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Sample records for voies aerodigestives superieures

  1. Chemoprevention of aerodigestive cancer.

    PubMed

    Berwick, M; Schantz, S

    1997-01-01

    Effective chemoprevention of aerodigestive tumors could have far-reaching effects. Aerodigestive cancer accounts for one-third of all cancer deaths in the United States and is the most common cancer in some areas of the world. Prognosis is poor, and a reduced quality of life remains in those who do survive. To date, there have been no effective chemopreventive agents, but many new compounds hold promise. The concepts of field carcinogenesis and multi step carcinogenesis underpin the development of chemopreventive agents for aerodigestive tract tumors. Important risk factors are tobacco use, alcohol consumption, dietary habits, genetic susceptibility, socioeconomic status, and the interaction of these. Two promising areas for surrogate biomarker development are tissue autofluorescence and DNA repair. Numerous chemoprevention trials have shown that antioxidant compounds are effective in reversing precursor lesions. Studies of the effects of chemopreventive agents on second primary tumors are ongoing. Finally, large-scale trials of the anti-oxidant beta carotene have been disappointing; they have shown that among heavy smokers and possibly heavy alcohol consumers beta carotene increases risk for lung cancer incidence and mortality. These findings underline the critical need to better understand specific mechanisms of action at a particular tissue site, and under various conditions, such as heavy smoking. Novel agents are under development: epigallacatchin gallate, or green tea, curcumin, and a new emphasis on folic acid. Studies to date show that targeting susceptible subgroups, by means of genetic or lifestyle factors, and all ethnic groups will facilitate the goals of chemoprevention studies. PMID:9433643

  2. Foreign Bodies in the Aerodigestive Tract

    PubMed Central

    Lawson, Victor G.; Middleton, William G.

    1986-01-01

    Foreign bodies in the aerodigestive tract are common. They may cause minimal disturbance of function, severe morbidity or even sudden death. They enter the aerodigestive tract because of haste during eating, disturbances in physical function, impairments due to extreme youth or age, or contamination of food with foreign bodies. Common symptoms are pain, dysphagia, odynophagia, cough, airway distress, hemoptysis and hematemesis. Signs include point tenderness, respiratory distress and surgical emphysema. Clinical, radiological and endoscopic investigations are described, as are principles of crisis and elective management. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7Fig. 8Fig. 9 PMID:21267132

  3. Management of foreign bodies in the aerodigestive tract.

    PubMed

    Hariga, Inès; Khamassi, Khaled; Zribi, Sarra; Amor, Mohamed Ben; Gamra, Olfa Ben; Mbarek, Chiraz; Khedim, Abdelkader El

    2014-01-01

    Foreign body (FB) aspiration and ingestion are frequently encountered by emergent otolaryngology services. The authors describe their experience in the management of FB cases in the aerodigestive tract. We carry a retrospective study about 626 patients who came or were referred to our department between 1996 and 2007 with a history or suspicion of a FB in the aerodigestive tract (except nasal and oropharyngeal FB). All of them have undergone rigid endoscopy under general anaesthesia. Children younger than 10 years were the most involved (36.9%) followed by patients between 71 and 80 years old (11.3%). The FB were visible on clinical examination in 39 cases. Chest and neck X-ray, showed radio-opaque FB in 302 cases (48.7%). A total of 626 rigid endoscopies were performed. FB were encountered in 549 patients (87.7%). The most involved sites were the oesophagus (51.9%) followed by the tracheobronchial tree (33.9%) and the hypopharynx (13.5%). Bones (22%) and coins (20.1%) were the most frequently encountered FB. Successful removal was achieved in 521 cases (94.9% of the FB found). The complication rate after rigid endoscopy was 1.3%. FB in the aerodigestive tract are frequent and may lead to severe complications. Removal through the rigid endoscope still has its place as the most reliable method. Prevention and public education for this serious problem should be considered. PMID:24533387

  4. Effects of air pollution on the upper aerodigestive tract.

    PubMed

    Holt, G R

    1996-02-01

    The main route of contamination of the human body with airborne pollutants is through the upper air and food passages. Because of the delicate balance of the mucous membranes and special sensory organs of these passages with respect to mucociliary activity, local and recruited immune responses, rapid uptake of chemicals, and carcinogenic potential, the ingestion or inhalation of pollutants in the air can be harmful to these internal body barriers. The particular target organs for air pollution effects on the upper aerodigestive tract include the mucosa, olfactory epithelium, auditory receptor cells, glottic epithelium, and adjacent neural and muscular tissues. Hearing loss caused by noise exposure may be aggravated by the concomitant inhalation of solvents. The strongest evidence for the carcinogenic effect of occupational inhalants in the nasal cavity and paranasal sinuses is seen with exposure to hardwood dust, tobacco smoke, furniture making, and leather tanning. With the exception of tobacco smoke, which produces squamous cell carcinomas, the majority of the occupationally related cancers are adenocarcinomas, usually of the intestinal variety. Tobacco smoke, passive or active, may lead to end-artery obliteration at the level of the otic end organ, causing a progressive sensorineural hearing loss. Further environmental research in the upper aerodigestive tract should aim at developing biologic markers to determine early, premalignant tissue changes; identifying the effects of chronic, low-dose toxic exposure on mucous membranes and neurosensory organs; providing field-tested tools for the standardized screening of large at-risk populations. PMID:8637732

  5. Upper aerodigestive tract neurofunctional mechanisms: lifelong evolution and exercise.

    PubMed

    Robbins, JoAnne

    2011-10-01

    The transformation of the upper aerodigestive tract--oral cavity, pharynx, and larynx--serves the functions of eating, speaking, and breathing during sleeping and waking hours. These life-sustaining functions may be produced by a central neural sensorimotor system that shares certain neuroanatomic networks while maintaining separate neural functional systems and network structures. Current understanding of development, maturation, underlying neural correlates, and integrative factors are discussed in light of currently available imaging modalities and recently emerging interventions. Exercise and an array of additional treatments together seem to provide promising translational pathways for evidence-based innovation, novel habilitation, and rehabilitation strategies and delay, or even prevent neuromuscular decline cross-cutting functions and supporting quality of life throughout increasingly enduring lifespans. PMID:21910155

  6. Pediatric upper aero-digestive and respiratory tract burns

    PubMed Central

    Ofri, Adam; Harvey, John G; Holland, Andrew J A

    2013-01-01

    Upper aero-digestive and respiratory tract burns may occur in isolation or in association with cutaneous burn injury. Major respiratory burns have been linked with a high mortality and morbidity. Despite the importance of these injuries there have been few studies in children. A retrospective case note review between December 2000 and March 2011 of all pediatric upper aero-digestive and respiratory tract burns referred to the New South Wales Statewide Burn Injury Service was performed. Data were collected on patient characteristics, injury details, requirement for intubation, length of stay (LOS), morbidity and mortality. There were 33 patients diagnosed, with a median age of 5.4 years and a male to female ratio of 1.2:1. Mechanism of injury was ingestion of a caustic material (n=15), flame (n=11) or scald (n=7). Overall 14 (42%) patients were intubated; the majority associated with burns to the face (79%) and oropharynx (64%). Median LOS was 6 days (range 3 to 23). Of those patients admitted to intensive care, 50% had a positive bacterial culture. The most common sites of infection were tracheal/endotracheal (80%) and burn sites (44%). There were 2 (6%) deaths in the series. Whilst the majority of children with upper airway and respiratory tract burns required intubation, the overall morbidity and mortality was low compared to adult series. This may reflect that a number of children suffered an upper aero digestive tract burn following ingestion of a caustic material or hot liquids, rather than a lower tract, inhalational flame burn. PMID:24273696

  7. Button battery injuries in the pediatric aerodigestive tract.

    PubMed

    Ettyreddy, Abhinav R; Georg, Matthew W; Chi, David H; Gaines, Barbara A; Simons, Jeffrey P

    2015-12-01

    Children with a button battery impaction present with nonspecific symptoms that may account for a delay in medical care. We conducted a retrospective study of the clinical presentation, management, and complications associated with button battery ingestion in the pediatric aerodigestive tract and to evaluate the associated long-term morbidity. We reviewed the medical records of 23 patients who were treated for button battery impaction at our tertiary care children's hospital from Jan. 1, 2000, through July 31, 2013. This population was made up of 14 boys and 9 girls, aged 7 days to 12 years (mean: 4 yr). Patients were divided into three groups based on the site of impaction; there were 9 impactions in the esophagus and 7 each in the nasal cavity and stomach. We compiled information on the type and size of each battery, the duration of the impaction, presenting symptoms, treatment, and outcomes. The mean duration of battery impaction was 40.6, 30.7, and 21.0 hours in the esophagus, nasal cavity, and stomach, respectively. We were able to identify the specific type of battery in 13 cases; 11 of these cases (85%) involved a 3-V 20-mm lithium ion battery, including all cases of esophageal impaction in which the type of battery was identified. The most common presenting signs and symptoms were vomiting (n = 7 [30%]), difficulty feeding (n = 5 [22%]), cough (n = 5), and bloody nasal discharge (n = 5); none of the presenting signs and symptoms predicted the severity of the injury or the outcome. The median length of hospital stay was far greater in the esophageal group (12 days) than in the nasal and stomach groups (1 day each; p = 0.006). Battery impaction in the esophagus for more than 15 hours was associated with a significantly longer postoperative hospital stay than impaction for less than 15 hours (p = 0.04). Esophageal complications included strictures (n = 5), perforation (n = 3), and tracheoesophageal fistula formation (n = 2). Clinicians should consider battery impaction in the upper aerodigestive tract as an emergency that can lead to significant long-term morbidity, and therefore immediate surgical intervention is required. PMID:26670755

  8. Life course models for upper aero-digestive tract cancer.

    PubMed

    Gupta, Bhawna; Lalloo, Ratilal; Johnson, Newell W

    2015-06-01

    Upper aero-digestive tract (UADT) cancers are collectively cancers of various human body sites, such as the oral cavity, pharynx, oesophagus and larynx. Worldwide, they are the fourth most frequent cancer type and the fourth most common cause of mortality from cancer. Many studies have shown that several chronic diseases, such as cancer, which occur more commonly in later adulthood, are influenced by social and psychological circumstances during birth, childhood, adolescence and early adult life. It is suggested that the build up of problematic circumstances throughout life is the cause of disease, rather than circumstances that happen at one point in time. UADT cancer is a chronic disease of complex multifactorial origin and most of the underlying exposures/risks cannot be considered as individual factors or in isolation, as they act at different levels, which differ from time to time. Thus, life-course epidemiology, rather than drawing false dichotomies between different risk factors of the underlying disease, attempts to integrate biological and social risk processes that cause the chronic disease. It studies how socially patterned exposures during all stages of life--childhood, adolescence and early adult--influence disease risk in adulthood and socio-economic position and hence may account for social inequalities in adult health and mortality. Furthermore, varying health effects, according to the timing or duration of exposure to socio-economic circumstances, may indicate important traces to the causes of cancer. In this paper, we have attempted to draw a conceptual framework on the relationships between socio-economic inequalities, oral health risk factors along the life-course of an individual and incidence of UADT cancer. PMID:25939378

  9. Epigenetic pathogenesis of human papillomavirus in upper aerodigestive tract cancers.

    PubMed

    Talukdar, Fazlur Rahman; Ghosh, Sankar Kumar; Laskar, Ruhina Shirin; Kannan, Ravi; Choudhury, Biswadeep; Bhowmik, Arup

    2015-11-01

    Human papillomavirus (HPV) has been recently associated with squamous cell carcinoma of upper aerodigestive tract (SCC of UADT), but its possible role in promoting aberrant methylation in these tumors has largely remained unexplored. Herein, we investigated the association of HPV with aberrant methylation in tumor-related genes/loci consisting of the classical CpG Island Methylator Phenotype (CIMP) panel markers (p16, MLH1, MINT1, MINT2, and MINT31) and other frequently methylated cancer-related genes (DAPK1, GSTP1, BRCA1, ECAD, and RASSF1) and survival of UDAT cancers. The study includes 219 SCC of UADT patients from different hospitals of Northeast India. Detection of HPV and aberrant promoter methylation was performed by PCR and Methylation Specific PCR respectively. Association study was conducted by Logistic regression analysis and overall survival analysis was done by Kaplan-Meier plot. HPV was detected in 37% of cases, with HPV-18 as the major high-risk sub-type. Although HPV presence did not seem to affect survival in overall UADT cancers, but was associated with a favourable prognosis in head and neck squamous cell carcinoma. Hierarchical clustering revealed three distinct clusters with different methylation profile and HPV presence. Among these, the CIMP-high subgroup exhibited the highest HPV positive cases (66%). Furthermore, multivariate analysis revealed a strong synergistic association of HPV and tobacco towards modulating promoter hypermethylation in UADT cancer (OR?=?27.50 [95% CI?=?11.51-88.03] for CIMP-high vs. CIMP-low). The present study proposes a potential role of HPV in impelling aberrant methylation in specific tumor related loci, which might contribute in the initiation and progression of SCC of UADT. © 2014 Wiley Periodicals, Inc. PMID:25213493

  10. Low dose, low noise, and high resolution volume of interest (VOI) imaging in C-arm flat-detector CT

    NASA Astrophysics Data System (ADS)

    Kolditz, Daniel; Kyriakou, Yiannis; Kalender, Willi A.

    2010-04-01

    The high flexibility of C-arm flat-detector computed tomography (FDCT) is used in a volume of interest (VOI) imaging method to handle the challenges of increasing spatial resolution, reducing noise and saving dose. A low-dose overview scan of the object and a high-dose scan of an arbitrary VOI are combined. The first scan is adequate for orientation to select the VOI and the second scan assures high image quality in the VOI. The combination is based on a forward projection of the reconstructed overview volume and the measured VOI data in the raw data domain. Differences in the projection values are matched before a standard Feldkamp-type reconstruction is performed. In simulations, spatial resolution, noise and contrast detectability were evaluated. Measurements of an anthropomorphic phantom were used to validate the proposed method for realistic application. In Monte Carlo dose simulations the dose reduction potential was investigated. By combination of the two scans an image is generated which covers the whole object and provides the actual VOI at high image quality. Spatial resolution was increased whereas noise was decreased from outside to inside the VOI, e.g. for the simulations from 0.8 lp/mm to 3.0 lp/mm and from 39 HU to 18 HU, respectively. Simultaneously, the cumulative dose for this two-scan procedure was significantly reduced in comparison to a conventional high dose scan, e.g. for the performed simulations and measurements by about 95 %. The proposed VOI approach offers significant benefits with respect to high-resolution and low-contrast imaging of a VOI at reduced dose.

  11. About the Lung and Upper Aerodigestive Cancer Research Group | Division of Cancer Prevention

    Cancer.gov

    The Lung and Upper Aerodigestive Cancer Research Group conducts and supports research on the prevention and early detection of lung and head and neck cancers, as well as new approaches to clinical prevention studies including cancer immunoprevention.Phase 0/I/II Cancer Prevention Clinical Trials ProgramThe group jointly administers the Phase 0/I/II Cancer Prevention Clinical Trials Program evaluating new agents, surrogate biomarkers, and technologies to identify premalignant lesions, and related cancers.  |

  12. About the Lung and Upper Aerodigestive Cancer Research Group | Division of Cancer Prevention

    Cancer.gov

    The Lung and Upper Aerodigestive Cancer Research Group conducts and supports research on the prevention and early detection of lung and head and neck cancers, as well as new approaches to clinical prevention studies including cancer immunoprevention.Phase 0/I/II Cancer Prevention Clinical Trials ProgramThe group jointly administers the Phase 0/I/II Cancer Prevention Clinical Trials Program evaluating new agents, surrogate biomarkers, and technologies to identify premalignant lesions, and related cancers.  |

  13. Usefulness of percutaneous endoscopic gastrostomy for supportive therapy of advanced aerodigestive cancer

    PubMed Central

    Ogino, Haruei; Akiho, Hirotada

    2013-01-01

    Aerodigestive cancer, like esophageal cancer or head and neck cancer, is well known to have a poor prognosis. It is often diagnosed in the late stages, with dysphagia being the major symptom. Insufficient nutrition and lack of stimulation of the intestinal mucosa may worsen immune compromise due to toxic side effects. A poor nutritional status is a significant prognostic factor for increased mortality. Therefore, it is most important to optimize enteral nutrition in patients with aerodigestive cancer before and during treatment, as well as during palliative treatment. Percutaneous endoscopic gastrostomy (PEG) may be useful for nutritional support. However, PEG tube placement is limited by digestive tract stenosis and is an invasive endoscopic procedure with a risk of complications. There are three PEG techniques. The pull/push and introducer methods have been established as standard techniques for PEG tube placement. The modified introducer method, namely the direct method, allows for direct placement of a larger button-bumper-type catheter device. PEG tube placement using the introducer method or the direct method may be a much safer alternative than the pull/push method. PEG may be recommended in patients with aerodigestive cancer because of the improved complication rate. PMID:24244880

  14. ErbB receptors in the biology and pathology of the aerodigestive tract

    SciTech Connect

    Morgan, Sarah; Grandis, Jennifer R.

    2009-02-15

    The most common sites of malignancies in the aerodigestive tract include the lung, head and neck and the esophagus. Esophageal adenocarcinomas (EA), esophageal squamous cell carcinomas (ESCC), and squamous cell carcinomas of the head and neck (SCCHN) are the primary focus of this review. Traditional treatment for aerodigestive tract cancers includes primary chemoradiotherapy (CRT) or surgical resection followed by radiation (or CRT). Recent developments in treatment have focused increasingly on molecular targeting strategies including cetuximab (a monoclonal antibody against epidermal growth factor receptor (EGFR)). Cetuximab was FDA approved in 2006 for treatment of SCCHN, underscoring the importance of understanding the biology of these malignancies. EGFR is a member of the ErbB family of growth factor receptor tyrosine kinases. The major pathways activated by ErbB receptors include Ras/Raf/MAPK; PI3K/AKT; PLC{gamma} and STATs, all of which lead to the transcription of target genes that may contribute to aerodigestive tumor progression. This review explores the expression of ErbB receptors in EA, ESCC and SCCHN and the signaling pathways of EGFR in SCCHN.

  15. Les kystes hydatiques du foie rompus dans les voies biliaires: à propos de 120 cas

    PubMed Central

    Moujahid, Mountassir; Tajdine, Mohamed Tarik

    2011-01-01

    Etude rétrospective rapportant une série de kystes hydatiques rompus dans les voies biliaires colligés dans le service de chirurgie de l'hôpital militaire Avicenne à Marrakech. Entre 1990 à 2008, sur 536 kystes hydatiques du foie opérés dans le service, 120 étaient compliqués de rupture dans les voies biliaires soit 22,38%. Il y avait 82hommes et 38 femmes. L’âge moyen était de 35 ans avec des extrêmes allant de 10 à 60 ans. La clinique était dominée par la crise d'angiocholite ou une douleur du flanc droit. L'ictère était isolé dans huit cas. La fistule biliokystique était latente dans plus de 50% des cas. Le traitement a consisté en une résection du dôme saillant dans103cas (85,84%), une périkystectomie chez 11 malades (9,16%) et une lobectomie gauche dans six cas (5%). Le traitement de la fistule bilio kystique a consisté en une suture chez 36malades et un drainage bipolaire dans 25 cas, La déconnexion kysto-biliaire ou cholédocotomie trans hépatico kystique selon Perdomo était pratiquée dans 49cas et une anastomose bilio-digestive cholédoco-duodénale dans 10 cas. La durée moyenne d'hospitalisation était de 20jours. Nous déplorons deux décès par choc septique et un troisième par encéphalopathie secondaire à une cirrhose biliaire. La morbidité était représentée par huit abcès sous phrénique, douze fistules biliaires prolongées et deux occlusions intestinales. Les kystes hydatiques rompus dans les voies biliaires représentent la complication la plus grave de cette pathologie bénigne. Le traitement repose sur des méthodes radicales qui sont d'une efficacité reconnue, mais de réalisation dangereuse et les méthodes conservatrices, en particulier la déconnexion kysto-biliaire qui est une méthode simple et qui donne de bons résultats à court et à long terme. PMID:22384289

  16. Upper aerodigestive cancer in battery manufacturers and steel workers exposed to mineral acid mists.

    PubMed Central

    Coggon, D; Pannett, B; Wield, G

    1996-01-01

    OBJECTIVE--To assess the risk of cancer from inhalation of mineral acid mists. METHODS--A cohort study and nested case-control study of upper aerodigestive tumours were carried out in men employed since 1950 at two battery plants and two steel works in Britain. The cohort was identified from personnel records and included 2678 men with definite exposure to acid mists (mainly sulphuric acid), 367 with possible exposure, and 1356 who were unexposed. Mortality was compared with that in the national population by the person-years method. Cases of upper aerodigestive cancer were identified from death certificates and cancer registrations, and their exposure to acids was compared with that of age matched controls (five per case) from the same plant by conditional logistic regression. RESULTS--In follow up to 31 December 1993, 93% of men were traced, including 1277 who had died. Among the men definitely exposed to acid mists, overall mortality was less than in the national population (standardised mortality ratio (SMR) 0.92, 95% confidence interval (95% CI) 0.85-0.98) as was mortality from all cancers (SMR 0.92, 95% CI 0.79-1.05) and specifically from cancer of the larynx (SMR 0.48, 95% CI 0.01-2.70) and lung (SMR 0.98, 95% CI 0.78-1.22). A total of 15 incident or fatal cases of upper aerodigestive cancer were identified during follow up. When these men were compared with controls, risk was moderately increased in those who had worked for at least five years in jobs entailing exposures to sulphuric or hydrochloric acid in excess of 1 mg/m3 (OR 2.0, 95% CI 0.4-10). CONCLUSIONS--These findings are consistent with those from other studies which have indicated a hazard of upper aerodigestive cancer from acid mists. However, they indicate that any risk from exposures to sulphuric and hydrochloric acid below 1 mg/m3 is small. PMID:8704867

  17. Incidence of foreign bodies in aerodigestive tract in vindhya region: our experience.

    PubMed

    Gupta, Richa; Poorey, V K

    2014-06-01

    Foreign bodies in aerodigestive tract are frequent occurrence and may lead to life threatening situation due to obstruction caused in respiratory passages. To present foreign body ingestion cases observed in a 5-year period at the S.S. Medical College and G.M. Hospital, Rewa (MP). The present study is a retrospective analysis including 108 patients of foreign bodies of aerodigestive tract of Vindhya region who presented to the S.S. Medical College and G.M. Hospital, Rewa from January 2008 to August 2012. About 92 patients of total 108 patients had evidence of foreign body in food passage with age ranging from 9 month to 85 years. Most patients 65 (70.65 %) belong to <10 year age group. Radiological evidence was found in 76 (82.6 %) patients. Most common foreign body was found to be coin 75 (81.52 %). The commonest site of lodgement was cricopharynx. About 16 patients of total 108 patients had evidence of foreign body in airway with age ranging from 9 months to 72 years. Most cases 8 (50 %) belong to <10 year age. Maximum cases showed vegetative foreign body with right bronchus (58.33 %) as commonest site of lodgement. Early detection by meticulous history, imaging modality and prompt management remains basis for favourable outcome and prevents future complications. PMID:24822150

  18. Establishment and biochemical characterization of primary cells of the upper aerodigestive tract.

    PubMed

    Rickert, Dorothee; Franke, R-P; Fernández, Cecilia A; Kilroy, Susan; Yan, Li; Moses, Marsha A

    2007-01-01

    The upper aerodigestive tract, composed of the oral cavity, the pharynx and the esophagus, is a complex system whose components function in both organ-specific ways as well in serving as a protective barrier against the enzymes which initiate digestion as well as against the mechanical functions which serve to ensure movement of food through the upper aerodigestive tract. Given these diverse functional requirements, the study of the anatomy and physiology of this region are uniquely complex and significantly understudied. The goal of the current study was to develop a simple and reproducible method for the isolation, growth, and maintenance of primary epithelial cells from the oral cavity, the pharynx and the esophagus. In addition, given the increased interest in diseases characterized by a loss of mucosal integrity in these areas which is often accompanied by a diminished wound healing capability, these cells were biochemically characterized with a focus on the components of the extracellular matrix remodeling axis including the activity and inhibition of the matrix metalloproteinases (MMPs). PMID:17211061

  19. Comparative p53 mutational spectra in aerodigestive tract tumors in Hong Kong Chinese patients.

    PubMed

    Chan, W C; Leung, C S; Lung, M L

    1999-01-01

    The p53 mutations in colorectal, esophageal and lung carcinomas from Hong Kong were studied previously. The availability of mutation data for these cancers in one geographical region prompted investigations into special features of these p53 alterations. Mutations in codons 175, 176, 248 and 273 accounted for 35% of all mutations detected. A hot spot at codon 176 observed in esophageal carcinomas was not detected in any of the other aerodigestive tract tumors studied and appeared to be uniquely restricted to Chinese esophageal cancers. Other unique mutation sites, and a notably higher frequency of insertions and deletions in each of these cancers, were also detected in Chinese patients as compared to Caucasians. PMID:9864422

  20. Migrating foreign bodies in the upper aerodigestive tract: a surgical challenge.

    PubMed

    Shergill, Gurshinderpal Singh; Nayak, Dipak Ranjan; Dora, Asheesh; Shergill, Ankur Kaur

    2015-01-01

    Migrating foreign bodies in the aerodigestive tract are uncommon but can pose serious complications. Long-standing migrating foreign bodies can exist manifesting chronic and unusual symptoms such as chronic cough, recurrent episodes of dyspnoea and fever. Adverse body reactions to foreign objects such as adhesions can cause difficulty in their diagnosis, localisation and removal. A thorough clinical and radiographical approach is of immense value in such cases. We report two difficult cases of migrated foreign bodies: a 2-year-old child with a long-standing foreign body that migrated to the upper mediastinum, and an adult patient with a fish bone that migrated to the oropharyngeal muscles. Presentations of these cases were not alike, with chronic unusual recurrent symptoms in one and typical acute symptoms in the other. The diagnosis and precise localisation of both foreign bodies was challenging, and an open approach was employed to remove them. PMID:25994437

  1. Therapeutic approaches to the treatment of recurrent respiratory papillomatosis of the aerodigestive tract (a clinical study)

    PubMed Central

    Avramov, Toma; Vetckova, Evelina; Nikolova, Maria; Valev, Dinko; Manolova, Antoaneta; Tafradgiiska, Maya; Kostadinov, Dimitar; Tchalacov, Ivan

    2014-01-01

    Recurrent respiratory papillomatosis (RRP) is a rare disease, characterized by recurrent proliferation of benign squamous cell papillomas in the larynx as well as in the other parts of the aerodigestive tract. We have compared different treatment options for RRP of the aerodigestive tract including surgical, conservative and combined approaches. A total of 43 patients with papillomatosis that received a combined therapy were followed in the period from 2009 to 2013. The treatment included electrosurgery and CO2 laser surgery alongside with either immunotherapy with Bacillus Calmette-Guerin (BCG) (Calgevax) or ?-interferon. In the control group without immunotherapy (n = 16) we used conventional microlaryngeal surgery. During the follow-up, relapse occurred in two patients for the CO2 laser surgery with Calgevax immunotherapy group (n = 16). In the group treated with ?-interferon preceded by CO2 laser surgery (n = 9) and electrosurgery (n = 2), relapse had occurred in three patients. Among the control group, recurrence was observed in six patients. This required re-operation. Our data showed a three times more frequent relapses among patients who were operated with conventional surgery as compared to those operated with CO2 laser surgery and Calgevax immunotherapy, and two times more often relapses in patients operated with conventional surgery as compared to those with electrosurgery and CO2 laser surgery and application of ?-interferon therapy. Conventional and laser surgeries have a palliative effect, though playing an important role in ensuring the airway patency. While specific antivirus treatment for human papilloma viruses does not exist, the immune modulation with Calgevax considerably reduces the frequency of relapses, by stimulating cellular immune effector mechanisms. The combined protocol allows rarefication of relapses and improvement of patients’ quality of life, but not complete healing. PMID:26692782

  2. Protective Role of Aerodigestive Reflexes Against Aspiration: Study on Subjects With Impaired and Preserved Reflexes

    PubMed Central

    DUA, KULWINDER; SURAPANENI, SRI NAVEEN; KURIBAYASHI, SHIKO; HAFEEZULLAH, MOHAMMED; SHAKER, REZA

    2012-01-01

    BACKGROUND & AIMS Direct evidence to support the airway protective function of aerodigestive reflexes triggered by pharyngeal stimulation was previously demonstrated by abolishing these reflexes by topical pharyngeal anesthesia in normal subjects. Studies have also shown that these reflexes deteriorate in cigarette smokers. Aim of this study was to determine the influence of defective pharyngeal aerodigestive reflexes on airway protection in cigarette smokers. METHODS Pharyngoglottal Closure reflex; PGCR, Pharyngo-UES Contractile reflex; PUCR, and Reflexive Pharyngeal Swallow; RPS were studied in 15 healthy non-smokers (24.2 ± 3.3 SD y, 7 males) and 15 healthy chronic smokers (27.3 ± 8.1, 7 males). To elicit these reflexes and to evaluate aspiration, colored water was perfused into the hypopharynx at the rate of 1 mL/min. Maximum volume of water that can safely dwell in the hypopharynx before spilling into the larynx (Hypopharyngeal Safe Volume; HPSV) and the threshold volume to elicit PGCR, PUCR, and RPS were determined in smokers and results compared with non-smokers. RESULTS At baseline, RPS was elicited in all non-smokers (100%) and in only 3 of 15 smokers (20%; P < .001). None of the non-smokers showed evidence of laryngeal spillage of water, whereas 12 of 15 smokers with absent RPS had laryngeal spillage. Pharyngeal anesthesia abolished RPS reflex in all non-smokers resulting in laryngeal spillage. The HPSV was 0.61 ± 0.06 mL and 0.76 ± 0.06 mL in non-smokers and smokers respectively (P = .1). CONCLUSIONS Deteriorated reflexive pharyngeal swallow in chronic cigarette smokers predispose them to risks of aspiration and similarly, abolishing this reflex in non-smokers also results in laryngeal spillage. These observations directly demonstrate the airway protective function of RPS. PMID:21420407

  3. Jaw mobility changes in patients with upper aerodigestive tract cancer undergoing radiation therapy

    PubMed Central

    Wienandts, Patrícia; Mozzini, Carolina; Pinto, Rosélie; da Motta, Neiro; Jotz, Geraldo

    2015-01-01

    Background Radiation therapy is a therapeutic modality widely used for treatment of upper aerodigestive tract (UADT) neoplasms. However, its action is not restricted to tumor cells, and it may cause a variety of adverse reactions, including reduced jaw mobility. Material and Methods A prospective cohort study was conducted to assess changes in jaw mobility in patients with UADT cancer undergoing radiation therapy. Results Fifty-six patients completed the study. The results showed a significant reduction in mouth opening (p<0.001), right lateral excursion (p=0.038) and left lateral excursion (p=0.035) of the jaw, a significant increase in the presence (p<0.001) and severity of oral mucositis (p<0.001), and a significant decrease in performance status (p<0.001) after radiation therapy. Thirty-six patients (64.3%) exhibited reduction in mouth opening after treatment. The variables significantly associated with mouth opening reduction on bivariate analysis were: modification of diet (p=0.037), radiation field (p=0.024), presence of mucositis (p=0.003), and reduction in performance status (p=0.007). After adjustment by the multivariate model, the only variables that remained significantly associated with reduction in mouth opening were presence of mucositis (p=0.018) and reduction in performance status (p=0.47). Conclusions These findings indicate that patients with upper aerodigestive tract cancer experience reduced jaw mobility after radiation therapy, which is strongly correlated with mucositis and reduced functional ability. Key words:Head and neck neoplasms, vertical dimension, radiation therapy, mucositis, temporomandibular joint, joint range of motion, trismus. PMID:26449427

  4. VOI-based valley filters and valley valves in bilayer graphene quantum wires

    NASA Astrophysics Data System (ADS)

    Lue, Ning-Yuan; Wu, George Yu-Shu

    2014-03-01

    Electrons in graphene have an inherent valley degree of freedom called valley pseudospin. Based on the valley-orbit interaction(VOI) in gapped graphene, we propose a valley filter/valve in gapped bilayer graphene(BLG)-based quantum wire device, and it's consistent with planar processing and is operated with electric gates producing an in-plane electric field transverse to the wire. The device consists of a quantum wire patterned in BLG by electrical gates, with the vicinity of the quantum wire being oxidized (or implanted with a line of point defects parallel to the wire). The transverse electric field produces a Rashba-type splitting in the valley subbands, and the oxidation (or defects) opens a pseudogap at the point where the two subbands cross. Valley polarization is generated when placing the Fermi level inside the pseudogap. We discuss the pseudogap, the valley polarization, and their dependence on the strength of the electric field and the distance between the oxidized region and the quantum wire. When the electric field is reversed, opposite valley polarity is attained. Therefore, the proposed valley filter can also be put together to form a valley valve.

