent subradical hysterectomy and 19 patients received radical hysterectomy, both with simultaneous bilateral salpingo-oophorectomy and pelvic and paraaortic lymphadenectomy. Results Comparing the surgical outcomes in subradical hysterectomy group vs radical hysterectomy group, there were no significant differences in operative time, estimated blood loss, and hospital stay. After surgery, 37.1% vs 36.8% patients received postoperative radiotherapy in the subradical hysterectomy group vs radical hysterectomy group, without statistically significant difference. As for postoperative complications, the early postoperative complication rate in patients who underwent subradical hysterectomy was 14.3%, significantly lower than that in patients submitted to radical hysterectomy (14.3% vs 42.1%), with P=0.043. However, there was no significant difference in late postoperative complication rate between the two surgical procedures. Regarding the clinical prognosis, patients receiving the subradical hysterectomy showed similar survival to their counterparts undergoing the radical procedures. The relapse rate was 5.71% vs 5.26%, respectively, without significant difference. There were no deaths in both surgical groups. Conclusion For stage II endometrial carcinoma, subradical hysterectomy presented with less early postoperative complications and similar survival duration and recurrence compared with radical hysterectomy and should be advocated in clinical treatment. PMID:26937200

  8. Predictive value of a proposed subclassification of stages I and II cervical cancer based on clinical tumor diameter.

    PubMed

    Eifel, Patricia J; Jhingran, Anuja; Levenback, Charles F; Tucker, Susan

    2009-01-01

    Hospital records of 4490 patients treated for International Federation of Gynecology and Obstetrics (FIGO) stage IB, IIA, or IIB carcinoma of the cervix between 1960 and 2001 at 1 institution were reviewed. Outcomes were estimated using the Kaplan-Meier method and compared using the log-rank method. A proportional hazards regression model was used to evaluate the relative importance of predictive factors. The rates of disease-specific survival and pelvic disease control were strongly correlated with tumor diameter, FIGO stage, histological subtype, and clinical node status. Regression analysis demonstrated that a diameter of greater than 4 cm, a diameter of greater than 6 cm, FIGO stage II (vs IB), the presence and level of lymph node involvement, and histological subtype were all highly significant independent predictors of poor disease-specific survival. Intermediate tumor-diameter categories (>5 cm or >7 cm) and FIGO stage IIB (vs IB or IIA) did not contribute significant additional information to the model. Only a tumor diameter of greater than 4 cm, a diameter of greater than 6 cm, the presence of lymph node involvement, and histological subtype were independent predictors of pelvic disease control. On the basis of these results, we propose dividing each of the FIGO categories IB, IIA, and IIB into 3 groups according to clinical tumor diameter: (1) less than or equal to 4 cm, (2) 4.1 to 6 cm, and (3) greater than 6 cm. The proposed modified system would provide more accurate prognostic information, facilitate comparisons, and maintain continuity with the current staging system. PMID:19258933

  9. Deciphering tectonic, climatic-induced and hydrothermal signals in the late-stage exhumation history of the upper Rhne valley (Swiss Alps)

    NASA Astrophysics Data System (ADS)

    Valla, Pierre; Rahn, Meinert; Shuster, David; van der Beek, Peter

    2015-04-01

    Neogene exhumation of the European Alps is understood as the interplay between tectonics and climatic-induced erosion. While the former has been influenced by a decrease in plate convergence, the latter has been suggested to be affected by climatic variation and the onset of Plio-Quaternary glaciations, leading to relief amplification. However, even though geomorphologic and sedimentologic studies both suggest topographic relief change and transition from fluvial to oscillations between glacial/fluvial conditions, precise quantification on both the timing and magnitude of this transition are yet sparse. Our study focuses on the upper Rhne valley (Swiss Central Alps) within the Visp-Brig area (Aar massif). This area encompasses some of the most spectacular reliefs within the Alps with several nearby summits around or above 4000 m crosscut by the glacially overdeepened Rhne valley. It also shows among the highest late Neogene exhumation rates within the Western-Central European Alps, influenced by tectonic activity along the major Simplon-Rhne extensional fault system. Moreover, the upper Rhne valley has experienced enhanced glacial erosion associated with strong relief development during the Pliocene-Quaternary period. Finally, structural inheritance, late-stage tectonics and rapid exhumation may have promoted recent hydrothermal activity in this region, although timing of its onset and its precise causes remain poorly understood. We investigated the late-stage cooling history by using different low-temperature thermochronometers along a pseudo-vertical bedrock profile (elevation between 600 and 2900 m) and additional samples from an on-site 500-m geothermal well, resulting in a total elevation difference of nearly 3 km. Apatite fission-track (AFT) ages and track-length data have been added to previously published and new apatite (U-Th-Sm)/He (AHe) and 4He/3He data. Our results confirm high-exhumation rates (0.6 to 0.9 km/Myr) within late-Cenozoic to Pliocene times. Combined with AFT data from the literature, our age pattern reveals no exhumation difference across the Simplon fault system during the last 6-8 Ma, suggesting only strike-slip detachment activity of the structure during that period. Thermal modelling using HeFTy confirms rapid exhumation and evidences a late-stage cooling contrast between high-elevation and valley-bottom/geothermal well samples, in agreement with previous 4He/3He data. This late-stage exhumation is associated to the onset of major Alpine glaciation triggering the Rhne valley carving at ~1 Ma. Apatite track length measurements suggest that the well samples have been affected by recent hydrothermal activity. This agrees well with the present-day observation of high geothermal activity below the Rhne valley floor, whose origin has been primarily linked to structural inheritance (Simplon-Rhne extensional fault system). Our thermochronology data helps to put constrain on the onset timing of this geothermal activity, which we propose to be concordant with the onset of major alpine glaciations, glacial erosion and bedrock-fracture development promoting localized fluid circulation and hydrothermal activity below the Rhne valley floor.

  10. Toxicity of smelter slag-contaminated sediments from Upper Lake Roosevelt and associated metals to early life stage White Sturgeon (Acipenser transmontanus Richardson, 1836)

    USGS Publications Warehouse

    Little, E.E.; Calfee, R.D.; Linder, G.

    2014-01-01

    The toxicity of five smelter slag-contaminated sediments from the upper Columbia River and metals associated with those slags (cadmium, copper, zinc) was evaluated in 96-h exposures of White Sturgeon (Acipenser transmontanus Richardson, 1836) at 8 and 30 days post-hatch. Leachates prepared from slag-contaminated sediments were evaluated for toxicity. Leachates yielded a maximum aqueous copper concentration of 11.8 μg L−1 observed in sediment collected at Dead Man's Eddy (DME), the sampling site nearest the smelter. All leachates were nonlethal to sturgeon that were 8 day post-hatch (dph), but leachates from three of the five sediments were toxic to fish that were 30 dph, suggesting that the latter life stage is highly vulnerable to metals exposure. Fish maintained consistent and prolonged contact with sediments and did not avoid contaminated sediments when provided a choice between contaminated and uncontaminated sediments. White Sturgeon also failed to avoid aqueous copper (1.5–20 μg L−1). In water-only 96-h exposures of 35 dph sturgeon with the three metals, similar toxicity was observed during exposure to water spiked with copper alone and in combination with cadmium and zinc. Cadmium ranging from 3.2 to 41 μg L−1 or zinc ranging from 21 to 275 μg L−1 was not lethal, but induced adverse behavioral changes including a loss of equilibrium. These results suggest that metals associated with smelter slags may pose an increased exposure risk to early life stage sturgeon if fish occupy areas contaminated by slags.

  11. Effects of laser immunotherapy on late-stage, metastatic breast cancer patients in a Phase II clinical trial

    NASA Astrophysics Data System (ADS)

    Ferrel, Gabriela L.; Zhou, Feifan; Li, Xiaosong; Hode, Tomas; Nordquist, Robert E.; Alleruzzo, Luciano; Chen, Wei R.

    2014-03-01

    Laser immunotherapy (LIT), a novel technique with a local intervention to induce systemic antitumor effects, was developed to treat metastatic cancers. The pre-clinical studies of LIT have shown its unique characteristics in generating a specific antitumor immunity in treating metastatic tumors in rats and mice. For late-stage, metastatic breast cancer patients, who were considered to be out of other available treatment options, we conducted a small Phase II clinical trial using LIT starting in 2009 in Lima, Peru. This Phase II study was closed in December of 2012, as acknowldged by the Ministry of Health (MOH) of Peur letter 438-2014-OGITT/INS dated March 5th, 2014. Ten patients were enrolled and received LIT in one or multiple 4-week treatment cycles. At the study closing date, four patients were alive and two of them remained cancer free. Here, following the successful conclusion of our Phase II study, we report the clinical effects of LIT on metastatic breast cancer patients. Specifically, we present the overall status of all the patients three years after the treatment and also the outcomes of two long-term surviving patients.

  12. Development and Lab-Scale Testing of a Gas Generator Hybrid Fuel in Support of the Hydrogen Peroxide Hybrid Upper Stage Program

    NASA Technical Reports Server (NTRS)

    Lund, Gary K.; Starrett, William David; Jensen, Kent C.; McNeal, Curtis (Technical Monitor)

    2001-01-01

    As part of a NASA funded contract to develop and demonstrate a gas generator cycle hybrid rocket motor for upper stage space motor applications, the development and demonstration of a low sensitivity, high performance fuel composition was undertaken. The ultimate goal of the development program was to demonstrate successful hybrid operation (start, stop, throttling) of the fuel with high concentration (90+%) hydrogen peroxide. The formulation development and lab-scale testing of a simple DOT Class 1.4c gas generator propellant is described. Both forward injected center perforated and aft injected end burner hybrid combustion behavior were evaluated with gaseous oxygen and catalytically decomposed 90% hydrogen peroxide. Cross flow and static environments were found to yield profoundly different combustion behaviors, which were further governed by binder type, oxidizer level and, significantly, oxidizer particle size. Primary extinguishment was accomplished via manipulation of PDL behavior and oxidizer turndown, which is enhanced with the hydrogen peroxide system. Laboratory scale combustor results compared very well with 11-inch and 24-inch sub-scale test results with 90% hydrogen peroxide.

  13. Natural growth and diet of known-age pallid sturgeon (Scaphirhynchus albus) early life stages in the upper Missouri River basin, Montana and North Dakota

    USGS Publications Warehouse

    Braaten, P.J.; Fuller, D.B.; Lott, R.D.; Haddix, T.M.; Holte, L.D.; Wilson, R.H.; Bartron, M.L.; Kalie, J.A.; DeHaan, P.W.; Ardren, W.R.; Holm, R.J.; Jaeger, M.E.

    2012-01-01

    Prior to anthropogenic modifications, the historic Missouri River provided ecological conditions suitable for reproduction, growth, and survival of pallid sturgeon Scaphirhynchus albus. However, little information is available to discern whether altered conditions in the contemporary Missouri River are suitable for feeding, growth and survival of endangered pallid sturgeon during the early life stages. In 2004 and 2007, nearly 600 000 pallid sturgeon free embryos and larvae were released in the upper Missouri River and survivors from these releases were collected during 20042010 to quantify natural growth rates and diet composition. Based on genetic analysis and known-age at release (117 days post-hatch, dph), age at capture (dph, years) could be determined for each survivor. Totals of 23 and 28 survivors from the 2004 and 2007 releases, respectively, were sampled. Growth of pallid sturgeon was rapid (1.91 mm day-1) during the initial 1348 dph, then slowed as fish approached maximum length (120140 mm) towards the end of the first growing season. The diet of young-of-year pallid sturgeon was comprised of Diptera larvae, Diptera pupae, and Ephemeroptera nymphs. Growth of pallid sturgeon from ages 16 years was about 48.0 mm year-1. This study provides the first assessment of natural growth and diet of young pallid sturgeon in the wild. Results depict pallid sturgeon growth trajectories that may be expected for naturally produced wild stocks under contemporary habitat conditions in the Missouri River and Yellowstone River.

  14. Masters of their conditions II: intercultural theatre, narration and stage work with patients and healers.

    PubMed

    Arpin, Jacques

    2008-09-01

    What can a healer learn from theatre and performance studies? What can theatre and performance studies bring to healing practices? Both disciplines are distinct in Western societies, at times merged into miscellaneous forms of 'art therapy'. What lessons can we learn from traditions that do not separate these competencies and have always integrated them as being naturally complementary? In a consultation of cultural psychiatry, both patients and healers are actively aware of various degrees of merging of art and medicine. Narration, then, cannot be limited to verbal case-history making and verbal therapeutic approaches. Bringing patients and healers on a stage and using all forms of text and performance allow for another way of (re)constructing case histories. Expanding the narrative process opens doors to exploring traditions: their origin, their apprenticeship, their performance and their transmission. PMID:18799638

  15. Outcome of transoral robotic surgery for stage I-II oropharyngeal cancer.

    PubMed

    van Loon, J W L; Smeele, L E; Hilgers, F J M; van den Brekel, M W M

    2015-01-01

    Traditionally T1-2N0 oropharyngeal carcinoma is treated with a single treatment modality, being either radiotherapy or surgery. Currently, minimally invasive surgery, such as transoral robotic surgery (TORS), is gaining popularity. The aim of this study is to assess whether T1-2N0 oropharyngeal cancer can be safely and effectively resected with TORS, and to determine the oncologic and functional outcomes. In addition, the long-term quality-of-life outcomes are reported. Between 2007 and 2012, 18 patients with early stage oropharyngeal cancers underwent transoral resection with the da Vinci robot system in the Netherlands Cancer Institute. All surviving patients filled out the self-report assessments of quality-of-life questionnaires. Median robot-assisted operating time was 115 min (range 43-186 min), while median estimated blood loss was 5 ml (range 0-125 ml). In three cases the exposure was insufficient to obtain clear tumor margins because of tumor extension and local anatomy. Fourteen patients had clear surgical margins. Four patients received adjuvant radiotherapy. Nine patients underwent an elective unilateral neck dissection. The oropharyngeal cancer recurred in two patients. Regarding the quality of life, patients who needed postoperative radiotherapy had a worse outcome and patients treated with transoral resection only did quite well. TORS seems to be an oncologically safe surgical treatment for early stage T1-2N0 oropharyngeal cancer based on this relatively small group of patients. Selecting patients in whom sufficient surgical exposure can be obtained, should be performed with the greatest care to avoid the need for adjuvant radiotherapy. Comparing radiotherapy and TORS or CO2 laser should be the next step in finding the optimal treatment for patients with T1-2N0 oropharyngeal carcinoma. PMID:24609641

  16. Declining Use of Radiotherapy in Stage I and II Hodgkin's Disease and Its Effect on Survival and Secondary Malignancies

    SciTech Connect

    Koshy, Matthew; Rich, Shayna E.; Mahmood, Usama; Kwok, Young

    2012-02-01

    Purpose: Concerns regarding long-term toxicities have led some to withhold radiotherapy (RT) for the treatment of Stage I and II Hodgkin's disease (HD). The present study was undertaken to assess the use of RT for HD and its effect on overall survival and the development of secondary malignancies. Methods and Materials: The present study included data from the Surveillance, Epidemiology, and End Results database from patients aged {>=}20 years who had been diagnosed with Stage I or II HD between 1988 and 2006. Overall survival was estimated using the Kaplan-Meier method, and the Cox multivariate regression model was used to analyze trends. Results: A total of 12,247 patients were selected, and 51.5% had received RT. The median follow-up for the present cohort was 4.9 years, with 21% of the cohort having >10 years of follow-up. Between 1988 and 1991, 62.9% had undergone RT, but between 2004 and 2006, only 43.7% had undergone RT (p < .001). The 5-year overall survival rate was 76% for patients who had not received RT and 87% for those who had (p < .001). The hazard ratio adjusted for other variables in the regression model showed that patients who had not undergone RT (hazard ratio, 1.72; 95% confidence interval, 1.72-2.02) was associated with significantly worse survival compared with patients who had received RT. The actuarial rate of developing a second malignancy was 14.6% vs. 15.0% at 15 years for those who had and had not undergone RT, respectively (p = .089). Conclusions: The present study is one of the largest studies to examine the role of RT for Stage I and II HD. Our results revealed a survival benefit with the addition of RT with no increase in the development of secondary malignancies compared with patients who had not received RT. Furthermore, the present nationwide study revealed a >20% absolute decrease in the use of RT from 1988 to 2006.

  17. Single Stage Silicone Border Molded Closed Mouth Impression Technique-Part II.

    PubMed

    Solomon, E G R

    2011-09-01

    Functioning of a complete denture depends to a great extent on the impression technique. Several impression techniques have been described in the literature since the turn of this century when Greene [Clinical courses in dental prothesis, 1916] brothers introduced the first scientific system of recording dental impression. Advocates of each technique have their own claim of superiority over the other. The introduction of elastomeric impression materials [Skinner and Cooper, J Am Dent Assoc 51:523-536, 1955] has made possible new techniques of recording impression for complete denture construction. These rubber like materials are of two types; one has a polysulfide base and is popularily known as polysulfide rubber (Thiokol and Mercaptan). The other variety has a silicone base known as silicone rubber or silicone elastomer. Silicone elastomers are available in four different consistencies; a thin easy flowing light bodied material,a creamy medium bodied material, a highly viscous heavy bodied material and a kneadable putty material. This paper describes an active closed mouth impression technique with one stage border molding using putty silicone material as a substitute for low fusing compound. PMID:22942578

  18. Scenario for ultrarelativistic nuclear collisions. II. Geometry of quantum states at the earliest stage

    NASA Astrophysics Data System (ADS)

    Makhlin, A.

    2001-04-01

    We suggest that the ultrarelativistic collisions of heavy ions provide the simplest situation for the study of strong interactions which can be understood from first principles and without any model assumptions about the microscopic structure of the colliding nuclei. We argue that the boost-invariant geometry of the collision, and the existence of hard partons in the final states, both supported by the data, make a sufficient basis for the quantum theory of the phenomenon. We conclude that the quantum nature of the entire process is defined by its global geometry, which is enforced by a macroscopic finite size of the colliding objects. In this paper, we study the qualitative aspects of the theory and review its development in two subsequent papers. Our key result is that the effective mass of the quark in the expanding system formed in the collision of the two nuclei is gradually built up reaching its maximum by the time the quark mode becomes sufficiently localized. The chromo-magneto-static interaction of the color currents flowing in the rapidity direction is the main mechanism which is responsible for the generation of the effective mass of the soft quark mode and, therefore, for the physical scale at the earliest stage of the collision.

  19. A randomized control study of treating secondary stage II breast cancer-related lymphoedema with free lymph node transfer.

    PubMed

    Dionyssiou, Dimitrios; Demiri, Efterpi; Tsimponis, Antonis; Sarafis, Alexandros; Mpalaris, Vasillios; Tatsidou, Georgia; Arsos, Georgios

    2016-02-01

    Microsurgical techniques are increasingly used for treating severe lymphoedema cases. The purpose of this study was to evaluate the effectiveness of free vascularized lymph node transfer (LNT) in stage II breast cancer-related lymphoedema patients in comparison with non-surgical management. During the last 3 years, 83 female patients were examined at our lymphoedema clinic. Finally, 36 cases were included in this study and randomly divided in two groups: group A patients (n = 18, mean age 47 years) underwent microsurgical LNT; followed by 6 months of physiotherapy and compression, while group B patients (n = 18, mean age 49 years) were managed by physiotherapy and compression alone for 6 months. Patients of both groups removed their elastic garments after 6 months and were re-examined 1 year later. All the 36 patients had detailed evaluation of the affected extremity including limb volume measurement, infection episodes and scale scoring of pain, feeling of heaviness and functional status both at baseline and 18 month. Limb volume reduction was observed in both groups; mean reduction was greater in group A (57 %) than in group B (18 %). Infection episodes in group A were significantly reduced compared to those in group B patients. All group A patients reported painless and feeling of heaviness-free extremities with overall functional improvement, while the corresponding changes in group B patients were no more than marginal. Moreover, the LNT procedure was estimated as cost effective compared to conservative treatment alone. LNT represents an effective therapeutic approach for stage II lymphoedema patients; it significantly reduces limb volume, decreases recurrent infections and improves the overall function. PMID:26895326

  20. Overexpression of the S100A2 protein as a prognostic marker for patients with stage II and III colorectal cancer

    PubMed Central

    MASUDA, TAIKI; ISHIKAWA, TOSHIAKI; MOGUSHI, KAORU; OKAZAKI, SATOSHI; ISHIGURO, MEGUMI; IIDA, SATORU; MIZUSHIMA, HIROSHI; TANAKA, HIROSHI; UETAKE, HIROYUKI; SUGIHARA, KENICHI

    2016-01-01

    We aimed to identify a novel prognostic biomarker related to recurrence in stage II and III colorectal cancer (CRC) patients. Stage II and III CRC tissue mRNA expression was profiled using an Affymetrix Gene Chip, and copy number profiles of 125 patients were generated using an Affymetrix 250K Sty array. Genes showing both upregulated expression and copy number gains in cases involving recurrence were extracted as candidate biomarkers. The protein expression of the candidate gene was assessed using immunohistochemical staining of tissue from 161 patients. The relationship between protein expression and clinicopathological features was also examined. We identified 9 candidate genes related to recurrence of stage II and III CRC, whose mRNA expression was significantly higher in CRC than in normal tissue. Of these proteins, the S100 calcium-binding protein A2 (S100A2) has been observed in several human cancers. S100A2 protein overexpression in CRC cells was associated with significantly worse overall survival and relapse-free survival, indicating that S100A2 is an independent risk factor for stage II and III CRC recurrence. S100A2 overexpression in cancer cells could be a biomarker of poor prognosis in stage II and III CRC recurrence and a target for treatment of this disease. PMID:26783118

  1. Influence of oceanographic processes on the early life stages of the blue shrimp ( Litopenaeus stylirostris) in the Upper Gulf of California

    NASA Astrophysics Data System (ADS)

    Calderon-Aguilera, L. E.; Marinone, S. G.; Aragón-Noriega, E. A.

    2003-02-01

    The possible relationship between circulation patterns and the recruitment of early stages of penaeid shrimp in the Upper Gulf of California was explored by collecting postlarvae (mesh size 0.505 mm) simultaneously in two locations, one off the coast of Sonora (Golfo de Santa Clara: 31°44'49ʺN-114°33'12ʺW) and the other off the Baja California peninsula (San Felipe: 31°11'8.3ʺ N-114°53'13.9ʺW) during two complete fortnightly cycles (July 12-27, 1995 and June 30-July 16, 1996). Individuals with cephalothoracic length from 0.8 to 3.91 mm without a clear size-increasing pattern were found throughout the sampling period, suggesting continuous recruitment to the area. The circulation in the study area was simulated with a three-dimensional baroclinic model forced with tides and climatological hydrography at the mouth of the Gulf of California, and winds and heat and freshwater fluxes at the sea-air interface. Spawning stock surveys have shown that maximum concentration of mature females is near the coast of Sonora (mainland Mexico). The model predicts surface currents of about 8 cm s -1 and suggests that postlarvae found off the coast of the peninsula may come from a different reproductive unit than those found off the mainland coast. This may explain why postlarvae found in Golfo de Santa Clara (mainland) are larger (and, presumably, older) than those found in San Felipe (Baja California). Possible relationships among circulation patterns, lunar cycle, former Colorado River runoffs and time of spawning are discussed.

  2. Unraveling hominin behavior at another anthropogenic site from Olduvai Gorge (Tanzania): new archaeological and taphonomic research at BK, Upper Bed II.

    PubMed

    Domnguez-Rodrigo, M; Mabulla, A; Bunn, H T; Barba, R; Diez-Martn, F; Egeland, C P; Esplez, E; Egeland, A; Yravedra, J; Snchez, P

    2009-09-01

    New archaeological excavations and research at BK, Upper Bed II (Olduvai Gorge, Tanzania) have yielded a rich and unbiased collection of fossil bones. These new excavations show that BK is a stratified deposit formed in a riverine setting close to an alluvial plain. The present taphonomic study reveals the second-largest collection of hominin-modified bones from Olduvai, with abundant cut marks found on most of the anatomical areas preserved. Meat and marrow exploitation is reconstructed using the taphonomic signatures left on the bones by hominins. Highly cut-marked long limb shafts, especially those of upper limb bones, suggest that hominins at BK were actively engaged in acquiring small and middle-sized animals using strategies other than passive scavenging. The exploitation of large-sized game (Pelorovis) by Lower Pleistocene hominins, as suggested by previous researchers, is supported by the present study. PMID:19632702

  3. The management of stage I-II Hodgkin's disease with irradiation alone or combined modality therapy: the Stanford experience

    SciTech Connect

    Hoppe, R.T.; Coleman, C.N.; Cox, R.S.; Rosenberg, S.A.; Kaplan, H.S.

    1982-03-01

    At Stanford University, between 1968 and 1978, 230 patients with pathologic stage I-II Hodgkin's disease were treated on prospective clinical trials with either irradiation alone or irradiation followed by 6 cycles of adjuvant combination chemotherapy. The actuarial survival at 10 yr was 84% for patients in either treatment group. Freedom from relapse at 10 yr was 77% among patients treated with irradiation alone and 84% after treatment with combined modality therapy (p(Gehan) = 0.09). Freedom from second relapse at 10 yr was 89% and 95%, respectively (p(Gehan) = 0.56). Several prognostic factors were evaluated in order to identify patients at high risk for relapse or with poor ultimate survival after initial treatment with irradiation alone. Systemic symptoms, histologic subtype, age, and limited extranodal involvement (E-lesions) did not affect the prognosis of patients and failed to identify patients whose survival could be improved by the routine use of combined modality therapy. Patients with large mediastinal masses (mediastinal mass ratio greater than or equal to 1/3) had a significantly poorer freedom from relapse when treated with irradiation alone than when treated initially with combined modality therapy (45% versus 81% at 10 yr, p(Gehan) = 0.03). The 10-yr survival of these patients, however, was not significantly different (84% versus 74%). The implications of these observations on the management of patients with early stage Hodgkin's disease are discussed.

  4. Analysis of cosmetic results and complications in patients with Stage I and II breast cancer treated by biopsy and irradiation

    SciTech Connect

    Clarke, D.; Martinez, A.; Cox, R.S.

    1983-12-01

    Between May, 1973 and December, 1980, 78 Stage I and II breast carcinomas in 76 patients were treated by biopsy and radiotherapy with curative intent. With a maximum follow-up of 10 years, a minimum of 2 1/2 years and a median follow-up of 3 1/2 years, a loco-regional control rate of 97% was obtained. Cosmetic results and treatment complications were studied. Patient characteristics, tumor size, excisional biopsy technique, axillary staging procedure and radiotherapy techniques were analyzed and all found to be important factors affecting cosmesis and complications. The most common complications included transient breast edema observed in 51% of patients, breast fibrosis (usually mild) seen in 23% of the population, axillary hematoma or seroma formation in 15%, mild arm edema in 14% and basilic vein thrombosis in 10% of patients. The causes of these and other less frequent complications are discussed. The overall cosmetic result was excellent in 78%, satisfactory in 18% and unsatisfactory in 4% of patients. Recommendations for improving cosmetic results and minimizing complications are made.

  5. Long-term oncologic outcomes of laparoscopic vs open surgery for stages II and III rectal cancer: A retrospective cohort study

    PubMed Central

    Zhou, Zhen-Xu; Zhao, Li-Ying; Lin, Tian; Liu, Hao; Deng, Hai-Jun; Zhu, Heng-Liang; Yan, Jun; Li, Guo-Xin

    2015-01-01

    AIM: To evaluate the 5-year survival after laparoscopic surgery vs open surgery for stages II and III rectal cancer. METHODS: This study enrolled 406 consecutive patients who underwent curative resection for stages II and III rectal cancer between January 2000 and December 2009 [laparoscopic rectal resection (LRR), n = 152; open rectal resection (ORR), n = 254]. Clinical characteristics, operative outcomes, pathological outcomes, postoperative recovery, and 5-year survival outcomes were compared between the two groups. RESULTS: Most of the clinical characteristics were similar except age (59 years vs 55 years, P = 0.033) between the LRR group and ORR group. The proportion of anterior resection was higher in the LRR group than that in the ORR group (81.6% vs 66.1%, P = 0.001). The LRR group had less estimated blood loss (50 mL vs 200 mL, P < 0.001) and a lower rate of blood transfusion (4.6% vs 11.8%, P = 0.019) compared to the ORR group. The pathological outcomes of the two groups were comparable. The LRR group was associated with faster recovery of bowel function (2.8 d vs 3.7 d, P < 0.001) and shorter postoperative hospital stay (11.7 d vs 13.7 d, P < 0.001). The median follow-up time was 63 mo in the LRR group and 65 mo in the ORR group. As for the survival outcomes, the 5-year local recurrence rate (16.0% vs 16.4%, P = 0.753), 5-year disease-free survival (DFS) rate (63.0% vs 63.1%, P = 0.589), and 5-year overall survival (OS) rate (68.1% vs 63.5%, P = 0.682) were comparable between the LRR group and the ORR group. Stage by stage, there were also no statistical differences between the LRR group and the ORR group in terms of the 5-year local recurrence rate (stage II: 6.3% vs 8.7%, P = 0.623; stage III: 26.4% vs 23.2%, P = 0.747), 5-year DFS rate (stage II: 77.5% vs 77.6%, P = 0.462; stage III: 46.5% vs 50.9%, P = 0.738), and 5-year OS rate (stage II: 81.4% vs 74.3%, P = 0.242; stage III: 53.9% vs 54.1%, P = 0.459). CONCLUSION: LRR for stages II and III rectal cancer can yield comparable long-term survival while achieving short-term benefits compared to open surgery. PMID:25987773

  6. High levels of microRNA-21 in the stroma of colorectal cancers predict short disease-free survival in stage II colon cancer patients

    PubMed Central

    Jrgensen, Stine; Fog, Jacob Ulrik; Skilde, Rolf; Christensen, Ib Jarle; Hansen, Ulla; Brnner, Nils; Baker, Adam; Mller, Sren; Nielsen, Hans Jrgen

    2010-01-01

    Approximately 25% of all patients with stage II colorectal cancer will experience recurrent disease and subsequently die within 5years. MicroRNA-21 (miR-21) is upregulated in several cancer types and has been associated with survival in colon cancer. In the present study we developed a robust in situ hybridization assay using high-affinity Locked Nucleic Acid (LNA) probes that specifically detect miR-21 in formalin-fixed paraffin embedded (FFPE) tissue samples. The expression of miR-21 was analyzed by in situ hybridization on 130 stage II colon and 67 stage II rectal cancer specimens. The miR-21 signal was revealed as a blue chromogenic reaction, predominantly observed in fibroblast-like cells located in the stromal compartment of the tumors. The expression levels were measured using image analysis. The miR-21 signal was determined as the total blue area (TB), or the area fraction relative to the nuclear density (TBR) obtained using a red nuclear stain. High TBR (and TB) estimates of miR-21 expression correlated significantly with shorter disease-free survival (p=0.004, HR=1.28, 95% CI: 1.061.55) in the stage II colon cancer patient group, whereas no significant correlation with disease-free survival was observed in the stage II rectal cancer group. In multivariate analysis both TB and TBR estimates were independent of other clinical parameters (age, gender, total leukocyte count, K-RAS mutational status and MSI). We conclude that miR-21 is primarily a stromal microRNA, which when measured by image analysis identifies a subgroup of stage II colon cancer patients with short disease-free survival. Electronic supplementary material The online version of this article (doi:10.1007/s10585-010-9355-7) contains supplementary material, which is available to authorized users. PMID:21069438

  7. New technique of one-stage reconstruction of a large full-thickness defect in the upper lip: bilateral reverse composite nasolabial flap.

    PubMed

    Sarifakio?lu, NedIm; Aslan, Grcan; TerzIo?lu, Ahmet; Ate?, Levent

    2002-08-01

    Lips are important features because of their location, function, and aesthetics. Reconstruction of the upper lip presents the surgeon with one of the greatest challenges. Total upper lip reconstruction is a frequent and demanding procedure, and its difficulty is related to the size and the site of the loss of the aesthetic subunits such as the Cupid's bow and the philtral columns. PMID:12187351

  8. A quasi-static model of global atmospheric electricity. II - Electrical coupling between the upper and lower atmosphere

    NASA Technical Reports Server (NTRS)

    Roble, R. G.; Hays, P. B.

    1979-01-01

    The paper presents a model of global atmospheric electricity used to examine the effect of upper atmospheric generators on the global electrical circuit. The model represents thunderstorms as dipole current generators randomly distributed in areas of known thunderstorm frequency; the electrical conductivity in the model increases with altitude, and electrical effects are coupled with a passive magnetosphere along geomagnetic field lines. The large horizontal-scale potential differences at ionospheric heights map downward into the lower atmosphere where the perturbations in the ground electric field are superimposed on the diurnal variation. Finally, changes in the upper atmospheric conductivity due to solar flares, polar cap absorptions, and Forbush decreases are shown to alter the downward mapping of the high-latitude potential pattern and the global distribution of fields and currents.

  9. CXCL10/CXCR3 overexpression as a biomarker of poor prognosis in patients with stage II colorectal cancer

    PubMed Central

    BAI, MING; CHEN, XIA; BA, YI

    2016-01-01

    The CXCL10/CXCR3 axis of inflammatory mediators is one of the most important groups of chemokine axes, which has been proven to be a lymphocyte-associated metastasis mediator in several tumors. The term inflammatory adhesions refers to tumors found to be attached to the surrouding tissues during surgery, although no cancer cell infiltration is later identified on pathological examination. The aim of the present study was to investigate the clinical characteristics of stage II colorectal cancer (CRC) and determine the correlation between the CXCL10/CXCR3 axis, inflammatory adhesions and prognosis. Clinicohistopathological data were collected from 401 CRC patients who had undergone R0 resection. Statistical analysis was performed with SPSS 17.0 software. Immunohistochemistry (IHC) was applied to measure the expression of CXCL10 and CXCR3 in 71 recurrent CRC patients, 72 non-recurrent CRC patients and 10 samples from normal peritumoral tissues, all retrieved from the Tianjin Medical University Cancer Institute and Hospital, Tianjin, China. Inflammatory adhesions, tumor location and size and the number of high-risk factors for reccurrence were more significantly associated with overall survival (OS) rather than disease-free survival in all the patients as determined by the log-rank and Cox's regression hazard analysis. Further analysis demonstrated that only the presence of inflammatory adhesions (P=0.025) was associated with the OS of recurrent patients. Patients with recurrence exhibited higher CXCR3 (P<0.001) and CXCL10 (P<0.001) expression compared with non-recurrent patients, as determined by IHC. The correlation between clinicopathological variables, CXCL10/CXCR3 expression and survival was also analyzed: Inflammatory adhesions and general tumor type (ulcerated vs. elevated) exhibited a significant correlation with CXCR3; however, the expression of CXCL10 was not significantly correlated with tumor location, histological type, size, gender, or preoperative carcinoembryonic antigen and hemoglobin levels. Furthermore, patients exhibiting a high expression of CXCR3 presented with a higher risk of relapse; among those, patients with inflammatory adhesions always exhibited worse survival. However, no such association was identified for CXCL10 expression. In conclusion, CXCR3 expression may be used as a prognostic marker and may contribute to the prediction of clinical outcome in stage II CRC patients. PMID:26870351

  10. Kinematics of stage II fatigue crack propagation: A quantification of the plastic blunting process in one-phase metallic materials

    NASA Astrophysics Data System (ADS)

    Choi, Seon-Ho

    The goal of the work is to carry out an experimental analysis to predict the kinetics of stage II fatigue crack growth based on the strain field around a fatigue crack tip in polycrystalline nickel as a model material. The strains ahead of the crack tip were measured by digital image correlation (DIC) with standard compact tension (CT) specimens. Cracks were grown under constant stress intensity factor range (SIFR), in the stage II region of fatigue crack growth, to prevent excessive stretch of the plastic zone. Two specimen sizes, one that experienced large scale yielding and another that did not, were used to assess the consistency of the model. The strain field showed a 'V' shape, corresponding to "forward" strains ahead of the crack tip and strongly depended upon the microstructure. Deformation was sometimes concentrated along a particular slip system resulting in a very strong ridge in the 'V'. In most cases the local crack tip followed this stronger ridge and did not change its direction after several in-situ loading cycles. The maximum opening strain ahead of a crack tip shows a power law relationship with applied SIFR regardless of specimen size. However, it experiences too much scatter due to the microstructure to be used as a reliable parameter. A "volumetric strain," was defined to address this issue. This volumetric strain also shows a power law relationship with applied SIFR. The combination of this result with the Paris relationship indicated that the crack growth rate had an almost linear relationship with the volumetric strains. Crack growth rates were estimated in-situ using half the measured crack tip opening displacement (CTOD). The in-situ measurements were higher than the average crack growth rate obtained by standard fatigue crack growth tests. This was due mainly to differences in constraint. To compensate, a constraint factor was introduced via 3D elastic-plastic finite element analysis (FEA). When the in-situ measurement data were multiplied by this constraint factor both data agreed well. Finally, misorientation measurements using orientation imaging microscopy (OIM) revealed that there was a substantial amount of cumulative lattice rotation after fatigue crack growth, with large strains corresponding to large lattice rotations. Lattice rotation caused by one loading cycle was measurable at high loads and was correlated with the opening strain measured by the DIC, indicating that strain localization persisted for several cycles.

  11. Does chemotherapy improve survival in high-risk stage I and II Merkel cell carcinoma of the skin?

    SciTech Connect

    Poulsen, Michael G. . E-mail: michael_poulsen@health.qld.gov.au; Rischin, Danny; Porter, Ian; Walpole, Euan; Harvey, Jennifer; Hamilton, Chris; Keller, Jacqui; Tripcony, Lee

    2006-01-01

    Purpose: The effectiveness of synchronous carboplatin, etoposide, and radiation therapy in improving survival was evaluated by comparison of a matched set of historic control subjects with patients treated in a prospective Phase II study that used synchronous chemotherapy and radiation and adjuvant chemotherapy. Patients and Methods: Patients were included in the analysis if they had disease localized to the primary site and nodes, and they were required to have at least one of the following high-risk features: recurrence after initial therapy, involved nodes, primary size greater than 1 cm, or gross residual disease after surgery. All patients who received chemotherapy were treated in a standardized fashion as part of a Phase II study (Trans-Tasman Radiation Oncology Group TROG 96:07) from 1997 to 2001. Radiation was delivered to the primary site and nodes to a dose of 50 Gy in 25 fractions over 5 weeks, and synchronous carboplatin (AUC 4.5) and etoposide, 80 mg/m{sup 2} i.v. on Days 1 to 3, were given in Weeks 1, 4, 7, and 10. The historic group represents a single institution's experience from 1988 to 1996 and was treated with surgery and radiation alone, and patients were included if they fulfilled the eligibility criteria of TROG 96:07. Patients with occult cutaneous disease were not included for the purpose of this analysis. Because of imbalances in the prognostic variables between the two treatment groups, comparisons were made by application of Cox's proportional hazard modeling. Overall survival, disease-specific survival, locoregional control, and distant control were used as endpoints for the study. Results: Of the 102 patients who had high-risk Stage I and II disease, 40 were treated with chemotherapy (TROG 96:07) and 62 were treated without chemotherapy (historic control subjects). When Cox's proportional hazards modeling was applied, the only significant factors for overall survival were recurrent disease, age, and the presence of residual disease. For disease-specific survival, recurrent disease was the only significant factor. Primary site on the lower limb had an adverse effect on locoregional control. For distant control, the only significant factor was residual disease. Conclusions: The multivariate analysis suggests chemotherapy has no effect on survival, but because of the wide confidence limits, a chemotherapy effect cannot be excluded. A study of this size is inadequately powered to detect small improvements in survival, and a larger randomized study remains the only way to truly confirm whether chemotherapy improves the results in high-risk MCC.

  12. Phase II study of celecoxib with cisplatin plus etoposide in extensive-stage small cell lung cancer.

    PubMed

    Arajo, Antnio M F; Mendez, Jose C; Coelho, Ana L; Sousa, Berta; Barata, Fernando; Figueiredo, Ana; Amaro, Teresina; Azevedo, Isabel; Soares, Marta

    2009-05-01

    We performed a phase II trial to test whether a cyclooxygenase (COX-2) inhibitor, celecoxib, added to standard first-line combination chemotherapy (CT) and as maintenance therapy would improve outcomes in extensive-stage (ES) small-cell lung cancer (SCLC). This was a multicenter trial in CT-naive patients with ES-SCLC. They received standard cisplatin and etoposide (EP) up to 6 cycles and celecoxib 400 mg PO bid continuously until disease progression. Primary end points were response rate (RR), time to progression (TTP), and toxicity. Secondary were overall survival (OS) and quality of life. Of 74 expected patients, only 24 were enrolled and the study stopped earlier because of the published safety concerns about celecoxib. The patients, all male, were between 38 and 74 years. A total of 130 cycles of CT were administered. Toxicity associated with celecoxib was minimal. The RR was 56.5%. Median TTP and OS were 8.6 and 11.3 months, respectively. These data suggest that celecoxib may safely be combined with EP for treatment of ES-SCLC. This combination showed a promising activity and, despite the safety concerns regarding celecoxib, it would be interesting to further evaluate this regimen. PMID:19266367

  13. Activation of the PI3K/AKT pathway correlates with prognosis in stage II colon cancer

    PubMed Central

    Malinowsky, K; Nitsche, U; Janssen, K-P; Bader, F G; Spth, C; Drecoll, E; Keller, G; Hfler, H; Slotta-Huspenina, J; Becker, K-F

    2014-01-01

    Background: Patients with UICC/AJCC stage II colon cancer have a high 5-year overall survival rate after surgery. Nevertheless, a significant subgroup of patients develops tumour recurrence. Currently, there are no clinically established biomarkers available to identify this patient group. We applied reverse-phase protein arrays (RPPA) for phosphatidylinositide-3-kinase pathway activation mapping to stratify patients according to their risk of tumour recurrence after surgery. Methods: Full-length proteins were extracted from formalin-fixed, paraffin-embedded tissue samples of 118 patients who underwent curative resection. RPPA technology was used to analyse expression and/or phosphorylation levels of six major factors of the phosphatidylinositide-3-kinase pathway. Oncogenic mutations of KRAS and BRAF, and DNA microsatellite status, currently discussed as prognostic markers, were analysed in parallel. Results: Expression of phospho-AKT (HR=3.52; P=0.032), S6RP (HR=6.3; P=0.044), and phospho-4E-BP1 (HR=4.12; P=0.011) were prognostic factors for disease-free survival. None of the molecular genetic alterations were significantly associated with prognosis. Conclusions: Our data indicate that activation of the PI3K/AKT pathway evidenced on the protein level might be a valuable prognostic marker to stratify patients for their risk of tumour recurrence. Beside adjuvant chemotherapy targeting of upregulated PI3K/AKT signalling may be an attractive strategy for treatment of high-risk patients. PMID:24619078

  14. HER2 gene amplification and EGFR expression in a large cohort of surgically staged patients with nonendometrioid (type II) endometrial cancer

    PubMed Central

    Konecny, G E; Santos, L; Winterhoff, B; Hatmal, M; Keeney, G L; Mariani, A; Jones, M; Neuper, C; Thomas, B; Muderspach, L; Riehle, D; Wang, H-J; Dowdy, S; Podratz, K C; Press, M F

    2008-01-01

    Type II endometrial cancers (uterine serous papillary and clear cell histologies) represent rare but highly aggressive variants of endometrial cancer (EC). HER2 and EGFR may be differentially expressed in type II EC. Here, we evaluate the clinical role of HER2 and EGFR in a large cohort of surgically staged patients with type II (nonendometrioid) EC and compare the findings with those seen in a representative cohort of type I (endometrioid) EC. In this study HER2 gene amplification was studied by fluorescence in situ hybridisation (FISH) and EGFR expression by immunohistochemistry. Tissue microarrays were constructed from 279 patients with EC (145 patients with type I and 134 patients with type II EC). All patients were completely surgically staged and long-term clinical follow up was available for 258 patients. The rate of HER2 gene amplification was significantly higher in type II EC compared with type I EC (17 vs 1%, P<0.001). HER2 gene amplification was detected in 17 and 16% of the cases with uterine serous papillary and clear cell type histology, respectively. In contrast, EGFR expression was significantly lower in type II compared with type I EC (34 vs 46%, P=0.041). EGFR expression but not HER2 gene amplification was significantly associated with poor overall survival in patients with type II EC, (EGFR, median survival 20 vs 33 months, P=0.028; HER2, median survival 18 vs 29 months, P=0.113) and EGFR expression retained prognostic independence when adjusting for histology, stage, grade, and age (EGFR, P=0.0197; HER2, P=0.7855). We conclude that assessment of HER2 gene amplification and/or EGFR expression may help to select type II EC patients who could benefit from therapeutic strategies targeting both HER2 and EGFR. PMID:19088718

  15. The Importance of California Public Libraries in Increasing Public Access to the Internet: Findings from the InFoPeople Site Visits. Stage II Final Report.

    ERIC Educational Resources Information Center

    Bertot, John Carlo; McClure, Charles R.; Ryan, Joe

    In less than five years, the California State Library-sponsored InFoPeople project connected 46% of California's public libraries to the Internet and established a highly regarded, sustained training program to assist librarians in taking advantage of the new networked resources and services. The primary objective of this Stage II report was to…

  16. Effect of {sup 18}F-FDG PET/CT Imaging in Patients With Clinical Stage II and III Breast Cancer

    SciTech Connect

    Groheux, David Moretti, Jean-Luc; Baillet, Georges; Espie, Marc; Giacchetti, Sylvie; Hindie, Elif; Hennequin, Christophe; Vilcoq, Jacques-Robert; Cuvier, Caroline; Toubert, Marie-Elisabeth; Filmont, Jean-Emmanuel; Sarandi, Farid; Misset, Jean-Louis

    2008-07-01

    Purpose: To investigate the potential effect of using {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) in the initial assessment of patients with clinical Stage II or III breast cancer. Methods and Materials: During 14 consecutive months, 39 patients (40 tumors) who presented with Stage II or III breast cancer on the basis of a routine extension assessment were prospectively included in this study. PET/CT was performed in addition to the initial assessment. Results: In 3 cases, PET/CT showed extra-axillary lymph node involvement that had not been demonstrated with conventional techniques. Two of these patients had hypermetabolic lymph nodes in the subpectoral and infraclavicular regions, and the third had a hypermetabolic internal mammary node. PET/CT showed distant uptake in 4 women. Of these 4 women, 1 had pleural involvement and 3 had bone metastasis. Overall, of the 39 women, the PET/CT results modified the initial stage in 7 (18%). The modified staging altered the treatment plan for 5 patients (13%). It led to radiotherapy in 4 patients (bone metastasis, pleural lesion, subpectoral lymph nodes, and internal mammary nodes) and excision of, and radiotherapy to, the infraclavicular lymph nodes in 1 patient. Conclusions: PET/CT can provide information on extra-axillary lymph node involvement and can uncover occult distant metastases in a significant percentage of patients. Therefore, initial PET/CT could enable better treatment planning for patients with Stage II and III breast cancer.

  17. Acceleration of type 2 spicules in the solar chromosphere. II. Viscous braking and upper bounds on coronal energy input

    SciTech Connect

    Goodman, Michael L.

    2014-04-20

    A magnetohydrodynamic model is used to determine conditions under which the Lorentz force accelerates plasma to type 2 spicule speeds in the chromosphere. The model generalizes a previous model to include a more realistic pre-spicule state, and the vertical viscous force. Two cases of acceleration under upper chromospheric conditions are considered. The magnetic field strength for these cases is ≤12.5 and 25 G. Plasma is accelerated to terminal vertical speeds of 66 and 78 km s{sup –1} in 100 s, compared with 124 and 397 km s{sup –1} for the case of zero viscosity. The flows are localized within horizontal diameters ∼80 and 50 km. The total thermal energy generated by viscous dissipation is ∼10 times larger than that due to Joule dissipation, but the magnitude of the total cooling due to rarefaction is ≳ this energy. Compressive heating dominates during the early phase of acceleration. The maximum energy injected into the corona by type 2 spicules, defined as the energy flux in the upper chromosphere, may largely balance total coronal energy losses in quiet regions, possibly also in coronal holes, but not in active regions. It is proposed that magnetic flux emergence in intergranular regions drives type 2 spicules.

  18. Long-term results of high-dose-rate brachytherapy in the primary treatment of medically inoperable stage I-II endometrial carcinoma

    SciTech Connect

    Niazi, Tamim M.; Souhami, Luis . E-mail: luis.souhami@muhc.mcgill.ca; Portelance, Lorraine; Bahoric, Boris; Gilbert, Lucy; Stanimir, Gerald

    2005-11-15

    Purpose: Total-abdominal hysterectomy and bilateral salpingo-oophorectomy (TAHBSO) is the gold-standard therapy for patients with endometrial carcinoma. However, patients with high operative risks are usually treated with radiation therapy (RT) alone. The goal of this study was to update our experience of high-dose-rate brachytherapy (HDRB), with or without external-beam irradiation (EBRT), for such patients. Methods and Materials: Between 1984 and 2003, 38 patients with Stage I and Stage II adenocarcinoma of the endometrium considered high operative risk received RT as the primary treatment. The median age was 74.1 years. Before 1996, the local extent of the disease was assessed by an examination under anesthesia (EUA) and by EUA and magnetic resonance imaging (MRI) thereafter. Eight patients (21%) were treated with combined HDRB and EBRT, and 30 patients (79%) were treated with with HDRB alone. The median HDRB dose was 23.9 Gy, typically delivered in 3 fractions in a weekly schedule. The median EBRT dose was 42 Gy. Results: At a median follow-up of 57.5 months for patients at risk, 11 patients (29%) have failed: 6 patients (16%) locally, 4 patients (10.5%) distantly, and 1 patient (3%) locally and distantly. Local failure was established by biopsy, and 4 patients were salvaged by TAHBSO. Higher stage and higher grade were both associated with increased failure rate. The 15-year disease-specific survival (DSS) was 78% for all stages, 90% for Stage I, and 42% for Stage II (p < 0.0001). The 15-year DSS was 91% for Grade I and 67% for Grade II and III combined (p = 0.0254). Patients with Stage I disease established by MRI (11 patients) and who received a total HDRB dose of 30 Gy had a DSS rate of 100% at 10 years. Four patients experienced late toxicities: 1 Grade II and 3 Grade III or IV. Conclusion: Medically inoperable Stage I endometrial carcinoma may be safely and effectively treated with HDRB as the primary therapy. In selected Stage I patients, our results are equivalent to that of surgery. We believe that the alternative option of HDRB as the primary therapy for selected Stage I endometrial carcinoma, even in patients with low operative risks, needs further evaluation.

  19. Exploring the bases for a mixed reality stroke rehabilitation system, Part II: Design of Interactive Feedback for upper limb rehabilitation

    PubMed Central

    2011-01-01

    Background Few existing interactive rehabilitation systems can effectively communicate multiple aspects of movement performance simultaneously, in a manner that appropriately adapts across various training scenarios. In order to address the need for such systems within stroke rehabilitation training, a unified approach for designing interactive systems for upper limb rehabilitation of stroke survivors has been developed and applied for the implementation of an Adaptive Mixed Reality Rehabilitation (AMRR) System. Results The AMRR system provides computational evaluation and multimedia feedback for the upper limb rehabilitation of stroke survivors. A participant's movements are tracked by motion capture technology and evaluated by computational means. The resulting data are used to generate interactive media-based feedback that communicates to the participant detailed, intuitive evaluations of his performance. This article describes how the AMRR system's interactive feedback is designed to address specific movement challenges faced by stroke survivors. Multimedia examples are provided to illustrate each feedback component. Supportive data are provided for three participants of varying impairment levels to demonstrate the system's ability to train both targeted and integrated aspects of movement. Conclusions The AMRR system supports training of multiple movement aspects together or in isolation, within adaptable sequences, through cohesive feedback that is based on formalized compositional design principles. From preliminary analysis of the data, we infer that the system's ability to train multiple foci together or in isolation in adaptable sequences, utilizing appropriately designed feedback, can lead to functional improvement. The evaluation and feedback frameworks established within the AMRR system will be applied to the development of a novel home-based system to provide an engaging yet low-cost extension of training for longer periods of time. PMID:21899779

  20. Motor impairments related to brain injury timing in early hemiparesis Part II: abnormal upper extremity joint torque synergies

    PubMed Central

    Sukal-Moulton, Theresa; Krosschell, Kristin J.; Gaebler-Spira, Deborah J.; Dewald, Julius P.A.

    2014-01-01

    Background Extensive neuromotor development occurs early in human life, and the timing of brain injury may affect the resulting motor impairment. In part I of this paper series it was demonstrated that the distribution of weakness in the upper extremity depended on the timing of brain injury in individuals with childhood-onset hemiparesis. Objective The goal of this study was to characterize how timing of brain injury impacts joint torque synergies, or losses of independent joint control. Method Twenty-four individuals with hemiparesis were divided into three groups based on the timing of their injury: before birth (PRE-natal, n=8), around the time of birth (PERI-natal, n=8) and after 6 months of age (POST-natal, n=8). Individuals with hemiparesis, as well as 8 typically developing peers participated in maximal isometric shoulder, elbow, wrist, and finger torque generation tasks while their efforts were recorded by a multiple degree-of-freedom load cell. Motor output in 4 joints of the upper extremity were concurrently measured during 8 primary torque generation tasks to quantify joint torque synergies. Results There were a number of significant coupling patterns identified in individuals with hemiparesis that differed from the typically developing group. POST-natal differences were most noted in the coupling of shoulder abductors with elbow, wrist, and finger flexors, while the PRE-natal group demonstrated significant distal joint coupling with elbow flexion. Conclusion The torque synergies measured provide indirect evidence for the use of bulbospinal pathways in the POST-natal group, while those with earlier injury may utilize relatively preserved ipsilateral corticospinal motor pathways. PMID:23911972

  1. Outcomes and Effect of Radiotherapy in Patients With Stage I or II Diffuse Large B-Cell Lymphoma: A Surveillance, Epidemiology, and End Results Analysis

    SciTech Connect

    Ballonoff, Ari Rusthoven, Kyle E.; Schwer, Amanda; McCammon, Robert; Kavanagh, Brian; Bassetti, Michael; Newman, Francis; Rabinovitch, Rachel

    2008-12-01

    Purpose: To assess disease-specific survival (DSS), overall survival (OS), and the effect of radiotherapy (RT) in patients with localized diffuse large B-cell lymphoma (DLBCL). Patients and Methods: The Surveillance, Epidemiology, and End Results database was queried for all patients diagnosed with Stage I, IE, II, or IIE DLBCL between 1988 and 2004. The analyzable data included gender, age, race, stage, presence of extranodal disease, and RT administration. Patients who had died or were lost to follow-up within 6 months of diagnosis were excluded. Results: A total of 13,420 patients met the search criteria. Of these, 5,547 (41%) had received RT and 7,873 (59%) had not. RT was associated with a significant DSS (hazard ratio, 0.82, p <0.0001) and OS benefit that persisted during the 15 years of follow-up. Elderly patients, defined either as those >60 or >70 years old, had significantly improved DSS and OS associated with RT. On multivariate analysis, RT was significantly associated with increased DSS and OS. The 5-year DSS outcomes were highly variable among patient subsets, defined by age, stage, and extranodal disease (range for RT-treated patients, 70% for Stage II, age >60 years to 87% for Stage I, age {<=}60 years). Conclusion: This analysis presents the largest detailed data set of Stage I-II DLBCL patients. The results of our study have demonstrated that RT is associated with a survival advantage in patients with localized DLBCL, a benefit that extends to elderly patients. Outcomes for discrete patient subsets varied greatly. The development of tailored therapy according to the relapse risk is warranted, rather than uniform treatment of all early-stage DLBCL.

  2. Study protocol of the SACURA trial: a randomized phase III trial of efficacy and safety of UFT as adjuvant chemotherapy for stage II colon cancer

    PubMed Central

    2012-01-01

    Background Adjuvant chemotherapy for stage III colon cancer is internationally accepted as standard treatment with established efficacy, but the usefulness of adjuvant chemotherapy for stage II colon cancer remains controversial. The major Western guidelines recommend adjuvant chemotherapy for high-risk stage II cancer, but this is not clearly defined and the efficacy has not been confirmed. Methods/design SACURA trial is a multicenter randomized phase III study which aims to evaluate the superiority of 1-year adjuvant treatment with UFT to observation without any adjuvant treatment after surgery for stage II colon cancer in a large population, and to identify high-risk factors of recurrence/death in stage II colon cancer and predictors of efficacy and adverse events of the chemotherapy. Patients aged between 20 and 80?years with curatively resected stage II colon cancer are randomly assigned to a observation group or UFT adjuvant therapy group (UFT at 500600?mg/day as tegafur in 2 divided doses after meals for 5?days, followed by 2-day rest. This 1-week treatment cycle is repeated for 1?year). The patients are followed up for 5?years until recurrence or death. Treatment delivery and adverse events are entered into a web-based case report form system every 3?months. The target sample size is 2,000 patients. The primary endpoint is disease-free survival, and the secondary endpoints are overall survival, recurrence-free survival, and incidence and severity of adverse events. In an additional translational study, the mRNA expression of 5-FU-related enzymes, microsatellite instability and chromosomal instability, and histopathological factors including tumor budding are assessed to evaluate correlation with recurrences, survivals and adverse events. Discussion A total of 2,024 patients were enrolled from October 2006 to July 2010. The results of this study will provide important information that help to improve the therapeutic strategy for stage II colon cancer. Trial registration ClinicalTrials.gov NCT00392899. PMID:22769569

  3. Biologic subtype is a more important prognostic factor than nodal involvement in patients with stages I and II breast carcinoma

    PubMed Central

    Kim, Hyosun; Cho, Jihyoung; Kwon, Sun Young

    2016-01-01

    Purpose Nodal infiltration has been one of the most important prognostic factors in breast cancer. In recent decades, risk stratification has greatly changed, and is applied in accordance with hormone receptor and human epidermal growth factor receptor 2 (HER2) status. We compared the prognostic power of tumor subtype to nodal involvement in early breast cancer. Methods We reviewed the medical records of 505 patients who had curative surgery for stage I or II breast cancer. We analyzed clinicopathologic factors according to tumor subtype and nodal involvement. Tumors were classified into 4 subtypes according to immunohistochemical status of estrogen receptor, progesterone receptor, HER2, and Ki67 labeling index. Disease-free survival (DFS) and overall survival were analyzed. Results There were 363 node-negative patients (71.9%) and 142 node-positive patients (28.1%). Luminal A, Luminal B, HER2, and triple-negative breast cancer subtypes were composed of 207 (41.0%), 147 (29.1%), 42 (8.3%), and 109 patients (21.6%), respectively. The median follow-up period was 89.5 months. Node negative-luminal A subtype showed the best prognosis with regard to 5-year DFS, and the pN1-triple negative subtype was associated with the shortest DFS (95.1% vs. 67.8%; hazard ratio, 9.554; P < 0.001). However, the node negative-triple negative subtype was associated with a worse 5-year DFS than the pN1-luminal A subtype ([86.4%; hazard ratio, 2.647; P = 0.048] vs. [93.2%; hazard ratio, 2.061; P = 0.194]). Conclusion Node negative-triple negative breast cancer was associated with a poorer prognosis than pN1-luminal A subtype. Tumor subtype has greater prognostic power compared to nodal status in early breast cancer. PMID:26793686

  4. The effect of postoperative radiotherapy on the feasibility of optimal dose adjuvant CMF chemotheraphy in stage II breast carcinoma

    SciTech Connect

    Sulkes, A.; Brufman, G.; Rizel, S.; Weshler, Z.; Biran, S.; Fuks, Z.