  5. A Model for Predicting Gastrostomy Tube Placement in Patients Undergoing Surgery for Upper Aerodigestive Tract Lesions

    PubMed Central

    Mays, Ashley C.; Moustafa, Farah; Worley, Mitch; Waltonen, Joshua D.; D'Agostino, Ralph

    2015-01-01

    IMPORTANCE Identifying high-risk patients in the preoperative period can allow physicians to optimize nutritional status early for better outcomes after head and neck cancer resections. OBJECTIVE To develop a model to predict preoperatively the need for gastrostomy tube (G-tube) placement in patients undergoing surgery of the upper aerodigestive tract. DESIGN, SETTING, AND PARTICIPANTS This retrospective medical record review included all adult patients diagnosed with head and neck cancers who underwent tumor resection from 2007 through 2012 at Wake Forest Baptist Health, a level 1 tertiary care center. Records were screened for patient demographics, tumor characteristics, surgical treatment type, and postoperative placement of G-tube. A total of 743 patients underwent resection of head and neck tumors. Of these, 203 were excluded for prior G-tube placement, prior head and neck resection, G-tube placement for chemoradiotherapy, and resection for solely nodal disease, leaving 540 patients for analysis. MAIN OUTCOMES AND MEASURES Placement of postoperative G-tube. RESULTS Of the 540 included patients, 23% required G-tube placement. The following variables were significant and independent predictors of G-tube placement: preoperative irradiation (odds ratio [OR], 4.1; 95% CI, 2.4–6.9; P < .001), supracricoid laryngectomy (OR, 26.0; 95% CI, 4.9–142.9; P < .001), tracheostomy tube placement (OR, 2.6; 95% CI, 1.5–4.4; P < .001), clinical node stage N0 vs N2 (OR, 2.4; 95% CI, 1.4–4.2; P = .01), clinical node stage N1 vs N2 (OR, 1.6; 95% CI, 0.8–3.3; P = .01), preoperative weight loss (OR, 2.0; 95% CI, 1.2–3.2; P = .004), dysphagia (OR, 2.0; 95% CI, 1.2–3.2; P = .005), reconstruction type (OR, 1.9; 95% CI, 1.1–2.9; P = .02), and tumor stage (OR, 1.8; 95% CI, 1.1–2.9; P = .03). A predictive model was developed based on these variables. In the validation analysis, we found that the average predicted score for patients who received G-tubes was statistically different than the score for the patients who did not receive G-tubes (P = .01). CONCLUSIONS AND RELEVANCE We present a validated and comprehensive model for preoperatively predicting the need for G-tube placement in patients undergoing surgery of the upper aerodigestive tract. Early enteral access in high-risk patients may prevent complications in postoperative healing and improve overall outcomes, including quality of life. PMID:25321077

  6. 40Ar/39Ar laserprobe study of the Day Nui Con Voi Metamorphic Complex, Vietnam

    NASA Astrophysics Data System (ADS)

    Wu, C.; Lo, C.; Yeh, M.; Chung, S.; Lee, T.

    2009-12-01

    The garnet bearing gneiss within the Day Nui Con Voi (DNCV) Metamorphic Complex along the Red River Shear Zone (RRSZ) in North Vietnam, recorded a long tectonothermal history since the Indosinian orogeny. In-situ 40Ar/39Ar laserprobe study of biotite inclusions within garnet porphyroblasts and matrix biotites, combining with microstructural and scanning electron microscopy (SEM) studies, deciphered the timing and duration of thermal events. Biotites from two matrix fabrics from different deformation events show approximately similar 40Ar/39Ar age ranges in 19-24Ma, depending grain size. These matrix biotite ages are best interpreted to record a rapid cooling event associating with the left-lateral shearing event of the RRSZ. Whereas, all biotite inclusions exhibit age zoning patterns with 40Ar/39Ar ages gradually increase from 17 Ma to more than 28 Ma according to their diffusion pathways. These age variations may have resultant from a combination effect of argon retention by garnet shielding, which provides a best recorder to the metamorphic event, and argon diffusion loss along the deformed cracks during the shearing event of the RRSZ. Diffusion modeling of these age zoning indicated that the total duration of argon diffusion loss may have lasted for nearly 9 Myr and argon diffusion may have occurred sometime around 24.5Ma. These results are generally in good agreement with previous interpretation, but provide better resolution of 40Ar/39Ar age data for deciphering the history of thermal event in the DNCV Metamorphic Complex and the left-lateral shearing event of the RRSZ in Vietnam, as well.

  7. Hyaluronic Acid: Perspectives in Upper Aero-Digestive Tract. A Systematic Review

    PubMed Central

    Casale, Manuele; Moffa, Antonio; Sabatino, Lorenzo; Pace, Annalisa; Oliveto, Giuseppe; Vitali, Massimiliano; Baptista, Peter; Salvinelli, Fabrizio

    2015-01-01

    Background To date, topical therapies guarantee a better delivery of high concentrations of pharmacologic agents to the mucosa of the upper aerodigestive tract (UADT). The use of topical drugs, which are able to reduce mucosal inflammation and to improve healing tissues, can represent a relevant therapeutic advance. Topical sodium hyaluronate (SH) has recently been recognized as adjuvant treatment in the chronic inflammatory disease of the UADT. Aims The aim of our work was to review the published literature regarding all the potential therapeutic effects of SH in the chronic inflammatory disease of UADT. Methods Relevant published studies were searched in Pubmed, Google Scholar, Ovid using keywords (“sodium hyaluronate” and “upper airways”) or Medical Subject Headings. Results At the end of our selection process, sixteen publications have been included. Six of them in the post-operative period of nasal-sinus surgery, 2 of them in pediatric patients affected by recurrent upper respiratory tract infections, 4 of them in reducing symptoms and preventing exacerbations of chronic upper airways in adult population, 4 of them in patients with chronic inflammatory disease of UADT, including gastro-esophageal reflux disease (GERD). Conclusions Topical administration of SH plays a pivotkey role in the postoperative phase of patients undergoing FESS and nasal surgery, and positive results are generally observed in all the patients suffering from UADT chronic inflammatory disease. PMID:26120837

  8. Deformation sequences of the Day Nui Con Voi metamorphic belt, northern Vietnam

    NASA Astrophysics Data System (ADS)

    Yeh, M. W.; Lee, T. Y.; Lo, C. H.; Chung, S. L.; Lan, C. Y.; Lee, J. C.; Lin, T. S.; Lin, Y. J.

    2003-04-01

    The correlation of structure, microstructure and metamorphic assemblages is of fundamental importance to the understanding of the complex tectonic history and kinematics of the Day Nui Con Voi (DNCV) metamorphic belt in Vietnam along the Ailao Shan-Red River (ASRR) shear zone as it provides constraints on the relative timing of the deformation, kinematics and metamorphism. High-grade metamorphic rocks of amphibolite faces showed consistent deformation sequences of three folding events followed by one brittle deformation through all four cross sections from Lao Cai to Viet Tri indicated the DNCV belt experienced similar deformation condition throughout its length. The first deformation event, D1, produced up-right folds (locally preserved) with sub-vertical, NE-SW striking axial planes with dextral sense of shear probably formed during the early phase of the lowermost Triassic Indosinian orogeny. Followed by this compressional event is a gravitational collapsing event, D2, which is the major deformation and metamorphic event characterized by kyanite grade metamorphism and large scale horizontal folds with NW-SE (320) striking sub-horizontal axial pane showing sinsistral sense of shear most likely formed during the Oligocene-Miocene SE extrusion of Indochina peninsula. The 3rd folding event, D3, is a post-metamorphism doming event with NW-SE (310) striking sub-vertical axial plane that folded/tilted the once sub-horizontal D2 axial planes into shallowly (<30 degrees) NE dipping on the NE limb, and SW dipping on the SW limb possibly due to left-lateral movement of the N-S trending Xian Shui He fault system in Mid-Miocene. The outward decreasing of the metamorphic grade from kyanite to garnet then biotite indicated the D3 occurred post metamorphism. Reactivation of the sub-horizontal D2 fold axial planes showed dextral sense of shear possibly due to Late Miocene-Pliocene right-lateral movement of the ASRR shear zone. This right lateral movement continuously deformed the DNCV with brittle fractures such as joints and normal faults (D4) striking NE-SW to E-W and NW-SE.

  9. FDOPA metabolism in the adult porcine brain: influence of tracer circulation time and VOI selection on estimates of striatal DOPA decarboxylation.

    PubMed

    Danielsen, E H; Smith, D F; Andersen, F; Gee, A D; Bender, D; Hansen, S B; Hermansen, F; Østergaard, L; Cumming, P; Gjedde, A

    2001-10-30

    Different methodologies for PET data analysis influence the magnitude of estimates of blood-brain transfer coefficients and rate constants for the metabolism of FDOPA in living striatum. We now test the effects on several kinetic parameters of automatic procedures for volume of interest (VOI) selection. We also tested the sensitivity of the estimates to dynamic frame sequence duration, and produced a standard method for minimizing the variations in physiological estimates for FDOPA kinetics in minipig brain. We used minipigs because our previous work has shown them to provide an appropriate animal model for study normal and pathological cerebral DOPA metabolism using PET. Time-activity curves in striatum of adult minipigs were acquired in VOIs defined manually on MR-images, or alternatively on the basis of the radioactivity concentration based on the most radioactive voxel in the last scan frame. For all frame sequences, the relative decarboxylase activity (k(3)(D)) declined significantly (P < 0.006) as the VOI threshold declined from 95 to 70% of the most radioactive voxel. Irrespective of VOI size, the magnitude of k(3)(D) declined significantly (P < 0.001) from 0.074+/-0.008 to 0.045+/-0.005 per min (mean+/-S.E.M.) as total sequence length increased from 60 to 120 min circulation. The method of VOI selection had no significant effect on the striatum decarboxylation index of FDOPA calculated relative to the radioactivity in cerebellum (k(3)(S)). PMID:11595282

  10. Quantitative expression and immunogenicity of MAGE-3 and -6 in upper aerodigestive tract cancer.

    PubMed

    Filho, Pedro A Andrade; López-Albaitero, Andrés; Xi, Liqiang; Gooding, William; Godfrey, Tony; Ferris, Robert L

    2009-10-15

    The MAGE antigens are frequently expressed cancer vaccine targets. However, quantitative analysis of MAGE expression in upper aerodigestive tract (UADT) tumor cells and its association with T-cell recognition has not been performed, hindering the selection of appropriate candidates for MAGE-specific immunotherapy. Using quantitative RT-PCR (QRT-PCR), we evaluated the expression of MAGE-3/6 in 65 UADT cancers, 48 normal samples from tumor matched sites and 7 HLA-A*0201+ squamous cell carcinoma of the head and neck (SCCHN) cell lines. Expression results were confirmed using Western blot. HLA-A*0201:MAGE-3- (271-279) specific cytotoxic T lymphocytes (MAGE-CTL) from SCCHN patients and healthy donors showed that MAGE-3/6 expression was highly associated with CTL recognition in vitro. On the basis of the MAGE-3/6 expression, we could identify 31 (47%) of the 65 UADT tumors, which appeared to express MAGE-3/6 at levels that correlated with efficient CTL recognition. To confirm that the level of MAGE-3 expression was responsible for CTL recognition, 2 MAGE-3/6 mRNA(high) SCCHN cell lines, PCI-13 and PCI-30, were subjected to MAGE-3/6-specific knockdown. RNAi-transfected cells showed that MAGE expression and MAGE-CTL recognition were significantly reduced. Furthermore, treatment of cells expressing low MAGE-3/6 mRNA with a demethylating agent, 5-aza-2'-deoxycytidine (DAC), increased the expression of MAGE-3/6 and CTL recognition. Thus, using QRT-PCR UADT cancers frequently express MAGE-3/6 at levels sufficient for CTL recognition, supporting the use of a QRT-PCR-based assay for the selection of candidates likely to respond to MAGE-3/6 immunotherapy. Demethylating agents could increase the number of patients amenable for targeting epigenetically modified tumor antigens in vaccine trials. PMID:19610063

  11. Targeted expression of ornithine decarboxylase antizyme prevents upper aerodigestive tract carcinogenesis in p53-deficient mice

    PubMed Central

    Feith, David J.

    2013-01-01

    Upper aerodigestive tract (UADT) cancers of the oral cavity and esophagus are a significant global health burden, and there is an urgent need to develop relevant animal models to identify chemopreventive and therapeutic strategies to combat these diseases. Antizyme (AZ) is a multifunctional negative regulator of cellular polyamine levels, and here, we evaluate the susceptibility of keratin 5 (K5)-AZ transgenic mice to tumor models that combine chemical carcinogenesis with dietary and genetic risk factors known to influence human susceptibility to UADT cancer and promote UADT carcinogenesis in mice. First, p53+/- and K5-AZ/p53+/- (AZ/p53+/-) mice were placed on a zinc-deficient (ZD) or zinc-sufficient (ZS) diet and chronically exposed to 4-nitroquinoline 1-oxide. Tongue tumor incidence, multiplicity and size were substantially reduced in both ZD and ZS AZ/p53+/- mice compared with p53+/-. AZ expression also reduced progression to carcinoma in situ or invasive carcinoma and decreased expression of the squamous cell carcinoma biomarkers K14, cyclooxygenase-2 and metallothionein. Next, AZ-expressing p53+/- and p53 null mice were placed on the ZD diet and treated with a single dose of N-nitrosomethylbenzylamine. Regardless of p53 status, forestomach (FST) tumor incidence, multiplicity and size were greatly reduced with AZ expression, which was also associated with a significant decrease in FST epithelial thickness along with reduced proliferation marker K6 and increased differentiation marker loricrin. These studies demonstrate the powerful tumor suppressive effects of targeted AZ expression in two distinct and unique mouse models and validate the polyamine metabolic pathway as a target for chemoprevention of UADT cancers. PMID:23222816

  12. 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 insertion–deletion 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 case–control 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], 1.7–3.8). This association was observed in lung (aOR, 2.61; 95% CI, 1.5–4.9) and head and neck (aOR, 2.75; 95% CI, 1.4–5.6) cancers, but not significantly in esophageal cancer (aOR, 1.66; 95% CI, 0.7–5.8). 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

  13. Augmentation of Radiation Response by Panitumumab in Models of Upper Aerodigestive Tract Cancer

    SciTech Connect

    Kruser, Tim J.; Armstrong, Eric A.; Ghia, Amol J.; Huang Shyhmin; Wheeler, Deric L.; Radinsky, Robert; Freeman, Daniel J.; Harari, Paul M.

    2008-10-01

    Purpose: To examine the interaction between panitumumab, a fully human anti-epidermal growth factor receptor monoclonal antibody, and radiation in head-and-neck squamous cell carcinoma and non-small-cell lung cancer cell lines and xenografts. Methods and Materials: The head-and-neck squamous cell carcinoma lines UM-SCC1 and SCC-1483, as well as the non-small-cell lung cancer line H226, were studied. Tumor xenografts in athymic nude mice were used to assess the in vivo activity of panitumumab alone and combined with radiation. In vitro assays were performed to assess the effect of panitumumab on radiation-induced cell signaling, apoptosis, and DNA damage. Results: Panitumumab increased the radiosensitivity as measured by the clonogenic survival assay. Radiation-induced epidermal growth factor receptor phosphorylation and downstream signaling through mitogen-activated protein kinase (MAPK) and signal transducer and activator of transcription 3 (STAT3) was inhibited by panitumumab. Panitumumab augmented radiation-induced DNA damage by 1.2-1.6-fold in each of the cell lines studied as assessed by residual {gamma}-H{sub 2}AX foci after radiation. Radiation-induced apoptosis was increased 1.4-1.9-fold by panitumumab, as evidenced by Annexin V-fluorescein isothiocyanate staining and flow cytometry. In vivo, the combination therapy of panitumumab and radiation was superior to panitumumab or radiation alone in the H226 xenografts (p = 0.01) and showed a similar trend in the SCC-1483 xenografts (p = 0.08). In vivo, immunohistochemistry demonstrated the ability of panitumumab to augment the antiproliferative and antiangiogenic effects of radiation. Conclusion: These studies have identified a favorable interaction in the combination of radiation and panitumumab in upper aerodigestive tract tumor models, both in vitro and in vivo. These data suggest that clinical investigations examining the combination of radiation and panitumumab in the treatment of epithelial tumors warrant additional pursuit.

  14. Occupation and risk of upper aerodigestive tract cancer: the ARCAGE study.

    PubMed

    Richiardi, Lorenzo; Corbin, Marine; Marron, Manuela; Ahrens, Wolfgang; Pohlabeln, Hermann; Lagiou, Pagona; Minaki, Ploumitsa; Agudo, Antonio; Castellsague, Xavier; Slamova, Alena; Schejbalova, Miriam; Kjaerheim, Kristina; Barzan, Luigi; Talamini, Renato; Macfarlane, Gary J; Macfarlane, Tatiana V; Canova, Cristina; Simonato, Lorenzo; Conway, David I; McKinney, Patricia A; Sneddon, Linda; Thomson, Peter; Znaor, Ariana; Healy, Claire M; McCartan, Bernard E; Benhamou, Simone; Bouchardy, Christine; Hashibe, Mia; Brennan, Paul; Merletti, Franco

    2012-05-15

    We investigated the association between occupational history and upper aerodigestive tract (UADT) cancer risk in the ARCAGE European case-control study. The study included 1,851 patients with incident cancer of the oral cavity, oropharynx, hypopharynx, larynx or esophagus and 1,949 controls. We estimated odds ratios (OR) and 95% confidence intervals (CI) for ever employment in 283 occupations and 172 industries, adjusting for smoking and alcohol. Men (1,457 cases) and women (394 cases) were analyzed separately and we incorporated a semi-Bayes adjustment approach for multiple comparisons. Among men, we found increased risks for occupational categories previously reported to be associated with at least one type of UADT cancer, including painters (OR = 1.74, 95% CI: 1.01-3.00), bricklayers (1.58, 1.05-2.37), workers employed in the erection of roofs and frames (2.62, 1.08-6.36), reinforced concreters (3.46, 1.11-10.8), dockers (2.91, 1.05-8.05) and workers employed in the construction of roads (3.03, 1.23-7.46), general construction of buildings (1.44, 1.12-1.85) and cargo handling (2.60, 1.17-5.75). With the exception of the first three categories, risks both increased when restricting to long duration of employment and remained elevated after semi-Bayes adjustment. Increased risks were also found for loggers (3.56, 1.20-10.5) and cattle and dairy farming (3.60, 1.15-11.2). Among women, there was no clear evidence of increased risks of UADT cancer in association with occupations or industrial activities. This study provides evidence of an association between some occupational categories and UADT cancer risk among men. The most consistent findings, also supported by previous studies, were obtained for specific workers employed in the construction industry. PMID:21671472

  15. Inverse association between yoghurt intake and upper aerodigestive tract cancer risk in a Japanese population.

    PubMed

    Kawakita, Daisuke; Sato, Fumihito; Hosono, Satoyo; Ito, Hidemi; Oze, Isao; Watanabe, Miki; Hanai, Nobuhiro; Hatooka, Shunzo; Hasegawa, Yasuhisa; Shinoda, Masayuki; Tajima, Kazuo; Murakami, Shingo; Tanaka, Hideo; Matsuo, Keitaro

    2012-09-01

    Although the combination of tobacco smoking and alcohol drinking account for approximately 80% of upper aerodigestive tract (UADT) cancer risk, the role of dietary factors, including dairy products, in the risk of these cancers remains controversial. We aimed to evaluate the association between dairy product intake and UADT cancer risk in a Japanese population. We conducted a case-control study in 959 patients with UADT cancer and 2877 sex- and age-matched noncancer control subjects who visited the Aichi Cancer Center in Nagoya, Japan. Data on lifestyle factors, including diet, were obtained by self-administered questionnaire. Associations were assessed by multivariate logistic regression models that considered potential confounders. We found a significant inverse association between yoghurt intake and UADT cancer risk with multivariate-adjusted odds ratios and 95% confidence intervals for <1 time/week, ? 1 time/week and <1 time/day, and ? 1 time/day consumption of yoghurt of 0.70 (95% confidence interval: 0.54-0.91), 0.67 (0.54-0.84), and 0.73 (0.55-0.95) relative to nonconsumers (P trend=0.005). When stratified by primary tumor site, this association was significant among patients with hypopharyngeal, laryngeal, and esophageal cancer. However, we saw no significant association between milk or butter intake and UADT cancer risk. In this study, we found that a high intake of yoghurt may lower the risk of developing UADT cancer in a Japanese population. Further investigation of this association is warranted. PMID:22179690

  16. Measurement of SUVs-maximum for normal region using VOI in PET/MRI and PET/CT.

    PubMed

    Park, Jeong Kyu; Kim, Sung Kyu; Cho, Ihn Ho; Kong, Eun Jung

    2014-01-01

    The purpose of this research is to establish an overall data set associated with the VOI (Volume of Interest), which is available for simultaneous assessment of PET/MRI and PET/CT regardless of the use of contrast media. The participants as objects of this investigation are 26 healthy examinees in Korea, SUV (standardized-uptake-value)s-maximum evaluation for whole-body F-18 FDG (fluorodeoxyglucose) PET/MRI image using VOI of normal region has exhibited very significant difference to that for whole-body F-18 FDG PET/CT image (significant probability value (P) < 0.0001). However, there appeared high correlation between them in view of statistics (R-square (R) > 0.8). It is shown that one needs to decide SUVs-maximum for PET/MRI with the reduction of 25.0~26.4% from their evaluated value and needs to decide with the reduction of 28.8~29.4% in the same situation but with the use of contrast media. The use of SUVLBM-maximum (SUVLean Body Mass-maximum) is very advantageous in reading overall image of PET/CT and PET/MRI to medical doctors and researchers, if we consider its convenience and efficiency. We expect that this research enhances the level of the early stage accurate diagnosis with whole-body images of PET/MRI and PET/CT. PMID:24672297

  17. Measurement of SUVs-Maximum for Normal Region Using VOI in PET/MRI and PET/CT

    PubMed Central

    Kim, Sung Kyu; Cho, Ihn Ho; Kong, Eun Jung

    2014-01-01

    The purpose of this research is to establish an overall data set associated with the VOI (Volume of Interest), which is available for simultaneous assessment of PET/MRI and PET/CT regardless of the use of contrast media. The participants as objects of this investigation are 26 healthy examinees in Korea, SUV (standardized-uptake-value)s-maximum evaluation for whole-body F-18?FDG (fluorodeoxyglucose) PET/MRI image using VOI of normal region has exhibited very significant difference to that for whole-body F-18?FDG PET/CT image (significant probability value (P) < 0.0001). However, there appeared high correlation between them in view of statistics (R-square (R) > 0.8). It is shown that one needs to decide SUVs-maximum for PET/MRI with the reduction of 25.0~26.4% from their evaluated value and needs to decide with the reduction of 28.8~29.4% in the same situation but with the use of contrast media. The use of SUVLBM-maximum (SUVLean Body Mass-maximum) is very advantageous in reading overall image of PET/CT and PET/MRI to medical doctors and researchers, if we consider its convenience and efficiency. We expect that this research enhances the level of the early stage accurate diagnosis with whole-body images of PET/MRI and PET/CT. PMID:24672297

  18. [Narrow band imaging for early diagnosis of epithelial dysplasias and microinvasive tumors in the upper aerodigestive tract].

    PubMed

    Arens, C; Betz, C; Kraft, M; Voigt-Zimmermann, S

    2016-01-01

    The various stages of tumor growth are characterized by typical epithelial, vascular, and secondary connective tissue changes. Narrow band imaging (NBI) endoscopy is a minimally invasive imaging technique that presents vascular structures in particular at a higher contrast than white light endoscopy alone. In combination with high-resolution image recording and reproduction (high-definition television, HDTV; ultra-high definition, 4K), progress has been made in otolaryngological differential diagnostics, both pre- and intraoperatively. This progress represents an important step towards a so-called optical biopsy. Flexible endoscopy in combination with NBI allows detailed assessment of areas of the upper aerodigestive tract which are difficult to assess by rigid endoscopy. Papillomas, precancerous, and cancerous lesions are characterized by epithelial and connective tissue changes, as well as by typical perpendicular vascular changes. Systematic use of NBI is recommended in the differential diagnosis of malignant lesions of the upper aerodigestive tract. NBI also convinces by a significant improvement in pre- and intraoperative assessment of superficial resection margins. In particular, the combination of NBI and contact endoscopy (compact endoscopy) permits excellent therapeutic decisions during tumor surgery. Intraoperative determination of resection margins at unprecedented precision is possible. In addition, assessment of the form and extent of the perpendicular vessel loops stimulated by epithelial signaling enables differential diagnostic decisions to be made, approximating our goal of an optical biopsy. PMID:26677856

  19. The influence of alcohol consumption on worldwide trends in mortality from upper aerodigestive tract cancers in men.

    PubMed Central

    Macfarlane, G J; Macfarlane, T V; Lowenfels, A B

    1996-01-01

    STUDY OBJECTIVES: To assess current trends in male mortality from cancers of the oral cavity/pharynx, oesophagus, and larynx (upper aerodigestive tract cancers), and relate these to past national consumption of alcohol and smoking of cigarettes. To assess the impact of current trends in alcohol consumption and tobacco smoking on likely future rates of these cancers. DESIGN: Mortality data for cancers of the oral cavity/pharynx, oesophagus, and larynx were obtained for the years 1955-89 in 25 countries located in North America, Australasia, Europe, and Japan. Information on past and current alcohol consumption was also obtained for these countries, while current national lung cancer rates were used as a proxy measure of past smoking levels. SETTING: The World Health Organization mortality database. MAIN RESULTS: National death rates from cancers of the oral cavity/pharynx, oesophagus, and larynx (considered together) are currently increasing among men and are most strongly associated with the level of per capita consumption of alcohol 20 years previously. They were less strongly associated with the level of alcohol consumption 10 years ago, and only very weakly associated with the current level of lung cancer mortality (a marker of past smoking habits). Regression analysis showed that the national rate of upper aerodigestive tract cancer could be estimated using information on past alcohol consumption and an interaction term between alcohol consumption and current lung cancer rates. Assuming stability in rates of lung cancer, the sizeable increase in alcohol consumption from 5 to 10 litres per capita each year that occurred in some countries during the 1960s and 70s means that increases of around 5 per 100,000 in the death rate from these cancers can be expected in these countries in the next decades. CONCLUSIONS: Previous alcohol consumption in a country is a strong predictor of deaths from cancers of the upper aerodigestive tract in men, and current increases in death rates can probably be related to increases in consumption which took place during the 1960s and 70s. Combined with a reduction in tobacco smoking, which is already taking place in some countries, reversing the trend of increases in consumption of alcohol has the potential for a sizeable impact on the burden of these cancers. Images PMID:9039382

  20. A new way for multidimensional medical data management: volume of interest (VOI)-based retrieval of medical images with visual and functional features.

    PubMed

    Kim, Jinman; Cai, Weidong; Feng, Dagan; Wu, Hao

    2006-07-01

    The advances in digital medical imaging and storage in integrated databases are resulting in growing demands for efficient image retrieval and management. Content-based image retrieval (CBIR) refers to the retrieval of images from a database, using the visual features derived from the information in the image, and has become an attractive approach to managing large medical image archives. In conventional CBIR systems for medical images, images are often segmented into regions which are used to derive two-dimensional visual features for region-based queries. Although such approach has the advantage of including only relevant regions in the formulation of a query, medical images that are inherently multidimensional can potentially benefit from the multidimensional feature extraction which could open up new opportunities in visual feature extraction and retrieval. In this study, we present a volume of interest (VOI) based content-based retrieval of four-dimensional (three spatial and one temporal) dynamic PET images. By segmenting the images into VOIs consisting of functionally similar voxels (e.g., a tumor structure), multidimensional visual and functional features were extracted and used as region-based query features. A prototype VOI-based functional image retrieval system (VOI-FIRS) has been designed to demonstrate the proposed multidimensional feature extraction and retrieval. Experimental results show that the proposed system allows for the retrieval of related images that constitute similar visual and functional VOI features, and can find potential applications in medical data management, such as to aid in education, diagnosis, and statistical analysis. PMID:16871730

  1. Site-specific accumulation of the cancer preventive dietary polyphenol ellagic acid in epithelial cells of the aerodigestive tract.