    1983-01-01

    The impact of a number of variables upon the effectiveness of adjuvant chemotherapy given to 87 patients with Stage II breast carcinoma was retrospectively analyzed. Adjuvant chemotherapy consisted of cyclophosphamide, methotrexate and 5-fluorouracil (CMF). Drugs were given in optimal doses (85% or more of the planned dose) to 17% of the patients; in intermediate doses (66 to 84% of the planned dose) to 50% of the patients; and in low doses (65% or less of the planned dose) to 33% of the patients. Myelosuppression was the main reason for giving intermediate or low doses. At a median follow-up of three years, 84% of all patients remain alive. Radiation therapy preceding chemotherapy was given to 70% of the patients, concomitant irradation and chemotherapy to 15%, and 13 patients (15%) received chemotheapy only. Of the 14 patients who received optimal doses of CMF, 12 (86%) also received radiation therapy. Disease-free survival at three years is similar for irradiated and nonirradiated patients, but the latter have a higher incidence of local recurrence (5% vs. 15%), although the difference is not statistically significant. Delay in the intiation of chemotherapy, mostly because of the administration of postoperative irradiation, adversely affected the probability and duration of disease-free survival, particulararly in premenopausal women in whom chemotherapy was started within more than 90 days of mastectomy. The administration of optimal doses of adjuvant chemotherapy should follow the primary treatment to the breast tumor as closely as possible. If radiation therapy is indicated as well, it should be delivered concomitantly with chemotherapy, given the feasibility of administering both modalities simultaneously, as demonstrated in this study.

  5. Long-term evaluation of intrapleural bacillus Calmette-Guerin with or without adjuvant chemotherapy in completely resected stages II and III non-small-cell lung cancer.

    PubMed

    Macchiarini, P; Hardin, M; Angeletti, C A

    1991-08-01

    Between January 1979 and December 1980, 52 patients with completely resected stages II and III non-small-cell lung cancer (NSCLC) were randomly assigned to receive either adjuvant chemotherapy (cyclophosphamide, doxorubicin, and vincristine--CAV) plus intrapleural bacillus Calmette-Guerin (BCG) (n = 26) or adjuvant CAV alone (n = 26). Careful intraoperative staging was performed in all patients, and stratification for histology (squamous versus nonsquamous) and stage (II or III) ensured a balanced randomization for these factors. With a median follow-up time of 111 months, overall 10-year and median survival were 21% and 20 months (range 2-127 + months), respectively. Thirty-four (95%) patients relapsed in extrathoracic sites, and five (5%) developed loco-regional recurrence; their overall median disease-free interval (DFI) was 10 months (range 1-73 months). There was a 9% and 2.5 month difference in survival (p = .76) and disease-free interval (p = .67), respectively, favoring the BCG arm. There were no significant differences in the sites and patterns of first recurrence comparing the two treatment arms. In conclusion, there is no suggestion of a significant therapeutic advantage from intrapleural BCG in conjunction with adjuvant chemotherapy for completely resected stages II and III NSCLC. PMID:1650528

  6. Feasibility of endoscopic mucosal resection as salvage treatment for patients with local failure after definitive chemoradiotherapy for stage IB, II, and III esophageal squamous cell cancer.

    PubMed

    Makazu, M; Kato, K; Takisawa, H; Yoshinaga, S; Oda, I; Saito, Y; Mayahara, H; Ito, Y; Itami, J; Hamaguchi, T; Yamada, Y; Shimada, Y

    2014-01-01

    Local failure after definitive chemoradiotherapy (CRT) for stage IB, II, and III esophageal cancer is one of the causes of poor outcome. Endoscopic mucosal resection (EMR) is an effective treatment for superficial esophageal cancer. However, its feasibility as a salvage treatment for local recurrent or residual tumors after definitive CRT for stage IB, II, and III esophageal cancer remains unclear. Between January 2000 and February 2008, 274 patients with stage IB, II, and III esophageal squamous cell cancer excluding T4 received definitive CRT at the National Cancer Center Hospital, Japan. Of these patients, nine patients with local recurrence after achieving complete response and two patients with residual tumor underwent salvage EMR. The technique of salvage EMR involved a strip biopsy method. We retrospectively reviewed the 11 patients (13 lesions). Characteristics of all 11 patients were as follows: median age of 69 (range: 45-78); male/female: 10/1; baseline clinical stage (Union for International Cancer Control 7th) IB/IIA/IIB/III: 1/3/7/0. The depth of resected tumor was limited to the mucosal layer in seven lesions and submucosal in six lesions. En bloc resection was performed on six lesions (46%). The vertical margin was free of cancer cells in 11 lesions (84.6%). No major complications, such as hemorrhage requiring blood transfusion and perforation, were experienced. At a median follow-up period of 38.9 months (range: 5.3-94 months) after salvage EMR, no recurrence was detected in six patients (54%). Local recurrence was detected in five patients (27%). Of these patients, two had lung metastasis simultaneously, and one was also detected lung metastasis 2 months after the detection of local recurrence. The 5-year survival rate after salvage EMR was 41.6%. Salvage EMR is a feasible treatment option for local recurrent or residual lesions after definitive chemotherapy and/or radiotherapy for stage IB, II, and III esophageal squamous cell cancer. PMID:23442160

  7. Upper crustal structure from the Santa Monica Mountains to the Sierra Nevada, Southern California: Tomographic results from the Los Angeles Regional Seismic Experiment, Phase II (LARSE II)

    USGS Publications Warehouse

    Lutter, W.J.; Fuis, G.S.; Ryberg, T.; Okaya, D.A.; Clayton, R.W.; Davis, P.M.; Prodehl, C.; Murphy, J.M.; Langenheim, V.E.; Benthien, M.L.; Godfrey, N.J.; Christensen, N.I.; Thygesen, K.; Thurber, C.H.; Simila, G.; Keller, Gordon R.

    2004-01-01

    In 1999, the U.S. Geological Survey and the Southern California Earthquake Center (SCEC) collected refraction and low-fold reflection data along a 150-km-long corridor extending from the Santa Monica Mountains northward to the Sierra Nevada. This profile was part of the second phase of the Los Angeles Region Seismic Experiment (LARSE II). Chief imaging targets included sedimentary basins beneath the San Fernando and Santa Clarita Valleys and the deep structure of major faults along the transect, including causative faults for the 1971 M 6.7 San Fernando and 1994 M 6.7 Northridge earthquakes, the San Gabriel Fault, and the San Andreas Fault. Tomographic modeling of first arrivals using the methods of Hole (1992) and Lutter et al. (1999) produces velocity models that are similar to each other and are well resolved to depths of 5-7.5 km. These models, together with oil-test well data and independent forward modeling of LARSE II refraction data, suggest that regions of relatively low velocity and high velocity gradient in the San Fernando Valley and the northern Santa Clarita Valley (north of the San Gabriel Fault) correspond to Cenozoic sedimentary basin fill and reach maximum depths along the profile of ???4.3 km and >3 km , respectively. The Antelope Valley, within the western Mojave Desert, is also underlain by low-velocity, high-gradient sedimentary fill to an interpreted maximum depth of ???2.4 km. Below depths of ???2 km, velocities of basement rocks in the Santa Monica Mountains and the central Transverse Ranges vary between 5.5 and 6.0 km/sec, but in the Mojave Desert, basement rocks vary in velocity between 5.25 and 6.25 km/sec. The San Andreas Fault separates differing velocity structures of the central Transverse Ranges and Mojave Desert. A weak low-velocity zone is centered approximately on the north-dipping aftershock zone of the 1971 San Fernando earthquake and possibly along the deep projection of the San Gabriel Fault. Modeling of gravity data, using densities inferred from the velocity model, indicates that different velocity-density relationships hold for both sedimentary and basement rocks as one crosses the San Andreas Fault. The LARSE II velocity model can now be used to improve the SCEC Community Velocity Model, which is used to calculate seismic amplitudes for large scenario earthquakes.

  8. Carboplatin and Paclitaxel or Oxaliplatin and Capecitabine With or Without Bevacizumab as First-Line Therapy in Treating Patients With Newly Diagnosed Stage II-IV or Recurrent Stage I Epithelial Ovarian or Fallopian Tube Cancer

    ClinicalTrials.gov

    2016-03-04

    Borderline Ovarian Mucinous Tumor; Ovarian Mucinous Cystadenocarcinoma; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Stage IA Fallopian Tube Cancer; Stage IA Ovarian Cancer; Stage IB Fallopian Tube Cancer; Stage IB Ovarian Cancer; Stage IC Fallopian Tube Cancer; Stage IC Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer

  9. A Phase II Study of Ifosfamide, Methotrexate, Etoposide, and Prednisolone for Previously Untreated Stage I/II Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type: A Multicenter Trial of the Korean Cancer Study Group

    PubMed Central

    Kim, Tae Min; Kim, Dong-Wan; Kang, Yoon-Koo; Chung, Jooseop; Song, Hong-Suk; Kim, Hyo Jung; Kim, Byung Soo; Lee, Jong-Seok; Kim, Hawk; Yang, Sung Hyun; Yuh, Young Jin; Bae, Sung Hwa; Hyun, Myung Soo; Jeon, Yoon Kyung; Kim, Chul Woo

    2014-01-01

    Background. Combination chemotherapy consisting of ifosfamide, methotrexate, etoposide, and prednisolone (IMEP) was active as first-line and second-line treatment for extranodal natural killer/T-cell lymphoma (NTCL). Methods. Forty-four patients with chemo-nave stage I/II NTCL were enrolled in a prospective, multicenter, phase II study and received six cycles of IMEP (ifosfamide 1.5 g/m2 on days 13; methotrextate 30 mg/m2 on days 3 and 10; etoposide 100 mg/m2 on days 13; and prednisolone 60 mg/m2 per day on days 15) followed by involved field radiotherapy (IFRT). Results. Overall response rates were 73% (complete remission [CR] in 11 of 41 evaluable patients [27%]) after IMEP chemotherapy and 78% (CR 18 of 27 evaluable patients [67%]) after IMEP followed by IFRT. Neutropenia and thrombocytopenia were documented in 33 patients (75%) and 7 patients (16%), respectively. Only 8 patients (18%) experienced febrile neutropenia. Three-year progression-free survival (PFS) and overall survival (OS) were 66% and 56%, respectively. High Ki-67 (?70%) and Ann Arbor stage II independently reduced PFS (p = .004) and OS (p = .001), respectively. Conclusion. Due to the high rate of progression during IMEP chemotherapy, IFRT needs to be introduced earlier. Moreover, active chemotherapy including an l-asparaginase-based regimen should be use to reduce systemic treatment failure in stage I/II NTCL. PMID:25280488

  10. Horizontal flow fields observed in Hinode G-band images. II. Flow fields in the final stages of sunspot decay

    NASA Astrophysics Data System (ADS)

    Verma, M.; Balthasar, H.; Deng, N.; Liu, C.; Shimizu, T.; Wang, H.; Denker, C.

    2012-02-01

    Context. Generation and dissipation of magnetic fields is a fundamental physical process on the Sun. In comparison to flux emergence and the initial stages of sunspot formation, the demise of sunspots still lacks a comprehensive description. Aims: The evolution of sunspots is most commonly discussed in terms of their intensity and magnetic field. Here, we present additional information about the three-dimensional flow field in the vicinity of sunspots towards the end of their existence. Methods: We present a subset of multi-wavelengths observations obtained with the Japanese Hinode mission, the Solar Dynamics Observatory (SDO), and the Vacuum Tower Telescope (VTT) at Observatorio del Teide, Tenerife, Spain during the time period 2010 November 18-23. Horizontal proper motions were derived from G-band and Ca ii H images, whereas line-of-sight velocities were extracted from VTT echelle Hα λ656.28 nm spectra and Fe i λ630.25 nm spectral data of the Hinode/Spectro-Polarimeter, which also provided three-dimensional magnetic field information. The Helioseismic and Magnetic Imager on board SDO provided continuum images and line-of-sight magnetograms, in addition to the high-resolution observations for the entire disk passage of the active region. Results: We perform a quantitative study of photospheric and chromospheric flow fields in and around decaying sunspots. In one of the trailing sunspots of active region NOAA 11126, we observe moat flow and moving magnetic features (MMFs), even after its penumbra had decayed. We also detect a superpenumbral structure around this pore. We find that MMFs follow well-defined, radial paths from the spot all the way to the border of a supergranular cell surrounding the spot. In contrast, flux emergence near the other sunspot prevents the establishment of similar well ordered flow patterns, which could be discerned around a tiny pore of merely 2 Mm diameter. After the disappearance of the sunspots/pores, a coherent patch of abnormal granulation remained at their location, which was characterized by more uniform horizontal proper motions, low divergence values, and smaller photospheric Doppler velocities. This region, thus, differs significantly from granulation and other areas covered by G-band bright points. We conclude that this peculiar flow pattern is a signature of sunspot decay and the dispersal of magnetic flux.

  11. Differences in plasma TIMP-1 levels between healthy people and patients with rectal cancer stage II or III

    PubMed Central

    Oblak, Irena; Anderluh, Franc; Velenik, Vaneja; Mozina, Barbara; Ocvirk, Janja; Ciric, Eva; Podvrsnik, Natasa Hrovatic

    2011-01-01

    Background The purpose of the study was to analyse whether the levels of the tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) are higher in patients with rectal cancer as compared with healthy blood donors. Patients and methods. Two hundred and seventeen patients (147 male, 70 female) with histologically confirmed non-metastatic rectal cancer (clinical stage IIIII) and 45 healthy blood donors (15 male, 30 female) were included in analysis. Patients mean age was 66 years (range: 3487 years) and healthy blood donors mean age was 35 years (range: 1864 years). Plasma TIMP-1 concentrations were measured with an enzyme-linked immunosorbent assay (ELISA) using commercially available TIMP-1 ELISA kit. Mann-Whitney-test for independent groups was used to assess the differences of plasma TIMP-1 levels and clinicopathological parameters. Two-sided tests were used and the differences at P<0.05 were considered as statistically significant. Results Median patients TIMP-1 level was 180 ng/mL (range: 22-538 ng/mL); the mean (SD) level was 193.7 (79.5) ng/mL. The median healthy blood donors TIMP-1 level was 112 ng/mL (range: 48-211 ng/mL); the mean (SD) level was 115 (35.7) ng/mL. TIMP-1 levels in patients with rectal cancer were statistically significantly higher than TIMP-1 levels in healthy blood donors (P<0.0001). Significant differences in TIMP-1 levels were not found comparing gender (P=0.43), but in both groups TIMP-1 levels were increased with higher age (P=0.007). Conclusions Patients with rectal cancer had statistically significantly higher mean and median TIMP-1 level than healthy blood donors which is in accordance with the results published in other publications. These findings suggest possibility that plasma TIMP-1 levels could be used as new biological markers for early cancer detection. PMID:22933958

  12. A retrospective study using the pressure ulcer scale for healing (PUSH) tool to examine factors affecting stage II pressure ulcer healing in a Korean acute care hospital.

    PubMed

    Park, Kyung Hee

    2014-09-01

    Stage II pressure ulcers (PUs) should be managed promptly and appropriately in order to prevent complications. To identify the factors affecting Stage II PU healing and optimize care, the electronic medical records of patients with a Stage II PU in an acute care hospital were examined. Patient and ulcer characteristics as well as nutritional assessment variables were retrieved, and ulcer variables were used to calculate Pressure Ulcer Scale for Healing (PUSH) scores. The effect of all variables on healing status (healed versus nonhealed) and change in PUSH score for healing rate were compared. Records of 309 Stage II PUs from 155 patients (mean age 61.2 15.2 [range 5-89] years, 182 [58.9%] male) were retrieved and analyzed. Of those, 221 healed and 88 were documented as not healed at the end of the study. The variables that were significantly different between patients with PUs that did and did not heal were: major diagnosis (P = 0.001), peripheral arterial disease (P = 0.007), smoking (P = 0.048), serum albumin ( <2.5 g/dL) (P = 0.002), antidepressant use (P = 0.035), vitamin use (P = 0.006), history of surgery (P <0.001), PU size (P = 0.003), Malnutrition Universal Screening Tool (MUST) score (P = 0.020), Braden scale score (P = 0.003), and mean arterial pressure (MAP, mm Hg) (P = 0.026). The Cox proportional hazard model showed a significant positive difference in PUSH score change -indicative of healing - when pressure-redistribution surfaces were used (P <0.001, HR = 2.317), PU size was small (?3.0 cm2, P = 0.006, HR = 1.670), MAP (within a range of 52-112 mm Hg) was higher P = 0.010, HR = 1.016), and patients were provided multivitamins (P = 0.037, HR=1.431). The results of this study suggest strategies for healing Stage II PUs in the acute care setting should include early recognition of lower-stage PUs, the provision of static pressure-redistribution surfaces and multivitamins, and maintaining higher MAP may facilitate healing and prevent deterioration. Further prospective research is warranted to verify the effect of these interventions. PMID:25211606

  13. High body mass index reduces glomerular filtration rate decline in type II diabetes mellitus patients with stage 3 or 4 chronic kidney disease.

    PubMed

    Huang, Wen-Hung; Chen, Chao-Yu; Lin, Ja-Liang; Lin-Tan, Dan-Tzu; Hsu, Ching-Wei; Yen, Tzung-Hai

    2014-08-01

    Whether high body mass index (BMI) has an effect on progressive diabetic nephropathy in type II diabetes mellitus (DM) patients with chronic kidney disease (CKD) stage 3 or 4 remains unclear. This prospective study aimed to investigate the relationship between BMI and progression of renal function deterioration in type II DM patients with CKD stage 3 or 4.A total of 105 type II DM patients with CKD stage 3 or 4 participated in this 24-month prospective observational study. Patients were divided into 3 groups according to BMI as follows: normal group, BMI of 18.5-22.9 kg/m; overweight group, BMI of 23-24.9 kg/m; and obese group, BMI of ≥25 kg/m. The primary end point was a 2-fold elevation in serum creatinine levels (measured twice with a 1-month interval) from baseline values, need for long-term dialysis, or death during the 24-month observation period.In the linear regression analysis with the stepwise method, each 1 kg/m increase in BMI led to an increase of 0.32 mL min × 1.73 m in the estimated glomerular filtration rate (95% confidence interval, CI, 0.01-0.62; P = 0.04) during the 24-month study period. Moreover, multivariate Cox regression analysis showed that compared with the obese group, the normal BMI group (hazard ratio = 2.76, 95% CI : 1.27-6; P = 0.01) achieved the primary outcome after adjusting for other factors.In this 24-month prospective observational study, we showed that BMI of ≥25 kg/m was a protective factor for renal function deterioration in type II DM patients with CKD stage 3 or 4. PMID:25101985

  14. High Body Mass Index Reduces Glomerular Filtration Rate Decline in Type II Diabetes Mellitus Patients With Stage 3 or 4 Chronic Kidney Disease

    PubMed Central

    Huang, Wen-Hung; Chen, Chao-Yu; Lin, Ja-Liang; Lin-Tan, Dan-Tzu; Hsu, Ching-Wei; Yen, Tzung-Hai

    2014-01-01

    Abstract Whether high body mass index (BMI) has an effect on progressive diabetic nephropathy in type II diabetes mellitus (DM) patients with chronic kidney disease (CKD) stage 3 or 4 remains unclear. This prospective study aimed to investigate the relationship between BMI and progression of renal function deterioration in type II DM patients with CKD stage 3 or 4. A total of 105 type II DM patients with CKD stage 3 or 4 participated in this 24-month prospective observational study. Patients were divided into 3 groups according to BMI as follows: normal group, BMI of 18.5–22.9 kg/m2; overweight group, BMI of 23–24.9 kg/m2; and obese group, BMI of ≥25 kg/m2. The primary end point was a 2-fold elevation in serum creatinine levels (measured twice with a 1-month interval) from baseline values, need for long-term dialysis, or death during the 24-month observation period. In the linear regression analysis with the stepwise method, each 1 kg/m2 increase in BMI led to an increase of 0.32 mL min−1 × 1.73 m−2 in the estimated glomerular filtration rate (95% confidence interval, CI, 0.01–0.62; P = 0.04) during the 24-month study period. Moreover, multivariate Cox regression analysis showed that compared with the obese group, the normal BMI group (hazard ratio = 2.76, 95% CI : 1.27–6; P = 0.01) achieved the primary outcome after adjusting for other factors. In this 24-month prospective observational study, we showed that BMI of ≥25 kg/m2 was a protective factor for renal function deterioration in type II DM patients with CKD stage 3 or 4. PMID:25101985

  15. Analysis of local chronic inflammatory cell infiltrate combined with systemic inflammation improves prognostication in stage II colon cancer independent of standard clinicopathologic criteria.

    PubMed

    Turner, Natalie; Wong, Hui-Li; Templeton, Arnoud; Tripathy, Sagarika; Whiti Rogers, Te; Croxford, Matthew; Jones, Ian; Sinnathamby, Mathuranthakan; Desai, Jayesh; Tie, Jeanne; Bae, Susie; Christie, Michael; Gibbs, Peter; Tran, Ben

    2016-02-01

    In Stage II colon cancer, multiple independent studies have shown that a dense intratumoural immune infiltrate (local inflammation) is associated with improved outcomes, while systemic inflammation, measured by various markers, has been associated with poorer outcomes. However, previous studies have not considered the interaction between local and systemic inflammation, nor have they assessed the type of inflammatory response compared with standard clinicopathologic criteria. In order to evaluate the potential clinical utility of inflammatory markers in Stage II colon cancer, we examined local and systemic inflammation in a consecutive series of patients with resected Stage II colon cancer between 2000 and 2010 who were identified from a prospective clinical database. Increased intratumoural chronic inflammatory cell (CIC) density, as assessed by pathologist review of hematoxylin and eosin stained slides, was used to represent local inflammation. Neutrophil-to-lymphocyte ratio (NLR) >5, as calculated from pre-operative full blood counts, was used to represent systemic inflammation. In 396 eligible patients identified, there was a non-significant inverse relationship between local and systemic inflammation. Increased CIC density was significantly associated with improved overall (HR 0.45, p?=?0.001) and recurrence-free survival (HR 0.37, p?=?0.003). High NLR was significantly associated with poorer overall survival (HR 2.56, p?Stage II colon cancer. PMID:26270488

  16. Comparison of type II and type I diabetics treated for end-stage renal disease in a large prepaid health plan population.

    PubMed

    Ordonez, J D; Hiatt, R A

    1989-01-01

    From 1978 through 1984, the incidence of treated end-stage renal disease (ESRD) secondary to diabetic nephropathy increased from 3 to 19 per million population among the membership of the Kaiser Permanente Medical Care Program in Northern California. Forty-eight percent had type II diabetes. Among 66 type II diabetics retinopathy was less severe and hypertension was more frequent than among 50 type I diabetics. Blacks were represented in a higher proportion than expected from their proportion of the health plan membership. Among type II diabetics who developed ESRD, once proteinuria occurred, nephropathy progressed at the same rate observed in type I diabetics. This observation suggests that the clinical progression of diabetic nephropathy may be similar for both types of diabetes after the development of proteinuria, but requires prospectively collected data for confirmation. PMID:2739829

  17. Pretreatment prognostic factors in patients with early-stage (I/II) non-small-cell lung cancer treated with hyperfractionated radiation therapy alone

    SciTech Connect

    Jeremic, Branislav . E-mail: b.jeremic@iaea.org; Milicic, Biljana; Dagovic, Aleksandar; Acimovic, Ljubisa; Milisavljevic, Slobodan

    2006-07-15

    Purpose: To investigate influence of various pretreatment prognostic factors in patients with early stage (I/II) non-small-cell lung cancer (NSCLC) treated with hyperfractionated radiation therapy alone. Patients and Methods: One hundred and sixteen patients were treated with tumor doses of 69.6 Gy, 1.2-Gy, twice-daily fractionation. There were 49 patients with Stage I and 67 patients with Stage II. Eighty patients had Karnofsky performance status (KPS) 90-100 and 95 patients had <5% weight loss. Peripheral tumors were observed in 57 patients. Squamous histology was observed in 70 patients and the majority of patients had concomitant disease (n = 72). Results: The median survival time for all patients was 29 months; 5-year survival was 29%. The median time to local progression and the distant metastasis were not achieved, whereas 5-year local progression-free and distant metastasis-free survivals were 50% and 72%, respectively. Multivariate analysis identified KPS, weight loss, location, histology, and the reason for not undergoing surgery as prognostic factors for survival. KPS, location, and histology influenced local progression-free survival, whereas only KPS and weight loss influenced distant metastasis-free survival. Conclusions: This retrospective analysis identified KPS and weight loss as the most important prognostic factors of outcome in patients with early-stage NSCLC treated with hyperfractionation radiation therapy.

  18. Factors influencing goal attainment in patients with post-stroke upper limb spasticity following treatment with botulinum toxin A in real-life clinical practice: sub-analyses from the Upper Limb International Spasticity (ULIS)-II Study.

    PubMed

    Fheodoroff, Klemens; Ashford, Stephen; Jacinto, Jorge; Maisonobe, Pascal; Balcaitiene, Jovita; Turner-Stokes, Lynne

    2015-04-01

    In this post-hoc analysis of the ULIS-II study, we investigated factors influencing person-centred goal setting and achievement following botulinum toxin-A (BoNT-A) treatment in 456 adults with post-stroke upper limb spasticity (ULS). Patients with primary goals categorised as passive function had greater motor impairment (p < 0.001), contractures (soft tissue shortening [STS]) (p = 0.006) and spasticity (p = 0.02) than those setting other goal types. Patients with goals categorised as active function had less motor impairment (0.0001), contracture (p < 0.0001), spasticity (p < 0.001) and shorter time since stroke (p = 0.001). Patients setting goals for pain were older (p = 0.01) with more contractures (p = 0.008). The proportion of patients achieving their primary goal was not impacted by timing of first-ever BoNT-A injection (medium-term (≤1 year) vs. longer-term (>1 year)) post-stroke (80.0% vs. 79.2%) or presence or absence of severe contractures (76.7% vs. 80.6%), although goal types differed. Earlier BoNT-A intervention was associated with greater achievement of active function goals. Severe contractures impacted negatively on goal achievement except in pain and passive function. Goal setting by patients with ULS is influenced by impairment severity, age and time since stroke. Our findings resonate with clinical experience and may assist patients and clinicians in selecting realistic, achievable goals for treatment. PMID:25856546

  19. Factors Influencing Goal Attainment in Patients with Post-Stroke Upper Limb Spasticity Following Treatment with Botulinum Toxin A in Real-Life Clinical Practice: Sub-Analyses from the Upper Limb International Spasticity (ULIS)-II Study

    PubMed Central

    Fheodoroff, Klemens; Ashford, Stephen; Jacinto, Jorge; Maisonobe, Pascal; Balcaitiene, Jovita; Turner-Stokes, Lynne

    2015-01-01

    In this post-hoc analysis of the ULIS-II study, we investigated factors influencing person-centred goal setting and achievement following botulinum toxin-A (BoNT-A) treatment in 456 adults with post-stroke upper limb spasticity (ULS). Patients with primary goals categorised as passive function had greater motor impairment (p < 0.001), contractures (soft tissue shortening [STS]) (p = 0.006) and spasticity (p = 0.02) than those setting other goal types. Patients with goals categorised as active function had less motor impairment (0.0001), contracture (p < 0.0001), spasticity (p < 0.001) and shorter time since stroke (p = 0.001). Patients setting goals for pain were older (p = 0.01) with more contractures (p = 0.008). The proportion of patients achieving their primary goal was not impacted by timing of first-ever BoNT-A injection (medium-term (?1 year) vs. longer-term (>1 year)) post-stroke (80.0% vs. 79.2%) or presence or absence of severe contractures (76.7% vs. 80.6%), although goal types differed. Earlier BoNT-A intervention was associated with greater achievement of active function goals. Severe contractures impacted negatively on goal achievement except in pain and passive function. Goal setting by patients with ULS is influenced by impairment severity, age and time since stroke. Our findings resonate with clinical experience and may assist patients and clinicians in selecting realistic, achievable goals for treatment. PMID:25856546

  20. NASA Goddard Earth Sciences Graduate Student Program. [FIRE CIRRUS-II examination of coupling between an upper tropospheric cloud system and synoptic-scale dynamics

    NASA Technical Reports Server (NTRS)

    Ackerman, Thomas P.

    1994-01-01

    The evolution of synoptic-scale dynamics associated with a middle and upper tropospheric cloud event that occurred on 26 November 1991 is examined. The case under consideration occurred during the FIRE CIRRUS-II Intensive Field Observing Period held in Coffeyville, KS during Nov. and Dec., 1991. Using data from the wind profiler demonstration network and a temporally and spatially augmented radiosonde array, emphasis is given to explaining the evolution of the kinematically-derived ageostrophic vertical circulations and correlating the circulation with the forcing of an extensively sampled cloud field. This is facilitated by decomposing the horizontal divergence into its component parts through a natural coordinate representation of the flow. Ageostrophic vertical circulations are inferred and compared to the circulation forcing arising from geostrophic confluence and shearing deformation derived from the Sawyer-Eliassen Equation. It is found that a thermodynamically indirect vertical circulation existed in association with a jet streak exit region. The circulation was displaced to the cyclonic side of the jet axis due to the orientation of the jet exit between a deepening diffluent trough and building ridge. The cloud line formed in the ascending branch of the vertical circulation with the most concentrated cloud development occurring in conjunction with the maximum large-scale vertical motion. The relationship between the large scale dynamics and the parameterization of middle and upper tropospheric clouds in large-scale models is discussed and an example of ice water contents derived from a parameterization forced by the diagnosed vertical motions and observed water vapor contents is presented.

  1. Stages of Learning: Building a Native Curriculum. Teachers' Guide, Student Activities--Part I, Research Unit--Part II.

    ERIC Educational Resources Information Center

    Candline, Mary

    This language arts curriculum developed for Native American students in Manitoba (Canada) consists of a teachers' guide, a student guide, and a research unit. The curriculum includes reading selections and learning activities appropriate for the different reading levels of both upper elementary and secondary students. The purpose of the unit is…

  2. Broad-spectrum Antibiotic Plus Metronidazole May Not Prevent the Deterioration of Necrotizing Enterocolitis From Stage II to III in Full-term and Near-term Infants

    PubMed Central

    Luo, Li-Juan; Li, Xin; Yang, Kai-Di; Lu, Jiang-Yi; Li, Lu-Quan

    2015-01-01

    Abstract Necrotizing enterocolitis (NEC) is the most common and frequently dangerous neonatal gastrointestinal disease. Studies have shown broad-spectrum antibiotics plus anaerobic antimicrobial therapy did not prevent the deterioration of NEC among very low birth preterm infants. However, few studies about this therapy which focused on full-term and near-term infant with NEC has been reported. The aim of this study was to evaluate the effect of broad-spectrum antibiotic plus metronidazole in preventing the deterioration of NEC from stage II to III in full-term and near-term infants. A retrospective cohort study based on the propensity score (PS) 1:1 matching was performed among the full-term and near-term infants with NEC (Bell stageII). All infants who received broad-spectrum antibiotics were divided into 2 groups: group with metronidazole treatment (metronidazole was used ≥4 days continuously, 15 mg/kg/day) and group without metronidazole treatment. The depraved rates of stage II NEC between the 2 groups were compared. Meanwhile, the risk factors associated with the deterioration of stage II NEC were analyzed by case-control study in the PS-matched cases. A total of 229 infants met the inclusion criteria. Before PS-matching, we found the deterioration of NEC rate in the group with metronidazole treatment was higher than that in the group without metronidazole treatment (18.1% [28/155] vs 8.1% [6/74]; P = 0.048). After PS-matching, 73 pairs were matched, and the depraved rate of NEC in the group with metronidazole treatment was not lower than that in the group without metronidazole treatment (15.1% vs 8.2%; P = 0.2). Binary logistic regression analysis showed that sepsis after NEC (odds ratio [OR] 3.748, 95% confidence interval [CI] 1.171–11.998, P = 0.03), the need to use transfusion of blood products after diagnosis of NEC (OR 8.003, 95% CI 2.365–27.087, P = 0.00), and the need of longer time for nasogastric suction were risk factors for stage II NEC progressing to stage III (OR 1.102, 95% CI 1.004–1.21, P = 0.04). Broad-spectrum antibiotic plus metronidazole may not prevent the deterioration of NEC in full-term and near-term infants. Those infants who had sepsis required transfusion of blood products, and needed longer time for nasogastric suction after stage II NEC was more likely to progress to stage III. PMID:26496340

  3. Prognostic Impact of Erythropoietin Expression and Erythropoietin Receptor Expression on Locoregional Control and Survival of Patients Irradiated for Stage II/III Non-Small-Cell Lung Cancer

    SciTech Connect

    Rades, Dirk; Setter, Cornelia; Dahl, Olav; Schild, Steven E.; Noack, Frank

    2011-06-01

    Purpose: Prognostic factors can guide the physician in selecting the optimal treatment for an individual patient. This study investigates the prognostic value of erythropoietin (EPO) and EPO receptor (EPO-R) expression of tumor cells for locoregional control and survival in non-small-cell lung cancer (NSCLC) patients. Methods and Materials: Fourteen factors were investigated in 62 patients irradiated for stage II/III NSCLC, as follows: age, gender, Karnofsky performance score (KPS), histology, grading, TNM/American Joint Committee on Cancer (AJCC) stage, surgery, chemotherapy, pack years (average number of packages of cigarettes smoked per day multiplied by the number of years smoked), smoking during radiotherapy, hemoglobin levels during radiotherapy, EPO expression, and EPO-R expression. Additionally, patients with tumors expressing both EPO and EPO-R were compared to those expressing either EPO or EPO-R and to those expressing neither EPO nor EPO-R. Results: On univariate analysis, improved locoregional control was associated with AJCC stage II cancer (p < 0.048), surgery (p < 0.042), no smoking during radiotherapy (p = 0.024), and no EPO expression (p = 0.001). A trend was observed for a KPS of >70 (p = 0.08), an N stage of 0 to 1 (p = 0.07), and no EPO-R expression (p = 0.10). On multivariate analysis, AJCC stage II and no EPO expression remained significant. No smoking during radiotherapy was almost significant. On univariate analysis, improved survival was associated with N stage 0 to 1 (p = 0.009), surgery (p = 0.039), hemoglobin levels of {>=}12 g/d (p = 0.016), and no EPO expression (p = 0.001). On multivariate analysis, N stage 0 to 1 and no EPO expression maintained significance. Hemoglobin levels of {>=}12 g/d were almost significant. On subgroup analyses, patients with tumors expressing both EPO and EPO-R had worse outcomes than those expressing either EPO or EPO-R and those expressing neither EPO nor RPO-R. Conclusions: EPO expression of tumor cells was an independent prognostic factor for locoregional control and survival in patients irradiated for NSCLC. EPO-R expression showed a trend. Patients with tumors expressing both EPO and EPO-R have an unfavorable prognosis.

  4. Photodetection of early cancer in the upper aerodigestive tract and the bronchi using photofrin II and colorectal adenocarcinoma with fluoresceinated monoclonal antibodies

    NASA Astrophysics Data System (ADS)

    Wagnieres, Georges A.; Braichotte, Daniel; Chatelain, Andre; Depeursinge, Christian D.; Monnier, Philippe; Savary, Jean-Francois; Fontolliet, Charlotte; Calmes, J.-M.; Givel, Jean-Claude; Chapuis, G.; Folli, S.; Pelegrin, A.; Buchegger, F.; Mach, J.-P.; van den Bergh, Hubert

    1991-11-01

    The performance of a fluorescence endoscope for the detection of early cancer is clinically evaluated. the apparatus is based on the imaging of the laser-induced fluorescence (LIF) of a dye which localizes in the tumor after IV injection with a higher concentration than in the surrounding normal tissue. The tests are carried out in several of the hollow organs, such as the upper aerodigestive tract, the bronchi, and the colon. In the two former cases the dye used is photofrin II, whereas in the latter case conjugates between monoclonal antibodies (Mab) directed against carcinoembrionic antigen (CEA) and fluorescein molecules are injected. The fluorescence contrast between tumor and surrounding tissue is enhanced by real-time image processing which eliminates most of the tissue autofluorescence as well as the fluorescence due to the relatively small amount of dye localized in the normal tissue. This is done by recording the fluorescence image in two spectral domains, after which these two images are digitized and manipulated with a mathematical operator (lookup-table). The sources of false positives and false negatives are evaluated in terms of the fluorescent dye and tissue optical properties.

  5. PAK6 increase chemoresistance and is a prognostic marker for stage II and III colon cancer patients undergoing 5-FU based chemotherapy.

    PubMed

    Chen, Jian; Lu, Huijun; Yan, Dongwang; Cui, Feifei; Wang, Xiaoliang; Yu, Fudong; Xue, Yingming; Feng, Xiaodong; Wang, Jingtao; Wang, Xiao; Jiang, Tao; Zhang, Meng; Zhao, Senlin; Yu, Yang; Tang, Huamei; Peng, Zhihai

    2015-01-01

    p21-Activated kinase 6 (PAK6) has been implicated in radiotherapy and docetaxel resistance. We have further evaluated PAK6 as a predictor of 5-fluorouracil (5-FU) treatment response in colon cancer. Here we report that in colon cancer PAK6 promotes tumor progression and chemoresistance both in vitro and in vivo. In the clinical analysis, PAK6 was overexpressed in 104 of 147 (70.75%) stage II and III patients who received 5-FU based chemotherapy after surgery. Multivariate Cox regression analysis indicated that PAK6 was an independent prognostic factor for overall survival (P < 0.001) and disease-free survival (P < 0.001). Colon cancer cell lines showed increased PAK6 expression upon 5-FU treatment. In PAK6-knockdown cells treated with 5-FU, cell viability and phosphorylation of BAD decreased, and the number of apoptotic cells, levels of cleaved caspase 3 and PARP increased compared to control cells. The opposite was observed in PAK6 overexpressing cells. Short hairpin RNA knockdown of PAK6 blocked cells in G2-M phase. Furthermore, Animal experiments results in vivo are consistent with outcomes in vitro. This study demonstrates that PAK6 is an independent prognostic factor for adjuvant 5-FU-based chemotherapy in patients with stage II and stage III colon cancer. PMID:25426562

  6. Comparison of stages in oil agglomeration process of quartz with sodium oleate in the presence of Ca(II) and Mg(II) ions.

    PubMed

    Ozkan, Alper; Ucbeyiay, Havvanur; Duzyol, Selma

    2009-01-01

    The oil agglomeration of quartz with sodium oleate in the presence of calcium and magnesium ions comprises three consecutive stages: adsorption of cations onto quartz surfaces, which leads to coagulation of the suspension, shear flocculation with sodium oleate and finally, agglomeration of flocs by kerosene. The effects of pH and cation concentration on these stages were investigated and the results were presented comparatively. It was found that all the stages of oil agglomeration of quartz exhibited sharp dependences on pH and cation concentration. That is, these stages generally took place in the pH and concentration ranges in which hydroxy complexes of the cations existed in the suspension. In the case of magnesium ion, the coagulation, shear flocculation and especially oil agglomeration of quartz improved after precipitation of hydroxide. These species of calcium and magnesium ions formed at high pH were adsorbed on the negatively charged surface of quartz, as a result of which the adsorption of sodium oleate became possible and thus the shear flocculation of the particles was achieved. Thereafter, the hydrophobic quartz flocs could be agglomerated by kerosene as bridging liquid. The increase in the shear flocculation efficiency depending on the increase of surface hydrophobicity enhanced the oil agglomeration of quartz with kerosene. The maximum recoveries for all the stages of the quartz were obtained in the presence of 10(-3) M magnesium and 5x10(-3) M calcium ions at pH 11. However, some differences in the behavior of shear flocculation and oil agglomeration of quartz suspension were observed above 10(-3) M concentration of magnesium ion. PMID:18849046

  7. Phase-space overlap measures. II. Design and implementation of staging methods for free-energy calculations.

    PubMed

    Wu, Di; Kofke, David A

    2005-08-22

    We consider staged free-energy calculation methods in the context of phase-space overlap relations, and argue that the selection of work-based methods should be guided by consideration of the phase-space overlap of the systems of interest. Stages should always be constructed such that work is performed only into a system that has a phase-space subset relation with the starting system. Thus multiple stages are required if the systems of interest are not such that one forms a phase-space subset with the other. Three two-stage methods are possible, termed umbrella sampling, overlap sampling, and funnel sampling. The last is appropriate for cases in which the subset relation holds, but only in the extreme, meaning that one system's important phase space constitutes a very small portion of the others. Umbrella sampling is most suitable for nonoverlap systems, and overlap sampling is appropriate for systems exhibiting partial phase-space overlap. We review recently introduced metrics that characterize phase-space overlap, showing that the performance of the single- and two-stage methods is consistent with the phase-space picture. We also demonstrate that a recently introduced bias-detection measure is effective in identifying inaccuracy in single- and multistage calculations. The examples used are the chemical-potential calculation for a Lennard-Jones liquid at moderate and at high densities, the same for model water at ambient conditions, and a process of charging a neutral ion in water. PMID:16164284

  8. Inlet flow distortion in turbomachinery. I - Comparison of theory and experiment in a transonic fan stage. II - A parameter study

    NASA Technical Reports Server (NTRS)

    Seidel, B. S.; Matwey, M. D.; Adamczyk, J. J.

    1980-01-01

    In the present paper, a semi-actuator-disk theory is reviewed that was developed previously for the distorted inflow to a single-stage axial-flow compressor. Flow distortion occurs far upstream; it may be a distortion in stagnation temperature, stagnation pressure, or both. Losses, quasi-steady deviation angles, and reference incidence correlations are included in the analysis, and both subsonic and transonic relative Mach numbers are considered. The theory is compared with measurements made in a transonic fan stage, and a parameter study is carried out to determine the influence of solidity on the attenuation of distortions in stagnation pressure and stagnation temperature.

  9. Regional anesthesia for an upper extremity amputation for palliative care in a patient with end-stage osteosarcoma complicated by a large anterior mediastinal mass

    PubMed Central

    Hakim, Mumin; Burrier, Candice; Bhalla, Tarun; Raman, Vidya T; Martin, David P; Dairo, Olamide; Mayerson, Joel L; Tobias, Joseph D

    2015-01-01

    Tumor progression during end-of-life care can lead to significant pain, which at times may be refractory to routine analgesic techniques. Although regional anesthesia is commonly used for postoperative pain care, there is limited experience with its use during home hospice care. We present a 24-year-old male with end-stage metastatic osteosarcoma who required anesthetic care for a right-sided above-the-elbow amputation. The anesthetic management was complicated by the presence of a large mediastinal mass, limited pulmonary reserve, and severe chronic pain with a high preoperative opioid requirement. Intraoperative anesthesia and postoperative pain management were provided by regional anesthesia using an interscalene catheter. He was discharged home with the interscalene catheter in place with a continuous local anesthetic infusion that allowed weaning of his chronic opioid medications and the provision of effective pain control. The perioperative applications of regional anesthesia in palliative and home hospice care are discussed. PMID:26442759

  10. Survival analysis of children with stage II testicular malignant germ cell tumors treated with surgery or surgery combined with adjuvant chemotherapy.

    PubMed

    Lu, Su-Ying; Sun, Xiao-Fei; Zhen, Zi-Jun; Qin, Zi-Ke; Liu, Zhuo-Wei; Zhu, Jia; Wang, Juan; Sun, Fei-Fei

    2015-02-01

    For children with stage II testicular malignant germ cell tumors (MGCT), the survival is good with surgery and adjuvant chemotherapy. However, there is limited data on surgical results for cases in which there was no imaging or pathologic evidence of residual tumor, but in which serum tumor markers either increased or failed to normalize after an appropriate period of half-life time post-surgery. To determine the use of chemotherapy for children with stage II germ cell tumors, we analyzed the outcomes (relapse rate and overall survival) of patients who were treated at the Sun Yat-sen University Cancer Center between January 1990 and May 2013. Twenty-four pediatric patients with a median age of 20 months (range, 4 months to 17 years) were enrolled in this study. In 20 cases (83.3%), the tumors had yolk sac histology. For definitive treatment, 21 patients underwent surgery alone, and 3 patients received surgery and adjuvant chemotherapy. No relapse was observed in the 3 patients who received adjuvant chemotherapy, whereas relapse occurred in 16 of the 21 patients (76.2%) treated with surgery alone. There were a total of 2 deaths. Treatment was stopped for 1 patient, who died 3 months later due to the tumor. The other patient achieved complete response after salvage treatment, but developed lung and pelvic metastases 7 months later and died of the tumor after stopping treatment. For children treated with surgery alone and surgery combined with adjuvant chemotherapy, the 3-year event-free survival rates were 23.8% and 100%, respectively (P = 0.042), and the 3-year overall survival rates were 90.5% and 100%, respectively (P = 0.588). These results suggest that adjuvant chemotherapy can help to reduce the recurrence rate and increase the survival rate for patients with stage II germ cell tumors. PMID:25322864

  11. Impact of Pre-Stage II Hemodynamics and Pulmonary Artery Anatomy on 12-Month Outcome in the Single Ventricle Reconstruction Trial

    PubMed Central

    Aiyagari, Ranjit; Rhodes, John F.; Shrader, Peter; Radtke, Wolfgang A.; Bandisode, Varsha M.; Bergersen, Lisa; Gillespie, Matthew J.; Gray, Robert G.; Guey, Lin T.; Hill, Kevin D.; Hirsch, Russel; Kim, Dennis W.; Lee, Kyong-Jin; Pelech, Andrew N.; Ringewald, Jeremy; Takao, Cheryl; Vincent, Julie A.; Ohye, Richard G.

    2014-01-01

    Objective To compare interstage cardiac catheterization hemodynamic and angiographic findings between shunt types for Single Ventricle Reconstruction (SVR) trial. Background The SVR trial, which randomized subjects to modified Blalock-Taussig shunt (MBTS) or right ventricle-to-pulmonary artery shunt (RVPAS) for the Norwood procedure, demonstrated RVPAS was associated with smaller pulmonary artery diameter, but superior 12-month transplant-free survival. Methods We analyzed pre-stage II catheterization data for SVR trial subjects. Hemodynamic variables and shunt and pulmonary angiography were compared between shunt types; their association with 12-month transplant-free survival was also evaluated. Results Of 549 randomized subjects, 389 underwent pre-stage II catheterization. Smaller size, lower aortic and superior vena cava saturation, and higher ventricular end-diastolic pressure (EDP) were associated with worse 12-month transplant-free survival. MBTS subjects had lower coronary perfusion pressure (27mmHg vs. 32mmHg, P<0.001) and higher Qp:Qs ratio (1.1 vs. 1.0, P=0.009). Higher Qp:Qs ratio increased the risk of death or transplant only in the RVPAS group (P=0.01). MBTS subjects had fewer shunt (14% vs. 28%, P=0.004) and severe left pulmonary artery stenoses (0.7% vs. 9.2%, P=0.003), larger mid-main branch pulmonary artery diameters and higher Nakata index (164 vs. 134, P<0.001). Conclusions Compared with RVPAS subjects, MBTS subjects had more hemodynamic abnormalities related to shunt physiology, while RVPAS subjects had more shunt or pulmonary obstruction of a severe degree, and inferior pulmonary artery growth at pre-stage II catheterization. Lower BSA, higher ventricular EDP, and lower SVC saturation were associated with worse 12-month transplant-free survival. PMID:24332668

  12. Involvement of Difference in Decrease of Hemoglobin Level in Poor Prognosis of Stage I and II Nasopharyngeal Carcinoma: Implication in Outcome of Radiotherapy

    SciTech Connect

    Gao Jin; Tao Yalan; Li Guo; Yi Wei; Xia Yunfei

    2012-03-15

    Purpose: To investigate the effect of hemoglobin (Hb) concentration and the difference in its decrease during treatment on outcome of radiotherapy (RT) alone for patients with Stage I and II nasopharyngeal carcinoma. Methods and Materials: A total of 572 patients with Stage I-II nasopharyngeal carcinoma with RT alone between January 2001 and December 2004 were retrospectively analyzed. Patient characteristics, tumor variables, and Hb level, including pre-RT Hb, mid-RT Hb, and dynamic change of Hb between pre- and post- RT and its difference in decrease ( White-Up-Pointing-Small-Triangle Hb) were subjected to univariate and multivariable analysis to identify factors that predict disease-specific survival (DSS), local regional recurrence-free survival (LRFS), and metastases-free survival (MFS). Results: The 5-year DSS was poorer in the Hb continuous decrease group than in the Hb noncontinuous decrease group (84% vs. 89%; p = 0.008). There was poorer 5-year DSS in patients with White-Up-Pointing-Small-Triangle Hb of >11.5 g/L than in those with White-Up-Pointing-Small-Triangle Hb of {<=}11.5 g/L (82% vs. 89%; p = 0.001), and poorer LRFS (79% vs. 83%; p = 0.035). Univariate and multivariate analysis showed that Hb decrease difference with greater than 11.5 g/L was an independent prognostic factor for DSS and LRFS. Conclusions: The difference in decrease of Hb level during the course of radiation treatment appeared as a poor prognostic factor in Stage I and II nasopharyngeal carcinoma patients.

  13. Outcome of patients with stage II/favorable histology Wilms tumor with and without local tumor spill. A report from the National Wilms Tumor Study Group

    PubMed Central

    Green, Daniel M.; Breslow, Norman E.; D’Angio, Giulio J.; Malogolowkin, Marcio H.; Ritchey, Michael L.; Evans, Audrey E.; Beckwith, J. Bruce; Perlman, Elizabeth J.; Shamberger, Robert C.; Peterson, Susan; Grundy, Paul E.; Dome, Jeffrey S.; Thomas, Patrick R.M.; Kalapurakal, John A.

    2014-01-01

    BACKGROUND Intra-operative tumor spill increases the risk of local recurrence of Wilms tumor, and adversely impacts relapse-free (RFS) and overall survival (OS) rates. METHODS Surgical checklists, operative notes, institutional pathology reports, central pathology review and flow sheets of 602 patients registered between August 1986 and September 1994 on National Wilms Tumor Study – 4 as randomized, followed or switched and coded as Final Stage II, favorable histology (FH) were reviewed. RFS and OS were estimated using the Kaplan-Meier method. Hazard ratios (HRs) were estimated using the Cox model and tested for statistical significance by the log-rank test. RESULTS Four hundred ninety-nine patients were found after review to have stage II, FH Wilms tumor. The eight-year RFS percentages were 85.0% (95% confidence interval (CI) – 81.1%, 88.1%) for those with no spill compared to 75.7% (65.8%, 83.2%) for those with spill. The eight-year OS percentages were 95.6% (93.1%, 97.3%) for those with no spill compared to 90.3% (82.2%, 94.9%) for those with spill. The HR for relapse among those with spill was 1.55 ((95%CI – 0.97,2.51), p = 0.067) and the HR for death was 1.94 ((0.92,4.09), p = 0.077). CONCLUSIONS RFS and OS were lower for patients who had intra-operative tumor spill. The majority of NWTS stage II, FH patients with intra-operative tumor spill have an overall excellent outcome when treated with two drug chemotherapy (vincristine and actinomycin D) and no abdominal irradiation. PMID:24038736

  14. Survival analysis of children with stage II testicular malignant germ cell tumors treated with surgery or surgery combined with adjuvant chemotherapy

    PubMed Central

    Lu, Su-Ying; Sun, Xiao-Fei; Zhen, Zi-Jun; Qin, Zi-Ke; Liu, Zhuo-Wei; Zhu, Jia; Wang, Juan; Sun, Fei-Fei

    2015-01-01

    For children with stage II testicular malignant germ cell tumors (MGCT), the survival is good with surgery and adjuvant chemotherapy. However, there is limited data on surgical results for cases in which there was no imaging or pathologic evidence of residual tumor, but in which serum tumor markers either increased or failed to normalize after an appropriate period of half-life time post-surgery. To determine the use of chemotherapy for children with stage II germ cell tumors, we analyzed the outcomes (relapse rate and overall survival) of patients who were treated at the Sun Yat-sen University Cancer Center between January 1990 and May 2013. Twenty-four pediatric patients with a median age of 20 months (range, 4 months to 17 years) were enrolled in this study. In 20 cases (83.3%), the tumors had yolk sac histology. For definitive treatment, 21 patients underwent surgery alone, and 3 patients received surgery and adjuvant chemotherapy. No relapse was observed in the 3 patients who received adjuvant chemotherapy, whereas relapse occurred in 16 of the 21 patients (76.2%) treated with surgery alone. There were a total of 2 deaths. Treatment was stopped for 1 patient, who died 3 months later due to the tumor. The other patient achieved complete response after salvage treatment, but developed lung and pelvic metastases 7 months later and died of the tumor after stopping treatment. For children treated with surgery alone and surgery combined with adjuvant chemotherapy, the 3-year event-free survival rates were 23.8% and 100%, respectively (P = 0.042), and the 3-year overall survival rates were 90.5% and 100%, respectively (P = 0.588). These results suggest that adjuvant chemotherapy can help to reduce the recurrence rate and increase the survival rate for patients with stage II germ cell tumors. PMID:25322864

  15. Changed salt appetite and central angiotensin II-induced cellular activation in rat offspring following hypoxia during fetal stages.

    PubMed

    Yang, Weili; Mao, Caiping; Xia, Fei; Zheng, Jianli; Wang, Aiqing; Zhu, Liyan; He, Rui; Xu, Zhice

    2010-06-01

    Hypoxia in pregnancy may induce fetal growth restriction and cause functional abnormalities during development. The present study determined the long-term influence of hypoxia in fetal life on dipsogenic behavior linked to central angiotensin (Ang) network in the offspring rats. Fetal blood pO(2) and body weight were decreased by hypoxia during pregnancy, followed by a postnatal "catch-up" growth. Subcutaneous hypertonic saline or intracerebroventricular Ang II significantly increased salt intake in the offspring prenatally exposed to hypoxia, while water intake was the same between the two groups. Ang II-induced c-fos expression was detected in the paraventricular nuclei, median preoptic nuclei, supraoptic nuclei, and subfornical organ in the brain, in association with reduced forebrain AT(2) receptor protein abundance in the offspring prenatally exposed to hypoxia. Levels of central AT(1) receptor protein were not changed between the two groups. Hypoxia during pregnancy could be linked to developmental problems related to behavioral dysfunctions in body fluid regulations in later life, in association with the change in central angiotensin II-mediated neural activation and expression of the Ang II receptor in the brain. PMID:20307607

  16. Neoadjuvant Chemoradiation With Paclitaxel/Carboplatin for Selected Stage III Non-Small-Cell Lung Cancer: Long-Term Results of a Trimodality Phase II Protocol

    SciTech Connect

    Hehr, Thomas; Friedel, Godehard; Steger, Volker; Spengler, Werner; Eschmann, Susanne M.; Bamberg, Michael; Budach, Wilfried

    2010-04-15

    Purpose: To evaluate, in a Phase II trial conducted August 1998 through January 2001, the efficacy of neoadjuvant chemotherapy followed by chemoradiotherapy and definitive surgery in patients with locally advanced non-small-cell lung cancer (LA-NSCLC), Stages IIIA bulky and selected Stage IIIB. Patients and Methods: Staging of LA-NSCLC included computed tomography of cranium, thorax, and abdomen, whole-body positron emission tomography, and video mediastinoscopy. Induction chemotherapy with weekly paclitaxel and carboplatin was followed by hyperfractionated accelerated thoracic radiotherapy (45 Gy) with simultaneous weekly paclitaxel and carboplatin. Four to six weeks after completion of induction therapy, restaging and resection of primary tumor and lymph nodes was intended. Results: A total of 59 consecutive patients were enrolled, 25% with Stage IIIA bulky disease, 65% with Stage IIIB, and 10% with Stage IV (excluded from further analysis). Forty-one patients completed induction therapy; in 52.4% a functional (positron emission tomography) downstaging was proven. Thirty-two patients (59.3%) underwent complete tumor resection, and 5 patients had an exploratory thoracotomy only. Histopathologic downstaging was proven in 59.4% and complete response in 21.9%. Hospital mortality was 5.4%. Median duration of follow-up for living patients was 62.1 months. Overall median survival was 22.6 months, 58.2 months for completely resected patients. During induction chemotherapy, Grade 3/4 granulocytopenia occurred in 8% of patients; the most common Grade 3/4 toxicity of chemoradiation was esophagitis, in 26.4% of patients. Conclusions: Induction paclitaxel/carboplatin with hyperfractionated accelerated chemoradiotherapy followed by complete tumor resection demonstrates high efficacy in LA-NSCLC and offers a promising chance of long-term survival.

  17. Value of Surveillance Studies for Patients With Stage I to II Diffuse Large B-Cell Lymphoma in the Rituximab Era

    SciTech Connect

    Hiniker, Susan M.; Pollom, Erqi L.; Khodadoust, Michael S.; Kozak, Margaret M.; Xu, Guofan; Quon, Andrew; Advani, Ranjana H.; Hoppe, Richard T.