    PubMed

    Whitley, Alexander C; Sweet, Douglas H; Walle, Thomas

    2006-09-01

    Ellagic acid (EA), a polyphenol present in berries, has been demonstrated to prevent oesophageal and colon cancer in animals. To better understand the site-specificity of these effects, we studied the accumulation and transport of [14C]EA in rat aerodigestive epithelial cells in-vivo and in cultured human cells. When [14C]EA was administered to rats by gavage, a high content of EA was found in the oesophagus and small intestine at 0.5 h after oral administration and in the colon at 12 h, with very low amounts in plasma and peripheral tissues. Studies in human intestinal Caco-2 and human oesophageal HET-1A cells found very limited transcellular transport (Caco-2) of EA but high accumulation (Caco-2 and HET-1A) in the cells. In more detailed studies in the Caco-2 cells, accumulation of EA displayed ATP- and Na+-dependency. Multiple interventions permitted the exclusion of a number of transporters as mediators of this uptake. A dramatically reduced transport of EA at low pH (5.5) compared with high pH (7.4) suggested an important role for the negative charge of EA. This was supported by the organic anion transport inhibitors 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid and bromosulfophthalein. The latter produced as much as 78% inhibition at the 100 microM concentration. Finally, Caco-2 cells were shown to express organic anion transporter 4 (OAT4) mRNA, as was the human large intestine. EA appears to be accumulated along the aerodigestive tract using OAT-like transporters, one of which might be OAT4. PMID:16945178

  2. Association between OGG1 Ser326Cys polymorphism and risk of upper aero-digestive tract and gastrointestinal cancers: a meta-analysis.

    PubMed

    Das, Sambuddha; Nath, Sayantan; Bhowmik, Aditi; Ghosh, Sankar Kumar; Choudhury, Yashmin

    2016-01-01

    Cancers of the upper aero-digestive and gastrointestinal tract are one of the major causes of mortality around the world. DNA repair genes play a vital role in preventing carcinogenesis by maintaining genomic integrity. Polymorphisms in the nucleotide sequence of DNA repair genes are often reported to be associated with an increased risk for different cancers. The OGG1 gene encodes the enzyme 8-oxoguanine DNA glycosylase which removes oxidatively damaged bases of DNA. Several studies report that the OGG1 Ser326Cys polymorphism increases the risk for cancers of the upper aero-digestive and gastrointestinal tract. However, other studies provide evidence that such an association does not exist. A meta-analysis to assess the role of OGG1 Ser326Cys polymorphism in the cancers of the upper aero-digestive and gastrointestinal tract was therefore undertaken in order to resolve this ambiguity. Seventeen studies were recruited for this meta-analysis after screening 58 articles with a total of 5533 cases and 6834 controls for which the odds ratio with 95 % confidence interval was calculated. Begg's funnel test and Egger's test were performed for calculating publication bias. Our study reveals an association between OGG1 Ser326Cys polymorphism and cancer susceptibility of the upper aero-digestive and gastrointestinal tract (CG + GG vs CC; odds ratio, OR 1.22; 95 % CI 1.05-1.41; GG vs CG + CC; OR 1.36; 95 % CI 1.09-1.70; GG vs CC; OR 1.46; 95 % CI 1.12-1.92). Subgroup analysis based on cancer types and ethnicity also revealed the association of OGG1 Ser326Cys polymorphism to the risk for upper aero-digestive and gastrointestinal tract cancers among both the Asian and the Caucasian populations. No risk was however observed for smoking habits and OGG1 Ser326Cys polymorphism. In conclusion, OGG1 Ser326Cys polymorphism may be associated with the increased risk for aero-digestive tract and gastro-intestinal cancers in both Asian and Caucasian populations. PMID:27026921

  3. Improved longitudinal [(18)F]-AV45 amyloid PET by white matter reference and VOI-based partial volume effect correction.

    PubMed

    Brendel, Matthias; Högenauer, Marcus; Delker, Andreas; Sauerbeck, Julia; Bartenstein, Peter; Seibyl, John; Rominger, Axel

    2015-03-01

    Amyloid positron-emission-tomography (PET) offers an important research and diagnostic tool for investigating Alzheimer's disease (AD). The majority of amyloid PET studies have used the cerebellum as a reference region, and clinical studies have not accounted for atrophy-based partial volume effects (PVE). Longitudinal studies using cerebellum as reference tissue have revealed only small mean increases and high inter-subject variability in amyloid binding. We aimed to test the effects of different reference regions and PVE-correction (PVEC) on the discriminatory power and longitudinal performance of amyloid PET. We analyzed [(18)F]-AV45 PET and T1-weighted MRI data of 962 subjects at baseline and two-year follow-up data of 258 subjects. Cortical composite volume-of-interest (VOI) values (COMP) for tracer uptake were generated using either full brain atlas VOIs, gray matter segmented VOIs or gray matter segmented VOIs after VOI-based PVEC. Standard-uptake-value ratios (SUVR) were calculated by scaling the COMP values to uptake in cerebellum (SUVRCBL), brainstem (SUVRBST) or white matter (SUVRWM). Mean SUV, SUVR, and changes after PVEC were compared at baseline between diagnostic groups of healthy controls (HC; N=316), mild cognitive impairment (MCI; N=483) and AD (N=163). Receiver operating characteristics (ROC) were calculated for the discriminations between HC, MCI and AD, and expressed as area under the curve (AUC). Finally, the longitudinal [(18)F]-AV45-PET data were used to analyze the impact of quantitation procedures on apparent changes in amyloid load over time. Reference region SUV was most constant between diagnosis groups for the white matter. PVEC led to decreases of COMP-SUV in HC (-18%) and MCI (-10%), but increases in AD (+7%). Highest AUCs were found when using PVEC with white matter scaling for the contrast between HC/AD (0.907) or with brainstem scaling for the contrast between HC/MCI (0.658). Longitudinal increases were greatest in all diagnosis groups with application of PVEC, and inter-subject variability was lowest for the white matter reference. Thus, discriminatory power of [(18)F]-AV45-PET was improved by use of a VOI-based PVEC and white matter or brainstem rather than cerebellum reference region. Detection of longitudinal amyloid increases was optimized with PVEC and white matter reference tissue. PMID:25482269

  4. The 12p13.33/RAD52 locus and genetic susceptibility to squamous cell cancers of upper aerodigestive tract.

    PubMed

    Delahaye-Sourdeix, Manon; Oliver, Javier; Timofeeva, Maria N; Gaborieau, Valérie; Johansson, Mattias; Chabrier, Amélie; Wozniak, Magdalena B; Brenner, Darren R; Vallée, Maxime P; Anantharaman, Devasena; Lagiou, Pagona; Holcátová, Ivana; Richiardi, Lorenzo; Kjaerheim, Kristina; Agudo, Antonio; Castellsagué, Xavier; Macfarlane, Tatiana V; Barzan, Luigi; Canova, Cristina; Thakker, Nalin S; Conway, David I; Znaor, Ariana; Healy, Claire M; Ahrens, Wolfgang; Zaridze, David; Szeszenia-Dabrowska, Neonilia; Lissowska, Jolanta; Fabianova, Eleonora; Mates, Ioan Nicolae; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Curado, Maria Paula; Koifman, Sergio; Menezes, Ana; Wünsch-Filho, Victor; Eluf-Neto, José; Boffetta, Paolo; Garrote, Leticia Fernández; Serraino, Diego; Lener, Marcin; Jaworowska, Ewa; Lubi?ski, Jan; Boccia, Stefania; Rajkumar, Thangarajan; Samant, Tanuja A; Mahimkar, Manoj B; Matsuo, Keitaro; Franceschi, Silvia; Byrnes, Graham; Brennan, Paul; McKay, James D

    2015-01-01

    Genetic variants located within the 12p13.33/RAD52 locus have been associated with lung squamous cell carcinoma (LUSC). Here, within 5,947 UADT cancers and 7,789 controls from 9 different studies, we found rs10849605, a common intronic variant in RAD52, to be also associated with upper aerodigestive tract (UADT) squamous cell carcinoma cases (OR = 1.09, 95% CI: 1.04-1.15, p = 6x10(-4)). We additionally identified rs10849605 as a RAD52 cis-eQTL inUADT(p = 1x10(-3)) and LUSC (p = 9x10(-4)) tumours, with the UADT/LUSC risk allele correlated with increased RAD52 expression levels. The 12p13.33 locus, encompassing rs10849605/RAD52, was identified as a significant somatic focal copy number amplification in UADT(n = 374, q-value = 0.075) and LUSC (n = 464, q-value = 0.007) tumors and correlated with higher RAD52 tumor expression levels (p = 6x10(-48) and p = 3x10(-29) in UADT and LUSC, respectively). In combination, these results implicate increased RAD52 expression in both genetic susceptibility and tumorigenesis of UADT and LUSC tumors. PMID:25793373

  5. The 12p13.33/RAD52 Locus and Genetic Susceptibility to Squamous Cell Cancers of Upper Aerodigestive Tract

    PubMed Central

    Delahaye-Sourdeix, Manon; Oliver, Javier; Timofeeva, Maria N.; Gaborieau, Valérie; Johansson, Mattias; Chabrier, Amélie; Wozniak, Magdalena B.; Brenner, Darren R.; Vallée, Maxime P.; Anantharaman, Devasena; Lagiou, Pagona; Holcátová, Ivana; Richiardi, Lorenzo; Kjaerheim, Kristina; Agudo, Antonio; Castellsagué, Xavier; Macfarlane, Tatiana V.; Barzan, Luigi; Canova, Cristina; Thakker, Nalin S.; Conway, David I.; Znaor, Ariana; Healy, Claire M.; Ahrens, Wolfgang; Zaridze, David; Szeszenia-Dabrowska, Neonilia; Lissowska, Jolanta; Fabianova, Eleonora; Mates, Ioan Nicolae; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Curado, Maria Paula; Koifman, Sergio; Menezes, Ana; Wünsch-Filho, Victor; Eluf-Neto, José; Boffetta, Paolo; Garrote, Leticia Fernández; Serraino, Diego; Lener, Marcin; Jaworowska, Ewa; Lubi?ski, Jan; Boccia, Stefania; Rajkumar, Thangarajan; Samant, Tanuja A.; Mahimkar, Manoj B.; Matsuo, Keitaro; Franceschi, Silvia; Byrnes, Graham; Brennan, Paul; McKay, James D.

    2015-01-01

    Genetic variants located within the 12p13.33/RAD52 locus have been associated with lung squamous cell carcinoma (LUSC). Here, within 5,947 UADT cancers and 7,789 controls from 9 different studies, we found rs10849605, a common intronic variant in RAD52, to be also associated with upper aerodigestive tract (UADT) squamous cell carcinoma cases (OR = 1.09, 95% CI: 1.04–1.15, p = 6x10?4). We additionally identified rs10849605 as a RAD52 cis-eQTL inUADT(p = 1x10?3) and LUSC (p = 9x10?4) tumours, with the UADT/LUSC risk allele correlated with increased RAD52 expression levels. The 12p13.33 locus, encompassing rs10849605/RAD52, was identified as a significant somatic focal copy number amplification in UADT(n = 374, q-value = 0.075) and LUSC (n = 464, q-value = 0.007) tumors and correlated with higher RAD52 tumor expression levels (p = 6x10?48 and p = 3x10?29 in UADT and LUSC, respectively). In combination, these results implicate increased RAD52 expression in both genetic susceptibility and tumorigenesis of UADT and LUSC tumors. PMID:25793373

  6. Aerodigestive Fistula Formation as a Rare Side Effect of Antiangiogenic Tyrosine Kinase Inhibitor Therapy for Thyroid Cancer

    PubMed Central

    Blevins, Dean P.; Dadu, Ramona; Hu, Mimi; Baik, Christina; Balachandran, Diwakar; Ross, William; Gunn, Brandon

    2014-01-01

    Background: In the past decade, targeted therapy with antiangiogenic drugs has become standard of care for most types of metastatic, progressive thyroid cancer. While these drugs were thought initially to be less toxic than traditional chemotherapy, they can have rare but serious and fatal toxicities. Once such toxicity that has been reported in other tumor types is upper airway fistula formation, which can be life-threatening. Summary: Here, we describe three patients treated with antiangiogenic tyrosine kinase inhibitors at two academic institutions who developed aerodigestive fistula. All three patients had risk factors for fistula formation, which included external beam radiation and/or large tumor with invasion of the tracheal wall. Conclusions: Fistula formation is a known but rare side effect of antiangiogenic tyrosine kinase inhibitors. Knowledge of the risk factors that may predispose thyroid cancer patients to this serious adverse event is vital prior to prescribing antiangiogenics. Particular caution should be observed when using these drugs in patients undergoing radiation therapy or surgery, or in patients whose tumor is invading vital structures of the neck, as they may be at higher risk of developing this rare complication. In these patients, antiangiogenic tyrosine kinase inhibitors should be used cautiously, patients should be aware of the risk, and physicians should monitor patients for symptoms of fistula. PMID:24635127

  7. Risk of upper aerodigestive tract cancers in a case-cohort study of autoworkers exposed to metalworking fluids

    PubMed Central

    Zeka, A; Eisen, E; Kriebel, D; Gore, R; Wegman, D

    2004-01-01

    Aims: To re-examine aerodigestive cancer risk in a cohort of autoworkers exposed to metal working fluids (MWF), using improved case definition and more recently diagnosed cases. Methods: The autoworker cohort included 31 100 hourly workers alive on 1 January 1985 who worked at three automobile plants in Michigan. A case-cohort design was carried out that included incident cases of cancers of the larynx, oesophagus, and stomach, and a 10% sample of the cohort. A Cox proportional hazards model was used to estimate MWF exposure effects. The smoothing method of penalised splines was used to explore the shape of the underlying exposure-response curves. Results: The most important finding was the association between larynx cancer incidence and cumulative straight MWF exposure. The results for oesophageal cancer were less consistent. For stomach cancer there was no evidence of excess risk. Conclusion: This association between larynx cancer and straight MWF exposures was consistent with a previous finding in this cohort, providing further support for a causal relation. PMID:15090663

  8. The transnasal VideoPanendoscopy (ViP): diagnostics of the upper aerodigestive tract using an anatomically correct model from the model to the patient.

    PubMed

    Herrmann, I F; Domagk, D; Strahl, M; Arens, Christoph

    2016-03-01

    Endoscopy of the upper aerodigestive tract (UADT) develops rapidly. New endoscopes in combination with special imaging techniques allow complete examinations of the UADT in an ambulatory setting. Therefore, it is necessary to educate and train young physicians in a standardized protocol. A special anatomical training model has been designed to allow a stepwise endoscopy training course. It can be used by specialists who would like to take advantage of transnasal VideoPanendoscopy for examination of suitable candidate patients. This method offers advantages for ENT doctors, gastroenterologists as well as endoscopic surgeons. PMID:25721195

  9. Immunophenotypic and Clinical Differences Between the Nasal and Extranasal Subtypes of Upper Aerodigestive Tract Natural Killer/T-Cell Lymphoma

    SciTech Connect

    Liu, Qing-Feng; Wang, Wei-Hu; Wang, Shu-Lian; Liu, Yue-Ping; Huang, Wen-Ting; Lu, Ning; Zhou, Li-Qiang; Ouyang, Han; Jin, Jing; Li, Ye-Xiong

    2014-03-15

    Purpose: To investigate, in a large cohort of patients, the immunophenotypic and clinical differences of nasal and extranasal extranodal nasal-type natural killer/T-cell lymphoma of the upper aerodigestive tract (UADT-NKTCL) and examine the relevance of the immunophenotype on the clinical behavior, prognosis, and treatment. Methods and Materials: A total of 231 patients with UADT-NKTCL were recruited. One hundred eighty-one patients had primary location in the nasal cavity (nasal UADT-NKTCL), and 50 patients had primary extranasal UADT-NKTCL. Results: Patients with extranasal UADT-NKTCL had more adverse clinical features, including advanced-stage disease, regional lymph node involvement, B symptoms, and poor performance status, than patients with nasal UADT-NKTCL. In addition, CD56 and granzyme B were less frequently expressed in extranasal UADT-NKTCL. The 5-year overall survival rate was 74.1% for the entire group and 76.0% for early-stage disease. The 5-year overall survival rate for extranasal UADT-NKTCL was similar or superior to that of nasal UADT-NKTCL for all disease stages (76.9% vs 73.4%, P=.465), stage I disease (75.9% vs 79.2%, P=.786), and stage II disease (83.3% vs 50.3%, P=.018). CD56 expression and a Ki-67 proliferation rate ≥50% predicted poorer survival for extranasal UADT-NKTCL but not for nasal UADT-NKTCL. Conclusions: Patients with nasal and extranasal UADT-NKTCL have significantly different clinical features, immunophenotypes, and prognosis. Extranasal UADT-NKTCL should be considered as a distinct subgroup apart from the most commonly diagnosed prototype of nasal UADT-NKTCL.

  10. Serum beta2-microglobin is a predictor of prognosis in patients with upper aerodigestive tract NK/T-cell lymphoma.

    PubMed

    Li, Zhi-Ming; Zhu, Ying-Jie; Sun, Jian; Xia, Yi; Huang, Jia-Jia; Zou, Ben-Yan; Lin, Tong-Yu; Huang, Hui-Qiang; Jiang, Wen-Qi

    2012-08-01

    Upper aerodigestive tract natural killer (NK)/T-cell lymphoma (UNKTL) is the most common type of extranodal NK/T-cell lymphoma, nasal type. Serum beta2-microglobulin (?2-M) was found to be a predictor in some subtypes of B-cell lymphoma. However, its prognostic significance in NK/T-cell lymphoma has never been explored. We retrospectively analyzed 82 patients newly diagnosed as UNKTL. Serum ?2-M was detected prior to treatment in this series. Various statistical analyses were performed to evaluate the significance of the relevant clinical parameters. High serum ?2-M level was calculated as ?2.5 mg/L by the median value. The number of patients with serum ?2-M ?2.5 mg/L at diagnosis was 39 (47.6%) and 43 patients (52.4%) with ?2-M <2.5 mg/L. Patients with high serum ?2-M level at diagnosis seemed to have more adverse clinical features: B symptoms (p=0.007) and elevated LDH level (p<0.001), and high KPI score (p=0.002). Serum ?2-M ?2.5 mg/L was significantly associated with poor overall survival (5-year OS, 35.2% vs 73.6%; p=0.001) and progression-free survival (5-year PFS, 27.5% vs 55.9%; p=0.028). For patients with early stage, serum ?2-M at diagnosis could also help to distinguish those with favorable outcomes from those with poor outcomes. In multivariate analysis, high serum ?2-M level remained its prognostic impact on survival (OS: p=0.002; PFS: p=0.039), independent of the International Prognostic Index score. Our study suggested high serum ?2-M was a novel predictor of prognosis in patients with UNKTL. A simply and regular way might be established to identify UNKTL patients of different risks at diagnosis. PMID:22373550

  11. Smoking addiction and the risk of upper-aerodigestive-tract cancer in a multicenter case-control study.

    PubMed

    Lee, Yuan-Chin Amy; Zugna, Daniela; Richiardi, Lorenzo; Merletti, Franco; Marron, Manuela; Ahrens, Wolfgang; Pohlabeln, Hermann; Lagiou, Pagona; Trichopoulos, Dimitrios; Agudo, Antonio; Castellsague, Xavier; Betka, Jaroslav; Holcatova, Ivana; Kjaerheim, Kristina; Macfarlane, Gary J; Macfarlane, Tatiana V; Talamini, Renato; Barzan, Luigi; Canova, Cristina; Simonato, Lorenzo; Conway, David I; McKinney, Patricia A; Thomson, Peter; Znaor, Ariana; Healy, Claire M; McCartan, Bernard E; Boffetta, Paolo; Brennan, Paul; Hashibe, Mia

    2013-12-01

    Although previous studies on tobacco and alcohol and the risk of upper-aerodigestive-tract (UADT) cancers have clearly shown dose-response relations with the frequency and duration of tobacco and alcohol, studies on addiction to tobacco smoking itself as a risk factor for UADT cancer have not been published, to our knowledge. The aim of this report is to assess whether smoking addiction is an independent risk factor or a refinement to smoking variables (intensity and duration) for UADT squamous cell carcinoma (SCC) risk in the multicenter case-control study (ARCAGE) in Western Europe. The analyses included 1,586 ever smoking UADT SCC cases and 1,260 ever smoking controls. Addiction was measured by a modified Fagerström score (first cigarette after waking up, difficulty refraining from smoking in places where it is forbidden and cigarettes per day). Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for UADT cancers with addiction variables were estimated with unconditional logistic regression. Among current smokers, the participants who smoked their first cigarette within 5 min of waking up were two times more likely to develop UADT SCC than those who smoked 60 min after waking up. Greater tobacco smoking addiction was associated with an increased risk of UADT SCC among current smokers (OR = 3.83, 95% CI: 2.56-5.73 for score of 3-7 vs. 0) but not among former smokers. These results may be consistent with a residual effect of smoking that was not captured by the questionnaire responses (smoking intensity and smoking duration) alone, suggesting addiction a refinement to smoking variables. PMID:23719996

  12. Alpha-Synuclein Pathology in Sensory Nerve Terminals of the Upper Aerodigestive Tract of Parkinson’s Disease Patients

    PubMed Central

    Mu, Liancai; Chen, Jingming; Sobotka, Stanislaw; Nyirenda, Themba; Benson, Brian; Gupta, Fiona; Sanders, Ira; Adler, Charles H.; Caviness, John N.; Shill, Holly A.; Sabbagh, Marwan; Samanta, Johan E.; Sue, Lucia I.; Beach, Thomas G.

    2015-01-01

    Dysphagia is common in Parkinson’s disease (PD) and causes significant morbidity and mortality. PD dysphagia has usually been explained as dysfunction of central motor control, much like other motor symptoms that are characteristic of the disease. However, PD dysphagia does not correlate with severity of motor symptoms nor does it respond to motor therapies. It is known that PD patients have sensory deficits in the pharynx, and that impaired sensation may contribute to dysphagia. However, the underlying cause of the pharyngeal sensory deficits in PD is not known. We hypothesized that PD dysphagia with sensory deficits may be due to degeneration of the sensory nerve terminals in the upper aerodigestive tract (UAT). We have previously shown that Lewy-type synucleinopathy (LTS) is present in the main pharyngeal sensory nerves of PD patients, but not in controls. In this study, the sensory terminals in UAT mucosa were studied to discern the presence and distribution of LTS. Whole-mount specimens (tongue-pharynx-larynx-upper esophagus) were obtained from 10 deceased human subjects with clinically diagnosed and neuropathologically confirmed PD (five with dysphagia and five without) and four age-matched healthy controls. Samples were taken from six sites and immunostained for phosphorylated α-synuclein (PAS). The results showed the presence of PAS-immunoreactive (PAS-ir) axons in all the PD subjects and in none of the controls. Notably, PD patients with dysphagia had more PAS-ir axons in the regions that are critical for initiating the swallowing reflex. These findings suggest that Lewy pathology affects mucosal sensory axons in specific regions of the UAT and may be related to PD dysphagia. PMID:26041249

  13. Genetic variants in DNA repair pathways and risk of upper aerodigestive tract cancers: combined analysis of data from two genome-wide association studies in European populations.

    PubMed

    Babron, Marie-Claude; Kazma, Rémi; Gaborieau, Valérie; McKay, James; Brennan, Paul; Sarasin, Alain; Benhamou, Simone

    2014-07-01

    DNA repair pathways are good candidates for upper aerodigestive tract cancer susceptibility because of their critical role in maintaining genome integrity. We have selected 13 pathways involved in DNA repair representing 212 autosomal genes. To assess the role of these pathways and their associated genes, two European data sets from the International Head and Neck Cancer Epidemiology consortium were pooled, totaling 1954 cases and 3121 controls, with documented demographic, lifetime alcohol and tobacco consumption information. We applied an innovative approach that tests single nucleotide polymorphism (SNP)-sets within DNA repair pathways and then within genes belonging to the significant pathways. We showed an association between the polymerase pathway and oral cavity/pharynx cancers (P-corrected = 4.45 × 10(-) (2)), explained entirely by the association with one SNP, rs1494961 (P = 2.65 × 10(-) (4)), a missense mutation V306I in the second exon of HELQ gene. We also found an association between the cell cycle regulation pathway and esophagus cancer (P-corrected = 1.48 × 10(-) (2)), explained by three SNPs located within or near CSNK1E gene: rs1534891 (P = 1.27 × 10(-) (4)), rs7289981 (P = 3.37 × 10(-) (3)) and rs13054361 (P = 4.09 × 10(-) (3)). As a first attempt to investigate pathway-level associations, our results suggest a role of specific DNA repair genes/pathways in specific upper aerodigestive tract cancer sites. PMID:24658182

  14. Genetic polymorphisms of alcohol dehydrogense-1B and aldehyde dehydrogenase-2, alcohol flushing, mean corpuscular volume, and aerodigestive tract neoplasia in Japanese drinkers.

    PubMed

    Yokoyama, Akira; Mizukami, Takeshi; Yokoyama, Tetsuji

    2015-01-01

    Genetic polymorphisms of alcohol dehydrogenase-1B (ADH1B) and aldehyde dehydrogenase-2 (ALDH2) modulate exposure levels to ethanol/acetaldehyde. Endoscopic screening of 6,014 Japanese alcoholics yielded high detection rates of esophageal squamous cell carcinoma (SCC; 4.1%) and head and neck SCC (1.0%). The risks of upper aerodigestive tract SCC/dysplasia, especially of multiple SCC/dysplasia, were increased in a multiplicative fashion by the presence of a combination of slow-metabolizing ADH1B*1/*1 and inactive heterozygous ALDH2*1/*2 because of prolonged exposure to higher concentrations of ethanol/acetaldehyde. A questionnaire asking about current and past facial flushing after drinking a glass (?180 mL) of beer is a reliable tool for detecting the presence of inactive ALDH2. We invented a health-risk appraisal (HRA) model including the flushing questionnaire and drinking, smoking, and dietary habits. Esophageal SCC was detected at a high rate by endoscopic mass-screening in high HRA score persons. A total of 5.0% of 4,879 alcoholics had a history of (4.0%) or newly diagnosed (1.0%) gastric cancer. Their high frequency of a history of gastric cancer is partly explained by gastrectomy being a risk factor for alcoholism because of altered ethanol metabolism, e.g., by blood ethanol level overshooting. The combination of H. pylori-associated atrophic gastritis and ALDH2*1/*2 showed the greatest risk of gastric cancer in alcoholics. High detection rates of advanced colorectal adenoma/carcinoma were found in alcoholics, 15.7% of 744 immunochemical fecal occult blood test (IFOBT)-negative alcoholics and 31.5% of the 393 IFOBT-positive alcoholics. Macrocytosis with an MCV?106 fl increased the risk of neoplasia in the entire aerodigestive tract of alcoholics, suggesting that poor nutrition as well as ethanol/acetaldehyde exposure plays an important role in neoplasia. PMID:25427912

  15. Early or Up-Front Radiotherapy Improved Survival of Localized Extranodal NK/T-Cell Lymphoma, Nasal-Type in the Upper Aerodigestive Tract

    SciTech Connect

    Huang Meijuan; Jiang Yu; Liu Weiping; Li Zhiping; Li Mei; Zhou Lin; Xu Yong; Yu Chunhua; Li Qiu; Peng Feng; Liu Jiyan; Luo Feng; Lu You

    2008-01-01

    Purpose: To investigate the role of early or up-front radiotherapy (RT), the optimal RT dose required to achieve appropriate treatment outcome and prognostic factors for patients with localized extranodal NK/T-cell lymphoma, nasal-type, in the upper aerodigestive tract. Methods and Materials: Eighty-two patients were reviewed. Eight patients were treated with chemotherapy (CT) alone, 9 patients received RT alone, and 65 patients were given combined modality treatment of CT and RT (CMT). Of those 74 patients receiving RT, 31 patients were given up-front RT, whereas CT was the initial therapy for 43 patients and 41 of those 43 patients received early RT. Results: Five-year overall survival (OS) and disease-free survival (DFS) were 52.3% and 39.2%, respectively. RT was the only independent prognostic factor for both OS and DFS at both the univariate and multivariate level. The 5-year OS and DFS were better in patients receiving {>=}54 Gy of RT as compared with that of <54 Gy (5-year OS 75.5% vs. 46.1%, p = 0.019; 5-year DFS 60.3% vs. 33.4%, p = 0.004). Up-front RT presented better survival in Stage I patients when compared with that of initial CT followed by early RT (5-year OS 90.0% vs. 48.9%, p = 0.012; 5-year DFS 78.7% vs. 39.9%, p = 0.021). Conclusion: Early or up-front RT had an essential role in improved OS and DFS in patients with localized extranodal NK/T-cell lymphoma, nasal-type, in the upper aerodigestive tract. The recommended tumor dose was at least 54 Gy. Up-front RT may yield more benefits on survival in patients with Stage I disease.

  16. Aerodigestive cancers: oral cancer.

    PubMed

    Haws, Luke; Haws, Bryn Taylor

    2014-09-01

    Worldwide, approximately 260,000 new cases of oral cancer occur, and more than 125,000 mortalities are attributed to oral cancers each year. Oral cancers most commonly arise in the tongue, followed by the floor of the mouth and the lower gum. Tobacco and alcohol use are the major risk factors, although human papillomavirus has been identified as an etiology in a small percentage of oral squamous cell cancers. Although the evidence to support routine annual screening for oral cancers is inconclusive, family physicians and dental practitioners should be attentive to precursor lesions, such as leukoplakia and erythroplakia, and strongly consider obtaining or referring for biopsy patients with suspicious lesions. Depending on stage, management of oral cancers often involves surgery, with or without postoperative radiotherapy or chemotherapy. Patients who have been treated for these cancers should undergo close surveillance by otolaryngology subspecialists, but their family physicians primarily will be responsible for their long-term care. Complications relating to management, including difficulties with speech, swallowing, and chewing, will need to be addressed. For patients with advanced-stage disease, family physicians also may be responsible for palliative and end-of-life care. PMID:25198382

  17. Radiotherapy in the treatment of mucosal melanoma of the upper aerodigestive tract: Analysis of 74 cases. A Rare Cancer Network study

    SciTech Connect

    Krengli, Marco . E-mail: krengli@tera.it; Masini, Laura; Kaanders, Johannes; Maingon, Philippe; Oei, Swan Bing; Zouhair, Abderrahim; Ozyar, Enis; Roelandts, Martine; Amichetti, Maurizio; Bosset, Mathieu; Mirimanoff, Rene-Olivier

    2006-07-01

    Purpose: To retrospectively analyze a series of mucosal melanoma of the upper aerodigestive tract to determine the prognostic factors and contribute to understanding the role of radiotherapy in the therapeutic strategy. Methods and Materials: Seventy-four patients were analyzed. The most frequent locations were nasal and oral, in 31 patients (41.9%) and 12 patients (16.2%), respectively. Sixty-three patients (85.1%) were in Stage I, 5 (6.8%) in Stage II, and 6 (8.1%) in Stage III. Treatment consisted of surgery in 17 patients (23.0%), surgery and radiotherapy in 42 (56.8%), radiotherapy in 11 (14.9%), and chemo-immunotherapy in 4 (5.4%). Median follow-up was 20 months. Results: Local control at 3 years was 57% after surgery alone and 71% after surgery and radiotherapy. Overall and disease-free survival rates, respectively, were 41% and 31% at 3 years and 14% and 22% at 10 years. After univariate analysis, female gender, melanosis, tumor size {<=}3 cm, Stage I, postoperative radiotherapy, and complete remission were favorable prognostic factors. Stage I and melanosis were confirmed by multivariate analysis. Conclusions: Local control was improved by postoperative radiotherapy, despite survival being as poor as in other published series. Stage I and melanosis at diagnosis were the most favorable prognostic factors.