    2015-05-01

    Background: The role of surveillance studies in limited-stage diffuse large B-cell lymphoma (DLBCL) in the rituximab era has not been well defined. We sought to evaluate the use of imaging (computed tomography [CT] and positron emission tomography [PET]-CT) scans and lactate dehydrogenase (LDH) in surveillance of patients with stage I to II DLBCL. Methods: A retrospective analysis was performed of patients who received definitive treatment between 2000 and 2013. Results: One hundred sixty-two consecutive patients with stage I to II DLBCL were treated with chemotherapy +/− rituximab, radiation, or combined modality therapy. The 5-year rates of overall survival (OS) and freedom from progression (FFP) were 81.2% and 80.8%, respectively. Of the 162 patients, 124 (77%) were followed up with at least 1 surveillance PET scan beyond end-of-treatment scans; of those, 94 of 124 (76%) achieved a complete metabolic response on PET scan after completion of chemotherapy, and this was associated with superior FFP (P=.01, HR=0.3) and OS (P=.01, HR 0.3). Eighteen patients experienced relapse after initial response to therapy. Nine relapses were initially suspected by surveillance imaging studies (8 PET, 1 CT), and 9 were suspected clinically (5 by patient-reported symptoms and 4 by symptoms and physical examination). No relapses were detected by surveillance LDH. The median duration from initiation of treatment to relapse was 14.3 months among patients with relapses suspected by imaging, and 59.8 months among patients with relapses suspected clinically (P=.077). There was no significant difference in OS from date of first therapy or OS after relapse between patients whose relapse was suspected by imaging versus clinically. Thirteen of 18 patients underwent successful salvage therapy after relapse. Conclusions: A complete response on PET scan immediately after initial chemotherapy is associated with superior FFP and OS in stage I to II DLBCL. The use of PET scans as posttreatment surveillance is not associated with a survival advantage. LDH is not a sensitive marker for relapse. Our results argue for limiting the use of posttreatment surveillance in patients with limited-stage DLBCL.

  18. Pharmacological Manipulation of Peripheral Vascular Resistance in Single Ventricle Patients (Stages I, II, and III of Palliation).

    PubMed

    Schwartz, Steven M; Floh, Alejandro A; Laussen, Peter C

    2016-01-01

    Pharmacological manipulation of afterload is often used in the management of single ventricle patients, both in the acute post-operative setting and more chronically. After the first stage of palliation the pulmonary and systemic circulations are in parallel and afterload reduction is often used to increase total cardiac output and systemic oxygen delivery. The effectiveness of this approach is likely to be dependent on the intrinsic contractile state of the myocardium as well as the post-operative vascular tone. A variety of clinical studies and theoretical models support this approach. The use of afterload reduction in this context must be balanced with the need to maintain a critical systemic blood pressure for organ perfusion and to promote pulmonary blood flow. After the second and third stages of palliation the use of acute afterload reduction is less complex and primarily directed at promoting cardiac output when it is low and/or controlling high blood pressure. Second stage palliation is particularly unique in that the cerebral and pulmonary circulations are in series and respond differently to many manipulations designed to control vascular resistance. The incidence of long-term circulatory failure in single ventricle patients has led to frequent use of afterload reducing agents in this population but data to suggest that this improves overall outcomes is lacking. Newer studies suggest there may be a role for drugs that reduce pulmonary vascular resistance. This chapter will discuss the principles of manipulation of systemic vascular resistance, or afterload, following each of the three stages of single ventricle reconstruction. This article addresses the seventh of eight topics comprising the special issue entitled "Pharmacologic strategies with afterload reduction in low cardiac output syndrome after pediatric cardiac surgery". PMID:26463984

  19. Bevacizumab and Intravenous or Intraperitoneal Chemotherapy in Treating Patients With Stage II-III Ovarian Epithelial Cancer, Fallopian Tube Cancer, or Primary Peritoneal Cancer

    ClinicalTrials.gov

    2016-03-25

    Malignant Ovarian Mixed Epithelial Tumor; Ovarian Brenner Tumor; Ovarian Clear Cell Cystadenocarcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mucinous Cystadenocarcinoma; Ovarian Serous Cystadenocarcinoma; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Undifferentiated Ovarian Carcinoma

  20. Post-disposal orbital evolution of satellites and upper stages used by the GPS and GLONASS navigation constellations: The long-term impact on the Medium Earth Orbit environment

    NASA Astrophysics Data System (ADS)

    Pardini, Carmen; Anselmo, Luciano

    2012-08-01

    The long-term evolution and environmental impact in MEO of all the abandoned spacecraft and upper stages associated with the GPS and GLONASS navigation constellations were analyzed. The orbits of the disposed objects, as of 1 May 2011, were propagated for 200 years and snapshots of their evolving distribution were obtained, together with an estimation of the changing collision probability with the spacecraft of the operational navigation systems existing or planned in MEO, i.e., GLONASS, GPS, Beidou and Galileo. The probability that the abandoned objects considered will collide with the operational spacecraft of the navigation constellations is very low, even taking into account the intrinsic eccentricity instability of the disposal orbits. Assuming the present or envisaged configuration of the constellations in MEO, the probability of collision, integrated over 200 years, would be <1/300 with a GLONASS spacecraft, <1/15,000 with a GPS or Beidou spacecraft, and <1/250,000 with a Galileo spacecraft. The worst disposal strategy consists in abandoning satellites and upper stages close to the altitude of the operational constellation (GLONASS), while a re-orbiting a few hundred km away (GPS) is able to guarantee an effective long-term dilution of the collision risk, irrespective of the eccentricity instability due to geopotential and luni-solar perturbations. The disposal strategies applied so far to the GPS satellites should be able to guarantee for at least a few centuries a sustainable MEO environment free of collisions among intact objects. Consequently, there would be no need to adopt disposal schemes targeting also the optimal value of the eccentricity vector. However, it should be pointed out that the GPS disposal strategy was devised well in advance of the Beidou constellation announcement, so most of the abandoned satellites were re-orbited fairly close to the altitude of the new Chinese system. A new re-orbiting approach will be therefore needed in the future.

  1. Allicin as a possible adjunctive therapeutic drug for stage II oral submucous fibrosis: a preliminary clinical trial in a Chinese cohort.

    PubMed

    Jiang, X; Zhang, Y; Li, F; Zhu, Y; Chen, Y; Yang, S; Sun, G

    2015-12-01

    The objective of this study was to investigate the efficacy and safety of allicin in the treatment of stage II oral submucous fibrosis (OSF) in a Chinese patient cohort. A randomized clinical trial was performed. Triamcinolone acetonide (TA) or allicin was injected intralesionally weekly for 16 weeks. Improvements in mouth opening, burning sensation, and oral health-related quality of life were evaluated. Forty-eight subjects completed the study without obvious adverse reactions. At 40 weeks, the net gain in mouth opening was 2.270.84mm in the TA group and 5.161.04mm in the allicin group. Burning sensation improved by 2.790.87 in the TA group and by 4.331.04 in the allicin group. The OHIP-14 score improved by 4.672.94 in the TA group and by 12.589.82 in the allicin group. Allicin intralesional injections improved mouth opening, burning sensation, and oral health-related quality of life in these stage II OSF patients. Allicin appears to be a potential adjunctive therapeutic drug. PMID:26165773

  2. Sirolimus and Vaccine Therapy in Treating Patients With Stage II-IV Ovarian Epithelial, Fallopian Tube, or Primary Peritoneal Cavity Cancer

    ClinicalTrials.gov

    2015-09-11

    Recurrent Fallopian Tube Cancer; Recurrent Ovarian Epithelial Cancer; Recurrent Primary Peritoneal Cavity Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIA Primary Peritoneal Cavity Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIB Primary Peritoneal Cavity Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIC Primary Peritoneal Cavity Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Primary Peritoneal Cavity Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Primary Peritoneal Cavity Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Primary Peritoneal Cavity Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Epithelial Cancer; Stage IV Primary Peritoneal Cavity Cancer

  3. Lenalidomide and Vaccine Therapy in Treating Patients With Early-Stage Asymptomatic Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

    ClinicalTrials.gov

    2015-11-03

    Chronic Lymphocytic Leukemia; Stage 0 Chronic Lymphocytic Leukemia; Stage I Chronic Lymphocytic Leukemia; Stage I Small Lymphocytic Lymphoma; Stage II Chronic Lymphocytic Leukemia; Stage II Small Lymphocytic Lymphoma

  4. Bevacizumab, Cisplatin, Radiation Therapy, and Fluorouracil in Treating Patients With Stage IIB, Stage III, Stage IVA, or Stage IVB Nasopharyngeal Cancer

    ClinicalTrials.gov

    2014-04-21

    Stage II Squamous Cell Carcinoma of the Nasopharynx; Stage III Lymphoepithelioma of the Nasopharynx; Stage III Squamous Cell Carcinoma of the Nasopharynx; Stage IV Lymphoepithelioma of the Nasopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx

  5. Akt Inhibitor MK-2206 and Anastrozole With or Without Goserelin Acetate in Treating Patients With Stage II-III Breast Cancer

    ClinicalTrials.gov

    2015-11-19

    Estrogen Receptor Positive; HER2/Neu Negative; Recurrent Breast Carcinoma; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

  6. Five-year Local Control on a Phase II Study of Hypofractionated Intensity Modulated Radiation Therapy with an Incorporated Boost for Early Stage Breast Cancer

    PubMed Central

    Freedman, Gary M; Anderson, Penny R; Bleicher, Richard J.; Litwin, Samuel; Li, Tianyu; Swaby, Ramona F; Ma, Chang-Ming Charlie; Li, Jinsheng; Sigurdson, Elin R; Watkins-Bruner, Deborah; Morrow, Monica; Goldstein, Lori J

    2012-01-01

    Purpose Conventional radiation fractionation of 1.8 2 Gy per day for early stage breast cancer requires daily treatment for 67 weeks. We report the five-year results of a phase II study of intensity modulated radiation therapy (IMRT), hypofractionation and incorporated boost that shortened treatment time to four weeks. Methods and methods The study design was phase II with a planned accrual of 75 patients. Eligibility included age ? 18, Tis-T2, Stage 0 II, and breast conservation. Using photon IMRT and an incorporated boost, the whole breast received 2.25 Gy per fraction total 45 Gy and the tumor bed 2.8 Gy per fraction total 56 Gy in 20 treatments over four weeks. Patients were followed every six months for five years. Results 75 patients were treated from 12/03 to 11/05. The median follow-up is 69 months. Median age was 52 years (range 3181). Median tumor size was 1.4 cm (range 0.13.5). 80% were node negative. 93% had negative and 7% close (> 0 and < 2 mm) margins. 76% were invasive ductal, 15% DCIS, 5% lobular and 4% other histology. 29% had grade 3 and 20% extensive in-situ carcinoma. 11% received chemotherapy, 36% received endocrine therapy, 33% received both and 20% neither. There were 3 local recurrences for a 5-year actuarial rate of 2.7%. Conclusions This 4-week course of hypofractionated radiation with incorporated boost is associated with excellent local control comparable to historical results of 67 weeks of conventional whole-breast fractionation with sequential boost. PMID:22580118

  7. Five-year Local Control in a Phase II Study of Hypofractionated Intensity Modulated Radiation Therapy With an Incorporated Boost for Early Stage Breast Cancer

    SciTech Connect

    Freedman, Gary M.; Anderson, Penny R.; Bleicher, Richard J.; Litwin, Samuel; Li Tianyu; Swaby, Ramona F.; Ma, Chang-Ming Charlie; Li Jinsheng; Sigurdson, Elin R.; Watkins-Bruner, Deborah; Morrow, Monica; Goldstein, Lori J.

    2012-11-15

    Purpose: Conventional radiation fractionation of 1.8-2 Gy per day for early stage breast cancer requires daily treatment for 6-7 weeks. We report the 5-year results of a phase II study of intensity modulated radiation therapy (IMRT), hypofractionation, and incorporated boost that shortened treatment time to 4 weeks. Methods and Materials: The study design was phase II with a planned accrual of 75 patients. Eligibility included patients aged {>=}18 years, Tis-T2, stage 0-II, and breast conservation. Photon IMRT and an incorporated boost was used, and the whole breast received 2.25 Gy per fraction for a total of 45 Gy, and the tumor bed received 2.8 Gy per fraction for a total of 56 Gy in 20 treatments over 4 weeks. Patients were followed every 6 months for 5 years. Results: Seventy-five patients were treated from December 2003 to November 2005. The median follow-up was 69 months. Median age was 52 years (range, 31-81). Median tumor size was 1.4 cm (range, 0.1-3.5). Eighty percent of tumors were node negative; 93% of patients had negative margins, and 7% of patients had close (>0 and <2 mm) margins; 76% of cancers were invasive ductal type: 15% were ductal carcinoma in situ, 5% were lobular, and 4% were other histology types. Twenty-nine percent of patients 29% had grade 3 carcinoma, and 20% of patients had extensive in situ carcinoma; 11% of patients received chemotherapy, 36% received endocrine therapy, 33% received both, and 20% received neither. There were 3 instances of local recurrence for a 5-year actuarial rate of 2.7%. Conclusions: This 4-week course of hypofractionated radiation with incorporated boost was associated with excellent local control, comparable to historical results of 6-7 weeks of conventional whole-breast fractionation with sequential boost.

  8. Molecular analysis of ras oncogenes in CIN III and in stage I and II invasive squamous cell carcinoma of the uterine cervix.

    PubMed Central

    O'Leary, J J; Landers, R J; Silva, I; Uhlmann, V; Crowley, M; Healy, I; Luttich, K

    1998-01-01

    AIM: To examine the prevalence of genital type human papilloma virus (HPV) and mutations at codons 12, 13, and 61 in H, Ki, and N-ras in CIN III and early invasive squamous cell carcinomas of the cervix. METHODS: Prevalence of HPV was examined in 20 CIN III and 20 stage I and II cervical carcinomas, using non-isotopic in situ hybridisation (NISH) and solution phase polymerase chain reaction (PCR). In addition, mutations at codons 12, 13, and 61 were examined in H, Ki, and N-ras in these CIN III and early invasive squamous cell carcinomas, to assess the prevalence of ras gene point mutations and to define where in the pathobiology of squamous cell carcinoma such events occur. A non-isotopic PCR/RFLP assay was used to define these mutations. RESULTS: Of the 20 CIN IIIs examined, 19 contained HPV 16 DNA sequences by PCR and NISH. Dual infection was not uncovered. The 20 early (stage I and II) invasive squamous cell carcinomas showed predominant HPV 16 positivity (17/20), with one case HPV 18 positive, confirmed on PCR and NISH. Activating mutations were not identified in any of the CIN III cases. Only one stage I, HPV 16 positive carcinoma showed an activating mutation in H-ras codon 12, which was not present in adjacent normal ectocervical mucosa from the same patient. CONCLUSIONS: ras Activation does not appear to occur in conjunction with HPV infection, particularly of HPV 16 infected high grade cervical intraepithelial neoplasia, or to occur commonly in early cervical squamous cell carcinoma. The postulated model of HPV linked carcinogenesis suggests malfunctional control of viral transcription as a necessary component of neoplastic progression. It is also clear that host gene alterations are equally necessary for HPV linked carcinogenesis to occur. Images PMID:9828814

  9. Mastectomy With Immediate Expander-Implant Reconstruction, Adjuvant Chemotherapy, and Radiation for Stage II-III Breast Cancer: Treatment Intervals and Clinical Outcomes

    SciTech Connect

    Wright, Jean L.; Cordeiro, Peter G.; Ben-Porat, Leah; Van Zee, Kimberly J.; Hudis, Clifford; Beal, Kathryn; McCormick, Beryl

    2008-01-01

    Purpose: To determine intervals between surgery and adjuvant chemotherapy and radiation in patients treated with mastectomy with immediate expander-implant reconstruction, and to evaluate locoregional and distant control and overall survival in these patients. Methods and Materials: Between May 1996 and March 2004, 104 patients with Stage II-III breast cancer were routinely treated at our institution under the following algorithm: (1) definitive mastectomy with axillary lymph node dissection and immediate tissue expander placement, (2) tissue expansion during chemotherapy, (3) exchange of tissue expander for permanent implant, (4) radiation. Patient, disease, and treatment characteristics and clinical outcomes were retrospectively evaluated. Results: Median age was 45 years. Twenty-six percent of patients were Stage II and 74% Stage III. All received adjuvant chemotherapy. Estrogen receptor staining was positive in 77%, and 78% received hormone therapy. Radiation was delivered to the chest wall with daily 0.5-cm bolus and to the supraclavicular fossa. Median dose was 5040 cGy. Median interval from surgery to chemotherapy was 5 weeks, from completion of chemotherapy to exchange 4 weeks, and from exchange to radiation 4 weeks. Median interval from completion of chemotherapy to start of radiation was 8 weeks. Median follow-up was 64 months from date of mastectomy. The 5-year rate for locoregional disease control was 100%, for distant metastasis-free survival 90%, and for overall survival 96%. Conclusions: Mastectomy with immediate expander-implant reconstruction, adjuvant chemotherapy, and radiation results in a median interval of 8 weeks from completion of chemotherapy to initiation of radiation and seems to be associated with acceptable 5-year locoregional control, distant metastasis-free survival, and overall survival.

  10. Biologic Determinants of Tumor Recurrence in Stage II Colon Cancer: Validation Study of the 12-Gene Recurrence Score in Cancer and Leukemia Group B (CALGB) 9581

    PubMed Central

    Venook, Alan P.; Niedzwiecki, Donna; Lopatin, Margarita; Ye, Xing; Lee, Mark; Friedman, Paula N.; Frankel, Wendy; Clark-Langone, Kim; Millward, Carl; Shak, Steven; Goldberg, Richard M.; Mahmoud, Najjia N.; Warren, Robert S.; Schilsky, Richard L.; Bertagnolli, Monica M.

    2013-01-01

    Purpose A greater understanding of the biology of tumor recurrence should improve adjuvant treatment decision making. We conducted a validation study of the 12-gene recurrence score (RS), a quantitative assay integrating stromal response and cell cycle gene expression, in tumor specimens from patients enrolled onto Cancer and Leukemia Group B (CALGB) 9581. Patients and Methods CALGB 9581 randomly assigned 1,713 patients with stage II colon cancer to treatment with edrecolomab or observation and found no survival difference. The analysis reported here included all patients with available tissue and recurrence (n = 162) and a random (approximately 1:3) selection of nonrecurring patients. RS was assessed in 690 formalin-fixed paraffin-embedded tumor samples with quantitative reverse transcriptase polymerase chain reaction by using prespecified genes and a previously validated algorithm. Association of RS and recurrence was analyzed by weighted Cox proportional hazards regression. Results Continuous RS was significantly associated with risk of recurrence (P = .013) as was mismatch repair (MMR) gene deficiency (P = .044). In multivariate analyses, RS was the strongest predictor of recurrence (P = .004), independent of T stage, MMR, number of nodes examined, grade, and lymphovascular invasion. In T3 MMR-intact (MMR-I) patients, prespecified low and high RS groups had average 5-year recurrence risks of 13% (95% CI, 10% to 16%) and 21% (95% CI, 16% to 26%), respectively. Conclusion The 12-gene RS predicts recurrence in stage II colon cancer in CALGB 9581. This is consistent with the importance of stromal response and cell cycle gene expression in colon tumor recurrence. RS appears to be most discerning for patients with T3 MMR-I tumors, although markers such as grade and lymphovascular invasion did not add value in this subset of patients. PMID:23530100

  11. PTEN, RASSF1 and DAPK site-specific hypermethylation and outcome in surgically treated stage I and II nonsmall cell lung cancer patients.

    PubMed

    Buckingham, Lela; Penfield Faber, L; Kim, Anthony; Liptay, Michael; Barger, Carter; Basu, Sanjib; Fidler, Mary; Walters, Kelly; Bonomi, Philip; Coon, John

    2010-04-01

    The primary objective of this study is to identify prognostic site-specific epigenetic changes in surgically treated Stage I and II nonsmall cell lung cancer (NSCLC) patients by quantifying methylation levels at multiple CpG sites within each gene promoter. Paraffin-embedded tumors from stage Ib, IIa and IIb in training and validation groups of 75 and 57 surgically treated NSCLC patients, respectively, were analyzed for p16, MGMT, RASSF1, RASSF5, CDH1, LET7, DAPK and PTEN promoter hypermethylation. Hypermethylation status was quantified individually at multiple CpG sites within each promoter by pyrosequencing. Molecular and clinical characteristics with time to recurrence (TTR) and overall survival (OS) were evaluated. Overall average promoter methylation levels of MGMT and RASSF1 were significantly higher in smokers than in nonsmokers (p = 0.006 and p = 0.029, respectively). Methylation levels of the p16 promoter were significantly higher in squamous cell carcinoma than in adenocarcinoma (p = 0.020). In univariate analysis, hypermethylation of RASSF1 at CpG sites -53 and -48 and PTEN at CpG site -1310 were the significantly associated with shorter TTR (p = 0.002 and p < 0.000, respectively). Hypermethylation of PTEN at -1310 and DAPK at -1482 were most significantly associated with outcome in multivariate analysis. These results show that methylation of specific promoter CpG sites in PTEN, RASSF1 and DAPK is associated with outcome in early stage surgically treated NSCLC. PMID:19795445

  12. Carboplatin, Paclitaxel, Bevacizumab, and Veliparib in Treating Patients With Newly Diagnosed Stage II-IV Ovarian Epithelial, Fallopian Tube, or Primary Peritoneal Cancer

    ClinicalTrials.gov

    2016-02-24

    Fallopian Tube Carcinosarcoma; Fallopian Tube Clear Cell Adenocarcinoma; Fallopian Tube Endometrioid Adenocarcinoma; Fallopian Tube Mucinous Adenocarcinoma; Fallopian Tube Serous Neoplasm; Fallopian Tube Transitional Cell Carcinoma; Ovarian Brenner Tumor; Ovarian Carcinosarcoma; Ovarian Clear Cell Adenocarcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mixed Epithelial Tumor; Ovarian Mucinous Adenocarcinoma; Ovarian Serous Adenocarcinoma; Ovarian Transitional Cell Carcinoma; Primary Peritoneal Serous Adenocarcinoma; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer; Undifferentiated Fallopian Tube Carcinoma; Undifferentiated Ovarian Carcinoma

  13. Oral vinorelbine and cisplatin with concomitant radiotherapy in stage III non-small-cell lung cancer: an open-label phase II multicentre trial (COVeRT study).

    PubMed

    Singhal, Nimit; Mislang, Anna; Karapetis, Christos S; Stephens, Sonya; Borg, Martin; Woodman, Richard J; Pittman, Kenneth

    2015-11-01

    Chemoradiotherapy regimens for stage III non-small-cell lung cancer (NSCLC) require ongoing evaluation. This South Australian multicentre prospective phase II study evaluated the safety, activity and outcomes of combination oral vinorelbine and cisplatin administered concurrently with radiotherapy for stage III NSCLC. Consecutive eligible patients received two cycles of oral vinorelbine 50?mg/m day 1 (D1), day 8 (D8) and intravenous cisplatin 50?mg/m D1 and D8 in a 21-day cycle. Chemotherapy was administered concurrently with radiotherapy at 60?Gy in 30 fractions, 2?Gy/fraction to the isocentre, all fields treated daily, 5 days a week over 6 weeks using 10?MV photons and three-dimensional conformal radiotherapy. The primary endpoint was to evaluate the progression-free survival (PFS). The secondary end points were safety, response rates and overall survival (OS). Forty-three eligible patients with stage III NSCLC - comprising 21 squamous cell carcinoma, 18 adenocarcinoma and four large cell carcinoma - were studied. Four patients did not complete the treatment. By intention-to-treat analysis, 25% showed a partial response and 65% had stable disease. None achieved a complete response. Of the 39 patients who completed protocol-specified treatment, 11 (28%) showed a partial response and 28 (72%) had stable disease. The median PFS was 25.2 months and the median OS was 48.3 months. Toxicities were manageable and generally mild, with the majority being either grade 1 (n=38) or grade 2 (n=21). Toxicities were mainly of oesophagitis, pneumonitis, fatigue, nausea and dysphagia. Two cycles of chemotherapy with oral vinorelbine and cisplatin administered concurrently with radical radiation had an acceptable toxicity profile and was active in inoperable stage III NSCLC. PFS and OS outcomes were encouraging. This regimen warrants further investigation. PMID:26339936

  14. Evaluation of the pair-culture effect in Ophyryotrocha puerilis (Polychaeta: Dorvilleidae). II. Conditions for the moult of the upper jaw

    NASA Astrophysics Data System (ADS)

    Kegel, B.; Pfannenstiel, H.-D.

    1983-06-01

    The conditions for moult of the upper jaw of Ophryotrocha puerilis were determined in isolated individuals and in groups of various sizes. The frequency of formation of the complicated upper jaw in both isolated individuals and in groups varies to a considerable extent. Although formation of the upper jaw and sex reversal normally are associated processes, the relationship of these two processes is not very well understood. Histological investigations at the light microscopic level demonstrate that the dental apparatus is an elaboration of the ectodermal stomodaeum which is considered to be a highly specialized part of the cuticle in the pharyngeal region of the gut.

  15. Behavioral manifestations of prolonged lead exposure initiated at different stages of the life cycle: II. Delayed spatial alternation.

    PubMed

    Cory-Slechta, D A; Pokora, M J; Widzowski, D V

    1991-01-01

    Since both Pb exposure and aging have been associated with alterations in memory functions, this study compared the effects of Pb exposure initiated at early, middle and later stages of the life cycle on delayed spatial alternation performance. Young (21 day old), adult (8 mon old) and old (16 mon old) rats were exposed for a total duration of 8.5 mon to 0, 2 or 10 mg Pb acetate/kg/day (young rats) or 0, 1.9 or 9.3 mg Pb acetate/kg/day (adult and old rats) in drinking water. These doses were designed to produce equivalent brain Pb concentrations across the three age groups. Behavioral testing began after 4 mon of exposure utilizing a standard delayed alternation paradigm with delay values of 0, 3, 6, 9 and 12 sec presented randomly during each experimental session for a total of 40 sessions. Aging, as expected, was associated with impairments of accuracy, but the disruption of accuracy at the 0 sec delay suggested that these were performance rather than memory deficits. Pb exposure actually improved delayed spatial alternation performance in both young and old animals: accuracy values were increased, while error frequencies declined in the two age groups. The increases in accuracy occurred primarily at the longest delay value in young rats, but were more prominent at short delay values in old rats. This difference may have been the result of a ceiling effect, since accuracy for young rats at short delay values was already quite high. Delayed spatial alternation performance of adult rats was generally unaffected by Pb exposure. A possible explanation of the improved performance of young and old Pb-exposed rats is one based on response perseveration, i.e., a facilitation of rote alternation behavior engendered by the cued alternation training program. The results of this study suggest that both early and late stages of the life cycle must be considered periods of enhanced vulnerability to Pb-induced behavioral changes. PMID:1795900

  16. [Part II. Scientific evidence in end-stage chronic organ failure. A position paper on shared care planning].

    PubMed

    Gristina, Giuseppe R; Orsi, Luciano; Carlucci, Annalisa; Causarano, Ignazio R; Formica, Marco; Roman, Massimo

    2014-01-01

    The therapeutic options related to chronic organ failure are interconnected to the variability of human biological responses and the personal history and choices of the chronically ill patient on one hand, and with the variable human answers to therapies on the other hand. All these aspects may explain the small number and low quality of studies aimed to define the clinical criteria useful in identifying end-stage chronically ill patients, as highlighted through the 2012-2013 Medline survey performed by the task force. These results prevented the grading of scientific evidence. However, taking into account the evidence based medicine definition, the task force believes the clinical reasoning and the individual experience of clinicians as well as the patients and families preferences cannot be replaced "tout court" with a strict methodological research. Accordingly, the working method selected by the task force members was to draw up a set of clinical parameters based on the available scientific literature, submitting it to a peer review process carried out by an expert panel. This paper discusses a set of clinical parameters included in the clinical decision-making algorithm and shared by nine medical societies. For each chronic organ failure these clinical parameters should be intended not as a rigid cutoff system to make a choice between two selected care options (intensive vs palliative), rather as the starting point for a joint and careful consideration regarding the opportunity to adopt the clinical decision-making algorithm care proposed in Part I. PMID:24553593

  17. Randomized Trial of Postoperative Adjuvant Therapy in Stage II and III Rectal Cancer to Define the Optimal Sequence of Chemotherapy and Radiotherapy: 10-Year Follow-Up

    SciTech Connect

    Kim, Tae-Won; Lee, Je-Hwan; Lee, Jung-Hee; Ahn, Jin-Hee; Kang, Yoon-Koo; Lee, Kyoo-Hyung; Yu, Chang-Sik; Kim, Jong-Hoon; Ahn, Seung-Do; Kim, Woo-Kun; Kim, Jin-Cheon; Lee, Jung-Shin

    2011-11-15

    Purpose: To determine the optimal sequence of postoperative adjuvant chemotherapy and radiotherapy in patients with Stage II or III rectal cancer. Methods and Materials: A total of 308 patients were randomized to early (n = 155) or late (n = 153) radiotherapy (RT). Treatment included eight cycles of chemotherapy, consisting of fluorouracil 375 mg/m{sup 2}/day and leucovorin 20 mg/m{sup 2}/day, at 4-week intervals, and pelvic radiotherapy of 45 Gy in 25 fractions. Radiotherapy started on Day 1 of the first chemotherapy cycle in the early RT arm and on Day 1 of the third chemotherapy cycle in the late RT arm. Results: At a median follow-up of 121 months for surviving patients, disease-free survival (DFS) at 10 years was not statistically significantly different between the early and late RT arms (71% vs. 63%; p = 0.162). A total of 36 patients (26.7%) in the early RT arm and 49 (35.3%) in the late RT arm experienced recurrence (p = 0.151). Overall survival did not differ significantly between the two treatment groups. However, in patients who underwent abdominoperineal resection, the DFS rate at 10 years was significantly greater in the early RT arm than in the late RT arm (63% vs. 40%; p = 0.043). Conclusions: After the long-term follow-up duration, this study failed to show a statistically significant DFS advantage for early radiotherapy with concurrent chemotherapy after resection of Stage II and III rectal cancer. Our results, however, suggest that if neoadjuvant chemoradiation is not given before surgery, then early postoperative chemoradiation should be considered for patients requiring an abdominoperineal resection.

  18. Treatment outcomes of patients with FIGO Stage I/II uterine cervical cancer treated with definitive radiotherapy: a multi-institutional retrospective research study

    PubMed Central

    Ariga, Takuro; Toita, Takafumi; Kato, Shingo; Kazumoto, Tomoko; Kubozono, Masaki; Tokumaru, Sunao; Eto, Hidehiro; Nishimura, Tetsuo; Niibe, Yuzuru; Nakata, Kensei; Kaneyasu, Yuko; Nonoshita, Takeshi; Uno, Takashi; Ohno, Tatsuya; Iwata, Hiromitsu; Harima, Yoko; Wada, Hitoshi; Yoshida, Kenji; Gomi, Hiromichi; Numasaki, Hodaka; Teshima, Teruki; Yamada, Shogo; Nakano, Takashi

    2015-01-01

    The purpose of this study was to analyze the patterns of care and outcomes of patients with FIGO Stage I/II cervical cancer who underwent definitive radiotherapy (RT) at multiple Japanese institutions. The Japanese Radiation Oncology Study Group (JROSG) performed a questionnaire-based survey of their cervical cancer patients who were treated with definitive RT between January 2000 and December 2005. A total of 667 patients were entered in this study. Although half of the patients were considered suitable for definitive RT based on the clinical features of the tumor, about one-third of the patients were prescribed RT instead of surgery because of poor medical status. The RT schedule most frequently utilized was whole-pelvic field irradiation (WP) of 30 Gy/15 fractions followed by WP with midline block of 20 Gy/10 fractions, and high-dose-rate intracavitary brachytherapy (HDR-ICBT) of 24 Gy/4 fractions prescribed at point A. Chemotherapy was administered to 306 patients (46%). The most frequent regimen contained cisplatin (CDDP). The median follow-up time for all patients was 65 months (range, 2135 months). The 5-year overall survival (OS), pelvic control (PC) and disease-free survival (DFS) rates for all patients were 78%, 90% and 69%, respectively. Tumor diameter and nodal status were significant prognostic indicators for OS, PC and DFS. Chemotherapy has potential for improving the OS and DFS of patients with bulky tumors, but not for non-bulky tumors. This study found that definitive RT for patients with Stage I/II cervical cancer achieved good survival outcomes. PMID:26109680

  19. Treatment outcomes of patients with FIGO Stage I/II uterine cervical cancer treated with definitive radiotherapy: a multi-institutional retrospective research study.

    PubMed

    Ariga, Takuro; Toita, Takafumi; Kato, Shingo; Kazumoto, Tomoko; Kubozono, Masaki; Tokumaru, Sunao; Eto, Hidehiro; Nishimura, Tetsuo; Niibe, Yuzuru; Nakata, Kensei; Kaneyasu, Yuko; Nonoshita, Takeshi; Uno, Takashi; Ohno, Tatsuya; Iwata, Hiromitsu; Harima, Yoko; Wada, Hitoshi; Yoshida, Kenji; Gomi, Hiromichi; Numasaki, Hodaka; Teshima, Teruki; Yamada, Shogo; Nakano, Takashi

    2015-09-01

    The purpose of this study was to analyze the patterns of care and outcomes of patients with FIGO Stage I/II cervical cancer who underwent definitive radiotherapy (RT) at multiple Japanese institutions. The Japanese Radiation Oncology Study Group (JROSG) performed a questionnaire-based survey of their cervical cancer patients who were treated with definitive RT between January 2000 and December 2005. A total of 667 patients were entered in this study. Although half of the patients were considered suitable for definitive RT based on the clinical features of the tumor, about one-third of the patients were prescribed RT instead of surgery because of poor medical status. The RT schedule most frequently utilized was whole-pelvic field irradiation (WP) of 30 Gy/15 fractions followed by WP with midline block of 20 Gy/10 fractions, and high-dose-rate intracavitary brachytherapy (HDR-ICBT) of 24 Gy/4 fractions prescribed at point A. Chemotherapy was administered to 306 patients (46%). The most frequent regimen contained cisplatin (CDDP). The median follow-up time for all patients was 65 months (range, 2-135 months). The 5-year overall survival (OS), pelvic control (PC) and disease-free survival (DFS) rates for all patients were 78%, 90% and 69%, respectively. Tumor diameter and nodal status were significant prognostic indicators for OS, PC and DFS. Chemotherapy has potential for improving the OS and DFS of patients with bulky tumors, but not for non-bulky tumors. This study found that definitive RT for patients with Stage I/II cervical cancer achieved good survival outcomes. PMID:26109680

  20. Impact of 18F-Fluoro-2-Deoxyglucose Positron Emission Tomography on Treatment Strategy and Radiotherapy Planning for Stage I-II Hodgkin Disease: A Prospective Multicenter Study

    SciTech Connect

    Pommier, Pascal; Dussart, Sophie; Girinsky, Theodore; Chabaud, Sylvie; Lagrange, Jean Leon; Nguyen, Tan Dat; Beckendorff, Veronique; D'Hombres, Anne; Artignan, Xavier; Bondiau, Pierre Yves; Carrie, Christian; Giammarile, Francesco

    2011-03-01

    Purpose: To quantify the impact of preradiotherapy 18F-fluoro-2-deoxyglucose positron-emission tomography (FDG-PET) on treatment strategy and radiotherapy planning for patients with Stage I/II Hodgkin disease included in a large prospective multicenter study. Patients and Methods: Conventional computed tomography and FDG-PET were performed just before the planned radiotherapy. The radiotherapy plan was first elaborated under blinded conditions for FDG-PET data. Then, the medical staff was asked to confirm or not confirm the treatment strategy and, if appropriate, to modify the radiotherapy plan based on additional information from FDG-PET. Results: Between January 2004 and January 2006, 137 patients were included (124 were available for analysis) in 11 centers (108 adults, 16 children). All but 1 patient had received chemotherapy before inclusion. Prechemotherapy work-up included FDG-PET for 61 patients, and data were available for elaboration of the first radiotherapy plan. Based on preradiotherapy FDG-PET data, the radiotherapy was cancelled in 6 patients (4.8%), and treatment plan modifications occurred in 16 patients (12.9%): total dose (11 patients), CTV volume (5 patients), number of beam incidences (6 patients), and number of CTV (6 patients). The concordance between the treatment strategies with or without preradiotherapy FDG-PET was 82.3%. Concordance results were not significantly different when prechemotherapy PET-CT information was available. Conclusion: Preradiotherapy FDG-PET for treatment planning in Hodgkin lymphoma may lead to significant modification of the treatment strategy and the radiotherapy planning in patients with Stage I or II Hodgkin disease, even in those who have undergone FDG-PET as part of the prechemotherapy work-up.

  1. An Ankle-Foot Orthosis With a Lateral Extension Reduces Forefoot Abduction in Subjects With Stage II Posterior Tibial Tendon Dysfunction.

    PubMed

    Neville, Christopher; Bucklin, Mary; Ordway, Nathaniel; Lemley, Frederick

    2016-01-01

    Study Design Controlled laboratory, repeated measures. Background Posterior tibial tendon dysfunction is a common musculoskeletal problem that includes tendon degeneration and collapse of the medial arch of the foot (flatfoot deformity). Ankle-foot orthoses (AFOs) typically are used to correct flatfoot deformity. Correction of flatfoot deformity involves increasing forefoot adduction, forefoot plantar flexion, and hindfoot inversion. Objectives To test whether a foot orthosis with a lateral extension reduces forefoot abduction in patients with stage II posterior tibial tendon dysfunction while walking. Methods The gait of 15 participants with stage II posterior tibial tendon dysfunction was evaluated under 3 conditions: a standard AFO, an AFO with a lateral extension, and a shoe-only control condition. Kinematic variables of interest were evaluated at designated time points in the gait cycle and included hindfoot inversion/eversion, forefoot plantar flexion/dorsiflexion, and forefoot abduction/adduction. A 3-by-4, repeated-measures analysis of variance (brace condition by gait phase) was used to compare variables across conditions. Results The AFO with a lateral extension resulted in a significantly greater change in forefoot adduction compared to the standard AFO (2.6, P = .02) and shoe-only conditions (4.1, P<.01) across all phases of stance. Forefoot plantar flexion was significantly increased when comparing the standard AFO and AFO with a lateral extension to the shoe-only condition. The AFO with the lateral extension also demonstrated significantly increased hindfoot inversion during the loading response and terminal stance phases. Conclusion Off-the-shelf and standard AFOs have been shown to improve forefoot plantar flexion and hindfoot eversion, but not forefoot adduction. A lateral extension added to a standard AFO along the forefoot significantly improved forefoot adduction in participants with posterior tibial tendon dysfunction while walking. J Orthop Sports Phys Ther 2016;46(1):26-33. Epub 11 Dec 2015. doi:10.2519/jospt.2016.5618. PMID:26654572

  2. The NQO1*2/*2 polymorphism is associated with poor overall survival in patients following resection of stages II and IIIa non-small cell lung cancer

    PubMed Central

    kolesar, Jill M.; Dahlberg, Suzanne E.; Marsh, Sharon; Mcleod, Howard L.; Johnson, David H.; Keller, Steven M.; Schiller, Joan H.

    2011-01-01

    NAD(P)H:quinone oxidoreductase 1 (NQO1), is a cytosolic flavoenzyme that catalyzes the two-electron reduction of quinones into hydroquinones. A polymorphism (NQO1*2) alters enzymatic activity of NQO1 resulting in diminished NQO1 activity. Malignancies with NQO1*2 may be resistant to radiation and chemotherapy with resulting poorer survival. NQO1 allele was evaluated in subjects enrolled in ECOG 3590, a randomized comparison of radiation (RT) vs radiation and chemotherapy with cisplatin/etoposide (RCT) in patients with completely resected stages II and IIIa NSCLC. Overall survival was estimated using the Kaplan-Meier method and compared via the log-rank test. Cox models were used to assess the impact of covariates on outcomes. Among 152 patients with assessable samples, 24 (16%) had NQO1*2. Median follow-up was 139 months. The presence of NQO1*2/*2 was associated with decreased overall survival (OS) (median in the heterozygote/wild-type group 42.3 vs. 33.5 months in the variant group, p=0.04). In a multivariable Cox model, variant NQO1 (HR=1.58, p=0.05), age <60 (HR=0.67, p=0.04), PS 1 (HR=1.47, p=0.05), cardiovascular disease (HR=1.93, p=0.003) and alkaline phosphatase <100 mg/ml (HR=0.59, p=0.005) were all significant predictors of OS. NQO1*2/*2 may be an independent predictor of poor overall survival in individuals with resected stages II and IIIa NSCLC. Although the basis for the NQO1 association with decreased survival requires additional evaluation, NQO1 may represent a biomarker for guiding individualized therapy. PMID:21479364

  3. Analytical Performance of a Formalin-fixed Paraffin-embedded Tissue-based 634-probe Prognostic Assay for Predicting Outcome of Patients With Stage II Colon Cancer.

    PubMed

    Plamadeala, Victoria; Huang, Shuguang; McCreary, Suzanne M; Reitze, Nicholas J; Ewing, Amy L; Gabrin, Michael J; Bennett, Ana E; Mulligan, Jude M; Wilson, Claire L; Wang, Dakun

    2014-01-30

    A formalin-fixed paraffin-embedded tissue-based prognostic assay to assess the risk for recurrence in stage II colon cancer has recently been clinically validated. This study describes the analytical performance and quality control measures of the assay. The reportable range was determined to be [-1.129, 1.414] in risk score units. The accuracy was evaluated with a split sample comparison within the production lab and between the production lab and a reference lab. The concordance between the replicates within the production lab was 79% (95% confidence interval, 64%-91%). There was no evidence of bias, and the concordance was 78% (95% confidence interval, 61%-90%) between the labs. The lab-to-lab concordance was further evaluated by simulating risk scores from the full reportable range. The simulation suggested a higher concordance. The sensitivity study demonstrated that the percentage of tumor tissue did not impact the risk score and that RNA concentration of 9.5 ng/?L was a conservative determination of the analyte lower limit of quantification. From the precision study, the repeatability and reproducibility estimates were 0.1267 and 0.0548 in risk score units, respectively. Furthermore, multifaceted quality control measures were implemented, such as proper tissue processing steps, high-risk and low-risk controls, nontemplate control, and a gene expression-based classifier to evaluate the cDNA amplification kit, a key reagent in the assay. In conclusion, this study demonstrates the strong analytical performance of the assay and further supports its use as an objective standardized prognostic test for stage II colon cancer. PMID:24487309

  4. Analytical performance of a formalin-fixed paraffin-embedded tissue-based 634-probe prognostic assay for predicting outcome of patients with stage II colon cancer.

    PubMed

    Plamadeala, Victoria; Huang, Shuguang; McCreary, Suzanne M; Reitze, Nicholas J; Ewing, Amy L; Gabrin, Michael J; Bennett, Ana E; Mulligan, Jude M; Wilson, Claire L; Wang, Dakun

    2014-04-01

    A formalin-fixed paraffin-embedded tissue-based prognostic assay to assess the risk for recurrence in stage II colon cancer has recently been clinically validated. This study describes the analytical performance and quality control measures of the assay. The reportable range was determined to be [-1.129, 1.414] in risk score units. The accuracy was evaluated with a split sample comparison within the production lab and between the production lab and a reference lab. The concordance between the replicates within the production lab was 79% (95% confidence interval, 64%-91%). There was no evidence of bias, and the concordance was 78% (95% confidence interval, 61%-90%) between the labs. The lab-to-lab concordance was further evaluated by simulating risk scores from the full reportable range. The simulation suggested a higher concordance. The sensitivity study demonstrated that the percentage of tumor tissue did not impact the risk score and that RNA concentration of 9.5 ng/?L was a conservative determination of the analyte lower limit of quantification. From the precision study, the repeatability and reproducibility estimates were 0.1267 and 0.0548 in risk score units, respectively. Furthermore, multifaceted quality control measures were implemented, such as proper tissue processing steps, high-risk and low-risk controls, nontemplate control, and a gene expression-based classifier to evaluate the cDNA amplification kit, a key reagent in the assay. In conclusion, this study demonstrates the strong analytical performance of the assay and further supports its use as an objective standardized prognostic test for stage II colon cancer. PMID:24717231

  5. Long-term follow-up of flexor digitorum longus transfer and calcaneal osteotomy for stage II posterior tibial tendon dysfunction.

    PubMed

    Chadwick, C; Whitehouse, S L; Saxby, T S

    2015-03-01

    Flexor digitorum longus transfer and medial displacement calcaneal osteotomy is a well-recognised form of treatment for stage II posterior tibial tendon dysfunction. Although excellent short- and medium-term results have been reported, the long-term outcome is unknown. We reviewed the clinical outcome of 31 patients with a symptomatic flexible flat-foot deformity who underwent this procedure between 1994 and 1996. There were 21 women and ten men with a mean age of 54.3 years (42 to 70). The mean follow-up was 15.2 years (11.4 to 16.5). All scores improved significantly (p < 0.001). The mean American Orthopedic Foot and Ankle Society (AOFAS) score improved from 48.4 pre-operatively to 90.3 (54 to 100) at the final follow-up. The mean pain component improved from 12.3 to 35.2 (20 to 40). The mean function score improved from 35.2 to 45.6 (30 to 50). The mean visual analogue score for pain improved from 7.3 to 1.3 (0 to 6). The mean Short Form-36 physical component score was 40.6 (sd 8.9), and this showed a significant correlation with the mean AOFAS score (r = 0.68, p = 0.005). A total of 27 patients (87%) were pain free and functioning well at the final follow-up. We believe that flexor digitorum longus transfer and calcaneal osteotomy provides long-term pain relief and satisfactory function in the treatment of stage II posterior tibial tendon dysfunction. PMID:25737518

  6. Thyroid Function in Women after Multimodal Treatment for Breast Cancer Stage II/III: Comparison With Controls From a Population Sample

    SciTech Connect

    Reinertsen, Kristin Valborg; Cvancarova, Milada; Wist, Erik; Bjoro, Trine; Dahl, Alv A.; Danielsen, Turi; Fossa, Sophie D.

    2009-11-01

    Purpose: A possible association between thyroid diseases (TD) and breast cancer (BC) has been debated. We examined prevalence and development of TD in women after multimodal treatment for Stage II/III BC compared with women from a general population. Secondarily, we explored the impact of two different radiotherapy (RT) techniques (standardized field arrangements vs. computed tomography [CT]-based dose planning) on TD in BC patients examined 35-120 months after primary BC treatment. Methods and Materials: A total of 403 BC patients completed a questionnaire about TD and had blood samples taken for analyses of thyroid function. All had undergone postoperative RT with or without (2%) adjuvant systemic treatment. The results in the BC patients were compared with a cancer-free, age-matched control group from a general population (CGr). Results: There was higher prevalence of self-reported hypothyroidism in the BC patients as compared with the CGr (18% vs. 6%, p < 0.001). The raised prevalence was predominantly due to a substantial increase in the development of hypothyroidism after BC diagnosis, whereas the prevalence of hypothyroidism before BC diagnosis was similar to that observed in the CGr. Patients treated with CT-based RT showed a trend for increased post-BC development of hypothyroidism as compared with those treated with standardized field arrangements (p = 0.08). Conclusions: Hypothyroidism is significantly increased in women after multimodal treatment for Stage II/III BC. Radiation to the thyroid gland may be a contributing factor. BC patients should be routinely screened for hypothyroidism.

  7. Evidence for Transitional Stages in the Evolution of Euglenid Group II Introns and Twintrons in the Monomorphina aenigmatica Plastid Genome

    PubMed Central

    Pombert, Jean-François; James, Erick R.; Janouškovec, Jan; Keeling, Patrick J.

    2012-01-01

    Background Photosynthetic euglenids acquired their plastid by secondary endosymbiosis of a prasinophyte-like green alga. But unlike its prasinophyte counterparts, the plastid genome of the euglenid Euglena gracilis is riddled with introns that interrupt almost every protein-encoding gene. The atypical group II introns and twintrons (introns-within-introns) found in the E. gracilis plastid have been hypothesized to have been acquired late in the evolution of euglenids, implying that massive numbers of introns may be lacking in other taxa. This late emergence was recently corroborated by the plastid genome sequences of the two basal euglenids, Eutreptiella gymnastica and Eutreptia viridis, which were found to contain fewer introns. Methodology/Principal Findings To gain further insights into the proliferation of introns in euglenid plastids, we have characterized the complete plastid genome sequence of Monomorphina aenigmatica, a freshwater species occupying an intermediate phylogenetic position between early and late branching euglenids. The M. aenigmatica UTEX 1284 plastid genome (74,746 bp, 70.6% A+T, 87 genes) contains 53 intron insertion sites, of which 41 were found to be shared with other euglenids including 12 of the 15 twintron insertion sites reported in E. gracilis. Conclusions The pattern of insertion sites suggests an ongoing but uneven process of intron gain in the lineage, with perhaps a minimum of two bursts of rapid intron proliferation. We also identified several sites that represent intermediates in the process of twintron evolution, where the external intron is in place, but not the internal one, offering a glimpse into how these convoluted molecular contraptions originate. PMID:23300929

  8. Tolvaptan Prolongs Blockage of the Vasopressin Type II Receptor Over 24 Hours in Responders With Stage D Heart Failure.

    PubMed

    Imamura, Teruhiko; Kinugawa, Koichiro; Komuro, Issei

    2016-01-19

    The urine aquaporin-2 (U-AQP2) level relative to the plasma arginine vasopressin (P-AVP) level is a novel predictor of the responsiveness to the vasopressin type 2 receptor (V2R) antagonist tolvaptan (TLV). However, little has been reported about the concentration-time profile of U-AQP2 after TLV treatment. We evaluated 24 patients with decompensated stage D heart failure (HF) who had received 3.75 mg/day of TLV on a de novo basis for > 7 days to treat congestion refractory to conventional diuretics. Seventeen patients were TLV-responders, whose 24-hour urine volume (UV) increased after TLV initiation; the other 7 patients were TLV-non-responders. The U-AQP2 of the TLV-responders, corrected for the urine creatinine concentration, decreased significantly at 4 hours after TLV administration without returning to the day-1 morning level on the morning of day-7. The TLV-non-responder U-AQP2 levels remained low even before the TLV treatment. On the morning of day-7, the TLV-responder U-AQP2/P-AVP ratio was comparable to that of the TLV-non-responders. Among 18 patients (11 responders and 7 non-responders), the day-7 TLV trough concentration was 64 ± 62 ng/mL and was negatively correlated with the estimated glomerular filtration rate (eGFR). TLV has antagonistic effects on the V2R over 24 hours in TLV-responders with advanced heart failure and chronic kidney disease, probably due to persistently elevated blood TLV concentration. The unresponsiveness to TLV in the TLV-non-responders is not attributable to malabsorption. PMID:26742881

  9. COLLISIONS BETWEEN GRAVITY-DOMINATED BODIES. II. THE DIVERSITY OF IMPACT OUTCOMES DURING THE END STAGE OF PLANET FORMATION

    SciTech Connect

    Stewart, Sarah T.; Leinhardt, Zoee M. E-mail: zoe.leinhardt@bristol.ac.uk

    2012-05-20

    Numerical simulations of the stochastic end stage of planet formation typically begin with a population of embryos and planetesimals that grow into planets by merging. We analyzed the impact parameters of collisions leading to the growth of terrestrial planets from recent N-body simulations that assumed perfect merging and calculated more realistic outcomes using a new analytic collision physics model. We find that collision outcomes are diverse and span all possible regimes: hit-and-run, merging, partial accretion, partial erosion, and catastrophic disruption. The primary outcomes of giant impacts between planetary embryos are approximately evenly split between partial accretion, graze-and-merge, and hit-and-run events. To explore the cumulative effects of more realistic collision outcomes, we modeled the growth of individual planets with a Monte Carlo technique using the distribution of impact parameters from N-body simulations. We find that fewer planets reached masses >0.7 M{sub Earth} using the collision physics model compared to simulations that assumed every collision results in perfect merging. For final planets with masses >0.7 M{sub Earth}, 60% are enriched in their core-to-mantle mass fraction by >10% compared to the initial embryo composition. Fragmentation during planet formation produces significant debris ({approx}15% of the final mass) and occurs primarily by erosion of the smaller body in partial accretion and hit-and-run events. In partial accretion events, the target body grows by preferentially accreting the iron core of the projectile and the escaping fragments are derived primarily from the silicate mantles of both bodies. Thus, the bulk composition of a planet can evolve via stochastic giant impacts.

  10. Effect of postoperative radiotherapy on changes in pulmonary function in patients with stage II and IIIA lung carcinoma

    SciTech Connect

    Choi, N.C.; Kanarek, D.J.; Grillo, H.C. )

    1990-01-01

    To assess the pulmonary tolerance to postoperative radiotherapy (RT) in patients with resected lung carcinoma, a prospective study was begun in January 1977, which consisted of (a) initial pulmonary function test (PFT) and arterial blood gases (ABG) at 1 month after surgery, and before beginning of postoperative RT, and (b) follow-up PFT and ABG 1 year after postoperative RT and then every year thereafter. As of December 1987, 137 patients have been enrolled into this study, and 71 patients who were free of recurrence were subjected to the follow-up PFT and ABG. The remaining 66 patients were unable to complete the follow-up studies because of recurrent carcinoma in 60, refusal to participate in the study in 5 patients even in the absence of significant respiratory symptoms, and progressive asbestos-related pleural thickening in 1 patient. The patient characteristics were as follows: Age ranged from 27 to 79 years with the median of 59 years; sex ratio was 1.4 to 1 for male to female; surgical procedures included lobectomy in 49 and pneumonectomy in 22 patients; tumor extent consisted of Stages T1-T2N1M0 in 44, T1-T2N2M0 in 9, and T3N0-N2M0 in 18 patients, respectively. Histologic types included squamous cell carcinoma in 26, adenocarcinoma in 42, small cell carcinoma in 1, and large cell carcinoma in 2 patients. Target volume for RT included the ipsilateral hilum, the mediastinum, and the thoracic inlet including both supraclavicular fossae. A total dose of 54 Gy was delivered in 1.8 Gy of daily fractions, 5 days per week over a period of 6 weeks. Contrary to expectation, there were minor changes in PFT indices in both lobectomy and pneumonectomy patients. The follow-up PFT in the lobectomy group showed small -3% to +2% changes in mean values of ventilatory indices, lung volume, and ABG.

  11. Toroidal Tank Development for Upper-stages

    NASA Technical Reports Server (NTRS)

    DeLay, Tom; Roberts, Keith

    2003-01-01

    The advantages, development, and fabrication of toroidal propellant tanks are profiled in this viewgraph presentation. Several images are included of independent research and development (IR&D) of toroidal propellant tanks at Marshall Space Flight Center (MSFC). Other images in the presentation give a brief overview of Thiokol conformal tank technology development. The presentation describes Thiokol's approach to continuous composite toroidal tank fabrication in detail. Images are shown of continuous and segmented toroidal tanks fabricated by Thiokol.

  12. SLS Dual Use Upper Stage (DUUS) Opportunities

    NASA Technical Reports Server (NTRS)

    Creech, Steve; Holladay, Jon; Jones, Davey

    2013-01-01

    Objective: Provide an overview of SLS DUUS type capability requirements to provide context for possible International Partner collaboration. Addition of a DUUS would greatly increase exploration mission capture and performance margin for cis-Lunar and Near Earth System exploration campaigns.

  13. Aggressive local therapy combined with systemic chemotherapy provides long-term control in grade II stage 2 canine mast cell tumour: 21 cases (1999-2012).

    PubMed

    Lejeune, A; Skorupski, K; Frazier, S; Vanhaezebrouck, I; Rebhun, R B; Reilly, C M; Rodriguez, C O

    2015-09-01

    This retrospective case series evaluates the outcome of 21 dogs with grade II stage 2 mast cell tumour (MCT) treated with adequate local therapy and adjuvant systemic chemotherapy (prednisone, vinblastine and CCNU). The median survival for all dogs was 1359 days (range, 188-2340). Median disease-free interval was 2120 days (149-2325 days). Dogs treated with surgery and chemotherapy had shorter survival (median, 1103 days; 188-2010 days) than those that underwent surgery, radiation therapy and chemotherapy as part of their treatment (median, 2056 days; 300-2340 days). Two patients had local recurrence in the radiation field and four patients had de novo MCT. Distant metastasis was not observed in any dogs. The results of this study suggest that, in the presence of loco-regional lymph node metastasis in grade II MCT, the use of prednisone, vinblastine and CCNU after adequate local-regional therapy can provide a median survival in excess of 40 months. PMID:23721492

  14. Taurus II Stage Test Simulations: Using Large-Scale CFD Simulations to Provide Critical Insight into Plume Induced Environments During Design

    NASA Technical Reports Server (NTRS)

    Struzenberg, L. L.; West, J. S.

    2011-01-01

    This paper describes the use of targeted Loci/CHEM CFD simulations to evaluate the effects of a dual-engine first-stage hot-fire test on an evolving integrated launch pad/test article design. This effort was undertaken as a part of the NESC Independent Assessment of the Taurus II Stage Test Series. The underlying conceptual model included development of a series of computational models and simulations to analyze the plume induced environments on the pad, facility structures and test article. A pathfinder simulation was first developed, capable of providing quick-turn around evaluation of plume impingement pressures on the flame deflector. Results from this simulation were available in time to provide data for an ongoing structural assessment of the deflector. The resulting recommendation was available in a timely manner and was incorporated into construction schedule for the new launch stand under construction at Wallops Flight Facility. A series of Reynolds-Averaged Navier-Stokes (RANS) quasi-steady simulations representative of various key elements of the test profile was performed to identify potential concerns with the test configuration and test profile. As required, unsteady Hybrid-RANS/LES simulations were performed, to provide additional insight into critical aspects of the test sequence. Modifications to the test-specific hardware and facility structures thermal protection as well as modifications to the planned hot-fire test profile were implemented based on these simulation results.