  18. 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.

  19. Risk factors for developing a second upper aerodigestive cancer after radiotherapy with or without chemotherapy in patients with head-and-neck cancers: An exploratory outcomes analysis

    SciTech Connect

    Taussky, Daniel . E-mail: daniel.taussky.chum@ssss.gouv.qc.ca; Rufibach, Kaspar M.Sc.; Huguenin, Pia; Allal, Abdelkarim S.

    2005-07-01

    Purpose: The objective was to assess the influence of treatment-related and patient-related factors on the risk of developing a second primary tumor (SPT) of the upper aerodigestive tract (UADT) in patients with locoregionally advanced nonmetastatic carcinomas of the head-and-neck region. Methods and Materials: The data of 521 patients with a minimum follow-up of 1 year were pooled: 224 patients from the Swiss Group for Clinical Cancer Research (SAKK) 10/94 trial, treated with 1.2 Gy b.i.d. to 74.4 Gy, and randomized to receive or not to receive simultaneous chemotherapy with cisplatin (excluding nasopharyngeal and maxillary sinus carcinomas); and 297 patients from Geneva, all treated with accelerated radiotherapy with concomitant boost to 69.9 Gy and predominantly cisplatin-based concomitant chemotherapy in 33% of patients (including 21 patients with nasopharyngeal carcinomas). An exploratory analysis using competing risk methodology was performed. Results: A total of 65 SPT of the UADT were observed after a median observation time of 4.7 years. The overall risk of experiencing an SPT of the UADT at 10 years in the presence of all other possible events was estimated to be 33%. There were no SPTs after treatment for nasopharyngeal carcinoma. In a multivariate logistic regression analysis, there was no difference in occurrence of SPT at 3 years with respect to the administration of chemotherapy (p = 0.31), age (p 0.62), performance status (p = 0.61), gender (p = 0.27), presence of nodal disease (p = 0.51), or T stage (p = 0.72). However, patients treated with concomitant boost had fewer SPTs (p = 0.0093). Conclusions: Our data do not suggest that addition of chemotherapy to radiotherapy influences the incidence of second cancers in patients with head-and-neck cancer. The difference in the incidence of SPT between the two radiotherapy schedule groups merits further exploration.

  20. Meat and heme iron intake and risk of squamous cell carcinoma of the upper aero-digestive tract in the European Prospective Investigation into Cancer and Nutrition (EPIC)

    PubMed Central

    Steffen, Annika; Bergmann, Manuela M.; Sánchez, María-José; Chirlaque, Maria-Dolores; Jakszyn, Paula; Amiano, Pilar; Quirós, J. Ramón; Gurrea, Aurelio Barricarte; Ferrari, Pietro; Romieu, Isabelle; Fedirko, Veronika; Bueno-de-Mesquita, H. B(as).; Siersema, Peter D.; Peeters, Petra HM; Khaw, Kay-Tee; Wareham, Nick; Allen, Naomi E.; Crowe, Francesca L.; Skeie, Guri; Hallmanns, Göran; Johansson, Ingegerd; Borgquist, Signe; Ericson, Ulrika; Egeberg, Rikke; Tjønneland, Anne; Overvad, Kim; Grote, Verena; Li, Kuanrong; Trichopoulou, Antonia; Oikonomidou, Despoina; Pantzalis, Menelaos; Tumino, Rosario; Panico, Salvatore; Palli, Domenico; Krogh, Vittorio; Naccarati, Alessio; Mouw, Traci; Vergnaud, Anne-Claire; Norat, Teresa; Boeing, Heiner

    2012-01-01

    Background Evidence from prospective studies on intake of meat and fish and risk of squamous cell carcinoma (SCC) of the upper aero-digestive tract (UADT) is scarce. We prospectively investigated the association of meat and fish intake with risk of SCC of the UADT and the possible mechanism via heme iron in the large multi-center European Prospective Investigation into Cancer and Nutrition (EPIC) study. Methods Multivariable proportional hazards models were used to estimate relative risks of SCC of the UADT in relation to intake of total meat, as well as subtypes of meat, fish and heme iron among 348,738 individuals from 7 European countries. Results During an average follow-up of 11.8 years, a total of 682 incident cases of UADT SCC were accrued. Intake of processed meat was positively associated with risk of SCC of the UADT in the total cohort (highest versus lowest quintile: RR=1.41; 95% CI=1.03-1.94), however, in stratified analyses, this association was confined to the group of current smokers (highest versus lowest quintile: RR=1.89; 95% CI=1.22-2.93). Red meat, poultry, fish and heme iron were not consistently related to UADT SCC. Conclusion Higher intake of processed meat was positively associated with SCC of the UADT among smokers. Although this finding was stable in various sensitivity analyses, we cannot rule out residual confounding by smoking. Confirmation in future studies and identification of biological mechanisms is warranted. Impact Smokers may further increase their risk for SCC of the UADT if they additionally consume large amounts of processed meat. PMID:23033453

  1. HP and UHT metamorphic associations in the Day Nui Con Voi?northwestern Vietnam: The consequence of convergence between the Indian and the Eurasian plates

    NASA Astrophysics Data System (ADS)

    Zhang, J.; Liu, J.; Tran, M. D.; Nguyen, Q. L.

    2014-12-01

    The Red River shear zone (RRSZ) is the most significant geologic discontinuity in Southeast Asia. The Day Nui Con Voi (DNCV) massif at the southernmost part of the shear zone bears records of Cenozoic RRSZ activity. The DNCV in northwestern Vietnam predominantly consists of HP granulite facies metapelites, and lenticular enclaves of HP mafic granulites, calc-silicate granulites and UHT aluminum-rich rocks in the metapelites. HP granulites are characterized by the key associations of garnet-kyanite-ternary feldspar (in metapelites) and garnet-clinopyroxene-plagioclase-quartz (in mafic granulites). In the latter case, rocks are typically orthopyroxene-free. The peak assemblage of the HP metapelites includes garnet + kyanite + ternary feldspar + quartz + rutile. The peak assemblage of the HP mafic granulites is garnet + clinopyroxene + plagioclase + quartz. Meanwhile, the peak assemblage of the calc-silicate granulites is high-Ca garnet (Grs>50) + diopside + scapolite + quartz. On the other hand, characteristic UHT metamorphic assemblage occur as the coexistence of spinel and quartz which indicates the metamorphic temperature is higher than 900?. The peak assemblage of the UHT rocks in DNCV is corundum + spinel + garnet + sillimanite + quartz. P-T conditions of peak metamorphism within HP granulite facies are: T = 750?850?, P = 12.5?14kbar. The temperature of UHT metamorphism is higher than 900?, the pressure is higher than 9?9.4 kbar. SHRIMP U-Pb dating of zircons from the HP mafic granulites and UHT rocks gave minimum ages of ca. 59 Ma and 40 Ma, respectively. HP metapelites gave ca. 60~50Ma and 30Ma. The above facts suggest the DNCV massif experienced HP granulite facies at its peak metamorphism at ˜59 Ma. Thermal disturbance on the local scale to UHT metamorphism occurred at ˜40 Ma. Then isothermal decompression to medium-pressure granulite facies occurred at ˜30Ma, which may reflect a rapid exhumation. The HP rocks are interpreted to be resulted from crustal thickening due to far-field compression during Indian-Eurasian convergence. However the high heat flow for UHT metamorphism was possibly attributed to upwelling of asthenosphere triggered by delamination of the thickened crust. The delamination may also be responsible for subsequent generation of high potassic magmas along the RRSZ belt.

  2. Association between the Cyclin D1 G870A polymorphism and the susceptibility to and prognosis of upper aerodigestive tract squamous cell carcinomas: an updated meta-analysis

    PubMed Central

    Meng, Yichen; Zhang, Chenglin; Zhou, Xuhui

    2016-01-01

    Purpose Several publications have investigated the association between the Cyclin D1 G to A substitution at nucleotide 870 (CCND1 G870A) polymorphism and squamous cell carcinoma (SCC) of the upper aerodigestive tract (UADT), but their conclusions still remain controversial. We conducted a meta-analysis to precisely evaluate this association. Patients and methods We electronically searched the Chinese National Knowledge Infrastructure, PubMed, and Embase (up to January 2015) databases for case–control studies on the association between the CCND1 G870A polymorphism and SCC of the UADT, and 23 studies were included in total. Results The meta-analysis results showed that there was a significant association between the CCND1 G870A polymorphism and the risk of SCC of the UADT (AA vs GG: odds ratio [OR] =1.33, 95% confidence interval [CI] =1.01–1.74, P<0.001 for heterogeneity; GA/AA vs GG: OR =1.24, 95% CI =1.01–1.51, P<0.001 for heterogeneity; AA vs GA/GG: OR =1.16, 95% CI =0.97–1.39, P<0.001 for heterogeneity; allele A vs allele G: OR =1.14, 95% CI =1.00–1.30, P<0.001 for heterogeneity; GA vs GG: OR =1.18, 95% CI =0.98–1.42, P<0.001 for heterogeneity). However, when analyzing prognosis, allele G was a potential risk factor for poor tumor differentiation (AA vs GA/GG: OR =2.60, 95% CI =1.15–5.86, P=0.836 for heterogeneity) and reduced disease-free intervals (OR =2.08, 95% CI =1.17–3.69, P=0.134 for heterogeneity). In the subgroup analysis, the cancer susceptibility of Asian groups, population-based control groups, nasopharyngeal cancer groups, and esophageal SCC groups were more likely to be affected by the CCND1 G870A polymorphism. No significant publication bias was found in our analysis (P=0.961 for Egger’s test and P=0.245 for Begg’s test). Conclusion The results of the present meta-analysis suggest that the variant CCND1 870A allele might confer an elevated risk of SCC of the UADT, particularly among Asians and individuals who have esophageal or nasopharyngeal cancers. Moreover, the CCND1 870A allele might also confer better tumor differentiation grades and longer disease-free intervals. PMID:26855585

  3. The neoplastic impact of tobacco-free betel-quid on the histological type and the anatomical site of aerodigestive tract cancers.

    PubMed

    Lee, Chien-Hung; Lee, Ka-Wo; Fang, Fu-Min; Wu, Deng-Chyang; Tsai, Shih-Meng; Chen, Ping-Ho; Shieh, Tien-Yu; Chen, Chung-Ho; Wu, I-Chen; Huang, Hsiao-Ling; Chen, Bai-Hsiun; Chang, Cheng-Hsien; Chen, Mu-Kuan; Chou, Shah-Hwa; Tsai, Yi-Shan; Chiang, Shang-Lun; Ko, Ying-Chin

    2012-09-01

    Little is known about any consequences of swallowing tobacco-free betel-quid (TF-BQ) juice/remnants following chewing and its carcinogenic impact on the upper aerodigestive tract (UADT) to gastrointestinal tract (GIT). We investigated the neoplastic impact of TF-BQ on different anatomical locations along UADT and GIT, and differences according to their histological categories. We conducted a multicenter case-control study examining patients with 2,163 pathology-proven UADT and GIT cancers, comparing them with 2,250 control subjects. Generalized additive models, piecewise regression and polytomous logistic models were applied to identify possible dose-dependent structures and cancer risks. Contrary to nonsignificant GIT-adenocarcinoma risk (aOR=0.9), TF-BQ users experienced a 1.7- to 16.2-fold higher risk of UADT-squamous cell carcinomas than nonusers, with the peak risk discovered in oral neoplasms. We separately observed a curvilinear and linear TF-BQ dose-risk relationship in oral/pharyngeal/esophageal and laryngeal cancers. Chewers of betel inflorescence were generally at a greater UADT cancer risk. A higher first-piecewise increased risk of esophageal cancer was recognized among areca-fluid swallowers than among nonswallowers (continuous aOR=1.12 vs. 1.03). TF-BQ use accounted for 66.1-78.7% and 17.8-33.2% of the cases of oral/pharyngeal and esophageal/laryngeal cancers, respectively. However, a reduction from heavy TF-BQ consumption to low-to-moderate consumption only reduced 11.3-34.6% of etiologic fraction of oral/pharyngeal cancers. Alcohol supra-additively modified the risk of TF-BQ in determining the development of oral, pharyngeal and esophageal cancers. In conclusion, the interplay of TF-BQ and alcohol/tobacco use, combined with how chewing habit is practiced, influences carcinogenic consequences on anatomically diverse sites of UADT and GIT cancers, and histologically different types. PMID:22174014

  4. Evaluation with mTHPC of early squamous cell carcinomas of the cheek pouch mucosa of Golden Syrian hamsters as a model for clinical PDT of early cancers in the upper aerodigestive tract, the esophag

    NASA Astrophysics Data System (ADS)

    Glanzmann, Thomas M.; Theumann, Jean-Francois; Forrer, Martin; Braichotte, Daniel; Wagnieres, Georges A.; van den Bergh, Hubert; Andrejevic-Blant, Snezana; Savary, Jean-Francois; Monnier, Philippe

    1995-03-01

    Golden Syrian hamsters are evaluated as an animal model for light induced fluorescence (LIF) photodetection and phototherapy of early squamous cell carcinomas of the upper aerodigestive tract, the esophagus, and the traecheo-bronchial tree. Carcinomas of this type are induced on the hamster cheek pouch mucosa by the application of the carcinogen 7,12-DMBA. For phototherapeutic experiments on the animals we utilized meso-(tetrahydoxyphenyl) chlorin (mTHPC). This drug is currently in phase I and II clinical trials for ENT patients presenting superficial `early' squamous cell carcinomas. By means of LIF we measured in vivo the kinetics of the uptake and removal of mTHPC in the normal and tumoral cheek mucosa and in the skin. The photodynamic therapy (PDT) reaction of the tissue after excitation of the photosensitizer with laser light at 652 nm was studied. Both pharmacokinetics and PDT efficacy are compared between animal model and clinical results with special emphasis on selectivity between normal and tumoral mucosa. These first experiments show that this tumor model in the hamster cheek pouch seems to be suitable for testing new photosensitizers preceding their clinical application as well as for optimization of the multiple parameters of clinical PDT.

  5. The nature of the Ailao Shan-Red River (ASRR) shear zone: Constraints from structural, microstructural and fabric analyses of metamorphic rocks from the Diancang Shan, Ailao Shan and Day Nui Con Voi massifs

    NASA Astrophysics Data System (ADS)

    Liu, Junlai; Tang, Yuan; Tran, My-Dung; Cao, Shuyun; Zhao, Li; Zhang, Zhaochong; Zhao, Zhidan; Chen, Wen

    2012-03-01

    The structural geology, timing of shearing, and tectonic implications of the ASRR shear zone, one of the most striking lineaments in Southeast Asia, have been the topics of extensive studies over the past few decades. The Xuelong Shan (XLS), Diancang Shan (DCS), Ailao Shan (ALS) and Day Nui Con Voi (DNCV) metamorphic massifs along the shear zone have preserved important information on its structural and tectonic evolution. Our field structural analysis, detailed microstructural and fabric analysis, as well as the quartz, sillimanite and garnet fabric studies of the sheared rocks from the massifs demonstrate the dominant roles of three deformation episodes during Cenozoic tectonic evolution in the shear zone. Among the contrasting structural and microstructural associations in the shear zone, D2 structures, which were formed at the brittle to ductile transition during large-scale left-lateral shearing in the second deformation episode, predominate over the structural styles of the other two deformation episodes. Discrete micro-shear zones with intensive grain size reduction compose the characteristic structural style of D2 deformation. In addition, several types of folds (early shearing folds, F21, and late-shearing folds, F22) were formed in the sheared rocks, including discrete to distributed mylonitic foliation, stretching lineation and shear fabrics (e.g., mica fish, domino structures, as well as sigma and delta fabrics). A sequence of microstructures from syn-kinematic magmatic flow, high-temperature solid-state deformation, to brittle-ductile shearing is well-preserved in the syn-kinematic leucocratic intrusions. Deformation structures from the first episode (D1) are characterized by F1 folds and distributed foliations (S1) in rocks due to pure shearing at high temperatures. They are preserved in weakly sheared (D2) rocks along the eastern margin of the ALS belt or in certain low-strain tectonic enclaves within the shear zone. Furthermore, semi-brittle deformation structures, such as hot striae and discrete retrogression zones, are attributed to normal-slip shearing in the third deformation episode (D3), which was probably locally active, along the eastern flank of the DCS range, for example. There are four quartz c-axis fabric patterns in the mylonitic rocks, including type A point maxima, type B Y point maxima with crossed girdles superimposition, type C quadrant maxima, as well as type D point and quadrant maxima combination. They are consistent with microscopic observations of microstructures of high-temperature pure shearing, low-temperature simple shearing and their superimposition. Integrated microstructural analysis and fabric thermometer studies provide information on both high temperature (up to 750 °C) and dominant low-temperature (300-600 °C) deformations of quartz grains in different rock types. Sillimanite and garnet fabrics, especially the latter, were primarily formed at the peak metamorphism during high-temperature pure shearing. The above structural, microstructural and fabric associations were generated in the tectonic framework of the Indian-Eurasian collision. The low-temperature microstructures and fabrics are attributed to left-lateral shearing along the ASRR shear zone from 27 to 21 Ma during the southeastward extrusion of the Indochina block, which postdated high-temperature deformation at the peak metamorphism during the collision.

  6. [Salvage surgery for upper aerodigestive tract tumours].

    PubMed

    Dolivet, Gilles; Cortese, Sophie; Mastronicola, Romina; Phulpin, Bérengère; Kaminski, Marie-Christine; Mecellem, Hinda; Gillon, Véronique; Gangloff, Pierre

    2011-01-01

    Salvage surgeries of head and neck tumors are considered as poor satisfactory either for disease control results or for aesthetic and functional outcomes. Several improvements have been made possible since few years in all fields of oncologic treatments. A new approach must be initiated in that context, moreover since take in charge for head and neck region (exclusive initial medical treatment) let us consider an increasement of clinical situations for which a salvage therapy could be performed. The new surgery techniques have to be considered, reconstructive and guided by systems, which can improve surgical skills (navigation, robotic, sentinel node procedure, nervous detection and so on), the help of reirradiation techniques, the use of medical therapy during surgical procedure, the photodynamic therapy and all the help provided by new medical imaging and modern biology, which can determine more precisely the status of the cancer when it is taken in charge. The mastery of those techniques improvements must follow on an evolution of the concepts in the field of combined salvage treatments performed by multidisciplinary teams. Those treatments have to be realized in structures, which have the techniques and the multiple skills for allowing increasement of outcomes of those severe diseases. PMID:21591296

  7. An Integrated Digital Campus Delivers ROI and VOI

    ERIC Educational Resources Information Center

    Forsstrom, Jan; Ham, Gary

    2007-01-01

    Five years ago, North Shore Community College (NSCC) encountered rising enrollments in the face of lagging state funding. The addition of two new campuses stretched NSCC thin as it attempted to provide administrative and academic services across five (more recently consolidated to four) locations. Its students increasingly struggled to balance the…

  8. Lung and Upper Aerodigestive Cancer | Division of Cancer Prevention

    Cancer.gov

    This group conducts and supports research on the prevention and early detection of lung and head and neck cancers, as well as new approac | Conducts and supports research on the prevention and early detection of lung and head and neck cancers.

  9. Lung and Upper Aerodigestive Cancer Staff | Division of Cancer Prevention

    Cancer.gov

    The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

  10. Lung and Upper Aerodigestive Cancer | Division of Cancer Prevention

    Cancer.gov

    This group conducts and supports research on the prevention and early detection of lung and head and neck cancers, as well as new approa | Conducts and supports research on the prevention and early detection of lung and head and neck cancers.

  11. Training in Human Relations for Engineers at the Ecole Superieure D'Informatique-Electronique-Automatique (ESIEA).

    ERIC Educational Resources Information Center

    Lafargue, M.; And Others

    1986-01-01

    Points out the need to provide engineers with training in human relations. Describes the process of developing a document defining the problem and steps to be taken toward solution, submitted to students for their evaluation. (JM)

  12. From "Ecoles Superieures de Commerce" to "Management Schools": Transformations and Continuity in French Business Schools

    ERIC Educational Resources Information Center

    Blanchard, Marianne

    2009-01-01

    Part of the national system of grandes Ecoles, French Business schools have known radical changes since the 1980s, notably in size, and have become more attractive to students both at a national and an international level. As a consequence, the French elitist system has been questioned by the competition of foreign--especially Anglo-Saxon--models.…

  13. Multimodality Neurological Data Visualization With Multi-VOI-Based DTI Fiber Dynamic Integration.

    PubMed

    Zhang, Qi; Alexander, Murray; Ryner, Lawrence

    2016-01-01

    Brain lesions are usually located adjacent to critical spinal structures, so it is a challenging task for neurosurgeons to precisely plan a surgical procedure without damaging healthy tissues and nerves. The advancement of medical imaging technologies produces a large amount of neurological data, which are capable of showing a wide variety of brain properties. Advanced algorithms of medical data computing and visualization are critically helpful in efficiently utilizing the acquired data for disease diagnosis and brain function and structure exploration, which is helpful for treatment planning. In this paper, we describe new algorithms and a software framework for multiple volume of interest specified diffusion tensor imaging (DTI) fiber dynamic visualization. The displayed results have been integrated with a volume rendering pipeline for multimodality neurological data exploration. A depth texture indexing algorithm is used to detect DTI fiber tracts in graphics process units (GPUs), which makes fibers to be displayed and interactively manipulated with brain data acquired from functional magnetic resonance imaging, T 1- and T 2-weighted anatomic imaging, and angiographic imaging. The developed software platform is built on an object-oriented structure, which is transparent and extensible. It provides a comprehensive human-computer interface for data exploration and information extraction. The GPU-accelerated high-performance computing kernels have been implemented to enable our software to dynamically visualize neurological data. The developed techniques will be useful in computer-aided neurological disease diagnosis, brain structure exploration, and general cognitive neuroscience. PMID:25376048

  14. Echelle chronologique des inversions du champ magnetique terrestre pour l'Eocene, le Paleocene et le Cretace superieur

    NASA Astrophysics Data System (ADS)

    Schlich, Roland

    1981-02-01

    The identification of magnetic anomaly patterns in the world ocean basins and the results of deep sea drilling by the Glomar Challenger allows us to propose a readjustment of the Heirtzler et al. original time scale of geomagnetic field reversals for the Eocene, Paleocene and Late Cretaceous. The largest difference reaches 7.5 million years and is located near anomalies 25 and 26 which correspond to the late Paleocene.

  15. Active Lung and Upper Aerodigestive Cancer Grants | Division of Cancer Prevention

    Cancer.gov

    Skip to main content Division of Cancer Prevention Search form Search Main menu Home Major Programs Research Networks Map Alliance of Glycobiologists for Detection of Cancer Barrett's Esophagus Translational Research Network (BETRNet) Cancer Prevention

  16. Active Lung and Upper Aerodigestive Cancer Grants | Division of Cancer Prevention

    Cancer.gov

    The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

  17. Lung and Upper Aerodigestive Cancer Clinical Trials | Division of Cancer Prevention

    Cancer.gov

    The Division of Cancer Prevention (DCP) conducts and supports research to determine a person's risk of cancer and to find ways to reduce the risk. This knowledge is critical to making progress against cancer because risk varies over the lifespan as genetic and epigenetic changes can transform healthy tissue into invasive cancer.

  18. Chromosomal aberrations in squamous cell carcinomas of the upper aerodigestive tract: biologic insights and clinical opportunities.

    PubMed

    Wreesmann, V B; Singh, B

    2005-09-01

    Oncogenesis results from a progressive accumulation of genetic aberrations consequent to a complex interplay between carcinogenic factors and innate infidelity of DNA surveillance mechanisms. Although the development of genetic aberrations is random, those conferring survival advantages are selected for in a Darwinian manner, thus allowing continuous adaptation to selection pressures. Chromosomal aberrations are a prominent manifestation of genetic damage, which can be closely linked with tumor behavior and outcome as exemplified by curative treatment of chronic myelogenous leukemia resulting from targeting the BCR-ABL translocation. In the case of head and neck squamous cell carcinomas (HNSCC), chromosomal changes are detectable at all stages of tumor development, providing excellent opportunities for genomic prognostication and therapy. Several studies have shown that the overall genomic profile of HNSCC is highly consistent, but individual tumors vary significantly in their complement of genetic alterations, thereby confounding clinical correlation. The application of modern genetic and bioinformatic analytic approaches has facilitated the identification of critical genomic changes in HNSCC, many of which have been linked to clinical outcome. These genetic aberrations represent excellent targets for novel therapeutics, but require validation. The initiation of phase III trials evaluating the therapeutic utility of genetic aberrations suggests a promising future for genome-based treatment of HNSCC. PMID:16091111

  19. Unusual causes of fatal upper aerodigestive tract obstruction in wild Bottlenose Dolphins (Tursiops aduncus).

    PubMed

    Byard, Roger W; Tomo, Ikuko; Kemper, Catherine M; Gibbs, Susan E; Bossley, Mike; Machado, Aaron; Hill, Mark

    2010-09-01

    Necropsy examination of dolphins living in Gulf St Vincent, Australia is routinely undertaken to enable the evaluation of disease processes and to provide rapid medicolegal assessment of any inflicted and/or accidental injuries. Two Indo-Pacific Bottlenose Dolphins (Tursiops aduncus) are reported to demonstrate conditions that may result in unexpected death involving upper airway compromise by quite unusual mechanisms. In the first case an adult male was found with extensive soft tissue trauma suggesting human interaction. At necropsy, death was due instead to upper airway obstruction from an impacted Slender-spined Porcupine Fish (Diodon nichthemerus) in the posterior pharynx and upper esophagus. In the second case, an adult male dolphin was found to have died, following several weeks' illness, from upper airway obstruction due to extensive respiratory tract papillomatosis within the blowhole. Given the infectious etiology of this condition the local population will be monitored for similar lesions. These cases demonstrate rare causes of upper airway obstruction in wild dolphins that were identifiable only after detailed necropsy examination. The possibility of human involvement in the deaths could be excluded. PMID:20165933

  20. Endoscopic tissue autofluorescence measurements in the upper aerodigestive tract and the bronchi

    NASA Astrophysics Data System (ADS)

    Braichotte, Daniel; Wagnieres, Georges A.; Monnier, Philippe; Savary, Jean-Francois; Bays, Roland; van den Bergh, Hubert; Chatelain, Andre

    1991-11-01

    A single multimode optical fiber is used to excite and collect tissue autofluorescence as well as the fluorescence of an IV-injected fluorescent tumor marker. Measurements of the relative fluorescence intensity of a tumor marker as a function of the time after IV injection permit measurement of the kinetics of this substance in tumor, normal tissue, and skin. The authors believe that these are the first measurements of this kind in patients. Furthermore, the autofluorescence spectrum generated at several excitation wavelengths in different tissues is compared, for instance in the oesophagus, the bronchi, and the tongue. The measuring system is based on an optical multichannel analyzer which measures the fluorescence excited by monochromatic radiation from a spectrally filtered Xe lamp. A correlation between the observed pharmacokinetics and tumor properties like the degree of vascularization is of fundamental importance for each selected tumor marker. Also, the results of these measurements are used for the optical detection of tumors.

  1. Les voies d'apprentissage en langue etrangere (Learning Processes in a Foreign Language). Working Papers on Bilingualism, No. 17.

    ERIC Educational Resources Information Center

    Frauenfelder, Uli; Porquier, Remy

    A general model for second language learning is proposed in this paper. First, this model aims to describe different components (input, intake, integration, output) of the learning process in terms of the information (explicit/implicit, linguistic/sociolinguistic) to which the learner is exposed. Secondly, the model serves to identify the stages,…

  2. Radiotherapy with concomitant continuous cisplatin infusion for unresectable tumors of the upper aerodigestive tract: results of a phase I study.

    PubMed

    Bachaud, J M; Chatelut, E; Canal, P; Albin, N; Yardeni, E; David, J M; Serrano, E; Daly-Schveitzer, N

    1997-02-01

    A phase I-II study was initiated in February 1991 of concomitant radiation and cisplatin (CDDP) in the treatment of unresectable head and neck squamous cell carcinomas (n = 12). The first patient was treated palliatively for a cervical recurrence of laryngeal cancer. The 11 other patients had locally advanced (stage IV) previously untreated carcinomas of the oropharynx (n = 9), hypopharynx (n = 1), or cervical node with unknown primary site (n = 1). Standard external radiation was carried out up to a total dose of 60 Gy/6 weeks (7 MeV electron beam) for the first patient and 72 Gy/8 weeks (Co60 beam) for the other 11 patients. CDDP was infused continuously during the entire radiation treatment, 5 days/week. The starting dose was 4 mg/m2/day and was escalated by increments of 1 mg/m2/day; dose-limiting toxicity was observed at 7 mg/m2/day. Neutropenia (grade 4, one patient; grade 3, three patients) and thrombocytopenia (grade 3, one patient; grade 2, one patient) were the limiting factors. Therefore, the recommended dose of CDDP is 6 mg/m2/day. All patients but one completed the scheduled radiation. For the entire group, mucositis was not more severe than that observed with radiotherapy alone. There was no nephro-, oto-, or neurotoxicity. A complete response was obtained in eight (66%) patients. Of these, four were free of disease 12-34 months after completion of treatment and one had a total glossectomy for a tongue necrosis. For the whole series, the mean overall survival was 16 months posttreatment. Pharmacokinetic analysis indicated the total cisplatin accumulation at the end of treatment to be 743-1551 ng/ml. Accumulation of ultrafilterable platin was noted in only one patient (137 ng/ml at the end of treatment). PMID:9020278

  3. Migration of a fish bone from the upper aerodigestive tract to the skin of the neck: a case report.

    PubMed

    Sinha, Ramanuj; Sen, Indranil; Saha, Jayanta; Mukherjee, Ankur; Guha, Ruma

    2013-08-01

    We describe an unusual case of a migratory foreign body (fish bone) in the neck of a 45-year-old woman. The 2.1-cm bone migrated from the esophagus and traversed through the entire soft tissue of the neck, and it almost extruded through the skin of the neck. With the patient under local anesthesia, the foreign body was easily extracted through an incision over the skin. PMID:23975496

  4. Local network interconnection through a satellite point-to-multipoint link. Ph.D. Thesis - Ecole Nationale Superieure des Telecommunications, 6 Jul. 1985

    NASA Technical Reports Server (NTRS)

    Duarte, O. Muniz Bandeira

    1986-01-01

    Four architectures to implement a point to multipoint satellite link protocol for communication services offered by the Telecom 1 satellite network are presented. A safe communication service with error correction and flow control facilities is described. It is shown that a time transparent communication system combines simplicity and cost advantages.