  15. Cardiac Mortality in Patients With Stage I and II Diffuse Large B-Cell Lymphoma Treated With and Without Radiation: A Surveillance, Epidemiology, and End-Results Analysis

    SciTech Connect

    Pugh, Thomas J.; Ballonoff, Ari; Rusthoven, Kyle E.; McCammon, Robert; Kavanagh, Brian; Newman, Francis; Rabinovitch, Rachel

    2010-03-01

    Purpose: Standard therapy for stage I and II diffuse large B-cell lymphoma consists of combined modality therapy with anthracycline-based chemotherapy, anti-CD20 antibody, and radiation therapy (RT). Curative approaches without RT typically utilize more intensive and/or protracted chemotherapy schedules. Anthracycline-based chemotherapy regimens are associated with a dose-dependent risk of left ventricular systolic dysfunction. We hypothesize that patients treated without RT, i.e., those who are treated with greater total chemotherapy cycles and hence cumulative anthracycline exposure, are at increased risk of cardiac mortality. Methods and Materials: The rate of cardiac-specific mortality (CSM) was analyzed in patients with stage I and II diffuse large B-cell lymphoma diagnosed between 1988 and 2004 by querying the National Cancer Institute Surveillance, Epidemiology, and End-Results database. Analyzable data included gender, age, race, stage, presence of extranodal disease, and RT administration. Results: A total of 15,454 patients met selection criteria; 6,021 (39%) patients received RT. The median follow-up was 36 months (range, 6-180 months). The median age was 64 years. The actuarial incidence rates of CSM at 5, 10, and 15 years were 4.3%, 9.0%, and 13.8%, respectively, in patients treated with RT vs. 5.9%, 10.8% and 16.1%, respectively, in patients treated without RT (p < 0.0001; hazard ratio, 1.35; 95% confidence interval [CI]: 1.16-1.56). The increase in cardiac deaths for patients treated without RT persisted throughout the follow-up period. On multivariate analysis, treatment without RT remained independently associated with an increased risk of CSM (Cox hazard ratio, 1.32; 95% CI: 1.13-1.54; p = 0.0005). Conclusions: Increased anthracycline exposure in patients treated only with chemotherapy regimens may result in an increase in cardiac deaths, detectable only through analysis of large sample sizes. Confirmatory evaluation through meta-analysis of randomized data and design of large prospective trials is warranted.

  16. Randomised controlled trial evaluating the efficacy of wrap therapy for wound healing acceleration in patients with NPUAP stage II and III pressure ulcer

    PubMed Central

    Mizuhara, Akihiro; Oonishi, Sandai; Takeuchi, Kensuke; Suzuki, Masatsune; Akiyama, Kazuhiro; Kobayashi, Kazuyo; Matsunaga, Kayoko

    2012-01-01

    Objectives To evaluate if wrap therapy using food wraps, which is widely used in Japanese clinical sites, is not inferior when compared to guideline adhesion treatments. Design Multicentre, prospective, randomised, open, blinded endpoint clinical trial. Setting 15 hospitals in Japan. Patients 66 older patients with new National Pressure Ulcer Advisory Panel stage II or III pressure ulcers. Interventions Of these 66 patients, 31 were divided into the conventional treatment guidelines group and 35 into the wrap therapy group. Main outcome measures The primary end point was the period until the pressure ulcers were cured. The secondary end point was a comparison of the speed of change in the Pressure Ulcer Scale for Healing score. Results 64 of the 66 patients were analysed. The estimated mean period until healing was 57.5?days (95% CI 45.2 to 69.8) in the control group as opposed to 59.8?days (95% CI 49.7 to 69.9) in the wrap therapy group. By the extent of pressure ulcer infiltration, the mean period until healing was 16.0?days (95% CI 8.1 to 23.9) in the control group as opposed to 18.8?days (95% CI 10.3 to 27.2) in the wrap therapy group with National Pressure Ulcer Advisory Panel stage II ulcers, and 71.8?days (95% CI 61.4 to 82.3) as opposed to 63.2?days (95% CI 53.0 to 73.4), respectively, with stage III ulcers. There is no statistical significance in difference in Pressure Ulcer Scale for Healing scores. Conclusions It might be possible to consider wrap therapy as an alternative choice in primary care settings as a simple and inexpensive dressing care. Clinical Trial registration UMIN Clinical Trials Registry UMIN000002658. Summary protocol is available on https://upload.umin.ac.jp/cgi-bin/ctr/ctr.cgi?function=brows&action=brows&type=detail&recptno=R000003235&admin=0&language=J PMID:22223842

  17. Dynamic Mechanical Analysis (DMA) to Help Characterize Vespel SP-211 Polyimide Material for Use as a 750 F Valve Seal on the Ares I Upper Stage J-2X Engine

    NASA Technical Reports Server (NTRS)

    Wingard, Doug

    2013-01-01

    DuPont (TM) Vespel (R) SP-211 polyimide was selected as the top candidate seal material for use in the Oxidizer Turbine Bypass Valve (OTBV) on NASA's Ares I Upper Stage J-2X engine. In the OTBV, the seal material would get exposed to temperatures up to 750degF for approx 10 minutes at a time. Although the J-2X engine is not reusable, the valve material could be exposed to multiple temperature cycles up to 750 F during engine operation. The Constellation Program that included the Ares I rocket was eventually cancelled, but the J-2X engine was chosen for continued use for development of NASA's Space Launch System (SLS). The SLS is a heavy-lift launch vehicle that will have capability of taking astronauts and hardware to the Moon, Mars and asteroids. Dynamic mechanical analysis (DMA) was one of several test techniques used to characterize Vespel SP-211 to help prove its worthiness for use on the OTBV of the J-2X engine.

  18. Dynamic Mechanical Analysis (DMA) to Help Characterize Vespel SP-211 Polyimide Material for Use as a 750 F Valve Seal on the Ares I Upper Stage J-2X Engine

    NASA Technical Reports Server (NTRS)

    Wingard, Doug

    2013-01-01

    DuPont(tm) Vespel(R) SP-211 polyimide was selected as the top candidate seal material for use in the Oxidizer Turbine Bypass Valve (OTBV) on NASA's Ares I Upper Stage J-2X engine. In the OTBV, the seal material would get exposed to temperatures up to 750degF for approx 10 minutes at a time. Although the J-2X engine is not reusable, the valve material could be exposed to multiple temperature cycles up to 750degF during engine operation. The Constellation Program that included the Ares I rocket was eventually cancelled, but the J-2X engine was chosen for continued use for development of NASA's Space Launch System (SLS). The SLS is a heavy-lift launch vehicle that will have capability of taking astronauts and hardware to the Moon, Mars and asteroids. Dynamic mechanical analysis (DMA) was one of several test techniques used to characterize Vespel SP-211 to help prove its worthiness for use on the OTBV of the J-2X engine.

  19. Ares I-X Launch Abort System, Crew Module, and Upper Stage Simulator Vibroacoustic Flight Data Evaluation, Comparison to Predictions, and Recommendations for Adjustments to Prediction Methodology and Assumptions

    NASA Technical Reports Server (NTRS)

    Smith, Andrew; Harrison, Phil

    2010-01-01

    The National Aeronautics and Space Administration (NASA) Constellation Program (CxP) has identified a series of tests to provide insight into the design and development of the Crew Launch Vehicle (CLV) and Crew Exploration Vehicle (CEV). Ares I-X was selected as the first suborbital development flight test to help meet CxP objectives. The Ares I-X flight test vehicle (FTV) is an early operational model of CLV, with specific emphasis on CLV and ground operation characteristics necessary to meet Ares I-X flight test objectives. The in-flight part of the test includes a trajectory to simulate maximum dynamic pressure during flight and perform a stage separation of the Upper Stage Simulator (USS) from the First Stage (FS). The in-flight test also includes recovery of the FS. The random vibration response from the ARES 1-X flight will be reconstructed for a few specific locations that were instrumented with accelerometers. This recorded data will be helpful in validating and refining vibration prediction tools and methodology. Measured vibroacoustic environments associated with lift off and ascent phases of the Ares I-X mission will be compared with pre-flight vibration predictions. The measured flight data was given as time histories which will be converted into power spectral density plots for comparison with the maximum predicted environments. The maximum predicted environments are documented in the Vibroacoustics and Shock Environment Data Book, AI1-SYS-ACOv4.10 Vibration predictions made using statistical energy analysis (SEA) VAOne computer program will also be incorporated in the comparisons. Ascent and lift off measured acoustics will also be compared to predictions to assess whether any discrepancies between the predicted vibration levels and measured vibration levels are attributable to inaccurate acoustic predictions. These comparisons will also be helpful in assessing whether adjustments to prediction methodologies are needed to improve agreement between the predicted and measured flight data. Future assessment will incorporate hybrid methods in VAOne analysis (i.e., boundary element methods, BEM and finite element methods, FEM). These hybrid methods will enable the ability to import NASTRAN models providing much more detailed modeling of the underlying beams and support structure of the ARES 1-X test vehicle. Measured acoustic data will be incorporated into these analyses to improve correlation for additional post flight analysis.

  20. Palliative Care Intervention in Improving Symptom Control and Quality of Life in Patients With Stage II-IV Non-small Cell Lung Cancer and Their Family Caregivers

    ClinicalTrials.gov

    2015-11-16

    no Evidence of Disease; Psychological Impact of Cancer and Its Treatment; Recurrent Non-small Cell Lung Cancer; Stage IIA Non-small Cell Lung Cancer; Stage IIB Non-small Cell Lung Cancer; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IV Non-small Cell Lung Cancer

  1. PET-Adjusted Intensity Modulated Radiation Therapy and Combination Chemotherapy in Treating Patients With Stage II-IV Non-small Cell Lung Cancer

    ClinicalTrials.gov

    2016-01-10

    Metastatic Malignant Neoplasm in the Brain; Recurrent Non-Small Cell Lung Carcinoma; Stage IIA Non-Small Cell Lung Carcinoma; Stage IIB Non-Small Cell Lung Carcinoma; Stage IIIA Non-Small Cell Lung Cancer; Stage IIIB Non-Small Cell Lung Cancer; Stage IV Non-Small Cell Lung Cancer

  2. Pegylated Liposomal Doxorubicin Hydrochloride and Carboplatin Followed by Surgery and Paclitaxel in Treating Patients With Triple Negative Stage II-III Breast Cancer

    ClinicalTrials.gov

    2015-06-10

    Estrogen Receptor-negative Breast Cancer; HER2-negative Breast Cancer; Progesterone Receptor-negative Breast Cancer; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Triple-negative Breast Cancer

  3. Lifestyle changes in free-living patients with peripheral vascular disease (Fontaine stage II) related to plasma and LDL lipid composition: a 15 month follow-up study.

    PubMed

    Ramrez-Tortosa, M C; Urbano, G; Lpez-Jurado, M; Nestares, T; Gomez, M C; Gonzlez, J; Mir, A; Ros, E; Mataix, J; Gil, A

    1999-10-01

    Peripheral vascular disease (PVD) is characterized by arteriosclerosis and lower extremity ischemia which cause intermittent claudication. Patients grouped in the Fontaine stage II have more than 75% organic stenosis in their large coronary arteries and exhibit a number of alterations in blood coagulation and plasma lipids. The aim of this study was to evaluate an intervention program of lifestyle habits including dietary recommendations, moderate exercise and decreased smoking in a population of patients with PVD for a period of 15 months, with respect to plasma-lipid and lipoprotein composition as well as LDL susceptibility to peroxidation. These parameters are well known risk indicators of arteriosclerosis and coronary heart disease. A total 13 subjects diagnosed with PVD (Fontaine stage II) were selected, while a healthy age-matched group (n=20) was used as a reference. This study design was an uncontrolled trial of lifestyle interventions. The group of patients was examined at 0, 3, 6, 9, 12 and 15 months. Patients smoking one or more packets of cigarettes per day at the beginning of the study (54.2%) decreased smoking by as much as 7.7% 15 months later. In addition, physical activity intensified significantly (walking > 1 km: 13.1-77%) and treadmill running increased over the study period while the energy intake decreased by 10%. The percentage of saturated fat in the diet decreased by 10% while the intake of polyunsaturated fat rose, and monounsaturated-fat intake showed a parallel trend to increase; the average intake of cholesterol also fell by 10% and plasma triglycerides and HDL-cholesterol showed a trend to decrease and increase, respectively. No permanent changes in LDL lipid fractions for patients were detected during the follow-up period and no differences between patients and the age-matched reference group were found. The macrophage uptake of plasma-oxidized LDL was significantly higher in patients than in the reference group and no differences due to the intervention period were detected. In conclusion, the education in lifestyle and nutritional habits of patients with PVD led to reduced energy intake parallel with augmented physical activity as well to a fall in plasma triglycerides and a rise in HDL-cholesterol, which are good indicators of a reduced risk of vascular and myocardial complications. PMID:10601535

  4. A phase II study with vinorelbine, gemcitabine and cisplatin in the treatment of patients with stage IIIb-IV non-small cell lung cancer (NSCLC).

    TOXLINE Toxicology Bibliographic Information

    Ginopoulos P; Mastronikolis NS; Giannios J; Karana A; Siabi V; Karvelas F; Rathossis S; Apostolopoulos N; Mastorakou A

    1999-01-01

    In our phase II study an acceptable and effective agent like cisplatin was used in combination with vinorelbine and gemcitabine in patients with non-small cell lung cancer (NSCLC). These two new cytostatic drugs have demonstrated, when used as a single-agent treatment, effective response rates (vinorelbine) and minimum toxicity (gemcitabine). The following schedule was used: (i) vinorelbine 25 mg/m2 on days 1 and 8; (ii) gemcitabine 1000 mg/m2 on days 1 and 8; and (iii) cisplatin 75 mg/m2 on day 8. The schedule was repeated every 21 days, with a maximum of six cycles per patient. A total of 31 patients with a mean Karnofsky performance status of 90% were evaluated and 29 of them were finally eligible. Of the patients, five (16.1%) were at stage IIIb and the remainder (83.9%) were at stage IV. The overall response rate was 65% (20 patients); six patients (19.4%) had complete response (CR) and 14 (45.2%) had partial response (PR). Two patients (6.5%) had stable disease and seven (22.6%) had progressive disease. The most notable toxicity was hematologic. Leukoneutropenia was mainly revealed after the third or fourth cycle and granulocyte-colony stimulating factor (G-CSF) was administered in 24 patients (77.4%). Mild anemia was found in almost all patients after the third or fourth cycle (Hb 10-11 g/dl) and eight patients (25.8%) required erythropoietin (EPO). Thrombocytopenia was more often observed compared with other known chemotherapeutic regimens; six patients (19.4%) had grade I thrombocytopenia and therapy was delayed in another four patients (12.9%) due to this complication. Non-hematologic toxicity was mild and well tolerated and consisted of alopecia (54.8%), nausea and vomiting (12.9%), constipation (12.9%), peripheral neuropathy (9.6%), diarrhea (6.5%), stomatitis (3.2%) and local phlebitis (3.2%). The examined combination provides us with one of the best overall responses rates reported, however at the cost of remarkable hematologic toxicity. Therefore, it would be better applied in patients with good performance status. The high response rates give us hope of using this combination as a neoadjuvant regimen.

  5. Fluorouracil-based preoperative chemoradiotherapy with or without oxaliplatin for stage II/III rectal cancer: a 3-year follow-up study

    PubMed Central

    Jiao, Dexin; Zhang, Rui; Gong, Zhiqiang; Liu, Fang; Chen, Yue; Yu, Qinrui; Sun, Liping; Duan, Hongyan; Zhu, Shendong; Liu, Fei; Wang, Jian

    2015-01-01

    Background Fluorouracil-based preoperative chemoradiotherapy has become the standard treatment for stage II/III rectal cancer. In order to improve the overall survival (OS) and disease-free survival (DFS), we added oxaliplatin to the standard treatment, and compared the effectiveness of these two treatment patterns. Methods A total of 206 patients enrolled in the prospective study had histologically confirmed rectal cancer of clinical stage II/III during July 2007 to July 2010. They were randomized into the experimental group received oxaliplatin and capecitabine in combination with radiotherapy, and the control group received capecitabine in combination with radiotherapy. All patients received surgery in 6?10 weeks after chemoradiotherapy and adjuvant chemotherapy with mFOLFOX6. The primary endpoints were DFS and OS, and the secondary endpoints included toxicity, compliance, and histopathological response. Results The 3-year OS in the experimental group and the control group was 90.29% vs. 86.41% (P>0.05), and the 3-year DFS was 80.58% vs. 69.90% (P>0.05). The pathological complete remission (pCR) rates were 23.30% and 19.42%, respectively (P=0.497). The 3-year local recurrence rates were 4.85% vs. 5.83% (P=0.694), and the 3-year distant metastasis rates were 16.50% and 28.16%, respectively (P=0.045). There were no significant differences in most grade 3?4 toxicities between two groups, however, grade 3?4 diarrhea occurred in 16.50% (17/103) of the experimental group, compared with 6.80% (7/103) of the control group (P=0.030). Also, the total grade 3?4 acute toxicity showed a significant difference (10.68% vs. 21.36%, P=0.037). Conclusions The experimental treatment did not lead significantly improved OS and DFS, and thus longer follow-up is warranted for our patient cohort. Adding oxaliplatin to capecitabine-based preoperative chemoradiotherapy can significantly reduce metastasis, but has only minimal impact on local recurrence. Although grade 3?4 toxicity rate increased (primarily gastrointestinal toxicity), patients can stand to be followed up with allopathic treatment. PMID:26752933

  6. Impact of Neoadjuvant Chemotherapy in Stage IIIII Triple Negative Breast Cancer on Eligibility for Breast-conserving Surgery and Breast Conservation Rates

    PubMed Central

    Golshan, Mehra; Cirrincione, Constance T.; Sikov, William M.; Berry, Donald A.; Jasinski, Sara; Weisberg, Tracey F.; Somlo, George; Hudis, Clifford; Winer, Eric; Ollila, David W.

    2016-01-01

    Objective To assess the efficacy of neoadjuvant systemic therapy (NST) at increasing the rate of successful breast-conserving therapy (BCT) in triple negative breast cancer. Background Inducing tumor regression to permit BCT is often cited to support administration of NST. To quantify this benefit, we conducted a surgical companion study to CALGB40603, a randomized phase II, 22 factorial trial of neoadjuvant paclitaxel carboplatin bevacizumab (B) followed by doxorubicin plus cyclophosphamide B in stage IIIII triple negative breast cancer. Methods Before and after NST, treating surgeons evaluated BCT candidacy by clinico-radiographic criteria; surgery performed was at surgeon and patient discretion. We measured (1) conversion rates from BCT-ineligible to BCT-eligible, (2) surgical choices in BCT candidates, and (3) rates of successful BCT with tumor-free margins. Results Four hundred four patients were assessable for surgical outcomes. Two hundred nineteen (54%) were BCT candidates before NST. One hundred ninety-seven (90%) remained BCT candidates after NST, of whom 138 (70%) chose BCT, which was successful in 130 (94%). Of 185 (46%) who were not BCT candidates before NST, 78 (42%) converted to candidates with NST. Of these, 53 (68%) chose BCT with a 91% (48/53) success rate. The overall BCT-eligibility rate rose from 54% to 68% (275/404) with NST. Addition of carboplatin, B, or both increased conversion rates. Conclusions This is the first study to document prospectively a 42% conversion rate from BCT-ineligible to BCT-eligible, resulting in a 14% absolute increase in BCT eligibility. BCT was successful in 93% of patients who opted for it, but 31% of BCT-eligible patients still chose mastectomy. PMID:26222764

  7. Effects of atorvastatin on systemic and renal NO dependency in patients with non-diabetic stage IIIII chronic kidney disease

    PubMed Central

    Mose, Frank Holden; Larsen, Thomas; Jensen, Janni Majgaard; Hansen, Annebirthe Bo; Bech, Jesper Nrgaard; Pedersen, Erling Bjerregaard

    2014-01-01

    Aims Clinical trials suggest that statins have beneficial effects on the cardiovascular system independent from their cholesterol lowering properties. In patients with chronic kidney disease stage IIIII, we tested the hypothesis that atorvastatin increased systemic and renal nitric oxide (NO) availability using L-NG-monomethyl arginine (L-NMMA) as an inhibitor of NO production. Methods In a randomized, placebo-controlled, crossover study patients were treated with atorvastatin for 5 days with standardized diet and fluid intake. Glomerular filtration reate (GFR), fractional excretions of sodium (FENa), urinary excretion of aquaporin-2 (u-AQP2) and epithelial sodium channels (u-ENaC?), vasoactive hormones (renin, angiotensin II, aldosterone, arginine vasopressin, endothelin-1 and brain natriuretic peptide) and central blood pressure (BP) estimated by applanation tonometry were measured before and after systemic administration of the NO inhibitor L-NMMA. Results Atorvastatin caused a significant reduction in U-ENaC?, but sodium excretion, , FENa and u-AQP2 were not changed by atorvastatin. L-NMMA reduced renal effect variables, including GFR, FENa and u-ENaC? and increased brachial BP and central BP to a similar extent during both treatments. Vasoactive hormones were changed in the same way by L-NMMA during atorvastatin and placebo treatment. Conclusion During, atorvastatin and placebo treatment, inhibition of nitric oxide synthesis induced the same response in brachial and central blood pressure, GFR, renal tubular function and vasoactive hormones. Thus, the data do not support that atorvastatin changes nitric oxide availability in patients with mild nephropathy. The reduced u-ENaC may reflect changes in sodium absorption in the nephron induced by atorvastatin. PMID:24697877

  8. Fibroblast Growth Factor 2-A Predictor of Outcome for Patients Irradiated for Stage II-III Non-Small-Cell Lung Cancer

    SciTech Connect

    Rades, Dirk; Setter, Cornelia; Dahl, Olav; Schild, Steven E.; Noack, Frank

    2012-01-01

    Purpose: The prognostic value of the tumor cell expression of the fibroblast growth factor 2 (FGF-2) in patients with non-small-cell lung cancer (NSCLC) is unclear. The present study investigated the effect of tumor cell expression of FGF-2 on the outcome of 60 patients irradiated for Stage II-III NSCLC. Methods and Materials: The effect of FGF-2 expression and 13 additional factors on locoregional control (LRC), metastasis-free survival (MFS), and overall survival (OS) were retrospectively evaluated. These additional factors included age, gender, Karnofsky performance status, histologic type, histologic grade, T and N category, American Joint Committee on Cancer stage, surgery, chemotherapy, pack-years, smoking during radiotherapy, and hemoglobin during radiotherapy. Locoregional failure was identified by endoscopy or computed tomography. Univariate analyses were performed with the Kaplan-Meier method and the Wilcoxon test and multivariate analyses with the Cox proportional hazard model. Results: On univariate analysis, improved LRC was associated with surgery (p = .017), greater hemoglobin levels (p = .036), and FGF-2 negativity (p <.001). On multivariate analysis of LRC, surgery (relative risk [RR], 2.44; p = .037), and FGF-2 expression (RR, 5.06; p <.001) maintained significance. On univariate analysis, improved MFS was associated with squamous cell carcinoma (p = .020), greater hemoglobin levels (p = .007), and FGF-2 negativity (p = .001). On multivariate analysis of MFS, the hemoglobin levels (RR, 2.65; p = .019) and FGF-2 expression (RR, 3.05; p = .004) were significant. On univariate analysis, improved OS was associated with a lower N category (p = .048), greater hemoglobin levels (p <.001), and FGF-2 negativity (p <.001). On multivariate analysis of OS, greater hemoglobin levels (RR, 4.62; p = .002) and FGF-2 expression (RR, 3.25; p = .002) maintained significance. Conclusions: Tumor cell expression of FGF-2 appeared to be an independent negative predictor of LRC, MFS, and OS.

  9. High Survival and Organ Function Rates After Primary Chemoradiotherapy for Intermediate-Stage Squamous Cell Carcinoma of the Head and Neck Treated in a Multicenter Phase II Trial

    PubMed Central

    Cohen, Ezra E.W.; Haraf, Daniel J.; List, Marcy A.; Kocherginsky, Masha; Mittal, Bharat B.; Rosen, Fred; Brockstein, Bruce; Williams, Rosalyn; Witt, Mary Ellyn; Stenson, Kerstin M.; Kies, Merrill S.; Vokes, Everett E.

    2015-01-01

    Purpose Patients with intermediate-stage squamous cell carcinoma of the head and neck traditionally have been treated with initial surgical resection followed by radiotherapy (RT) alone or chemoradiotherapy. A previous study in this patient population reported a 91% locoregional control rate and 65% overall survival (OS) rate at 5 years, with chemoradiotherapy used as primary treatment. This study was undertaken to assess whether shortening treatment duration with hyperfractionated RT would be feasible and improve locoregional control, organ preservation, and progression-free survival. Methods Eligible patients with stage II or III disease received fluorouracil, hydroxyurea, and RT given twice daily on a week-on/week-off schedule. Quality-of-life scores were measured using three validated indexes. Results All 53 patients enrolled are included in the analysis, with a median follow-up of 42 months (range, 5 to 98 months). Grade 3 or 4 in-field mucositis was observed in 77% and 9%, respectively. No patients required surgical salvage at the primary tumor site (pathological complete response rate, 100%). The 3-year progression-free and OS rates are 67% and 78%, respectively. The 3-year disease-specific mortality rate is 7%. At the time of analysis, 87% of surviving patients do not require enteral feeding support. Quality-of-life and performance assessment indicated that, although acute treatment toxicities were severe, most patients returned to pretreatment function by 12 months. Conclusion Concurrent chemoradiotherapy with hyperfractionated RT is feasible in this patient population and yields high local control and cure rates. Compared with our historical control using once-daily fractionation, hyperfractionation is accompanied by increased acute in-field toxicity. PMID:16849759

  10. Prospective evaluation of concurrent paclitaxel and radiation therapy after adjuvant doxorubicin and cyclophosphamide chemotherapy for Stage II or III breast cancer

    SciTech Connect

    Burstein, Harold J. . E-mail: hburstein@partners.org; Bellon, Jennifer R.; Galper, Sharon; Lu, H.-M.; Kuter, Irene; Wong, Julia; Gelman, Rebecca; Bunnell, Craig A.; Parker, Leroy M.; Garber, Judy E.; Winer, Eric P.; Harris, Jay R.; Powell, Simon N.

    2006-02-01

    Purpose: To evaluate the safety and feasibility of concurrent radiation therapy and paclitaxel-based adjuvant chemotherapy, given either weekly or every 3 weeks, after adjuvant doxorubicin and cyclophosphamide (AC). Methods and Materials: After definitive breast surgery and AC chemotherapy, 40 patients with operable Stage II or III breast cancer received protocol-based treatment with concurrent paclitaxel and radiation therapy. Paclitaxel was evaluated on 2 schedules, with treatment given either weekly x 12 weeks (60 mg/m{sup 2}), or every 3 weeks x 4 cycles (135-175 mg/m{sup 2}). Radiation fields and schedules were determined by the patient's surgery and pathology. The tolerability of concurrent therapy was evaluated in cohorts of 8 patients as a phase I study. Results: Weekly paclitaxel treatment at 60 mg/m{sup 2} per week with concurrent radiation led to dose-limiting toxicity in 4 of 16 patients (25%), including 3 who developed pneumonitis (either Grade 2 [1 patient] or Grade 3 [2 patients]) requiring steroids. Efforts to eliminate this toxicity in combination with weekly paclitaxel through treatment scheduling and CT-based radiotherapy simulation were not successful. By contrast, dose-limiting toxicity was not encountered among patients receiving concurrent radiation with paclitaxel given every 3 weeks at 135-175 mg/m{sup 2}. However, Grade 2 radiation pneumonitis not requiring steroid therapy was seen in 2 of 24 patients (8%) treated in such a fashion. Excessive radiation dermatitis was not observed with either paclitaxel schedule. Conclusions: Concurrent treatment with weekly paclitaxel and radiation therapy is not feasible after adjuvant AC chemotherapy for early-stage breast cancer. Concurrent treatment using a less frequent paclitaxel dosing schedule may be possible, but caution is warranted in light of the apparent possibility of pulmonary injury.

  11. Genetic variants within obesity-related genes are associated with tumor recurrence in patients with stages II/III colon cancer

    PubMed Central

    Sebio, Ana; Gerger, Armin; Matsusaka, Satoshi; Yang, Dongyun; Zhang, Wu; Stremitzer, Stefan; Stintizing, Sebastian; Sunakawa, Yu; Yamauchi, Shinichi; Ning, Yan; Fujimoto, Yoshiya; Ueno, Masashi; Lenz, Heinz-Josef

    2014-01-01

    Objective Obesity is an established risk factor for colorectal cancer (CRC) incidence and it is also linked to CRC recurrence and survival. Polymorphisms located in obesity-related genes are associated with increased risk of developing several cancer types including colorectal cancer. We evaluated whether SNPs in obesity-related genes may predict tumor recurrence in colon cancer patients. Methods Genotypes were obtained from germline DNA from 207 patients with stage II or III colon cancer at the Norris Comprehensive Cancer Center. Nine polymorphisms in eight obesity-related genes (PPAR, LEP, NFKB, CD36, DRG1, NGAL, REGIA and DSCR1) were evaluated. The primary endpoint of the study was 3-year recurrence rate. Positive associations were also tested in an independent Japanese cohort of 350 stage III CRC patients. Results In univariate analysis, for PPAR rs1801282, patients with a CC genotype had significantly lower recurrence probability (29± 4% standard error, SE) compared to patients with a CG genotype (48% ± 8% SE), HR: 1.77; 95%CI, 1.01-3.10; p=0.040. For DSCR1 rs6517239, patients with an AA genotype had higher recurrence probability than patients carrying at least one allele G (37% ± 4% SE vs 15% ± 6% SE), HR: 0.51, 95% CI, 0.27-0.94; p=0.027. This association was stronger in the patients bearing a left-sided tumor (HR: 0.34; 95%CI, 0.13-0.88; p=0.018). In the Japanese cohort no associations were found. Conclusion This hypothesis generating study suggests a potential influence of polymorphisms within obesity-related genes in the recurrence probability of colon cancer. These interesting results should be further evaluated. PMID:25379721

  12. Radiation Therapy Administration and Survival in Stage I/II Extranodal Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue

    SciTech Connect

    Olszewski, Adam J. Desai, Amrita

    2014-03-01

    Purpose: To determine the factors associated with the use of radiation therapy and associated survival outcomes in early-stage marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT). Methods and Materials: We extracted data on adult patients with stage I/II MALT lymphoma diagnoses between 1998 and 2010 recorded in the Surveillance, Epidemiology, and End Results (SEER) database. We studied factors associated with radiation therapy administration in a logistic regression model and described the cumulative incidence of lymphoma-related death (LRD) according to receipt of the treatment. The association of radiation therapy with survival was explored in multivariate models with adjustment for immortal time bias. Results: Of the 7774 identified patients, 36% received radiation therapy as part of the initial course of treatment. Older patients; black or Hispanic men; white, Hispanic, and black women; and socioeconomically disadvantaged and underinsured patients had a significantly lower chance of receiving radiation therapy. Radiation therapy administration was associated with a lower chance of LRD in most sites. In cutaneous, ocular, and salivary MALT lymphomas, the 5-year estimate of LRD after radiation therapy was 0%. The association of radiation therapy with overall survival in different lymphoma sites was heterogeneous, and statistically significant in cutaneous (hazard ratio 0.45, P=.009) and ocular (hazard ratio 0.47, P<.0001) locations after multivariate adjustment. Conclusions: Demographic factors are associated with the use of radiation therapy in MALT lymphoma. Clinicians should be sensitive to those disparities because the administration of radiation therapy may be associated with improved survival, particularly in cutaneous and ocular lymphomas.