  5. Laminar-turbulent transition; Proceedings of the IUTAM Symposium, Ecole Nationale Superieure de l'Aeronautique et de l'Espace, Toulouse, France, Sept. 11-15, 1989

    NASA Astrophysics Data System (ADS)

    Arnal, D.; Michel, R.

    The present conference discusses such topics in laminar-turbulent transition phenomena as the TS instability in similar boundary layer flows affected by an adverse pressure gradient, flight tests of a swept wing with suction, piezofoil arrays for airfoil flow instability investigations, the breakdown of a wave packet disturbance in a laminar boundary layer, a stability theory for chemically reacting flows, the subharmonic instability of compressible boundary layers, and wall turbulence in Blasius flow. Also discussed are stability-based methods for transition in three-dimensional flows, blunt-nosed swept supercritical LFC wings without nose flaps, the Goertler vortex instability mechanism at hypersonic speeds, wavy vortices in rotating channel flow, large-eddy simulations of mixing layers, boundary-layer tripping in supersonic flow, and visualizations of the boundary-layer transition.

  6. From Higher Education To Employment. Volume I: Australia, Austria, Belgium, Germany = De l'enseignement superieur a l'emploi. Volume I: Allemagne, Australie, Autriche, Belgique.

    ERIC Educational Resources Information Center

    Organisation for Economic Cooperation and Development, Paris (France).

    This volume presents reports on the flows of graduates from higher education and on their entry into working life in Germany, Austria, Belgium, and Australia. Each paper is written according to detailed guidelines designed to assemble information from many sources, to reflect the state of the art, and to illustrate a variety of approaches,…

  7. WindVOiCe, a Self-Reporting Survey: Adverse Health Effects, Industrial Wind Turbines, and the Need for Vigilance Monitoring

    ERIC Educational Resources Information Center

    Krogh, Carmen M. E.; Gillis, Lorrie; Kouwen, Nicholas; Aramini, Jeff

    2011-01-01

    Industrial wind turbines have been operating in many parts of the globe. Anecdotal reports of perceived adverse health effects relating to industrial wind turbines have been published in the media and on the Internet. Based on these reports, indications were that some residents perceived they were experiencing adverse health effects. The purpose…

  8. WindVOiCe, a Self-Reporting Survey: Adverse Health Effects, Industrial Wind Turbines, and the Need for Vigilance Monitoring

    ERIC Educational Resources Information Center

    Krogh, Carmen M. E.; Gillis, Lorrie; Kouwen, Nicholas; Aramini, Jeff

    2011-01-01

    Industrial wind turbines have been operating in many parts of the globe. Anecdotal reports of perceived adverse health effects relating to industrial wind turbines have been published in the media and on the Internet. Based on these reports, indications were that some residents perceived they were experiencing adverse health effects. The purpose…

  9. [Experimental hybridization of voies of the genus Microtus s.l. M. socialis with species of the group arvalis (Mammalia, Rodentia)].

    PubMed

    Koval'skaia, Iu M; Savinetskaia, L E; Aksenova, T G

    2014-01-01

    The results of interspecific crosses of the social vole Microtus socialis with the Altai vole M. obscurus, the East European vole M. rossiaemeridionalis, and the Transcaspian vole M. transcaspicus are presented. The role of the sperm head structure in the reproductive isolation of this species was studied. Hybrids were obtained in five of the six crossing combinations. It is established that significant differences in the sperm head shape in the social vole and in arvalis group species do not prevent fertilization. The sterility of hybrids indicates the existence of postcopulative mechanisms of reproductive isolation. PMID:25739313

  10. Autofluorescence spectroscopy of normal and malignant tissues: both in-vivo and ex-vivo measurements in the upper aero-digestive tract and lung tissues

    NASA Astrophysics Data System (ADS)

    A'Amar, Ousama M.; Lignon, Dominique; Menard, O.; Begorre, Henri; Guillemin, Francois H.; Yvroud, Edouard

    1996-04-01

    A spectroscopic system with flexible three optical fiber sensor had been developed to study tissue fluorescence for a clinical use. Autofluorescence spectra at 413 nm and 10 mW excitation light power from different tissues in oral cavity had been measured in vivo in 25 subjects. The correlation coefficient in spectral shape between individual spectra and the mean emission spectrum of each site was about 0.9 and fluorescence intensity variation ranged between 20% and 45% according to the examined site. The variation in fluorescence intensity of the main emission wavelength at about 520 nm between spectra of the lower part of tongue, gingiva, lips, floor of cavity, cheek and palate was not statistically significant. But the spectrum of the upper part of tongue had been characterized by an additional peak around 635 nm. Otherwise, autofluorescence spectra at 410 nm and 0.5 mW excitation light power of 8 carcinoma of buccal and lung tissues were measured. The fluorescence ratio at 520 emission peak between normal tissue and carcinoma was evaluated at a maximum value of 13 for a lung cancer (ex vivo measurement) and a minimum of 3.3 for a cancer of the oro-pharynx (in vivo measurement). On the other hand, a fluorescence peak at 635 nm had characterized the carcinoma of the floor of cavity and the upper part of tongue.

  11. 2008 Research Highlights

    Cancer.gov

    Alcohol, a known risk factor for upper aerodigestive cancers, is metabolized by several enzymes, including alcohol dehydrogenase (ADH). The genes in the ADH pathway are important candidate genes for aerodigestive cancers.

  12. Highlighting the Impacts of North-South Research Collaboration among Canadian and Southern Higher Education Partners (Principaux impacts des collaborations de recherche Nord-Sud entre les partenaires des etablissements d'enseignement superieur du Canada et du Sud)

    ERIC Educational Resources Information Center

    Association of Universities and Colleges of Canada, 2006

    2006-01-01

    The Association of Universities and Colleges of Canada (AUCC) felt it was timely to create an academic forum in which university researchers have the opportunity to engage with their peers and relevant stakeholders and document the impacts of their North-South research collaboration in a peer-reviewed publication. The Association achieved this by…

  13. EDUCAFRICA, December 1986. Special Issue: Case Studies on Higher Education in Africa. Special Volume 1=EDUCAFRICA, Decembre 1986. Etudes de cas sur L'Enseignement Superieur en Afrique, Tome 1.

    ERIC Educational Resources Information Center

    EDUCAFRICA, 1986

    1986-01-01

    Case studies of the development of higher education in 17 African countries are presented. Eleven of the case studies are written in French, and six are in English. The country reports that are in English are as follows: Cameroon, Ethiopia, Lesotho, Malawi, Sierra Leone, and Tanzania. The country reports in French are: Benin, Burkina Faso,…

  14. L'E.A.P. ou l'anglais enseigne dans les etudes superieures. Un guide pour le debutant (E.A.P. or English for Academic Purposes: A Guide for the Beginner).

    ERIC Educational Resources Information Center

    Roe, Peter J.

    1981-01-01

    Addresses those readers who are not familiar with EAP, offering an introductory discussion of its objectives and methods, in two parts. Devotes the first part to the needs that justify an EAP approach, and the second to its methodology, with particular attention to interdisciplinary, task-oriented instruction. Societe Nouvelle Didier Erudition, 40…

  15. Value of Information References

    SciTech Connect

    Morency, Christina

    2014-12-12

    This file contains a list of relevant references on value of information (VOI) in RIS format. VOI provides a quantitative analysis to evaluate the outcome of the combined technologies (seismology, hydrology, geodesy) used to monitor Brady's Geothermal Field.

  16. Integrated Molecular Profiling in Advanced Cancers Trial

    ClinicalTrials.gov

    2015-06-30

    Breast Cancer; Non-small Cell Lung Cancer; Colorectal Cancer; Genitourinary Cancer; Pancreatobiliary Gastrointestinal Cancer; Upper Aerodigestive Tract Cancer; Gynecological Cancers; Melanoma Cancers; Rare Cancers; Unknown Primary Cancers

  17. 28 CFR 91.54 - Applicability.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... major federal action that might significantly impact the quality of the human environment. The CEQ... may significantly impact the environment. (c) Projects. Although VOI/TIS money cannot be used for a... Impact Review Procedures for VOI/TIS Grant Program Application to Voi/tis Grant Program §...

  18. 28 CFR 91.54 - Applicability.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... major federal action that might significantly impact the quality of the human environment. The CEQ... may significantly impact the environment. (c) Projects. Although VOI/TIS money cannot be used for a... Impact Review Procedures for VOI/TIS Grant Program Application to Voi/tis Grant Program §...

  19. Trial of Postoperative Radiation, Cisplatin, and Panitumumab in Locally Advanced Head and Neck Cancer

    ClinicalTrials.gov

    2016-01-14

    Cancer of Head; Cancer of Head and Neck; Cancer of Neck; Cancer of the Head; Cancer of the Head and Neck; Cancer of the Neck; Head and Neck Cancer; Head Cancer; Head Neoplasms; Head, Neck Neoplasms; Neck Cancer; Neck Neoplasms; Neoplasms, Head; Neoplasms, Head and Neck; Neoplasms, Neck; Neoplasms, Upper Aerodigestive Tract; UADT Neoplasms; Upper Aerodigestive Tract Neoplasms

  20. Motivations d'etude d'une langue etrangere a l'universite: Enquete sur le francais dans l'enseignement sur le francais dans l'enseignement superieur israelien (Reasons for Studying a Foreign Language at the University: Investigation of Advanced French Instruction in Israel).

    ERIC Educational Resources Information Center

    Levy, Francine

    1995-01-01

    Presents a case study of the study of French at the University of Tel Aviv as an illustration of the cultural attitude toward foreign language learning. Knowledge of a foreign language elevates the student socially as the possessor of symbolic capital, establishing social differentiation between the possessors of that capital and others. (28…

  1. Review of Evaluative Mechanisms in the Departments of Advanced Education and Labour and Human Resources Development--New Brunswick = Examen des mecanismes d'evaluation au ministere de l'Enseignement superieur et du Travail et au ministere du Developpement des Ressources humaines du Nouveau-Brunswick.

    ERIC Educational Resources Information Center

    New Brunswick Labour Force Development Board, Fredericton.

    The evaluative mechanisms in the Department of Advanced Education and Labour and Department of Human Resources Development in the Canadian province of New Brunswick were reviewed. Data were gathered from the following: meetings with key staff in each department, briefing session for all key informants, 19 personal interviews, brief review of the…

  2. Contrast-to-noise ratio improvement in volume-of-interest cone beam breast CT

    NASA Astrophysics Data System (ADS)

    Shen, Youtao; Liu, Xinming; Lai, Chao-Jen; Zhong, Yuncheng; Yi, Ying; You, Zhicheng; Wang, Tianpeng; Shaw, Chris C.

    2012-03-01

    In this study, we demonstrated the contrast-to-noise ratio (CNR) improvement in breast cone beam CT (CBCT) using the volume-of-interest (VOI) scanning technique. In VOI breast CBCT, the breast is first scanned at a low exposure level. A pre-selected VOI is then scanned at a higher exposure level with collimated x-rays. The two image sets are combined together to reconstruct high quality 3-D images of the VOI. A flat panel detector based system was built to demonstrate and investigate the CNR improvement in VOI breast CBCT. The CNRs of the 8 plastic cones (Teflon, Delrin, polycarbonate, Lucite, solid water, high density polystyrene, nylon and polystyrene) in a breast phantom were measured in images obtained with the VOI CBCT technique and compared to those measured in standard full field CBCT images. CNRs in VOI CBCT images were found to be higher than those in regular CBCT images in all plastic cones. The mean glandular doses (MGDs) from the combination of a high exposure VOI scan and a low exposure full-field scan was estimated to be similar to that from regular full-field scan at standard exposure level. The VOI CBCT technique allows a VOI to be imaged with enhanced image quality with an MGD similar to that from regular CBCT technique.

  3. Four-dimensional volume-of-interest reconstruction for cone-beam computed tomography-guided radiation therapy

    SciTech Connect

    Ahmad, Moiz; Balter, Peter; Pan, Tinsu

    2011-10-15

    Purpose: Data sufficiency are a major problem in four-dimensional cone-beam computed tomography (4D-CBCT) on linear accelerator-integrated scanners for image-guided radiotherapy. Scan times must be in the range of 4-6 min to avoid undersampling artifacts. Various image reconstruction algorithms have been proposed to accommodate undersampled data acquisitions, but these algorithms are computationally expensive, may require long reconstruction times, and may require algorithm parameters to be optimized. The authors present a novel reconstruction method, 4D volume-of-interest (4D-VOI) reconstruction which suppresses undersampling artifacts and resolves lung tumor motion for undersampled 1-min scans. The 4D-VOI reconstruction is much less computationally expensive than other 4D-CBCT algorithms. Methods: The 4D-VOI method uses respiration-correlated projection data to reconstruct a four-dimensional (4D) image inside a VOI containing the moving tumor, and uncorrelated projection data to reconstruct a three-dimensional (3D) image outside the VOI. Anatomical motion is resolved inside the VOI and blurred outside the VOI. The authors acquired a 1-min. scan of an anthropomorphic chest phantom containing a moving water-filled sphere. The authors also used previously acquired 1-min scans for two lung cancer patients who had received CBCT-guided radiation therapy. The same raw data were used to test and compare the 4D-VOI reconstruction with the standard 4D reconstruction and the McKinnon-Bates (MB) reconstruction algorithms. Results: Both the 4D-VOI and the MB reconstructions suppress nearly all the streak artifacts compared with the standard 4D reconstruction, but the 4D-VOI has 3-8 times greater contrast-to-noise ratio than the MB reconstruction. In the dynamic chest phantom study, the 4D-VOI and the standard 4D reconstructions both resolved a moving sphere with an 18 mm displacement. The 4D-VOI reconstruction shows a motion blur of only 3 mm, whereas the MB reconstruction shows a motion blur of 13 mm. With graphics processing unit hardware used to accelerate computations, the 4D-VOI reconstruction required a 40-s reconstruction time. Conclusions: 4D-VOI reconstruction effectively reduces undersampling artifacts and resolves lung tumor motion in 4D-CBCT. The 4D-VOI reconstruction is computationally inexpensive compared with more sophisticated iterative algorithms. Compared with these algorithms, our 4D-VOI reconstruction is an attractive alternative in 4D-CBCT for reconstructing target motion without generating numerous streak artifacts.

  4. 3-D scalable medical image compression with optimized volume of interest coding.

    PubMed

    Sanchez, Victor; Abugharbieh, Rafeef; Nasiopoulos, Panos

    2010-10-01

    We present a novel 3-D scalable compression method for medical images with optimized volume of interest (VOI) coding. The method is presented within the framework of interactive telemedicine applications, where different remote clients may access the compressed 3-D medical imaging data stored on a central server and request the transmission of different VOIs from an initial lossy to a final lossless representation. The method employs the 3-D integer wavelet transform and a modified EBCOT with 3-D contexts to create a scalable bit-stream. Optimized VOI coding is attained by an optimization technique that reorders the output bit-stream after encoding, so that those bits belonging to a VOI are decoded at the highest quality possible at any bit-rate, while allowing for the decoding of background information with peripherally increasing quality around the VOI. The bit-stream reordering procedure is based on a weighting model that incorporates the position of the VOI and the mean energy of the wavelet coefficients. The background information with peripherally increasing quality around the VOI allows for placement of the VOI into the context of the 3-D image. Performance evaluations based on real 3-D medical imaging data showed that the proposed method achieves a higher reconstruction quality, in terms of the peak signal-to-noise ratio, than that achieved by 3D-JPEG2000 with VOI coding, when using the MAXSHIFT and general scaling-based methods. PMID:20562038

  5. High resolution dual detector volume-of-interest cone beam breast CT - Demonstration with a bench top system

    SciTech Connect

    Shen Youtao; Yi Ying; Zhong Yuncheng; Lai Chaojen; Liu Xinming; You Zhicheng; Ge Shuaiping; Wang Tianpeng; Shaw, Chris C.

    2011-12-15

    Purpose: In this study, we used a small field high resolution detector in conjunction with a full field flat panel detector to implement and investigate the dual detector volume-of-interest (VOI) cone beam breast computed tomography (CBCT) technique on a bench-top system. The potential of using this technique to image small calcifications without increasing the overall dose to the breast was demonstrated. Significant reduction of scatter components in the high resolution projection image data of the VOI was also shown. Methods: With the regular flat panel based CBCT technique, exposures were made at 80 kVp to generate an air kerma of 6 mGys at the isocenter. With the dual detector VOI CBCT technique, a high resolution small field CMOS detector was used to scan a cylindrical VOI (2.5 cm in diameter and height, 4.5 cm off-center) with collimated x-rays at four times of regular exposure level. A flat panel detector was used for full field scan with low x-ray exposures at half of the regular exposure level. The low exposure full field image data were used to fill in the truncated space in the VOI scan data and generate a complete projection image set. The Feldkamp-Davis-Kress (FDK) filtered backprojection algorithm was used to reconstruct high resolution images for the VOI. Two scanning techniques, one breast centered and the other VOI centered, were implemented and investigated. Paraffin cylinders with embedded thin aluminum (Al) wires were imaged and used in conjunction with optically stimulated luminescence (OSL) dose measurements to demonstrate the ability of this technique to image small calcifications without increasing the mean glandular dose (MGD). Results: Using exposures that produce an air kerma of 6 mGys at the isocenter, the regular CBCT technique was able to resolve the cross-sections of Al wires as thin as 254 {mu}m in diameter in the phantom. For the specific VOI studied, by increasing the exposure level by a factor of 4 for the VOI scan and reducing the exposure level by a factor of 2 for the full filed scan, the dual-detector CBCT technique was able to resolve the cross-sections of Al wires as thin as 152 {mu}m in diameter. The CNR evaluated for the entire Al wire cross-section was found to be improved from 5.5 in regular CBCT to 14.4 and 16.8 with the breast centered and VOI centered scanning techniques, respectively. Even inside VOI center, the VOI scan resulted in significant dose saving with the dose reduced by a factor of 1.6 at the VOI center. Dose saving outside the VOI was substantial with the dose reduced by a factor of 7.3 and 7.8 at the breast center for the breast centered and VOI centered scans, respectively, when compared to full field scan at the same exposure level. The differences between the two dual detector techniques in terms of dose saving and scatter reduction were small with VOI scan at 4x exposure level and full field scan at 0.5x exposure level. The MGDs were only 94% of that from the regular CBCT scan. Conclusions: For the specific VOI studied, the dual detector VOI CBCT technique has the potential to provide high quality images inside the VOI with MGD similar to or even lower than that of full field breast CBCT. It was also found that our results were compromised by the use of inadequate detectors for the VOI scan. An appropriately selected detector would better optimize the image quality improvement that can be achieved with the VOI CBCT technique.

  6. High resolution dual detector volume-of-interest cone beam breast CT––Demonstration with a bench top system

    PubMed Central

    Shen, Youtao; Yi, Ying; Zhong, Yuncheng; Lai, Chao-Jen; Liu, Xinming; You, Zhicheng; Ge, Shuaiping; Wang, Tianpeng; Shaw, Chris C.

    2011-01-01

    Purpose: In this study, we used a small field high resolution detector in conjunction with a full field flat panel detector to implement and investigate the dual detector volume-of-interest (VOI) cone beam breast computed tomography (CBCT) technique on a bench-top system. The potential of using this technique to image small calcifications without increasing the overall dose to the breast was demonstrated. Significant reduction of scatter components in the high resolution projection image data of the VOI was also shown. Methods: With the regular flat panel based CBCT technique, exposures were made at 80 kVp to generate an air kerma of 6 mGys at the isocenter. With the dual detector VOI CBCT technique, a high resolution small field CMOS detector was used to scan a cylindrical VOI (2.5 cm in diameter and height, 4.5 cm off-center) with collimated x-rays at four times of regular exposure level. A flat panel detector was used for full field scan with low x-ray exposures at half of the regular exposure level. The low exposure full field image data were used to fill in the truncated space in the VOI scan data and generate a complete projection image set. The Feldkamp-Davis-Kress (FDK) filtered backprojection algorithm was used to reconstruct high resolution images for the VOI. Two scanning techniques, one breast centered and the other VOI centered, were implemented and investigated. Paraffin cylinders with embedded thin aluminum (Al) wires were imaged and used in conjunction with optically stimulated luminescence (OSL) dose measurements to demonstrate the ability of this technique to image small calcifications without increasing the mean glandular dose (MGD). Results: Using exposures that produce an air kerma of 6 mGys at the isocenter, the regular CBCT technique was able to resolve the cross-sections of Al wires as thin as 254 ?m in diameter in the phantom. For the specific VOI studied, by increasing the exposure level by a factor of 4 for the VOI scan and reducing the exposure level by a factor of 2 for the full filed scan, the dual-detector CBCT technique was able to resolve the cross-sections of Al wires as thin as 152 ?m in diameter. The CNR evaluated for the entire Al wire cross-section was found to be improved from 5.5 in regular CBCT to 14.4 and 16.8 with the breast centered and VOI centered scanning techniques, respectively. Even inside VOI center, the VOI scan resulted in significant dose saving with the dose reduced by a factor of 1.6 at the VOI center. Dose saving outside the VOI was substantial with the dose reduced by a factor of 7.3 and 7.8 at the breast center for the breast centered and VOI centered scans, respectively, when compared to full field scan at the same exposure level. The differences between the two dual detector techniques in terms of dose saving and scatter reduction were small with VOI scan at 4×?exposure level and full field scan at 0.5×?exposure level. The MGDs were only 94% of that from the regular CBCT scan. Conclusions: For the specific VOI studied, the dual detector VOI CBCT technique has the potential to provide high quality images inside the VOI with MGD similar to or even lower than that of full field breast CBCT. It was also found that our results were compromised by the use of inadequate detectors for the VOI scan. An appropriately selected detector would better optimize the image quality improvement that can be achieved with the VOI CBCT technique. PMID:22149826

  7. 28 CFR 91.55 - Categorical exclusions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Environmental Impact Review Procedures for VOI/TIS Grant Program Application to Voi/tis Grant Program § 91.55... existing facility, unless the renovation would impact a structure which is on the National Register of... disposal, or water facilities. (c) Expansion of support facilities. Projects for the expansion of bed...

  8. 28 CFR 91.55 - Categorical exclusions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Environmental Impact Review Procedures for VOI/TIS Grant Program Application to Voi/tis Grant Program § 91.55... existing facility, unless the renovation would impact a structure which is on the National Register of... disposal, or water facilities. (c) Expansion of support facilities. Projects for the expansion of bed...

  9. 28 CFR 91.55 - Categorical exclusions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Environmental Impact Review Procedures for VOI/TIS Grant Program Application to Voi/tis Grant Program § 91.55... existing facility, unless the renovation would impact a structure which is on the National Register of... disposal, or water facilities. (c) Expansion of support facilities. Projects for the expansion of bed...

  10. 28 CFR 91.55 - Categorical exclusions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Environmental Impact Review Procedures for VOI/TIS Grant Program Application to Voi/tis Grant Program § 91.55... existing facility, unless the renovation would impact a structure which is on the National Register of... disposal, or water facilities. (c) Expansion of support facilities. Projects for the expansion of bed...

  11. Value of Information Evaluation using Field Data

    SciTech Connect

    Trainor-Guitton, W.

    2015-06-15

    Value of information (VOI) provides the ability to identify and prioritize useful information gathering for a geothermal prospect, either hydrothermal or for enhanced geothermal systems. Useful information provides a value greater than the cost of the information; wasteful information costs more than the expected value of the information. In this project we applied and refined VOI methodologies on selected geothermal prospects.

  12. When do we need more data? A primer on calculating the value of information for applied ecologists

    USGS Publications Warehouse

    Canessa, Stefano; Guillera-Arroita, Gurutzeta; Lahoz-Monfort, José J.; Southwell, Darren M; Armstrong, Doug P.; Chadès, Iadine; Lacy, Robert C; Converse, Sarah

    2015-01-01

    The VoI depends on our current knowledge, the quality of the information collected and the expected outcomes of the available management actions. Collecting information can require significant investments of resources; VoI analysis assists managers in deciding whether these investments are justified.

  13. Dual resolution cone beam breast CT: A feasibility study

    PubMed Central

    Chen, Lingyun; Shen, Youtao; Lai, Chao-Jen; Han, Tao; Zhong, Yuncheng; Ge, Shuaiping; Liu, Xinming; Wang, Tianpeng; Yang, Wei T.; Whitman, Gary J.; Shaw, Chris C.

    2009-01-01

    Purpose: In this study, the authors investigated the feasibility of a dual resolution volume-of-interest (VOI) cone beam breast CT technique and compared two implementation approaches in terms of dose saving and scatter reduction. Methods: With this technique, a lead VOI mask with an opening is inserted between the x-ray source and the breast to deliver x-ray exposure to the VOI while blocking x rays outside the VOI. A CCD detector is used to collect the high resolution projection data of the VOI. Low resolution cone beam CT (CBCT) images of the entire breast, acquired with a flat panel (FP) detector, were used to calculate the projection data outside the VOI with the ray-tracing reprojection method. The Feldkamp–Davis–Kress filtered backprojection algorithm was used to reconstruct the dual resolution 3D images. Breast phantoms with 180 ?m and smaller microcalcifications (MCs) were imaged with both FP and FP-CCD dual resolution CBCT systems, respectively. Two approaches of implementing the dual resolution technique, breast-centered approach and VOI-centered approach, were investigated and evaluated for dose saving and scatter reduction with Monte Carlo simulation using a GEANT4 package. Results: The results showed that the breast-centered approach saved more breast absorbed dose than did VOI-centered approach with similar scatter reduction. The MCs in fatty breast phantom, which were invisible with FP CBCT scan, became visible with the FP-CCD dual resolution CBCT scan. Conclusions: These results indicate potential improvement of the image quality inside the VOI with reduced breast dose both inside and outside the VOI. PMID:19810473

  14. Effects of computing parameters and measurement locations on the estimation of 3D NPS in non-stationary MDCT images.

    PubMed

    Miéville, Frédéric A; Bolard, Gregory; Bulling, Shelley; Gudinchet, François; Bochud, François O; Verdun, François R

    2013-11-01

    The goal of this study was to investigate the impact of computing parameters and the location of volumes of interest (VOI) on the calculation of 3D noise power spectrum (NPS) in order to determine an optimal set of computing parameters and propose a robust method for evaluating the noise properties of imaging systems. Noise stationarity in noise volumes acquired with a water phantom on a 128-MDCT and a 320-MDCT scanner were analyzed in the spatial domain in order to define locally stationary VOIs. The influence of the computing parameters in the 3D NPS measurement: the sampling distances bx,y,z and the VOI lengths Lx,y,z, the number of VOIs NVOI and the structured noise were investigated to minimize measurement errors. The effect of the VOI locations on the NPS was also investigated. Results showed that the noise (standard deviation) varies more in the r-direction (phantom radius) than z-direction plane. A 25 × 25 × 40 mm(3) VOI associated with DFOV = 200 mm (Lx,y,z = 64, bx,y = 0.391 mm with 512 × 512 matrix) and a first-order detrending method to reduce structured noise led to an accurate NPS estimation. NPS estimated from off centered small VOIs had a directional dependency contrary to NPS obtained from large VOIs located in the center of the volume or from small VOIs located on a concentric circle. This showed that the VOI size and location play a major role in the determination of NPS when images are not stationary. This study emphasizes the need for consistent measurement methods to assess and compare image quality in CT. PMID:22858431

  15. Fluence field modulated CT on a clinical TomoTherapy radiation therapy machine

    NASA Astrophysics Data System (ADS)

    Szczykutowicz, Timothy P.; Hermus, James

    2015-03-01

    Purpose: The multi-leaf collimator (MLC) assembly present on TomoTherapy (Accuray, Madison WI) radiation therapy (RT) and mega voltage CT machines is well suited to perform fluence field modulated CT (FFMCT). In addition, there is a demand in the RT environment for FFMCT imaging techniques, specifically volume of interest (VOI) imaging. Methods: A clinical TomoTherapy machine was programmed to deliver 30% imaging dose outside predefined VOIs. Four different size ROIs were placed at varying distances from isocenter. Projections intersecting the VOI received "full dose" while those not intersecting the VOI received 30% of the dose (i.e. the incident fluence for non VOI projections was 30% of the incident fluence for projections intersecting the VOI). Additional scans without fluence field modulation were acquired at "full" and 30% dose. The noise (pixel standard deviation) was measured inside the VOI region and compared between the three scans. Results: The VOI-FFMCT technique produced an image noise 1.09, 1.05, 1.05, and 1.21 times higher than the "full dose" scan for ROI sizes of 10 cm, 13 cm, 10 cm, and 6 cm respectively within the VOI region. Conclusions: Noise levels can be almost unchanged within clinically relevant VOIs sizes for RT applications while the integral imaging dose to the patient can be decreased, and/or the image quality in RT can be dramatically increased with no change in dose relative to non-FFMCT RT imaging. The ability to shift dose away from regions unimportant for clinical evaluation in order to improve image quality or reduce imaging dose has been demonstrated. This paper demonstrates that FFMCT can be performed using the MLC on a clinical TomoTherapy machine for the first time.