  13. Preoperative Chemotherapy for Operable Breast Cancer Is Associated with Better Compliance with Adjuvant Therapy in Matched Stage II and IIIA Patients

    PubMed Central

    Hsu, Chiu-Hsieh; Martinez, Maria Elena; Bouton, Marcia E.; Low, Boo Ghee; Salganick, Jason A.; Nodora, Jesse; Hibbard, Michael L.; Jha, Chandra

    2011-01-01

    Introduction. Preoperative chemotherapy (PC) for operable breast cancer has shown significant benefits in prospective trials. Many patients are treated in the community setting and some may question the applicability of PC outside the university setting. Methods. Retrospective review was performed of stage II and IIIA breast cancer patients treated from January 2002 to July 2009. Fifty-three of 57 patients who underwent PC were matched based on age, tumor size, and hormone receptor status with 53 patients who did not undergo PC. Differences in patient compliance with physician recommendations for all types of adjuvant therapy were evaluated. Crude odds ratios and adjusted odds ratios derived from conditional logistic regression models were calculated. Results. There were 106 patients included. Patient compliance with chemotherapy was better in the PC group than in the adjuvant chemotherapy (AC) group (100% versus 70%; p = .0001). Similarly, more patients in the PC group completed radiation therapy (96% versus 65%; p = .0003) and initiated hormonal therapy (100% versus 62%; p = .0001). Conditional logistic regression revealed that higher pathologic stage and current cigarette smoking were associated with poorer compliance with chemotherapy. For radiation therapy, the univariate model revealed that compliance with chemotherapy and being employed were associated with completion of radiation, whereas current cigarette smoking and larger pathologic size were associated with poorer compliance with radiation. For hormonal therapy, current cigarette smokers were more likely to be noncompliant with initiation of hormonal therapy. Conclusions. PC for operable breast cancer can improve patient compliance with chemotherapy. Current cigarette smokers were more likely to be noncompliant with all types of adjuvant therapy. PMID:21558134

  14. Conservative surgery and radiotherapy for stage I/II breast cancer using lung density correction: 10-year and 15-year results

    SciTech Connect

    Pierce, Lori J. . E-mail: ljpierce@umich.edu; Griffith, Kent A.; Hayman, James A.; Douglas, Kathye R.; Lichter, Allen S.

    2005-04-01

    Purpose: Radiotherapy (RT) planning for breast cancer using lung density correction improves dose homogeneity. Its use obviates the need for a medial wedge, thus reducing scatter to the opposite breast. Although lung density correction is used at many centers in planning for early-stage breast cancer, long-term results of local control and survival have not been reported. Since 1984, we have used lung density correction for dose calculations at the University of Michigan. We now present our 10-year and 15-year results. Methods and Materials: The records of 867 patients with Stage I/II breast cancer treated with breast-conserving surgery and RT with or without systemic therapy were reviewed. Tangential fields delivering 45-50 Gy to the whole breast calculated using lung density correction were used. A boost was added in 96.8% of patients for a total median dose of 61.8 Gy. Results: With a median follow-up of 6.6 years (range, 0.2-18.9 years), 5-, 10-, and 15-year actuarial rates of in-breast tumor recurrence as only first failure were 2.2%, 3.6%, and 5.4%, respectively. With surgical salvage, the 15-year cumulative rate of local control was 99.7%. Factors that significantly predicted for increased rate of local recurrence in multivariate analysis were age {<=} 35 years, hazard ratio 4.8 (95% confidence interval [CI], 1.6-13.9) p = 0.004; negative progesterone receptor status, hazard ratio 6.8 (95% CI, 2.3-20.3) p = < 0.001; negative estrogen receptor status, hazard ratio 4.0 (95% CI, 1.5-11.1) p = 0.007; and lack of adjuvant tamoxifen therapy, hazard ratio 7.7 (95% CI, 1.7-33.3) p = 0.008. Relapse-free survival rates at 5, 10, and 15 years were 84.6%, 70.8%, and 55.9%, respectively; breast cancer-specific survival rates were 94.4%, 90.5%, and 86.9%, respectively; and corresponding estimates for overall survival were 89.7%, 75.7%, and 61.3%. Conclusions: Use of lung density correction was associated with high rates of local control, relapse-free survival, breast cancer-specific survival, and overall survival compared with other reported series of breast-conserving surgery and RT in early-stage disease. These results will serve as a benchmark against which newer radiation delivery strategies such as intensity-modulated RT and partial breast RT can be compared.

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

    PubMed Central

    2013-01-01

    Background The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has markedly increased over the last three decades due to newly found associations with human papillomavirus (HPV) infection. Primary radiotherapy (RT) is the treatment of choice for OPSCC at most centers, and over the last decade, the addition of concurrent chemotherapy has led to a significant improvement in survival, but at the cost of increased acute and late toxicity. Transoral robotic surgery (TORS) has emerged as a promising alternative treatment, with preliminary case series demonstrating encouraging oncologic, functional, and quality of life (QOL) outcomes. However, comparisons of TORS and RT in a non-randomized fashion are susceptible to bias. The goal of this randomized phase II study is to compare QOL, functional outcomes, toxicity profiles, and survival following primary RT ( chemotherapy) vs. TORS ( adjuvant [chemo] RT) in patients with OPSCC. Methods/Design The target patient population comprises OPSCC patients who would be unlikely to require chemotherapy post-resection: Tumor stage T1-T2 with likely negative margins at surgery; Nodal stage N0-2, ?3?cm in size, with no evidence of extranodal extension on imaging. Participants will be randomized in a 1:1 ratio between Arm 1 (RT??chemotherapy) and Arm 2 (TORS??adjuvant [chemo] RT). In Arm 1, patients with N0 disease will receive RT alone, whereas N1-2 patients will receive concurrent chemoradiation. In Arm 2, patients will undergo TORS along with selective neck dissections, which may be staged. Pathologic high-risk features will be used to determine the requirement for adjuvant radiotherapy +/- chemotherapy. The primary endpoint is QOL score using the M.D. Anderson Dysphagia Inventory (MDADI), with secondary endpoints including survival, toxicity, other QOL outcomes, and swallowing function. A sample of 68 patients is required. Discussion This study, if successful, will provide a much-needed randomized comparison of the conventional strategy of primary RT vs. the novel strategy of primary TORS. The trial is designed to provide a definitive QOL comparison between the two arms, and to inform the design of an eventual phase III trial for survival outcomes. Trial registration NCT01590355 PMID:23514246

  16. E5501 - Phase II Study of Topotecan Sequenced with Etoposide/Cisplatin, and Irinotecan/Cisplatin Sequenced with Etoposide for Extensive Stage Small Cell Lung Cancer

    PubMed Central

    Owonikoko, Taofeek K.; Aisner, Joseph; Wang, Xin Victoria; Dahlberg, Suzanne E.; Rubin, Eric H.; Ramalingam, Suresh S.; Gounder, Murugesan; Rausch, Paul Gregory; Axelrod, Rita S.; Schiller, Joan H.

    2015-01-01

    Purpose Sequence dependent improved efficacy of topoisomerase I followed by topoisomerase 2 inhibitors was assessed in a randomized phase II study in extensive-stage small cell lung cancer (SCLC). Methods Patients with previously untreated extensive stage SCLC with measurable disease, ECOG performance status of 0 to 3 and stable brain metastases were eligible. Arm A consisted of topotecan (0.75 mg/m2) on days 1, 2 and 3, etoposide (70 mg/m2) and cisplatin (20 mg/m2) [PET] on days 8, 9 and 10 in a 3-week cycle. Arm B consisted of irinotecan (50 mg/m2) and cisplatin (20 mg/m2) on days 1 and 8 followed by etoposide (85 mg/m2 PO bid) on days 3 and 10 [PIE] in a 3-week cycle. Results We enrolled 140 patients and randomized 66 eligible patients to each arm. Only 54.5% of all patients completed the planned maximum 6 cycles. There were grade ≥3 treatment-related adverse events in approximately 70% of the patients on both arms including 6 treatment-related grade 5 events. The overall response rates (CR+PR) were 69.7% (90% CI: 59.1–78.9%, 95% CI: 57.1–80.4%) for arm A and 57.6% (90% CI: 46.7–67.9%, 95% CI:44.8–69.7%) for arm B. The median PFS and OS were 6.4 months (95% CI: 5.4–7.5 months) and 11.9 months (95% CI: 9.6–13.7 months) for arm A and 6.0 months (95% CI: 5.4–7.0 months) and 11.0 months (95% CI: 8.6–13.1 months) for arm B. Conclusion Sequential administration of topoisomerase inhibitors did not improve on the historical efficacy of standard platinum-doublet chemotherapy for extensive stage SCLC. PMID:24288121

  17. Compositionally heterogeneous podiform chromitite in the Shetland Ophiolite Complex (Scotland): Implications for chromitite petrogenesis and late-stage alteration in the upper mantle portion of a supra-subduction zone ophiolite

    NASA Astrophysics Data System (ADS)

    Derbyshire, E. J.; O'Driscoll, B.; Lenaz, D.; Gertisser, R.; Kronz, A.

    2013-03-01

    The mantle sequence of the ~ 492 Ma Shetland Ophiolite Complex (SOC; Scotland) contains abundant compositionally heterogeneous podiform chromitite bodies enclosed in elongate dunite lenses in the vicinity of the petrological Moho. Chromitite petrogenesis and late-stage alteration events recorded in these seams are examined here using petrography, mineral chemistry and crystal structural data. The resistant nature of Cr-spinel to serpentinisation and other late-stage alteration means that primary igneous compositions are preserved in unaltered crystal cores. Chromitite mineralogy and texture from five sampled localities at The Viels, Hagdale, Harold's Grave, Nikka Vord and Cliff reveal significant inter-pod chemical heterogeneity. The Cr-spinel mineral chemistry is consistent with supra-subduction zone melt extraction from the SOC peridotites. The occurrence of chromitite seams in the centres of the dunite lenses combined with variable Cr-spinel compositions at different chromitite seam localities supports a model of chromitite formation from spatially (and temporally?) fluctuating amounts of melt-rock interaction through channelised and/or porous melt flow. Pervasive serpentinisation of the SOC has led to the almost complete replacement of the primary (mantle) silicate mineral assemblages with serpentine (lizardite with minor chrysotile and antigorite). Magmatic sulphide (e.g., pentlandite) in dunite and chromitite is locally converted to reduced Ni-sulphide varieties (e.g., heazlewoodite and millerite). A post-serpentinisation (prograde) oxidisation event is recorded in the extensively altered Cliff chromitite seams in the west of the studied area, where chromitite Cr-spinel is extensively altered to ferritchromit. The ferritchromit may comprise > 50% of the volume of the Cliff Cr-spinels and contain appreciable quantities of 1-2 ?m inclusions of sperrylite (PtAs2) and Ni-arsenide, signifying the coeval formation of these minerals with ferritchromit at temperatures of up to ~ 500 C. The SOC chromitite Cr-spinels thus not only preserve key insights into the complex melting processes occurring in the upper mantle wedge but can also be utilised to construct a comprehensive alteration history of the lower mantle portions of such supra-subduction zone ophiolites.

  18. A two-stage fast Bayesian spectral density approach for ambient modal analysis. Part II: Mode shape assembly and case studies

    NASA Astrophysics Data System (ADS)

    Yan, Wang-Ji; Katafygiotis, Lambros S.

    2015-03-01

    A two-stage fast Bayesian spectral density approach based on a novel variable separation technique for ambient modal analysis was formulated in the companion paper. In full-scale operational modal tests covering a number of locations, the dofs of interest are usually measured or processed separately in individual setups so that a set of local mode shapes are obtained. The difficulty on how to assemble these local mode shapes to form overall mode shapes is a problem not addressed in the companion paper that needs to be resolved properly. This study presents a theory to assemble the local mode shapes using the Bayesian statistical framework so that the data quality of different clusters can be accounted for automatically. The optimal global mode shape can be obtained by a fast iterative scheme, while the associated uncertainties can be derived analytically. The theory described in Part I and II of this work is applied to modal identification using synthetic data and field data measured from two laboratory models equipped with wireless sensors. Successful validation of the proposed method demonstrates the potential for Bayesian approaches to accommodate multiple uncertainties for ambient modal analysis.

  19. A single-institution retrospective analysis of outcomes for stage I-II primary mediastinal large B-cell lymphoma treated with immunochemotherapy with or without radiotherapy.

    PubMed

    Binkley, Michael S; Hiniker, Susan M; Wu, Sharon; Natkunam, Yasodha; Mittra, Erik S; Advani, Ranjana H; Hoppe, Richard T

    2016-03-01

    As the optimal treatment for primary mediastinal large B-cell lymphoma (PMBCL) remains undefined, we evaluated outcomes of patients treated with standard and dose-intense rituximab-chemotherapy (R-CT) with and without radiotherapy (RT). We retrospectively identified 28 patients with stage I-II PMBCL in our lymphoma database, re-reviewed pathology slides and scored interim or post-chemotherapy PET/CTs using the Deauville scale. Fourteen patients received RT (36-45 Gy) preceded by either six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or 12 weeks of rituximab, etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone and bleomycin (R-VACOP-B) with median follow-up of 94 months. Fourteen patients received 4-8 cycles of dose-adjusted etoposide, vincristine, doxorubicin, cyclophosphamide and rituximab (DA-EPOCH-R) with median follow-up of 38 months; one of these received RT (36 Gy) due to post-chemotherapy PET/CT Deauville score 4. Following R-CT and RT or DA-EPOCH-R, 5-year and 3-year FFP and OS were both 100%. Both R-CHOP/R-VACOP-B with RT and DA-EPOCH-R demonstrate excellent outcomes. PMID:26159046

  20. Diet and Physical Activity Change or Usual Care in Improving Survival in Patients With Previously Treated Stage II, III, or IV Ovarian, Fallopian Tube, or Primary Peritoneal Cancer | Division of Cancer Prevention

    Cancer.gov

    This randomized phase III trial studies diet and physical activity changes to see how well they work compared with usual care in improving progression-free survival in patients with previously treated stage II, III, or IV ovarian, fallopian tube, or primary peritoneal cancer. A healthy lifestyle and counseling after treatment may improve progression-free survival in patients with previously treated cancer.

  1. Broad-spectrum Antibiotic Plus Metronidazole May Not Prevent the Deterioration of Necrotizing Enterocolitis From Stage II to III in Full-term and Near-term Infants: A Propensity Score-matched Cohort Study.

    PubMed

    Luo, Li-Juan; Li, Xin; Yang, Kai-Di; Lu, Jiang-Yi; Li, Lu-Quan

    2015-10-01

    Necrotizing enterocolitis (NEC) is the most common and frequently dangerous neonatal gastrointestinal disease. Studies have shown broad-spectrum antibiotics plus anaerobic antimicrobial therapy did not prevent the deterioration of NEC among very low birth preterm infants. However, few studies about this therapy which focused on full-term and near-term infant with NEC has been reported. The aim of this study was to evaluate the effect of broad-spectrum antibiotic plus metronidazole in preventing the deterioration of NEC from stage II to III in full-term and near-term infants.A retrospective cohort study based on the propensity score (PS) 1:1 matching was performed among the full-term and near-term infants with NEC (Bell stage ?II). All infants who received broad-spectrum antibiotics were divided into 2 groups: group with metronidazole treatment (metronidazole was used ?4 days continuously, 15 mg/kg/day) and group without metronidazole treatment. The depraved rates of stage II NEC between the 2 groups were compared. Meanwhile, the risk factors associated with the deterioration of stage II NEC were analyzed by case-control study in the PS-matched cases.A total of 229 infants met the inclusion criteria. Before PS-matching, we found the deterioration of NEC rate in the group with metronidazole treatment was higher than that in the group without metronidazole treatment (18.1% [28/155] vs 8.1% [6/74]; P = 0.048). After PS-matching, 73 pairs were matched, and the depraved rate of NEC in the group with metronidazole treatment was not lower than that in the group without metronidazole treatment (15.1% vs 8.2%; P = 0.2). Binary logistic regression analysis showed that sepsis after NEC (odds ratio [OR] 3.748, 95% confidence interval [CI] 1.171-11.998, P = 0.03), the need to use transfusion of blood products after diagnosis of NEC (OR 8.003, 95% CI 2.365-27.087, P = 0.00), and the need of longer time for nasogastric suction were risk factors for stage II NEC progressing to stage III (OR 1.102, 95% CI 1.004-1.21, P = 0.04).Broad-spectrum antibiotic plus metronidazole may not prevent the deterioration of NEC in full-term and near-term infants. Those infants who had sepsis required transfusion of blood products, and needed longer time for nasogastric suction after stage II NEC was more likely to progress to stage III. PMID:26496340

  2. Consolidative Involved-Node Proton Therapy for Stage IA-IIIB Mediastinal Hodgkin Lymphoma: Preliminary Dosimetric Outcomes From a Phase II Study

    SciTech Connect

    Hoppe, Bradford S.; Flampouri, Stella; Su Zhong; Morris, Christopher G.; Latif, Naeem

    2012-05-01

    Purpose: To compare the dose reduction to organs at risk (OARs) with proton therapy (PT) versus three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) in patients with mediastinal Hodgkin lymphoma (HL) enrolled on a Phase II study of involved-node radiotherapy (INRT). Methods and Materials: Between June 2009 and October 2010, 10 patients were enrolled on a University of Florida institutional review board-approved protocol for de novo 'classical' Stage IA-IIIB HL with mediastinal (bulky or nonbulky) involvement after chemotherapy. INRT was planned per European Organization for Research and Treatment of Cancer guidelines. Three separate optimized plans were developed for each patient: 3D-CRT, IMRT, and PT. The primary end point was a 50% reduction in the body V4 with PT compared with 3D-CRT or IMRT. Results: The median relative reduction with PT in the primary end point, body V4, was 51% compared with 3D-CRT (p = 0.0098) and 59% compared with IMRT (p = 0.0020), thus all patients were offered treatment with PT. PT provided the lowest mean dose to the heart, lungs, and breasts for all 10 patients compared with either 3D-CRT or IMRT. The median difference in the OAR mean dose reduction with PT compared with 3D-CRT were 10.4 Gy/CGE for heart; 5.5 Gy/CGE for lung; 0.9 Gy/CGE for breast; 8.3 Gy/CGE for esophagus; and 4.1 Gy/CGE for thyroid. The median differences for mean OAR dose reduction for PT compared with IMRT were 4.3 Gy/CGE for heart, 3.1 Gy/CGE for lung, 1.4 Gy/CGE for breast, 2.8 Gy/CGE for esophagus, and 2.7 Gy/CGE for thyroid. Conclusions: All 10 patients benefitted from dose reductions to OARs with PT compared with either 3D-CRT or IMRT. It is anticipated that these reductions in dose to OAR will translate into lower rates of late complications, but long-term follow-up on this Phase II INRT study is needed.

  3. Staged cascade fluidized bed combustor

    DOEpatents

    Cannon, Joseph N.; De Lucia, David E.; Jackson, William M.; Porter, James H.

    1984-01-01

    A fluid bed combustor comprising a plurality of fluidized bed stages interconnected by downcomers providing controlled solids transfer from stage to stage. Each stage is formed from a number of heat transfer tubes carried by a multiapertured web which passes fluidizing air to upper stages. The combustor cross section is tapered inwardly from the middle towards the top and bottom ends. Sorbent materials, as well as non-volatile solid fuels, are added to the top stages of the combustor, and volatile solid fuels are added at an intermediate stage.

  4. Three-dimensional conformal radiotherapy for locally advanced (Stage II and worse) head-and-neck cancer: Dosimetric and clinical evaluation

    SciTech Connect

    Portaluri, Maurizio . E-mail: portaluri@hotmail.com; Fucilli, Fulvio I.M.; Castagna, Roberta; Bambace, Santa; Pili, Giorgio; Tramacere, Francesco; Russo, Donatella; Francavilla, Maria Carmen

    2006-11-15

    Purpose: To evaluate the dosimetric parameters of three-dimensional conformal radiotherapy (3D-CRT) in locally advanced head-and-neck tumors (Stage II and above) and the effects on xerostomia. Methods and Materials: A total of 49 patients with histologically proven squamous cell cancer of the head and neck were consecutively treated with 3D-CRT using a one-point setup technique; 17 had larynx cancer, 12 oropharynx, 12 oral cavity, and 6 nasopharynx cancer; 2 had other sites of cancer. Of the 49 patients, 41 received postoperative RT and 8 definitive treatment. Also, 13 were treated with cisplatin-based chemotherapy before and during RT; in 6 cases, 5-fluorouracil was added. The follow-up time was 484-567 days (median, 530 days). Results: One-point setup can deliver 96% of the prescribed dose to the isocenter, to the whole planning target volume, including all node levels of the neck and without overdosages. The mean dose to the primary planning target volume was 49.54 {+-} 4.82 Gy (51.53 {+-} 5.47 Gy for larynx cases). The average dose to the contralateral parotid gland was approximately 38 Gy (30 Gy for larynx cases). The maximal dose to the spinal cord was 46 Gy. A Grade 0 Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer xerostomia score corresponded to a mean dose of 30 Gy to one parotid gland. A lower xerostomia score with a lower mean parotid dose and longer follow-up seemed to give rise to a sort of functional recovery phenomenon. Conclusion: Three dimensional-CRT in head-and-neck cancers permits good coverage of the planning target volume with about 10-11 segments and one isocenter. With a mean dose of approximately 30 Gy to the contralateral parotid, we observed no or mild xerostomia.

  5. Phase I Study of Oxaliplatin in Combination With Capecitabine and Radiotherapy as Postoperative Treatment for Stage II and III Rectal Cancer

    SciTech Connect

    Jin Jing

    2008-11-01

    Purpose: A Phase I study was conducted to determine the maximal tolerated dose and the dose-limiting toxicity (DLT) of oxaliplatin (OXA) combined with capecitabine and radiotherapy as adjuvant treatment in patients with operable rectal cancer. Patients and Methods: A total of 21 patients with Stage II or III rectal adenocarcinoma after curative surgery were treated with radiotherapy to a total dose of 50 Gy in 5 weeks. OXA was administered at a dosage of 40 (n = 6), 50 (n = 3),60 (n = 3), 70 (n = 3), or 80 mg/m{sup 2} (n = 6) once a week for 2 weeks (first cycle) followed by a second cycle after a 7-day break. Capecitabine at a fixed dose of 1,300 mg/m{sup 2}/d was administered orally at the same schedule as for OXA. DLT was defined as Grade 3 or 4 hematologic and nonhematologic toxicity. Results: Grade 1-3 leukopenia, diarrhea, and nausea/vomiting were the most common toxic side effects, and most were Grade 1-2. A DLT was first observed in 1 of 3 patients at 40 mg/m{sup 2} (Grade 3 diarrhea) but was not observed in the next 3 patients at the same level or in patients who received a dose level of 50-70 mg/m{sup 2}. At 80 mg/m{sup 2}, DLT occurred in 3 of 6 patients (1 Grade 4 leukopenia and 2 Grade 3 diarrhea). Conclusions: OXA combined with a fixed dose of capecitabine at 625 mg/m{sup 2} twice daily by mouth plus radiotherapy in the adjuvant setting was tolerable and clinically feasible. The maximal tolerated dose of OXA in this setting was 80 mg/m{sup 2}, comparable to the maximal tolerated dose of OXA in the neoadjuvant setting.

  6. Long-term prognostic and predictive factors in 107 stage II/III breast cancer patients treated with anthracycline-based neoadjuvant chemotherapy.

    PubMed Central

    Brain, E.; Garrino, C.; Misset, J. L.; Carbonero, I. G.; Itzhaki, M.; Cvitkovic, E.; Goldschmidt, E.; Burki, F.; Regensberg, C.; Pappo, E.; Hagipantelli, R.; Musset, M.

    1997-01-01

    The heterogeneity of therapeutic modalities and eligibility criteria and the lack of long-term follow-up in most reports of neoadjuvant chemotherapy for breast cancer preclude us from drawing conclusions about its value in clinically relevant patient subgroups. The present study aims to identify predictive and prognostic factors in 107 non-inflammatory stage II/III breast cancer patients treated between November 1980 and October 1991 with an anthracycline-based induction regimen before locoregional surgery. Preoperative chemotherapy comprised 3-6 cycles of doxorubicin (pirarubicin after 1986), vindesine, cyclophosphamide and 5-fluorouracil. Type of subsequent surgery and adjuvant treatment were decided individually. In analysis of outcome, univariate comparisons of end points were made using the log-rank test, and significant (P < or = 0.05) pre- and post-therapeutic factors were incorporated in a Cox multivariate analysis. With a median follow-up of 81 months (range 32-164+ months), the median disease-free survival (DFS) is 90.5 months while median overall survival has not yet been reached. Cytoprognostic grade and histopathological response in both the primary and lymph nodes were independent covariates associated with locoregional relapse with or without DFS and overall survival. Eleven patients with pathological complete response remain free of disease with a 68-month median follow-up, while the 18 with residual microscopic disease on the specimen showed a 60% cumulative incidence of locoregional recurrence. Despite encouraging response rates based on clinical or radiological evaluation (87% or 70%), neither method showed any significant correlation with pathological response and failed to contribute prognostic information on patients' outcome. Pathological evaluation of antitumoral activity of primary chemotherapy remains a major source of prognostic information and might be used to select patients in need of additional adjuvant treatment. PMID:9155059

  7. Concurrent chemotherapy (carboplatin, paclitaxel, etoposide) and involved-field radiotherapy in limited stage small cell lung cancer: a Dutch multicenter phase II study

    PubMed Central

    Baas, P; Belderbos, J S A; Senan, S; Kwa, H B; van Bochove, A; van Tinteren, H; Burgers, J A; van Meerbeeck, J P

    2006-01-01

    To improve the prognosis of limited stage small cell lung cancer (LS-SCLC) the addition of concurrent thoracic radiotherapy to a platinum-containing regimen is important. In the Netherlands, we initiated a multicenter, phase II study, of the combination of four cycles of carboplatin (AUC 5), paclitaxel (200?mg?m?2) and etoposide (2 50?mg orally for 5 days) combined with 45?Gy (daily fractions of 1.8?Gy). The radiation was given to the involved field and concurrently with the second and third chemotherapy cycle. Patients with a partial or complete response received prophylactic cranial irradiation to a dose of 30?Gy. From January 1999 to December 2001, 37 of the 38 patients with LS-SCLC entered were eligible for toxicity analysis and response. Grade 3 and 4 haematological toxicity occurred in 57% (21/37) with febrile neutropenia in 24% (9/37). There were no treatment-related deaths or other grade 4 toxicity. Grade 3 toxicities were oesophagitis (27%), radiation pneumonitis (6%), anorexia (14%), nausea (16%), dyspnea (19%) and lethargy (22%). The objective response rate was 92% (95% confidence interval (CI) 8098%) with a median survival time of 19.5 months (95% CI 12.829.2). The 1-, 2- and 5-year survival rate was 70, 47 and 27%, respectively. In field local recurrences occurred in six patients. Distant metastases were observed in 19 patients of which 13 in the brain. This study indicates that combination chemotherapy with concurrent involved-field radiation therapy is an effective treatment for LS-SCLC. Despite PCI, the brain remained the most important site of recurrence. PMID:16465191

  8. Does internal mammary node irradiation affect treatment outcome in clinical stage II-III breast cancer patients receiving neoadjuv ant chemotherapy?

    PubMed

    Kim, Kyung Hwan; Noh, Jae Myoung; Kim, Yong Bae; Chang, Jee Suk; Keum, Ki Chang; Huh, Seung Jae; Choi, Doo Ho; Park, Won; Suh, Chang-Ok

    2015-08-01

    The purpose of this study is to assess the value of internal mammary node irradiation (IMNI) in patients receiving postoperative radiotherapy after neoadjuvant chemotherapy (NAC) using modern systemic therapy. Between 2001 and 2009, 521 consecutive patients with clinical stage II-III breast cancer received NAC and postoperative radiotherapy. With a consistent policy, the treating rad