  16. The Idea of a Normal University in the 21st Century

    ERIC Educational Resources Information Center

    Hayhoe, Ruth; Li, Jun

    2010-01-01

    The establishment of normal colleges and universities is an important component of building a modern country, which possesses different value ethos with the universities. The emergence of the Ecole Normale Superieure in Paris and the local normal schools has set a new model for teacher education around the world and promoted values and knowledge…

  17. The Normative Effects of Higher Education Policy in France

    ERIC Educational Resources Information Center

    Langan, Elise

    2012-01-01

    This student survey was a response to the French youth unrest in 2005 and 2006. It considers the degree to which French higher and secondary education institutions create social cohesion. Focusing on three distinct higher-education institutions: "L'institut d'etudes politiques de Paris" (Sciences Po), "Ecole Normale Superieure," Paris 8, and a…

  18. Conceptual Integration of Hybridization by Algerian Students Intending to Teach Physical Sciences

    ERIC Educational Resources Information Center

    Salah, Hazzi; Dumon, Alain

    2011-01-01

    This work aims to assess the difficulties encountered by students of the Ecole Normale Superieure of Kouba (Algeria) intending to teach physical science in the integration of the hybridization of atomic orbitals. It is a concept that they should use in describing the formation of molecular orbitals ([sigma] and [pi]) in organic chemistry and gaps…

  19. Decrire et enseigner une competence de communication: remarques sur quelques solutions de continuite. L'Enseignement de la competence de communication en langues secondes. (Describing and Teaching Communicative Competence: Some Remarks on Solutions of Continuity. The Teaching of Communicative Competence in Second Languages.) Acts of the Colloquium of the Swiss Interuniversity Commission for Applied Linguistics. CILA Bulletin.

    ERIC Educational Resources Information Center

    Coste, Daniel

    Two projects of the Ecole Normale Superieure de Saint-Cloud (CREDIF) are described and critically analyzed in this paper: the definition of a threshold level, "Niveau-seuil," in French and a learning module, "Looking for Work," intended to teach necessary written French to migrant workers. The threshold level section is a reference document for…

  20. The Acquisition of Stereochemical Knowledge by Algerian Students Intending to Teach Physical Sciences

    ERIC Educational Resources Information Center

    Boukhechem, Mohamed-Salah; Dumon, Alain; Zouikri, Mohamed

    2011-01-01

    In this work we evaluated the level of difficulty found in learning stereochemistry concepts, by students intending to teach physical sciences at the Ecole Normale Superieure (ENS) Kouba (Algeria). A paper and pencil questionnaire was administered to 170 students to evaluate: their familiarity with Newman representations; their ability of linking…

  1. The Normative Effects of Higher Education Policy in France

    ERIC Educational Resources Information Center

    Langan, Elise

    2012-01-01

    This student survey was a response to the French youth unrest in 2005 and 2006. It considers the degree to which French higher and secondary education institutions create social cohesion. Focusing on three distinct higher-education institutions: "L'institut d'etudes politiques de Paris" (Sciences Po), "Ecole Normale Superieure," Paris 8, and a…

  2. A Prestigious Image: Advantage or Obstacle in Attracting Candidates to French Elite Higher Education?

    ERIC Educational Resources Information Center

    Draelants, Hugues

    2012-01-01

    One hundred and twenty students successful at entering four of the most famous French "grandes ecoles" ("Ecole Normale Superieure" Ulm, Polytechnique, HEC, Sciences Po) were questioned about their institution's image. We focus on how the prestige of these institutions in the French society played a role in students' attraction and contributed to…

  3. Teaching with "Voix et Images de France"

    ERIC Educational Resources Information Center

    Marrow, G. D.

    1970-01-01

    A report on the classroom use of Voix et Images de France," the French text prepared by the Centre de Recherche et d'Etude pourla Diffusion du Francais (CREDIF) at the Ecole Normale Superieure de Saint-Cloud in France. (FB)

  4. Conceptual Integration of Hybridization by Algerian Students Intending to Teach Physical Sciences

    ERIC Educational Resources Information Center

    Salah, Hazzi; Dumon, Alain

    2011-01-01

    This work aims to assess the difficulties encountered by students of the Ecole Normale Superieure of Kouba (Algeria) intending to teach physical science in the integration of the hybridization of atomic orbitals. It is a concept that they should use in describing the formation of molecular orbitals ([sigma] and [pi]) in organic chemistry and gaps…

  5. The Acquisition of Stereochemical Knowledge by Algerian Students Intending to Teach Physical Sciences

    ERIC Educational Resources Information Center

    Boukhechem, Mohamed-Salah; Dumon, Alain; Zouikri, Mohamed

    2011-01-01

    In this work we evaluated the level of difficulty found in learning stereochemistry concepts, by students intending to teach physical sciences at the Ecole Normale Superieure (ENS) Kouba (Algeria). A paper and pencil questionnaire was administered to 170 students to evaluate: their familiarity with Newman representations; their ability of linking…

  6. Interactive annotation of textures in thoracic CT scans

    NASA Astrophysics Data System (ADS)

    Kockelkorn, Thessa T. J. P.; de Jong, Pim A.; Gietema, Hester A.; Grutters, Jan C.; Prokop, Mathias; van Ginneken, Bram

    2010-03-01

    This study describes a system for interactive annotation of thoracic CT scans. Lung volumes in these scans are segmented and subdivided into roughly spherical volumes of interest (VOIs) with homogeneous texture using a clustering procedure. For each 3D VOI, 72 features are calculated. The observer inspects the scan to determine which textures are present and annotates, with mouse clicks, several VOIs of each texture. Based on these annotations, a k-nearest-neighbor classifier is trained, which classifies all remaining VOIs in the scan. The algorithm then presents a slice with suggested annotations to the user, in which the user can correct mistakes. The classifier is retrained, taking into account these new annotations, and the user is presented another slice for correction. This process continues until at least 50% of all lung voxels in the scan have been classified. The remaining VOIs are classified automatically. In this way, the entire lung volume is annotated. The system has been applied to scans of patients with usual and non-specific interstitial pneumonia. The results of interactive annotation are compared to a setup in which the user annotates all predefined VOIs manually. The interactive system is 3.7 times as fast as complete manual annotation of VOIs and differences between the methods are similar to interobserver variability. This is a first step towards precise volumetric quantitation of texture patterns in thoracic CT in clinical research and in clinical practice.

  7. Phenylketonuria: brain phenylalanine concentrations relate inversely to cerebral protein synthesis

    PubMed Central

    de Groot, Martijn J; Sijens, Paul E; Reijngoud, Dirk-Jan; Paans, Anne M; van Spronsen, Francjan J

    2015-01-01

    In phenylketonuria, elevated plasma phenylalanine concentrations may disturb blood-to-brain large neutral amino acid (LNAA) transport and cerebral protein synthesis (CPS). We investigated the associations between these processes, using data obtained by positron emission tomography with l-[1-11C]-tyrosine (11C-Tyr) as a tracer. Blood-to-brain transport of non-Phe LNAAs was modeled by the rate constant for 11C-Tyr transport from arterial plasma to brain tissue (K1), while CPS was modeled by the rate constant for 11C-Tyr incorporation into cerebral protein (k3). Brain phenylalanine concentrations were measured by magnetic resonance spectroscopy in three volumes of interest (VOIs): supraventricular brain tissue (VOI 1), ventricular brain tissue (VOI 2), and fluid-containing ventricular voxels (VOI 3). The associations between k3 and each predictor variable were analyzed by multiple linear regression. The rate constant k3 was inversely associated with brain phenylalanine concentrations in VOIs 2 and 3 (adjusted R2=0.826, F=19.936, P=0.021). Since brain phenylalanine concentrations in these VOIs highly correlated with each other, the specific associations of each predictor with k3 could not be determined. The associations between k3 and plasma phenylalanine concentration, K1, and brain phenylalanine concentrations in VOI 1 were nonsignificant. In conclusion, our study shows an inverse association between k3 and increased brain phenylalanine concentrations. PMID:25352046

  8. Realization of fluence field modulated CT on a clinical TomoTherapy megavoltage CT system.

    PubMed

    Szczykutowicz, Timothy P; Hermus, James; Geurts, Mark; Smilowitz, Jennifer

    2015-09-21

    The multi-leaf collimator (MLC) assembly present on TomoTherapy (Accuray, Madison WI) radiation therapy (RT) and mega voltage CT machines is well suited to perform fluence field modulated CT (FFMCT). In addition, there is a demand in the RT environment for FFMCT imaging techniques, specifically volume of interest (VOI) imaging. A clinical TomoTherapy machine was programmed to perform VOI. Four different size ROIs were placed at varying distances from isocenter. Projections intersecting the VOI received 'full dose' while those not intersecting the VOI received 30% of the dose (i.e. the incident fluence for non VOI projections was 30% of the incident fluence for projections intersecting the VOI). Additional scans without fluence field modulation were acquired at 'full' and 30% dose. The noise (pixel standard deviation) and mean CT number were measured inside the VOI region and compared between the three scans. Dose maps were generated using a dedicated TomoTherapy treatment planning dose calculator. The VOI-FFMCT technique produced an image noise 1.05, 1.00, 1.03, and 1.05 times higher than the 'full dose' scan for ROI sizes of 10?cm, 13?cm, 10?cm, and 6?cm respectively within the VOI region. The VOI-FFMCT technique required a total imaging dose equal to 0.61, 0.69, 0.60, and 0.50 times the 'full dose' acquisition dose for ROI sizes of 10?cm, 13?cm, 10?cm, and 6?cm respectively within the VOI region. Noise levels can be almost unchanged within clinically relevant VOIs sizes for RT applications while the integral imaging dose to the patient can be decreased, and/or the image quality in RT can be dramatically increased with no change in dose relative to non-FFMCT RT imaging. The ability to shift dose away from regions unimportant for clinical evaluation in order to improve image quality or reduce imaging dose has been demonstrated. This paper demonstrates that FFMCT can be performed using the MLC on a clinical TomoTherapy machine for the first time. PMID:26348406

  9. 28 CFR 91.53 - Other guidance.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Justice has also published NEPA procedures that incorporate the CEQ regulations at 28 CFR part 61... documents can be found at http://www.ojp.usdoj.gov/cpo. Application to VOI/TIS Grant Program...

  10. 76 FR 7181 - Advisory Commission on Accessible Instructional Materials in Postsecondary Education for Students...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-09

    ... (voice) or 781-245-9320 (TTY) or jgronneberg@cast.org by February 18, 2011. The Commission requests that... access will be provided via an internet webinar service utilizing VoiP (Voice Over Internet...

  11. 28 CFR 91.58 - Timing of the environmental review process.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... anticipated environmental impacts, an environmental impact statement should be initiated. (c) Design phase... CORRECTIONAL FACILITIES Environmental Impact Review Procedures for VOI/TIS Grant Program Environmental Review... the extent of a project's continuing adverse environmental impacts, and the feasibility of......

  12. Concentration maxima of volatile organic iodine compounds in the bottom layer water and the cold, dense water over the Chukchi Sea in the western Arctic Ocean: a possibility of production related to degradation of organic matter

    NASA Astrophysics Data System (ADS)

    Ooki, A.; Kawasaki, S.; Kuma, K.; Nishino, S.; Kikuchi, T.

    2015-07-01

    We conducted a shipboard observation over the Chukchi Sea and the Canada Basin in the western Arctic Ocean in September and October 2012 to obtain vertical distributions of four volatile organic iodine compounds (VOIs) in seawater. VOIs are believed to play a role in ozone destruction in the troposphere and lower stratosphere. The VOIs observed in this study were iodomethane (CH3I), iodoethane (C2H5I), diiodomethane (CH2I2) and chloroiodomethane (CH2ClI). Maximum concentrations of the four VOIs were found in the bottom layer water over the Chukchi Sea shelf, in which layer the maximum concentration of ammonium (NH4+) also occurred. A significant correlation was observed between C2H5I and NH4+ (correlate coefficient R = 0.93) and between CH3I and NH4+ (R = 0.77), suggesting production of these VOIs increased with degradation of organic matter. Over the northern Chukchi Sea shelf-slope area, concentration maxima of CH2I2, CH2ClI, and CH3I were found in the subsurface cold, dense water (CDW). A large nitrogen deficit (N-deficit = NH4+ + NO3- + NO2- - 16PO43-) simultaneously occurred in this water, suggesting production of the three VOIs in the sediment or the bottom layer water over the shelf, probably in association with degradation of organic matter. We conclude that VOI production over the Chukchi Sea shelf can be largely attributed to the degradation of organic matter that is produced in the highly productive shelf water. High concentrations of CH2ClI were also found in the Alaskan Coastal Water (ACW) from the Bering Strait to the surface of the northern Chukchi slope. The VOIs that originated at the Chukchi Sea shelf are expected to be laterally transported to the Arctic Ocean Basin though the subsurface CDW and the surface ACW.

  13. Foreign Bodies: Aspirated or Ingested? A Report of Two Unusual Cases

    PubMed Central

    Arabi Mianroodi, Aliasghar; Teimouri, Yeganeh; Vallance, Neil A.

    2012-01-01

    Introduction: The diagnosis of foreign bodies in the upper aerodigestive tract is usually straightforward but sometimes it can be delayed or the location of esophageal and upper airway foreign bodies can be mistakenly interchanged. Case Report: We present two interesting cases that caused diagnostic challenges which could have led to serious complications if a greater delay in diagnosis had occurred. Conclusion: In order to diagnose upper aerodigestive tract foreign bodies without delay, a careful history and physical examination with proper X-rays are helpful. PMID:24303392

  14. A RANDOMIZED TRIAL OF AN INTERVENTION TO INCREASE FRUIT AND VEGETABLE INTAKE IN DURATIVELY TREATED PATIENTS WITH EARLY STAGE HEAD AND NECK CANCER

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The leading cause of death in patients who have had curatively treated early stage head and neck (H&N) cancer is a second primary cancer of the upper aerodigestive tract(lung, esophagus, larynx, pharynx and oral cavity cancers). Low fruit and vegetable (F&V) intake has been associated with increased...

  15. Thursday's Agenda | Division of Cancer Prevention

    Cancer.gov

    TimeAgenda8:30 am - 8:50 amRegistration - Networking8:50 am - 8:55 amWelcome and Opening RemarksLeslie Ford, MDAssociate Director for Clinical ResearchDivision of Cancer Prevention, NCIEva Szabo, MD Chief, Lung and Upper Aerodigestive Cancer Research Group |

  16. Friday's Agenda | Division of Cancer Prevention

    Cancer.gov

    TimeAgenda8:00 am - 8:10 amWelcome and Opening RemarksLeslie Ford, MDAssociate Director for Clinical ResearchDivision of Cancer Prevention, NCIEva Szabo, MD Chief, Lung and Upper Aerodigestive Cancer Research GroupDivision of Cancer Prevention, NCI8:10 am - 8:40 amClinical Trials Statistical Concepts for Non-Statisticians |

  17. Feeding & Motor Functioning: Start at the Hips to Get to the Lips

    ERIC Educational Resources Information Center

    Donato, Jessica; Fox, Cathy; Mormon, Johnnie; Mormon, Mike

    2008-01-01

    Swallowing is one of the most complex movement patterns that people must use accurately throughout the day and night from the time they are born. These movement patterns are very closely integrated with breathing and movement of food through the aerodigestive tract. Malalignment or dysfunction in any part of these integrated patterns and systems…

  18. 42 CFR 88.1 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... pleura; and other ill-defined sites in the respiratory system and intrathoracic organs. (xi) Mesothelioma. (xii) Malignant neoplasms of the peripheral nerves and autonomic nervous system, and other connective... this part: (1) Aerodigestive disorders: (i) Interstitial lung disease. (ii) Chronic...

  19. Loss of HOP tumour suppressor expression in head and neck squamous cell carcinoma

    PubMed Central

    Lemaire, F; Millon, R; Muller, D; Rabouel, Y; Bracco, L; Abecassis, J; Wasylyk, B

    2004-01-01

    We report that homeodomain-only protein (HOP) is expressed in the suprabasal layer of normal upper aerodigestive tract epithelium and expression strongly decreases in hypopharyngeal carcinoma. Interestingly, HOP has very recently been shown to be a tumour suppressor involved in differentiation, suggesting that HOP may have a similar role in head and neck squamous cell carcinoma (HNSSC). PMID:15213722

  20. Feeding & Motor Functioning: Start at the Hips to Get to the Lips

    ERIC Educational Resources Information Center

    Donato, Jessica; Fox, Cathy; Mormon, Johnnie; Mormon, Mike

    2008-01-01

    Swallowing is one of the most complex movement patterns that people must use accurately throughout the day and night from the time they are born. These movement patterns are very closely integrated with breathing and movement of food through the aerodigestive tract. Malalignment or dysfunction in any part of these integrated patterns and systems…

  1. Solitary extramedullary plasmacytoma of the penis

    PubMed Central

    Scarberry, Kyle; Jegalian, Armin; Valent, Jason; Wood, Hadley M.

    2014-01-01

    Solitary extramedullary plasmacytomas are rare plasma cell malignancies, particularly outside the upper aerodigestive tract. A 90-year-old male presented with a penile mass suspicious for penile carcinoma. Pathology revealed the tumor to be an Epstein-Barr virus-associated plasmacytoma with no radiographic evidence of bone or other soft tissue involvement. There was no laboratory evidence of multiple myeloma. PMID:25125899

  2. Friday's Agenda | Division of Cancer Prevention

    Cancer.gov

    TimeAgenda8:00 am - 8:10 amWelcome and Opening RemarksLeslie Ford, MDAssociate Director for Clinical ResearchDivision of Cancer Prevention, NCIEva Szabo, MD Chief, Lung and Upper Aerodigestive Cancer Research GroupDivision of Cancer Prevention, NCI8:10 am - 8:40 amClinical Trials Statistical Concepts for Non-Statisticians |

  3. Organ Site-Specific SPOREs | Translational Research Program (TRP)

    Cancer.gov

    Skip to Content Search this site Organ Site-Specific SPOREs By State By Organ Location Last Updated: 01/02/15 Thyroid SPOREs SPOREs in Head and Neck (H&N) cancer support translational research on cancers of the upper aero-digestive tract and on thyroid

  4. Organ Site-Specific SPOREs | Translational Research Program (TRP)

    Cancer.gov

    Skip to Content Search this site Organ Site-Specific SPOREs By State By Organ Location Last Updated: 11/28/13 Head & Neck SPOREs SPOREs in Head and Neck (H&N) cancer support translational research on cancers of the upper aero-digestive tract and on

  5. Thursday's Agenda | Division of Cancer Prevention

    Cancer.gov

    TimeAgenda8:30 am - 8:50 amRegistration - Networking8:50 am - 8:55 amWelcome and Opening RemarksLeslie Ford, MDAssociate Director for Clinical ResearchDivision of Cancer Prevention, NCIEva Szabo, MD Chief, Lung and Upper Aerodigestive Cancer Research Group |

  6. The feasibility of white matter volume reduction analysis using SPM8 plus DARTEL for the diagnosis of patients with clinically diagnosed corticobasal syndrome and Richardson’s syndrome

    PubMed Central

    Sakurai, Keita; Imabayashi, Etsuko; Tokumaru, Aya M.; Hasebe, Shin; Murayama, Shigeo; Morimoto, Satoru; Kanemaru, Kazutomi; Takao, Masaki; Shibamoto, Yuta; Matsukawa, Noriyuki

    2014-01-01

    Purpose Diagnosing corticobasal degeneration (CBD) and progressive supranuclear palsy (PSP) is often difficult due to the wide variety of symptoms and overlaps in the similar clinical courses and neurological findings. The purpose of this study was to evaluate the utility of white matter (WM) atrophy for the diagnosis of patients with clinically diagnosed CBD (corticobasal syndrome, CBS) and PSP (Richardson’s syndrome, RS). Methods We randomly divided the 3D T1-weighted MR images of 18 CBS patients, 33 RS patients, and 32 age-matched controls into two groups. We obtained segmented WM images in the first group using Voxel-based specific regional analysis system for Alzheimer’s disease (VSRAD) based on statistical parametric mapping (SPM) 8 plus diffeomorphic anatomical registration through exponentiated Lie algebra. A target volume of interest (VOI) for disease-specific atrophy was subsequently determined in this group using SPM8 group analyses of WM atrophy between patients groups and controls. We then evaluated the utility of these VOIs for diagnosing CBS and RS patients in the second group. Z score values in these VOIs were used as the determinant in receiver operating characteristic (ROC) analyses. Results Specific target VOIs were determined in the bilateral frontal subcortical WM for CBS and in the midbrain tegmentum for RS. In ROC analyses, the target VOIs of CBS and RS compared to those of controls exhibited an area under curve (AUC) of 0.99 and 0.84, respectively, which indicated an adequate diagnostic power. The VOI of CBS revealed a higher AUC than that of RS for differentiating between CBS and RS (AUC, 0.75 vs 0.53). Conclusions Bilateral frontal WM volume reduction demonstrated a higher power for differentiating CBS from RS. This VOI analysis is useful for clinically diagnosing CBS and RS. PMID:26082887

  7. Concentration maxima of volatile organic iodine compounds in the bottom layer water and the cold, dense water over the Chukchi Sea in the western Arctic Ocean: a possibility of production related to the degradation of organic matter

    NASA Astrophysics Data System (ADS)

    Ooki, A.; Kawasaki, S.; Kuma, K.; Nishino, S.; Kikuchi, T.

    2016-01-01

    We conducted a shipboard observation over the Chukchi Sea and the Canada Basin in the western Arctic Ocean in September and October 2012 to obtain vertical distributions of four volatile organic iodine compounds (VOIs) in seawater. The VOIs observed in this study were iodomethane (CH3I), iodoethane (C2H5I), diiodomethane (CH2I2), and chloroiodomethane (CH2ClI). Maximum concentrations of the four VOIs were found in the bottom layer water over the Chukchi Sea shelf, in which layer the maximum concentration of ammonium (NH4+) also occurred. A significant correlation was observed between C2H5I and NH4+ (correlation coefficient R = 0.93, P < 0.01, n = 64) and between CH3I and NH4+ (R= 0.77, P < 0.01, n = 64), suggesting that the production of these VOIs increased with the degradation of organic matter. Over the northern Chukchi Sea shelf-slope area, concentration maxima of CHI2, CH2ClI, and CH3I were found in the subsurface cold, dense water (CDW). A large nitrogen deficit (N deficit = NH4++ NO3-+ NO2--16PO43-) occurred simultaneously in this water, suggesting the production of the three VOIs in the sediment or the bottom layer water over the shelf, probably in association with the degradation of organic matter. We conclude that VOI production over the Chukchi Sea shelf can be largely attributed to the degradation of organic matter that is produced in the highly productive shelf water. High concentrations of CH2ClI were also found in the Alaskan Coastal Water (ACW) from the Bering Strait to the surface of the northern Chukchi slope. The VOIs that originated at the Chukchi Sea shelf are expected to be laterally transported to the Arctic Ocean basin through the CDW and the surface ACW.

  8. Pancreas segmentation from 3D abdominal CT images using patient-specific weighted subspatial probabilistic atlases

    NASA Astrophysics Data System (ADS)

    Karasawa, Kenichi; Oda, Masahiro; Hayashi, Yuichiro; Nimura, Yukitaka; Kitasaka, Takayuki; Misawa, Kazunari; Fujiwara, Michitaka; Rueckert, Daniel; Mori, Kensaku

    2015-03-01

    Abdominal organ segmentations from CT volumes are now widely used in the computer-aided diagnosis and surgery assistance systems. Among abdominal organs, the pancreas is especially difficult to segment because of its large individual differences of the shape and position. In this paper, we propose a new pancreas segmentation method from 3D abdominal CT volumes using patient-specific weighted-subspatial probabilistic atlases. First of all, we perform normalization of organ shapes in training volumes and an input volume. We extract the Volume Of Interest (VOI) of the pancreas from the training volumes and an input volume. We divide each training VOI and input VOI into some cubic regions. We use a nonrigid registration method to register these cubic regions of the training VOI to corresponding regions of the input VOI. Based on the registration results, we calculate similarities between each cubic region of the training VOI and corresponding region of the input VOI. We select cubic regions of training volumes having the top N similarities in each cubic region. We subspatially construct probabilistic atlases weighted by the similarities in each cubic region. After integrating these probabilistic atlases in cubic regions into one, we perform a rough-to-precise segmentation of the pancreas using the atlas. The results of the experiments showed that utilization of the training volumes having the top N similarities in each cubic region led good results of the pancreas segmentation. The Jaccard Index and the average surface distance of the result were 58.9% and 2.04mm on average, respectively.

  9. Correlation of {sup 18}F-FDG Avid Volumes on Pre–Radiation Therapy and Post–Radiation Therapy FDG PET Scans in Recurrent Lung Cancer

    SciTech Connect

    Shusharina, Nadya Cho, Joseph; Sharp, Gregory C.; Choi, Noah C.

    2014-05-01

    Purpose: To investigate the spatial correlation between high uptake regions of 2-deoxy-2-[{sup 18}F]-fluoro-D-glucose positron emission tomography ({sup 18}F-FDG PET) before and after therapy in recurrent lung cancer. Methods and Materials: We enrolled 106 patients with inoperable lung cancer into a prospective study whose primary objectives were to determine first, the earliest time point when the maximum decrease in FDG uptake representing the maximum metabolic response (MMR) is attainable and second, the optimum cutoff value of MMR based on its predicted tumor control probability, sensitivity, and specificity. Of those patients, 61 completed the required 4 serial {sup 18}F-FDG PET examinations after therapy. Nineteen of 61 patients experienced local recurrence at the primary tumor and underwent analysis. The volumes of interest (VOI) on pretherapy FDG-PET were defined by use of an isocontour at ≥50% of maximum standard uptake value (SUV{sub max}) (≥50% of SUV{sub max}) with correction for heterogeneity. The VOI on posttherapy images were defined at ≥80% of SUV{sub max}. The VOI of pretherapy and posttherapy {sup 18}F-FDG PET images were correlated for the extent of overlap. Results: The size of VOI at pretherapy images was on average 25.7% (range, 8.8%-56.3%) of the pretherapy primary gross tumor volume (GTV), and their overlap fractions were 0.8 (95% confidence interval [CI]: 0.7-0.9), 0.63 (95% CI: 0.49-0.77), and 0.38 (95% CI: 0.19-0.57) of VOI of posttherapy FDG PET images at 10 days, 3 months, and 6 months, respectively. The residual uptake originated from the pretherapy VOI in 15 of 17 cases. Conclusions: VOI defined by the SUV{sub max}-≥50% isocontour may be a biological target volume for escalated radiation dose.

  10. Correlation of 18F-FDG Avid Volumes on Pre–Radiation Therapy and Post–Radiation Therapy FDG PET Scans in Recurrent Lung Cancer

    PubMed Central

    Shusharina, Nadya; Cho, Joseph; Sharp, Gregory C.; Choi, Noah C.

    2014-01-01

    Purpose To investigate the spatial correlation between high uptake regions of 2-deoxy-2-[18F]-fluoro-D-glucose positron emission tomography (18F-FDG PET) before and after therapy in recurrent lung cancer. Methods and Materials We enrolled 106 patients with inoperable lung cancer into a prospective study whose primary objectives were to determine first, the earliest time point when the maximum decrease in FDG uptake representing the maximum metabolic response (MMR) is attainable and second, the optimum cutoff value of MMR based on its predicted tumor control probability, sensitivity, and specificity. Of those patients, 61 completed the required 4 serial 18F-FDG PET examinations after therapy. Nineteen of 61 patients experienced local recurrence at the primary tumor and underwent analysis. The volumes of interest (VOI) on pretherapy FDG-PET were defined by use of an isocontour at ?50% of maximum standard uptake value (SUVmax) (?50% of SUVmax) with correction for heterogeneity. The VOI on posttherapy images were defined at ?80% of SUVmax. The VOI of pretherapy and posttherapy 18F-FDG PET images were correlated for the extent of overlap. Results The size of VOI at pretherapy images was on average 25.7% (range, 8.8%-56.3%) of the pretherapy primary gross tumor volume (GTV), and their overlap fractions were 0.8 (95% confidence interval [CI]: 0.7-0.9), 0.63 (95% CI: 0.49-0.77), and 0.38 (95% CI: 0.19-0.57) of VOI of posttherapy FDG PET images at 10 days, 3 months, and 6 months, respectively. The residual uptake originated from the pretherapy VOI in 15 of 17 cases. Conclusions VOI defined by the SUVmax- ?50% isocontour may be a biological target volume for escalated radiation dose. PMID:24725696

  11. Radiation doses in volume-of-interest breast computed tomography—A Monte Carlo simulation study

    SciTech Connect

    Lai, Chao-Jen Zhong, Yuncheng; Yi, Ying; Wang, Tianpeng; Shaw, Chris C.

    2015-06-15

    Purpose: Cone beam breast computed tomography (breast CT) with true three-dimensional, nearly isotropic spatial resolution has been developed and investigated over the past decade to overcome the problem of lesions overlapping with breast anatomical structures on two-dimensional mammographic images. However, the ability of breast CT to detect small objects, such as tissue structure edges and small calcifications, is limited. To resolve this problem, the authors proposed and developed a volume-of-interest (VOI) breast CT technique to image a small VOI using a higher radiation dose to improve that region’s visibility. In this study, the authors performed Monte Carlo simulations to estimate average breast dose and average glandular dose (AGD) for the VOI breast CT technique. Methods: Electron–Gamma-Shower system code-based Monte Carlo codes were used to simulate breast CT. The Monte Carlo codes estimated were validated using physical measurements of air kerma ratios and point doses in phantoms with an ion chamber and optically stimulated luminescence dosimeters. The validated full cone x-ray source was then collimated to simulate half cone beam x-rays to image digital pendant-geometry, hemi-ellipsoidal, homogeneous breast phantoms and to estimate breast doses with full field scans. 13-cm in diameter, 10-cm long hemi-ellipsoidal homogeneous phantoms were used to simulate median breasts. Breast compositions of 25% and 50% volumetric glandular fractions (VGFs) were used to investigate the influence on breast dose. The simulated half cone beam x-rays were then collimated to a narrow x-ray beam with an area of 2.5 × 2.5 cm{sup 2} field of view at the isocenter plane and to perform VOI field scans. The Monte Carlo results for the full field scans and the VOI field scans were then used to estimate the AGD for the VOI breast CT technique. Results: The ratios of air kerma ratios and dose measurement results from the Monte Carlo simulation to those from the physical measurements were 0.97 ± 0.03 and 1.10 ± 0.13, respectively, indicating that the accuracy of the Monte Carlo simulation was adequate. The normalized AGD with VOI field scans was substantially reduced by a factor of about 2 over the VOI region and by a factor of 18 over the entire breast for both 25% and 50% VGF simulated breasts compared with the normalized AGD with full field scans. The normalized AGD for the VOI breast CT technique can be kept the same as or lower than that for a full field scan with the exposure level for the VOI field scan increased by a factor of as much as 12. Conclusions: The authors’ Monte Carlo estimates of normalized AGDs for the VOI breast CT technique show that this technique can be used to markedly increase the dose to the breast and thus the visibility of the VOI region without increasing the dose to the breast. The results of this investigation should be helpful for those interested in using VOI breast CT technique to image small calcifications with dose concern.

  12. Completeness map evaluation demonstrated with candidate next-generation cardiac CT architectures

    SciTech Connect

    Liu Baodong; Bennett, James; Wang Ge; De Man, Bruno; Zeng Kai; Yin Zhye; Fitzgerald, Paul; Yu Hengyong

    2012-05-15

    Purpose: In this report, the authors introduce the general concept of the completeness map, as a means to evaluate the completeness of data acquired by a given CT system design (architecture and scan mode). They illustrate the utility of completeness map by applying the completeness map concept to a number of candidate CT system designs, as part of a study to advance the state-of-the-art in cardiac CT. Methods: In order to optimally reconstruct a point within a volume of interest (VOI), the Radon transform on all possible planes through that point should be measured. The authors quantified the extent to which this ideal condition is satisfied for the entire image volume. They first determined a Radon completeness number for each point in the VOI, as the percentage of possible planes that is actually measured. A completeness map is then defined as a 3D matrix of the completeness numbers for the entire VOI. The authors proposed algorithms to analyze the projection datasets in Radon space and compute the completeness number for a fixed point and apply these algorithms to various architectures and scan modes that they are evaluating. In this report, the authors consider four selected candidate architectures, operating with different scan modes, for a total of five system design alternatives. Each of these alternatives is evaluated using completeness map. Results: If the detector size and cone angle are large enough to cover the entire cardiac VOI, a single-source circular scan can have {>=}99% completeness over the entire VOI. However, only the central z-slice can be exactly reconstructed, which corresponds to 100% completeness. For a typical single-source architecture, if the detector is limited to an axial dimension of 40 mm, a helical scan needs about five rotations to form an exact reconstruction region covering the cardiac VOI, while a triple-source helical scan only requires two rotations, leading to a 2.5x improvement in temporal resolution. If the source and detector of an inverse-geometry (IGCT) system have the same axial extent, and the spacing of source points in the axial and transaxial directions is sufficiently small, the IGCT can also form an exact reconstruction region for the cardiac VOI. If the VOI can be covered by the x-ray beam in any view, a composite-circling scan can generate an exact reconstruction region covering the VOI. Conclusions: The completeness map evaluation provides useful information for selecting the next-generation cardiac CT system design. The proposed completeness map method provides a practical tool for analyzing complex scanning trajectories, where the theoretical image quality for some complex system designs is impossible to predict, without yet-undeveloped reconstruction algorithms.

  13. Fast automatic delineation of cardiac volume of interest in MSCT images

    NASA Astrophysics Data System (ADS)

    Lorenz, Cristian; Lessick, Jonathan; Lavi, Guy; Bulow, Thomas; Renisch, Steffen

    2004-05-01

    Computed Tomography Angiography (CTA) is an emerging modality for assessing cardiac anatomy. The delineation of the cardiac volume of interest (VOI) is a pre-processing step for subsequent visualization or image processing. It serves the suppression of anatomic structures being not in the primary focus of the cardiac application, such as sternum, ribs, spinal column, descending aorta and pulmonary vasculature. These structures obliterate standard visualizations such as direct volume renderings or maximum intensity projections. In addition, outcome and performance of post-processing steps such as ventricle suppression, coronary artery segmentation or the detection of short and long axes of the heart can be improved. The structures being part of the cardiac VOI (coronary arteries and veins, myocardium, ventricles and atria) differ tremendously in appearance. In addition, there is no clear image feature associated with the contour (or better cut-surface) distinguishing between cardiac VOI and surrounding tissue making the automatic delineation of the cardiac VOI a difficult task. The presented approach locates in a first step chest wall and descending aorta in all image slices giving a rough estimate of the location of the heart. In a second step, a Fourier based active contour approach delineates slice-wise the border of the cardiac VOI. The algorithm has been evaluated on 41 multi-slice CT data-sets including cases with coronary stents and venous and arterial bypasses. The typical processing time amounts to 5-10s on a 1GHz P3 PC.

  14. Application of value of information of tank waste characterization: A new paradigm for defining tank waste characterization requirements

    SciTech Connect

    Fassbender, L.L.; Brewster, M.E.; Brothers, A.J.

    1996-11-01

    This report presents the rationale for adopting a recommended characterization strategy that uses a risk-based decision-making framework for managing the Tank Waste Characterization program at Hanford. The risk-management/value-of-information (VOI) strategy that is illustrated explicitly links each information-gathering activity to its cost and provides a mechanism to ensure that characterization funds are spent where they can produce the largest reduction in risk. The approach was developed by tailoring well-known decision analysis techniques to specific tank waste characterization applications. This report illustrates how VOI calculations are performed and demonstrates that the VOI approach can definitely be used for real Tank Waste Remediation System (TWRS) characterization problems.

  15. Volume-of-interest imaging of the inner ear in a human temporal bone specimen using a robot- driven C-arm flat panel detector CT system.

    PubMed

    Kolditz, D; Struffert, T; Kyriakou, Y; Bozzato, A; Dörfler, A; Kalender, W A

    2012-11-01

    VOI imaging can provide higher image quality at a reduced dose for a subregion. In this study with a robot-driven C-arm FDCT system, the goals were proof of feasibility for inner ear imaging, higher flexibility during data acquisition, and easier processing during reconstruction. First a low-dose OV scan was acquired allowing an orientation and enabling the selection of the VOI. The C-arm was then moved by the robotic system without a need for patient movement and the VOI was scanned with adapted parameters. Uncompromised artifact-free image quality was achieved by the 2-scan approach and the dose was reduced by 80%-90% in comparison with conventional MSCT and FPCT scans. PMID:21835947

  16. Théorie de la cohérence de polarisation avec les matrices de Jones et la sphère de Poincaré Applications

    NASA Astrophysics Data System (ADS)

    Dettwiller, L.

    On exprime simplement le comportement de la fonction de cohérence et des intensités émergentes des voies d'un interféromètre quelconque, en fonction de la polarisation incidente, à l'aide de ses coordonnées dans la sphère de Poincaré sur des axes déterminés par l'interféromètre. On discute la possibilité d'obtenir une parfaite cohérence ou une parfaite incohérence de polarisation. On montre que, en dehors du cas scalaire, deux cas particuliers sont notables: celui où les deux voies ne sont pas dichroïques, et celui où les deux voies sont des polariseurs ou analyseurs. On analyse des cas d'interférences classiques en lumière polarisée, on actualise l'interprétation d'autres expériences anciennes moins connues, mais on montre aussi comment concevoir les interféromètres correspondants à tous les comportements possibles de la cohérence de polarisation, ce qui permet de proposer des idées d'expériences inédites.

  17. Methodological considerations for analyzing trabecular architecture: an example from the primate hand

    PubMed Central

    Kivell, Tracy L; Skinner, Matthew M; Lazenby, Richard; Hublin, Jean-Jacques

    2011-01-01

    Micro-computed tomographic analyses of trabecular bone architecture have been used to clarify the link between positional behavior and skeletal anatomy in primates. However, there are methodological decisions associated with quantifying and comparing trabecular anatomy across taxa that vary greatly in body size and morphology that can affect characterizations of trabecular architecture, such as choice of the volume of interest (VOI) size and location. The potential effects of these decisions may be amplified in small, irregular-shaped bones of the hands and feet that have more complex external morphology and more heterogeneous trabecular structure compared to, for example, the spherical epiphysis of the femoral head. In this study we investigate the effects of changes in VOI size and location on standard trabecular parameters in two bones of the hand, the capitate and third metacarpal, in a diverse sample of nonhuman primates that vary greatly in morphology, body mass and positional behavior. Results demonstrate that changes in VOI location and, to a lesser extent, changes in VOI size had a dramatic affect on many trabecular parameters, especially trabecular connectivity and structure (rods vs. plates), degree of anisotropy, and the primary orientation of the trabeculae. Although previous research has shown that some trabecular parameters are susceptible to slight variations in methodology (e.g. VOI location, scan resolution), this study provides a quantification of these effects in hand bones of a diverse sample of primates. An a priori understanding of the inherent biases created by the choice of VOI size and particularly location is critical to robust trabecular analysis and functional interpretation, especially in small bones with complex arthroses. PMID:20977475

  18. Pulmonary airways tree segmentation from CT examinations using adaptive volume of interest

    NASA Astrophysics Data System (ADS)

    Park, Sang Cheol; Kim, Won Pil; Zheng, Bin; Leader, Joseph K.; Pu, Jiantao; Tan, Jun; Gur, David

    2009-02-01

    Airways tree segmentation is an important step in quantitatively assessing the severity of and changes in several lung diseases such as chronic obstructive pulmonary disease (COPD), asthma, and cystic fibrosis. It can also be used in guiding bronchoscopy. The purpose of this study is to develop an automated scheme for segmenting the airways tree structure depicted on chest CT examinations. After lung volume segmentation, the scheme defines the first cylinder-like volume of interest (VOI) using a series of images depicting the trachea. The scheme then iteratively defines and adds subsequent VOIs using a region growing algorithm combined with adaptively determined thresholds in order to trace possible sections of airways located inside the combined VOI in question. The airway tree segmentation process is automatically terminated after the scheme assesses all defined VOIs in the iteratively assembled VOI list. In this preliminary study, ten CT examinations with 1.25mm section thickness and two different CT image reconstruction kernels ("bone" and "standard") were selected and used to test the proposed airways tree segmentation scheme. The experiment results showed that (1) adopting this approach affectively prevented the scheme from infiltrating into the parenchyma, (2) the proposed method reasonably accurately segmented the airways trees with lower false positive identification rate as compared with other previously reported schemes that are based on 2-D image segmentation and data analyses, and (3) the proposed adaptive, iterative threshold selection method for the region growing step in each identified VOI enables the scheme to segment the airways trees reliably to the 4th generation in this limited dataset with successful segmentation up to the 5th generation in a fraction of the airways tree branches.

  19. Receiver operating characteristic (ROC) curve for classification of 18F-NaF uptake on PET/CT*

    PubMed Central

    Valadares, Agnes Araujo; Duarte, Paulo Schiavom; Carvalho, Giovanna; Ono, Carla Rachel; Coura-Filho, George Barberio; Sado, Heitor Naoki; Sapienza, Marcelo Tatit; Buchpiguel, Carlos Alberto

    2016-01-01

    Objective To assess the cutoff values established by ROC curves to classify 18F-NaF uptake as normal or malignant. Materials and Methods PET/CT images were acquired 1 hour after administration of 185 MBq of 18F-NaF. Volumes of interest (VOIs) were drawn on three regions of the skeleton as follows: proximal right humerus diaphysis (HD), proximal right femoral diaphysis (FD) and first vertebral body (VB1), in a total of 254 patients, totalling 762 VOIs. The uptake in the VOIs was classified as normal or malignant on the basis of the radiopharmaceutical distribution pattern and of the CT images. A total of 675 volumes were classified as normal and 52 were classified as malignant. Thirty-five VOIs classified as indeterminate or nonmalignant lesions were excluded from analysis. The standardized uptake value (SUV) measured on the VOIs were plotted on an ROC curve for each one of the three regions. The area under the ROC (AUC) as well as the best cutoff SUVs to classify the VOIs were calculated. The best cutoff values were established as the ones with higher result of the sum of sensitivity and specificity. Results The AUCs were 0.933, 0.889 and 0.975 for UD, FD and VB1, respectively. The best SUV cutoffs were 9.0 (sensitivity: 73%; specificity: 99%), 8.4 (sensitivity: 79%; specificity: 94%) and 21.0 (sensitivity: 93%; specificity: 95%) for UD, FD and VB1, respectively. Conclusion The best cutoff value varies according to bone region of analysis and it is not possible to establish one value for the whole body. PMID:26929455

  20. Using PET/CT Bone Scan Dynamic Data to Evaluate Tibia Remodeling When a Taylor Spatial Frame Is Used: Short and Longer Term Differences.

    PubMed

    Lundblad, Henrik; Maguire, Gerald Q; Karlsson-Thur, Charlotte; Jonsson, Cathrine; Noz, Marilyn E; Zeleznik, Michael P; Jacobsson, Hans; Weidenhielm, Lars

    2015-01-01

    Eighteen consecutive patients, treated with a Taylor Spatial Frame for complex tibia conditions, gave their informed consent to undergo Na(18)F(-) PET/CT bone scans. We present a Patlak-like analysis utilizing an approximated blood time-activity curve eliminating the need for blood aliquots. Additionally, standardized uptake values (SUV) derived from dynamic acquisitions were compared to this Patlak-like approach. Spherical volumes of interest (VOIs) were drawn to include broken bone, other (normal) bone, and muscle. The SUV m (t) (m = max, mean) and a series of slopes were computed as (SUV m (t i ) - SUV m (t j ))/(t i - t j ), for pairs of time values t i and t j . A Patlak-like analysis was performed for the same time values by computing ((VOI p (t i )/VOI e (t i ))-(VOI p (t j )/VOI e (t j )))/(t i - t j ), where p = broken bone, other bone, and muscle and e = expected activity in a VOI. Paired comparisons between Patlak-like and SUV m slopes showed good agreement by both linear regression and correlation coefficient analysis (r = 84%, r s = 78%-SUVmax, r = 92%, and r s = 91%-SUVmean), suggesting static scans could substitute for dynamic studies. Patlak-like slope differences of 0.1?min(-1) or greater between examinations and SUVmax differences of ~5 usually indicated good remodeling progress, while negative Patlak-like slope differences of -0.06?min(-1) usually indicated poor remodeling progress in this cohort. PMID:26436093

  1. A Semi-Automated Technique Determining the Liver Standardized Uptake Value Reference for Tumor Delineation in FDG PET-CT

    PubMed Central

    Hirata, Kenji; Kobayashi, Kentaro; Wong, Koon-Pong; Manabe, Osamu; Surmak, Andrew; Tamaki, Nagara; Huang, Sung-Cheng

    2014-01-01

    Background 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)-computed tomography (CT) has been an essential modality in oncology. We propose a semi-automated algorithm to objectively determine liver standardized uptake value (SUV), which is used as a threshold for tumor delineation. Methods A large spherical volume of interest (VOI) was placed manually to roughly enclose the right lobe (RL) of the liver. For each voxel in this VOI, a coefficient of variation of voxel values (CVv) was calculated for neighboring voxels within a radius of d/2. The voxel with the minimum CVv was then selected, where a 30-mm spherical VOI was placed at that voxel in accordance with PERCIST criteria. Two nuclear medicine physicians independently defined 30-mm VOIs manually on 124 studies in 62 patients to generate the standard values, against which the results from the new method were compared. Results The semi-automated method was successful in determining the liver SUV that was consistent between the two physicians in all the studies (d?=?80 mm). The liver SUV threshold (mean +3 SD within 30-mm VOI) determined by the new semi-automated method (3.12±0.61) was not statistically different from those determined by the manual method (Physician-1: 3.14±0.58, Physician-2: 3.15±0.58). The semi-automated method produced tumor volumes that were not statistically different from those by experts' manual operation. Furthermore, the volume change in the two sequential studies had no statistical difference between semi-automated and manual methods. Conclusions Our semi-automated method could define the liver SUV robustly as the threshold value used for tumor volume measurements according to PERCIST. The method could avoid possible subjective bias of manual liver VOI placement and is thus expected to improve clinical performance of volume-based parameters for prediction of cancer treatment response. PMID:25162396

  2. CBCT with specification of imaging dose and CNR by anatomical volume of interest

    SciTech Connect

    Leary, Del; Robar, James L.

    2014-01-15

    Purpose: A novel method has been developed for volume of interest (VOI) cone-beam CT (CBCT) imaging using a 2.35 MV/Carbon target linac imaging beam line combined with dynamic multileaf collimator sequences. Methods: The authors demonstrate the concept of acquisition of multiple, separate imaging volumes, where volumes can be either completely separated or nested, and are associated with predetermined imaging dose and contrast-to-noise ratio (CNR) characteristics. Two individual MLC sequences were established in the planning system (Eclipse, Varian Medical) to collimate the beam according to a defined inner VOI (e.g., containing a target volume under image guidance) and an outer VOI (e.g., including surrounding landmarks or organs-at-risk). MLC sequences were interleaved as a function of gantry angle to produce a reconstructed CBCT image with nested VOIs. By controlling the ratio of inner-to-outer ratio of MLC segments (and thus Monitor Units) during acquisition, the relative dose and CNR in the two volumes can be controlled. Inner-to-outer ratios of 2:1 to 6:1 were examined. Results: The concept was explored using an anatomical head phantom to assess image quality. A geometric phantom was used to quantify absolute dose and CNR values for the various sequences. The authors found that the dose in the outer VOI decreased by a functional relationship dependent on the inner-to-outer sequence ratio, while the CNR varied by the square root of dose, as expected. Conclusions: In this study the authors demonstrate flexibility in VOI CBCT by tailoring the imaging dose and CNR distribution in separate volumes within the patient anatomy. This would allow for high quality imaging of a target volume for alignment purposes, with simultaneous low dose imaging of the surrounding anatomy (e.g., for coregistration)

  3. Volume of interest-based [18F]fluorodeoxyglucose PET discriminates MCI converting to Alzheimer's disease from healthy controls. A European Alzheimer's Disease Consortium (EADC) study

    PubMed Central

    Pagani, M.; De Carli, F.; Morbelli, S.; Öberg, J.; Chincarini, A.; Frisoni, G.B.; Galluzzi, S.; Perneczky, R.; Drzezga, A.; van Berckel, B.N.M.; Ossenkoppele, R.; Didic, M.; Guedj, E.; Brugnolo, A.; Picco, A.; Arnaldi, D.; Ferrara, M.; Buschiazzo, A.; Sambuceti, G.; Nobili, F.

    2014-01-01

    An emerging issue in neuroimaging is to assess the diagnostic reliability of PET and its application in clinical practice. We aimed at assessing the accuracy of brain FDG-PET in discriminating patients with MCI due to Alzheimer's disease and healthy controls. Sixty-two patients with amnestic MCI and 109 healthy subjects recruited in five centers of the European AD Consortium were enrolled. Group analysis was performed by SPM8 to confirm metabolic differences. Discriminant analyses were then carried out using the mean FDG uptake values normalized to the cerebellum computed in 45 anatomical volumes of interest (VOIs) in each hemisphere (90 VOIs) as defined in the Automated Anatomical Labeling (AAL) Atlas and on 12 meta-VOIs, bilaterally, obtained merging VOIs with similar anatomo-functional characteristics. Further, asymmetry indexes were calculated for both datasets. Accuracy of discrimination by a Support Vector Machine (SVM) and the AAL VOIs was tested against a validated method (PALZ). At the voxel level SMP8 showed a relative hypometabolism in the bilateral precuneus, and posterior cingulate, temporo-parietal and frontal cortices. Discriminant analysis classified subjects with an accuracy ranging between .91 and .83 as a function of data organization. The best values were obtained from a subset of 6 meta-VOIs plus 6 asymmetry values reaching an area under the ROC curve of .947, significantly larger than the one obtained by the PALZ score. High accuracy in discriminating MCI converters from healthy controls was reached by a non-linear classifier based on SVM applied on predefined anatomo-functional regions and inter-hemispheric asymmetries. Data pre-processing was automated and simplified by an in-house created Matlab-based script encouraging its routine clinical use. Further validation toward nonconverter MCI patients with adequately long follow-up is needed. PMID:25610765

  4. Volume of interest-based [18F]fluorodeoxyglucose PET discriminates MCI converting to Alzheimer's disease from healthy controls. A European Alzheimer's Disease Consortium (EADC) study.

    PubMed

    Pagani, M; De Carli, F; Morbelli, S; Öberg, J; Chincarini, A; Frisoni, G B; Galluzzi, S; Perneczky, R; Drzezga, A; van Berckel, B N M; Ossenkoppele, R; Didic, M; Guedj, E; Brugnolo, A; Picco, A; Arnaldi, D; Ferrara, M; Buschiazzo, A; Sambuceti, G; Nobili, F

    2015-01-01

    An emerging issue in neuroimaging is to assess the diagnostic reliability of PET and its application in clinical practice. We aimed at assessing the accuracy of brain FDG-PET in discriminating patients with MCI due to Alzheimer's disease and healthy controls. Sixty-two patients with amnestic MCI and 109 healthy subjects recruited in five centers of the European AD Consortium were enrolled. Group analysis was performed by SPM8 to confirm metabolic differences. Discriminant analyses were then carried out using the mean FDG uptake values normalized to the cerebellum computed in 45 anatomical volumes of interest (VOIs) in each hemisphere (90 VOIs) as defined in the Automated Anatomical Labeling (AAL) Atlas and on 12 meta-VOIs, bilaterally, obtained merging VOIs with similar anatomo-functional characteristics. Further, asymmetry indexes were calculated for both datasets. Accuracy of discrimination by a Support Vector Machine and the AAL VOIs was tested against a validated method (PALZ). At the voxel level SMP8 showed a relative hypometabolism in the bilateral precuneus, and posterior cingulate, temporo-parietal and frontal cortices. Discriminant analysis classified subjects with an accuracy ranging between .91 and .83 as a function of data organization. The best values were obtained from a subset of 6 meta-VOIs plus 6 asymmetry values reaching an area under the ROC curve of .947, significantly larger than the one obtained by the PALZ score. High accuracy in discriminating MCI converters from healthy controls was reached by a non-linear classifier based on SVM applied on predefined anatomo-functional regions and inter-hemispheric asymmetries. Data pre-processing was automated and simplified by an in-house created Matlab-based script encouraging its routine clinical use. Further validation toward nonconverter MCI patients with adequately long follow-up is needed. PMID:25610765

  5. Colon bypass with a colon-flap augmentation pharyngoesophagoplasty.

    PubMed

    Tettey, Mark; Edwin, Frank; Aniteye, Ernest; Tamatey, Martin; Entsua-Mensah, Ekow; Offosu-Appiah, Ernest; Adzamli, Innocent

    2015-01-01

    Extensive caustic stricture of the upper aero-digestive system (oro- and hypo-pharynx) is a severe injury with limited surgical options. We adopted augmentation of the cicatrized upper aero-digestive tract with colon as our preferred management option. The aim of this report is to describe our initial experience with the technique of colon-flap augmentation pharyngo-esophagoplasty (CFAP) for selected patients with severe pharyngo-esophageal stricture. Between October 2011 and June 2013, three male patients (aged 16, 4 and 18 years respectively) underwent CFAP following extensive pharyngo-esophageal stricture. Postoperative recovery was uneventful in all three cases and all started swallowing within 7-10 days after surgery without significant dysphagia. Colon-flap augmentation pharyngo-esophagoplasty is an effective procedure for reconstruction of the pharynx and the hypopharynx after extensive caustic pharyngoesophageal structure in selected cases. PMID:26587125

  6. Colon bypass with a colon-flap augmentation pharyngoesophagoplasty

    PubMed Central

    Tettey, Mark; Edwin, Frank; Aniteye, Ernest; Tamatey, Martin; Entsua-Mensah, Ekow; Offosu-Appiah, Ernest; Adzamli, Innocent

    2015-01-01

    Extensive caustic stricture of the upper aero-digestive system (oro- and hypo-pharynx) is a severe injury with limited surgical options. We adopted augmentation of the cicatrized upper aero-digestive tract with colon as our preferred management option. The aim of this report is to describe our initial experience with the technique of colon-flap augmentation pharyngo-esophagoplasty (CFAP) for selected patients with severe pharyngo-esophageal stricture. Between October 2011 and June 2013, three male patients (aged 16, 4 and 18 years respectively) underwent CFAP following extensive pharyngo-esophageal stricture. Postoperative recovery was uneventful in all three cases and all started swallowing within 7 - 10 days after surgery without significant dysphagia. Colon-flap augmentation pharyngo-esophagoplasty is an effective procedure for reconstruction of the pharynx and the hypopharynx after extensive caustic pharyngoesophageal structure in selected cases. PMID:26587125

  7. Cancers of the lung, head and neck on the rise: perspectives on the genotoxicity of air pollution

    PubMed Central

    Wong, Ian Chi Kei; Ng, Yuen-Keng; Lui, Vivian Wai Yan

    2014-01-01

    Outdoor air pollution has been recently classified as a class I human carcinogen by the World Health Organization (WHO). Cumulative evidence from across the globe shows that polluted air is associated with increased risk of lung, head and neck, and nasopharyngeal cancers—all of which affect the upper aerodigestive tract. Importantly, these cancers have been previously linked to smoking. In this article, we review epidemiologic and experimental evidence of the genotoxic and mutagenic effects of air pollution on DNA, purportedly a key mechanism for cancer development. The alarming increase in cancers of the upper aerodigestive tract in Asia suggests a need to focus government efforts and research on reducing air pollution, promoting clean energy, and investigating the carcinogenic effects of air pollution on humans. PMID:25011457

  8. Eva Szabo, MD | Division of Cancer Prevention

    Cancer.gov

    Dr. Eva Szabo is Chief of the Lung and Upper Aerodigestive Cancer Research Group at the NCI Division of Cancer Prevention. She graduated from Yale University with a BS in Molecular Biophysics and Biochemistry, received her MD from Duke University, and completed her internal medicine residency at Bellevue-NYU Medical Center. After completing her medical oncology fellowship at the National Cancer Institute, Dr. Szabo led a laboratory effort studying lung cancer biology. |

  9. Agenda [DRAFT] | Division of Cancer Prevention

    Cancer.gov

    I-SCORE Day 1 – Thursday, March 10, 2016 8:00 am - 8:20 am Registration 8:20 am - 8:30 am Introduction of Meeting Attendees 8:30 am - 8:40 am Welcome and Opening Remarks Leslie Ford, MD Associate Director for Clinical Research Division of Cancer Prevention, NCI Eva Szabo, MD Chief, Lung and Upper Aerodigestive Cancer Research Group

  10. Eva Szabo, MD | Division of Cancer Prevention

    Cancer.gov

    Dr. Eva Szabo is Chief of the Lung and Upper Aerodigestive Cancer Research Group at the NCI Division of Cancer Prevention. She graduated from Yale University with a BS in Molecular Biophysics and Biochemistry, received her MD from Duke University, and completed her internal medicine residency at Bellevue-NYU Medical Center. After completing her medical oncology fellowship at the National Cancer Institute, Dr. Szabo led a laboratory effort studying lung cancer biology. |

  11. DCTD Program Accomplishments 2010

    Cancer.gov

    Barbara A. Conley, M.D., is the newly appointed Associate Director of the Cancer Diagnosis Program (CDP). She is an NCI veteran who has held previous positions at the Institute. From 1997 to 2004, she participated in several key programs within the NCI, including Senior Investigator in the Clinical Investigations Branch of CTEP and Chief of the CDP Diagnostics Research Branch, as well as Head, Aerodigestive Diseases, in the intramural medicine branch.

  12. Esophageal reflexes modulate frontoparietal response in neonates: Novel application of concurrent NIRS and provocative esophageal manometry

    PubMed Central

    Pakiraih, Joanna F.; Hasenstab, Kathryn A.; Dar, Irfaan; Gao, Xiaoyu; Bates, D. Gregory; Kashou, Nasser H.

    2014-01-01

    Central and peripheral neural regulation of swallowing and aerodigestive reflexes is unclear in human neonates. Functional near infrared spectroscopy (NIRS) is a noninvasive method to measure changes in oxyhemoglobin (HbO) and deoxyhemoglobin (HbD). Pharyngoesophageal manometry permits evaluation of aerodigestive reflexes. Modalities were combined to investigate feasibility and to test neonatal frontoparietal cortical changes during pharyngoesophageal (visceral) stimulation and/or swallowing. Ten neonates (45.6 ± 3.0 wk postmenstrual age, 4.1 ± 0.5 kg) underwent novel pharyngoesophageal manometry concurrent with NIRS. To examine esophagus-brain interactions, we analyzed cortical hemodynamic response (HDR) latency and durations during aerodigestive provocation and esophageal reflexes. Data are presented as means ± SE or percent. HDR rates were 8.84 times more likely with basal spontaneous deglutition compared with sham stimuli (P = 0.004). Of 182 visceral stimuli, 95% were analyzable for esophageal responses, 38% for HDR, and 36% for both. Of analyzable HDR (n = 70): 1) HbO concentration (?mol/l) baseline 1.5 ± 0.7 vs. 3.7 ± 0.7 poststimulus was significant (P = 0.02), 2) HbD concentration (?mol/l) between baseline 0.1 ± 0.4 vs. poststimulus ?0.5 ± 0.4 was not significant (P = 0.73), and 3) hemispheric lateralization was 21% left only, 29% right only, and 50% bilateral. During concurrent esophageal and NIRS responses (n = 66): 1) peristaltic reflexes were present in 74% and HDR in 61% and 2) HDR was 4.75 times more likely with deglutition reflex vs. secondary peristaltic reflex (P = 0.016). Concurrent NIRS with visceral stimulation is feasible in neonates, and frontoparietal cortical activation is recognized. Deglutition contrasting with secondary peristalsis is related to cortical activation, thus implicating higher hierarchical aerodigestive protective functional neural networks. PMID:24789204

  13. Maturation of upstream and downstream esophageal reflexes in human premature neonates: the role of sleep and awake states

    PubMed Central

    Chan, Chin Yee; Fernandez, Soledad; Splaingard, Mark

    2013-01-01

    We tested the hypothesis that the sensory-motor characteristics of aerodigestive reflexes are dependent on stimulus type and volumes, sleep or awake states, and maturation. Thirteen neonates were studied at 33.6 ± 0.5 wk (time 1) and 37.3 ± 0.5 wk (time 2) postmenstrual age using multimodal provocative esophageal manometry concurrent with video polysomnography. Effects of graded volumes (399 infusions at time 1, 430 infusions at time 2) of midesophageal stimulation with air, water, and apple juice on the sensory thresholds and recruitment frequency of upper esophageal sphincter (UES), esophageal body, and lower esophageal sphincter (LES) reflexes were investigated during sleep and awake states. Sensory thresholds for aerodigestive reflexes between maturational stages were similar. Increased frequency recruitment of UES contractile reflex, LES relaxation reflex, and peristaltic reflexes were noted at time 2 (all, P < 0.05). Graded stimulus-response relationships were evident at time 1 and time 2 during awake and sleep states (P < 0.05). Secondary peristalsis vs. esophago-deglutition response proportions during sleep at time 1 vs. time 2 (P = 0.001) and awake vs. sleep at time 2 (P = 0.02) were distinct. We concluded that sensory-motor effects of esophageal mechanosensitivity, osmosensitivity, and chemosensitivity are advanced in sleep with maturation. Sleep further modulates the frequency recruitment and the type of aerodigestive reflexes. PMID:24008357

  14. Optical biopsy fiber-based fluorescence spectroscopy instrumentation

    NASA Astrophysics Data System (ADS)

    Katz, Alvin; Ganesan, Singaravelu; Yang, Yuanlong; Tang, Gui C.; Budansky, Yury; Celmer, Edward J.; Savage, Howard E.; Schantz, Stimson P.; Alfano, Robert R.

    1996-04-01

    Native fluorescence spectroscopy of biomolecules has emerged as a new modality to the medical community in characterizing the various physiological conditions of tissues. In the past several years, many groups have been working to introduce the spectroscopic methods to diagnose cancer. Researchers have successfully used native fluorescence to distinguish cancerous from normal tissue samples in rat and human tissue. We have developed three generations of instruments, called the CD-scan, CD-ratiometer and CD-map, to allow the medical community to use optics for diagnosing tissue. Using ultraviolet excitation and emission spectral measurements on both normal and cancerous tissue of the breast, gynecology, colon, and aerodigestive tract can be separated. For example, from emission intensities at 340 nm to 440 nm (300 nm excitation), a statistically consistent difference between malignant tissue and normal or benign tissue is observed. In order to utilize optical biopsy techniques in a clinical setting, the CD-scan instrument was developed, which allows for rapid and reliable in-vitro and in-vivo florescence measurements of the aerodigestive tract with high accuracy. The instrumentation employs high sensitivity detection techniques which allows for lamp excitation, small diameter optical fiber probes; the higher spatial resolution afforded by the small diameter probes can increase the ability to detect smaller tumors. The fiber optic probes allow for usage in the aerodigestive tract, cervix and colon. Needle based fiber probes have been developed for in-vivo detection of breast cancer.

  15. 28 CFR 91.66 - Public participation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Public participation. 91.66 Section 91.66 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) GRANTS FOR CORRECTIONAL FACILITIES Environmental Impact Review Procedures for VOI/TIS Grant Program Environmental Review Procedures § 91.66...

  16. 28 CFR 91.63 - Preparing an Environmental Impact Statement

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... existence of highly controversial environmental impacts. (b) CEQ regulations. The CEQ regulations in 40 CFR... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Preparing an Environmental Impact... CORRECTIONAL FACILITIES Environmental Impact Review Procedures for VOI/TIS Grant Program Environmental...

  17. 28 CFR 91.57 - Actions that normally require the preparation of an environmental impact statement.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... preparation of an environmental impact statement. 91.57 Section 91.57 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) GRANTS FOR CORRECTIONAL FACILITIES Environmental Impact Review Procedures for VOI/TIS... of an environmental impact statement. Significant impact. For the proposed construction of a...

  18. 28 CFR 91.63 - Preparing an Environmental Impact Statement

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... existence of highly controversial environmental impacts. (b) CEQ regulations. The CEQ regulations in 40 CFR... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Preparing an Environmental Impact... CORRECTIONAL FACILITIES Environmental Impact Review Procedures for VOI/TIS Grant Program Environmental...

  19. 28 CFR 91.63 - Preparing an Environmental Impact Statement

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... existence of highly controversial environmental impacts. (b) CEQ regulations. The CEQ regulations in 40 CFR... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Preparing an Environmental Impact... CORRECTIONAL FACILITIES Environmental Impact Review Procedures for VOI/TIS Grant Program Environmental...

  20. 28 CFR 91.63 - Preparing an Environmental Impact Statement

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... existence of highly controversial environmental impacts. (b) CEQ regulations. The CEQ regulations in 40 CFR... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Preparing an Environmental Impact... CORRECTIONAL FACILITIES Environmental Impact Review Procedures for VOI/TIS Grant Program Environmental...

  1. 28 CFR 91.62 - Preparing an Environmental Assessment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... FACILITIES Environmental Impact Review Procedures for VOI/TIS Grant Program Environmental Review Procedures... issue a Finding of No Significant Environmental Impact (FONSI) or prepare an Environmental Impact... location and design of the project, that protect, restore and enhance the environment. Completing an...

  2. 28 CFR 91.62 - Preparing an Environmental Assessment.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... FACILITIES Environmental Impact Review Procedures for VOI/TIS Grant Program Environmental Review Procedures... issue a Finding of No Significant Environmental Impact (FONSI) or prepare an Environmental Impact... location and design of the project, that protect, restore and enhance the environment. Completing an...

  3. 28 CFR 91.62 - Preparing an Environmental Assessment.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... FACILITIES Environmental Impact Review Procedures for VOI/TIS Grant Program Environmental Review Procedures... issue a Finding of No Significant Environmental Impact (FONSI) or prepare an Environmental Impact... location and design of the project, that protect, restore and enhance the environment. Completing an...

  4. 3D Monte Carlo model of optical transport in laser-irradiated cutaneous vascular malformations

    NASA Astrophysics Data System (ADS)

    Majaron, Boris; Milani?, Matija; Jia, Wangcun; Nelson, J. S.

    2010-11-01

    We have developed a three-dimensional Monte Carlo (MC) model of optical transport in skin and applied it to analysis of port wine stain treatment with sequential laser irradiation and intermittent cryogen spray cooling. Our MC model extends the approaches of the popular multi-layer model by Wang et al.1 to three dimensions, thus allowing treatment of skin inclusions with more complex geometries and arbitrary irradiation patterns. To overcome the obvious drawbacks of either "escape" or "mirror" boundary conditions at the lateral boundaries of the finely discretized volume of interest (VOI), photons exiting the VOI are propagated in laterally infinite tissue layers with appropriate optical properties, until they loose all their energy, escape into the air, or return to the VOI, but the energy deposition outside of the VOI is not computed and recorded. After discussing the selection of tissue parameters, we apply the model to analysis of blood photocoagulation and collateral thermal damage in treatment of port wine stain (PWS) lesions with sequential laser irradiation and intermittent cryogen spray cooling.

  5. 75 FR 16088 - Notice: Request for Substantive Comments on the EAC's Proposed Requirements for the Testing of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-31

    ... return their voted ballots. Following the successful completion of the VOI project, in the Fiscal Year... architectures servicing multiple jurisdictions. This is a highly secure remote voting solution and the Okaloosa.... domestic and military mail systems as well as foreign postal systems for the worldwide distribution...

  6. Quantification of signal selection efficiency, extra volume suppression and contamination for ISIS, STEAM and PRESS localized 1H NMR spectroscopy using an EEC localization test object.

    PubMed

    Yongbi, N M; Payne, G S; Collins, D J; Leach, M O

    1995-07-01

    The three most widely used single-volume NMR localization techniques (ISIS, STEAM and PRESS) are assessed quantitatively for 1H spectroscopy using an EEC localization test object. Signal selection efficiency, suppression of outer volume signals and contamination are measured on a 1.5 T whole-body Siemens GBS1 system. The ISIS signal selection efficiency (volume of interest (VOI), 1-125 cm3) ranged from 90% to 95%, with T1 relaxation during the sequence shown to account for the observed 5-10% signal loss. Contamination for ISIS was found to be higher for smaller VOIS and ranged from approximately 45% (VOI = 1 cm3) to approximately 9% (VOI = 125 cm3). For PRESS, contamination ranged from 7% to 12% and it was between 3% and 8% for STEAM. However, the maximum signal selection efficiency for the latter two techniques (echo time, 270 ms) was relatively low (10-17%), and limited by T2 losses and the non-rectangular slice profiles of sinc pulses. PMID:7568384

  7. 28 CFR 91.67 - State Environmental Policy Acts.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false State Environmental Policy Acts. 91.67... Environmental Impact Review Procedures for VOI/TIS Grant Program Other State and Federal Law Requirements § 91.67 State Environmental Policy Acts. (a) Coordination. OJP will coordinate with grantees to...

  8. 28 CFR 91.67 - State Environmental Policy Acts.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false State Environmental Policy Acts. 91.67... Environmental Impact Review Procedures for VOI/TIS Grant Program Other State and Federal Law Requirements § 91.67 State Environmental Policy Acts. (a) Coordination. OJP will coordinate with grantees to...

  9. 28 CFR 91.67 - State Environmental Policy Acts.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false State Environmental Policy Acts. 91.67... Environmental Impact Review Procedures for VOI/TIS Grant Program Other State and Federal Law Requirements § 91.67 State Environmental Policy Acts. (a) Coordination. OJP will coordinate with grantees to...

  10. 28 CFR 91.67 - State Environmental Policy Acts.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false State Environmental Policy Acts. 91.67... Environmental Impact Review Procedures for VOI/TIS Grant Program Other State and Federal Law Requirements § 91.67 State Environmental Policy Acts. (a) Coordination. OJP will coordinate with grantees to...

  11. 28 CFR 91.67 - State Environmental Policy Acts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false State Environmental Policy Acts. 91.67... Environmental Impact Review Procedures for VOI/TIS Grant Program Other State and Federal Law Requirements § 91.67 State Environmental Policy Acts. (a) Coordination. OJP will coordinate with grantees to...

  12. Image-derived input function obtained in a 3TMR-brainPET

    NASA Astrophysics Data System (ADS)

    da Silva, N. A.; Herzog, H.; Weirich, C.; Tellmann, L.; Rota Kops, E.; Hautzel, H.; Almeida, P.

    2013-02-01

    Aim: The combination of a high-resolution MR-compatible BrainPET insert operated within a 3 T MAGNETOM Trio MR scanner is an excellent tool for obtaining an image derived input function (IDIF), due to simultaneous imaging. In this work, we explore the possibility of obtaining an IDIF from volumes of interest (VOI) defined over the carotid arteries (CAs) using the MR data. Material and methods: FDG data from three patients without brain disorders were included. VOIs were drawn bilaterally over the CAs on a MPRAGE image using a 50% isocontour (MR50VOI). CA PET/MR co-registration was examined based on an individual and combined CA co-registration. After that, to estimate the IDIF, the MR50VOI average (IDIF-A), four hottest pixels per plane (IDIF-4H) and four hottest pixels in VOI (IDIF-4V) were considered. A model-based correction for residual partial volume effects involving venous blood samples was applied, from which partial volume (PV) and spillover (SP) coefficients were estimated. Additionally, a theoretical PV coefficient (PVt) was calculated based on MR50VOI. Results: The results show an excellent co-registration between the MR and PET, with an area under the curve ratio between both co-registration methods of 1.00±0.04. A good agreement between PV and PVt was found for IDIF-A, with PV of 0.39±0.06 and PVt 0.40±0.03, and for IDIF-4H, with PV of 0.47±0.05 and PVt 0.47±0.03. The SPs were 0.20±0.03 and 0.21±0.03 for IDIF-A and IDIF-4H, respectively. Conclusion: The integration of a high resolution BrainPET in an MR scanner allows to obtain an IDIF from an MR-based VOI. This must be corrected for a residual partial volume effect.

  13. SU-E-J-143: Short- and Near-Term Effects of Proton Therapy On Cerebral White Matter

    SciTech Connect

    Uh, J; Merchant, T; Ogg, R; Sabin, N; Hua, C; Indelicato, D

    2014-06-01

    Purpose: To assess early effects of proton therapy on the structural integrity of cerebral white matter in relation to the subsequent near-term development of such effects. Methods: Sixteen children (aged 2–19 years) with craniopharyngioma underwent proton therapy of 54 Cobalt Gray Equivalent (CGE) in a prospective therapeutic trial. Diffusion tensor imaging (DTI) was performed at baseline before proton therapy and every 3 months thereafter. Tract-based spatial statics analysis of DTI data was performed to derive the fractional anisotropy (FA) and radial diffusivity (RD) in 26 volumes of interest (VOIs). The dose distributions were spatially normalized to identify VOIs prone to high doses. The longitudinal percentage changes of the FA and RD in these VOIs at 3 and 12 months from the baseline were calculated, and their relationships were evaluated. Results: The average dose was highest to the cerebral peduncle (CP), corticospinal tract (CST) in the pons, pontine crossing tract (PCT), anterior/posterior limbs of the internal capsule (ALIC/PLIC), and genu of the corpus callosum (GCC). It ranged from 33.3 GCE (GCC) to 49.7 GCE (CP). A mild but statistically significant (P<0.05) decline of FA was observed 3 months after proton therapy in all VOIs except the PLIC and ranged from −1.7% (ALIC) to −2.8% (PCT). A significant increase of RD was found in the CP (3.5%) and ALIC (2.1%). The average longitudinal change from the baseline was reduced at 12 months for most VOIs. However, the standard deviation increased, indicating that the temporal pattern varied individually. The follow-up measurements at 3 and 12 months correlated for the CP, CST, PCT, and GCC (P < 0.04). Conclusion: DTI data suggest early (3 months) effects of proton therapy on microstructures in the white matter. The subsequent follow-up indicated individual variation of the changes, which was partly implied by the early effects.

  14. The value of information for managing contaminated sediments.

    PubMed

    Bates, Matthew E; Sparrevik, Magnus; de Lichy, Nicolas; Linkov, Igor

    2014-08-19

    Effective management of contaminated sediments is important for long-term human and environmental health, but site-management decisions are often made under high uncertainty and without the help of structured decision support tools. Potential trade-offs between remedial costs, environmental effects, human health risks, and societal benefits, as well as fundamental differences in stakeholder priorities, complicate decision making. Formal decision-analytic tools such as multicriteria decision analysis (MCDA) move beyond ad hoc decision support to quantitatively and holistically rank management alternatives and add transparency and replicability to the evaluation process. However, even the best decisions made under uncertainty may be found suboptimal in hindsight, once additional scientific, social, economic, or other details become known. Value of information (VoI) analysis extends MCDA by systematically evaluating the impact of uncertainty on a decision. VoI prioritizes future research in terms of expected decision relevance by helping decision makers estimate the likelihood that additional information will improve decision confidence or change their selection of a management plan. In this study, VoI analysis evaluates uncertainty, estimates decision confidence, and prioritizes research to inform selection of a sediment capping strategy for the dibenzo-p-dioxin and -furan contaminated Grenland fjord system in southern Norway. The VoI model extends stochastic MCDA to model decisions with and without simulated new information and compares decision confidence across scenarios with different degrees of remaining uncertainty. Results highlight opportunities for decision makers to benefit from additional information by anticipating the improved decision confidence (or lack thereof) expected from reducing uncertainties for each criterion or combination of criteria. This case study demonstrates the usefulness of VoI analysis for environmental decisions by predicting when decisions can be made confidently, for prioritizing areas of research to pursue to improve decision confidence, and for differentiating between decision-relevant and decision-irrelevant differences in evaluation perspectives, all of which help guide meaningful deliberation toward effective consensus solutions. PMID:24957130

  15. Improving initial polyp candidate extraction for CT colonography

    NASA Astrophysics Data System (ADS)

    Zhu, Hongbin; Fan, Yi; Lu, Hongbing; Liang, Zhengrong

    2010-04-01

    Reducing the number of false positives (FPs) as much as possible is a challenging task for computer-aided detection (CAD) of colonic polyps. As part of a typical CAD pipeline, an accurate and robust process for segmenting initial polyp candidates (IPCs) will significantly benefit the successive FP reduction procedures, such as feature-based classification of false and true positives (TPs). In this study, we introduce an improved scheme for segmenting IPCs. It consists of two main components. One is geodesic distance-based merging, which merges suspicious patches (SPs) for IPCs. Based on the merged SPs, another component, called convex dilation, grows each SP beyond the inner surface of the colon wall to form a volume of interest (VOI) for that IPC, so that the inner border of the VOI beyond the colon inner surface could be segmented as convex, as expected. The IPC segmentation strategy was evaluated using a database of 50 patient studies, which include 100 scans at supine and prone positions with 84 polyps and masses sized from 6 to 35 mm. The presented IPC segmentation strategy (or VOI extraction method) demonstrated improvements, in terms of having no undesirably merged true polyp and providing more helpful mean and variance of the image intensities rooted from the extracted VOI for classification of the TPs and FPs, over two other VOI extraction methods (i.e. the conventional method of Nappi and Yoshida (2003 Med. Phys. 30 1592-601) and our previous method (Zhu et al 2009 Cancer Manag. Res. 1 1-13). At a by-polyp sensitivity of 0.90, these three methods generated the FP rate (number of FPs per scan) of 4.78 (new method), 6.37 (Nappi) and 7.01 (Zhu) respectively.

  16. Interactive lung segmentation in abnormal human and animal chest CT scans

    SciTech Connect

    Kockelkorn, Thessa T. J. P. Viergever, Max A.; Schaefer-Prokop, Cornelia M.; Bozovic, Gracijela; Muñoz-Barrutia, Arrate; Rikxoort, Eva M. van; Brown, Matthew S.; Jong, Pim A. de; Ginneken, Bram van

    2014-08-15

    Purpose: Many medical image analysis systems require segmentation of the structures of interest as a first step. For scans with gross pathology, automatic segmentation methods may fail. The authors’ aim is to develop a versatile, fast, and reliable interactive system to segment anatomical structures. In this study, this system was used for segmenting lungs in challenging thoracic computed tomography (CT) scans. Methods: In volumetric thoracic CT scans, the chest is segmented and divided into 3D volumes of interest (VOIs), containing voxels with similar densities. These VOIs are automatically labeled as either lung tissue or nonlung tissue. The automatic labeling results can be corrected using an interactive or a supervised interactive approach. When using the supervised interactive system, the user is shown the classification results per slice, whereupon he/she can adjust incorrect labels. The system is retrained continuously, taking the corrections and approvals of the user into account. In this way, the system learns to make a better distinction between lung tissue and nonlung tissue. When using the interactive framework without supervised learning, the user corrects all incorrectly labeled VOIs manually. Both interactive segmentation tools were tested on 32 volumetric CT scans of pigs, mice and humans, containing pulmonary abnormalities. Results: On average, supervised interactive lung segmentation took under 9 min of user interaction. Algorithm computing time was 2 min on average, but can easily be reduced. On average, 2.0% of all VOIs in a scan had to be relabeled. Lung segmentation using the interactive segmentation method took on average 13 min and involved relabeling 3.0% of all VOIs on average. The resulting segmentations correspond well to manual delineations of eight axial slices per scan, with an average Dice similarity coefficient of 0.933. Conclusions: The authors have developed two fast and reliable methods for interactive lung segmentation in challenging chest CT images. Both systems do not require prior knowledge of the scans under consideration and work on a variety of scans.

  17. The impact of 3D volume of interest definition on accuracy and precision of activity estimation in quantitative SPECT and planar processing methods

    NASA Astrophysics Data System (ADS)

    He, Bin; Frey, Eric C.

    2010-06-01

    Accurate and precise estimation of organ activities is essential for treatment planning in targeted radionuclide therapy. We have previously evaluated the impact of processing methodology, statistical noise and variability in activity distribution and anatomy on the accuracy and precision of organ activity estimates obtained with quantitative SPECT (QSPECT) and planar (QPlanar) processing. Another important factor impacting the accuracy and precision of organ activity estimates is accuracy of and variability in the definition of organ regions of interest (ROI) or volumes of interest (VOI). The goal of this work was thus to systematically study the effects of VOI definition on the reliability of activity estimates. To this end, we performed Monte Carlo simulation studies using randomly perturbed and shifted VOIs to assess the impact on organ activity estimates. The 3D NCAT phantom was used with activities that modeled clinically observed 111In ibritumomab tiuxetan distributions. In order to study the errors resulting from misdefinitions due to manual segmentation errors, VOIs of the liver and left kidney were first manually defined. Each control point was then randomly perturbed to one of the nearest or next-nearest voxels in three ways: with no, inward or outward directional bias, resulting in random perturbation, erosion or dilation, respectively, of the VOIs. In order to study the errors resulting from the misregistration of VOIs, as would happen, e.g. in the case where the VOIs were defined using a misregistered anatomical image, the reconstructed SPECT images or projections were shifted by amounts ranging from -1 to 1 voxels in increments of with 0.1 voxels in both the transaxial and axial directions. The activity estimates from the shifted reconstructions or projections were compared to those from the originals, and average errors were computed for the QSPECT and QPlanar methods, respectively. For misregistration, errors in organ activity estimations were linear in the shift for both the QSPECT and QPlanar methods. QPlanar was less sensitive to object definition perturbations than QSPECT, especially for dilation and erosion cases. Up to 1 voxel misregistration or misdefinition resulted in up to 8% error in organ activity estimates, with the largest errors for small or low uptake organs. Both types of VOI definition errors produced larger errors in activity estimates for a small and low uptake organs (i.e. -7.5% to 5.3% for the left kidney) than for a large and high uptake organ (i.e. -2.9% to 2.1% for the liver). We observed that misregistration generally had larger effects than misdefinition, with errors ranging from -7.2% to 8.4%. The different imaging methods evaluated responded differently to the errors from misregistration and misdefinition. We found that QSPECT was more sensitive to misdefinition errors, but less sensitive to misregistration errors, as compared to the QPlanar method. Thus, sensitivity to VOI definition errors should be an important criterion in evaluating quantitative imaging methods.

  18. Completeness map evaluation demonstrated with candidate next-generation cardiac CT architectures

    PubMed Central

    Liu, Baodong; Bennett, James; Wang, Ge; De Man, Bruno; Zeng, Kai; Yin, Zhye; Fitzgerald, Paul; Yu, Hengyong

    2012-01-01

    Purpose: In this report, the authors introduce the general concept of the completeness map, as a means to evaluate the completeness of data acquired by a given CT system design (architecture and scan mode). They illustrate the utility of completeness map by applying the completeness map concept to a number of candidate CT system designs, as part of a study to advance the state-of-the-art in cardiac CT. Methods: In order to optimally reconstruct a point within a volume of interest (VOI), the Radon transform on all possible planes through that point should be measured. The authors quantified the extent to which this ideal condition is satisfied for the entire image volume. They first determined a Radon completeness number for each point in the VOI, as the percentage of possible planes that is actually measured. A completeness map is then defined as a 3D matrix of the completeness numbers for the entire VOI. The authors proposed algorithms to analyze the projection datasets in Radon space and compute the completeness number for a fixed point and apply these algorithms to various architectures and scan modes that they are evaluating. In this report, the authors consider four selected candidate architectures, operating with different scan modes, for a total of five system design alternatives. Each of these alternatives is evaluated using completeness map. Results: If the detector size and cone angle are large enough to cover the entire cardiac VOI, a single-source circular scan can have ?99% completeness over the entire VOI. However, only the central z-slice can be exactly reconstructed, which corresponds to 100% completeness. For a typical single-source architecture, if the detector is limited to an axial dimension of 40 mm, a helical scan needs about five rotations to form an exact reconstruction region covering the cardiac VOI, while a triple-source helical scan only requires two rotations, leading to a 2.5x improvement in temporal resolution. If the source and detector of an inverse-geometry (IGCT) system have the same axial extent, and the spacing of source points in the axial and transaxial directions is sufficiently small, the IGCT can also form an exact reconstruction region for the cardiac VOI. If the VOI can be covered by the x-ray beam in any view, a composite-circling scan can generate an exact reconstruction region covering the VOI. Conclusions: The completeness map evaluation provides useful information for selecting the next-generation cardiac CT system design. The proposed completeness map method provides a practical tool for analyzing complex scanning trajectories, where the theoretical image quality for some complex system designs is impossible to predict, without yet-undeveloped reconstruction algorithms. PMID:22559610

  19. TH-A-18C-11: An Investigation of KV CBCT Image Quality and Dose Reduction for Volume-Of-Interest Imaging Using Dynamic Collimation

    SciTech Connect

    Parsons, D; Robar, J

    2014-06-15

    Purpose: The focus of this work was to investigate the improvements in image quality and dose reduction for volume-of-interest (VOI) kV-CBCT using dynamic collimation. Methods: A prototype iris aperture was used to track a VOI during a CBCT acquisition. The current aperture design is capable of one-dimensional translation as a function of gantry angle and dynamic adjustment of the iris radius. The aperture occupies the location of the bow-tie filter on a Varian OBI system. CBCT and planar image quality was investigated as a function of aperture radius, while maintaining the same dose to the VOI, for a 20 cm diameter cylindrical water phantom with a 9 mm diameter bone insert centered on isocenter. Corresponding scatter-to-primary ratios (SPR) were determined at the detector plane with Monte Carlo simulation using EGSnrc. Dose distributions for various anatomical sites were modeled using a dynamic BEAMnrc library and DOSXYZnrc. The resulting VOI dose distributions were compared to full-field distributions. Results: SPR was reduced by a factor of 8.4 when decreasing iris diameter from 21.2 cm to 2.4 cm (at isocenter). Similarly, this change in iris diameter corresponds to a factor increase of approximately 1.4 and 1.5 in image contrast for CBCT and planar images, respectively, and similarly a factor decrease in image noise of approximately 1.7 and 1.5. This results in a measured gain in contrast-to-noise ratio of a factor of approximately 2.3 for both CBCT and planar images. Depending upon the anatomical site, dose was reduced to 10%–70% of the full field value along the central axis plane and down to 2% along the axial planes, while maintaining the same dose to the VOI compared to full-field techniques. Conclusion: The presented VOI technique offers improved image quality for image-guided radiotherapy while sparing the surrounding volume of unnecessary dose compared to full-field techniques.

  20. Comparison of output-based approaches used to substantiate bovine tuberculosis free status in Danish cattle herds.

    PubMed

    Foddai, Alessandro; Nielsen, Liza Rosenbaum; Willeberg, Preben; Alban, Lis

    2015-09-01

    We compared two published studies based on different output-based surveillance models, which were used for evaluating the performance of two meat inspection systems in cattle and to substantiate freedom from bovine tuberculosis (bTB) in Denmark. The systems were the current meat inspection methods (CMI) vs. the visual-only inspection (VOI). In one study, the surveillance system sensitivity (SSe) was estimated to substantiate the bTB free status. The other study used SSe in the estimation of the probability of freedom (PFree), based on the epidemiological concept of negative predictive value to substantiate the bTB free status. Both studies found that changing from CMI to VOI would markedly decrease the SSe. However, the two studies reported diverging conclusions regarding the effect on the substantiation of Denmark as a bTB free country, if VOI were to be introduced. The objectives of this work were: (a) to investigate the reasons why conclusions based on the two models differed, and (b) to create a hybrid model based on elements from both studies to evaluate the impact of a change from CMI to VOI. The hybrid model was based on the PFree approach to substantiate freedom from bTB and was parametrized with inputs according to the newest available information. The PFree was updated on an annual basis for each of 42 years of test-negative surveillance data (1995-2037), while assuming a low (<1%) annual probability of introduction of bTB into Danish cattle herds. The most important reasons for the difference between the study conclusions were: the approach chosen to substantiate the bTB free status (SSe vs. PFree) and the number of years of surveillance data considered. With the hybrid model, the PFree reached a level >95% after the first year of surveillance and remained ≥96% with both the CMI and VOI systems until the end of the analyzed period. It is appropriate to use the PFree of the surveillance system to substantiate confidence in bTB free status, when test-negative surveillance results can be documented over an extended period of time, while maintaining a low probability of introduction of bTB into the cattle population. For Denmark, the probability of introduction of bTB should be kept <1% on an annual basis to sustain the high confidence in freedom over time. The results could be considered when deciding if the CMI can be replaced by VOI in cattle abattoirs of countries for which bTB freedom can be demonstrated. PMID:26036341

  1. Unsupervised tumour segmentation in PET using local and global intensity-fitting active surface and alpha matting.

    PubMed

    Zeng, Ziming; Wang, Jue; Tiddeman, Bernie; Zwiggelaar, Reyer

    2013-10-01

    This paper proposes an unsupervised tumour segmentation approach for PET data. The method computes the volumes of interest (VOIs) with sub-voxel precision by considering the limited image resolution and partial volume effects. First, an improved anisotropic diffusion filter is used to remove image noise. A hierarchical local and global intensity active surface modelling scheme is then applied to segment VOIs, followed by an alpha matting step to further refine the segmentation boundary. The proposed method is validated on real PET images of head-and-neck cancer patients with ground truth provided by human experts, as well as custom-designed phantom PET images with objective ground truth. Experimental results show that our method outperforms previous automatic approaches in terms of segmentation accuracy. PMID:24034745

  2. Household air pollution and cancers other than lung: a meta-analysis.

    PubMed

    Josyula, Sowmya; Lin, Juan; Xue, Xiaonan; Rothman, Nathaniel; Lan, Qing; Rohan, Thomas E; Hosgood, H Dean

    2015-01-01

    Household air pollution (HAP) from solid fuel combustion contributes to 2.6% of the global burden of disease. HAP emissions are an established lung carcinogen; however, associations with other cancer sites have not been fully explored. We conducted a meta-analysis of 18 case-control studies. Using fixed-effects models, utilizing the adjusted odds ratios (OR) and 95% confidence intervals (95% CI) from each study, we evaluated the association between HAP and cervical neoplasia (663 cases and 1747 controls) and upper aero-digestive tract cancers (6022 cases and 15 325 controls). We found that HAP was associated with cervical neoplasia (OR = 6.46; 95% CI = 3.12-13.36; 4 studies); oral (OR = 2.44; 95% CI = 1.87-3.19; 4 studies; 1000 cases/3450 controls); nasopharyngeal (OR = 1.80; 95% CI = 1.42-2.29; 6 studies; 2231 cases/2160 controls); pharyngeal (OR = 3.56; 95% CI = 2.22-5.70; 4 studies; 1036 cases/3746 controls); and laryngeal (OR = 2.35; 95% CI = 1.72- 3.21; 5 studies; 1416 cases/4514 controls) cancers. The elevated risk for esophageal cancer (OR = 1.92; 95% CI = 0.82-4.49; 2 studies; 339 cases/1455 controls) was non-significant. HAP was associated with cervical neoplasia among studies that accounted for HPV infection (OR = 9.60; 95% CI = 3.79-24.32) and smoking (OR = 4.72; 95% CI = 1.84-12.07). Similarly, our observed associations between HAP and upper aero-digestive tract cancers remained significantly elevated when analyses were restricted to studies that controlled for smoking. No significant publication bias was detected. Our results suggest that the carcinogenic effect of HAP observed for lung cancer may extend to other cancers, including those of the cervix and the upper aero-digestive tract. Further research is needed to confirm these associations in prospective studies. PMID:25890249

  3. Effects of birth asphyxia on the modulation of pharyngeal provocation-induced adaptive reflexes.

    PubMed

    Gulati, Ish K; Shubert, Theresa R; Sitaram, Swetha; Wei, Lai; Jadcherla, Sudarshan R

    2015-10-15

    Perinatal asphyxia and aerodigestive symptoms are troublesome. We tested the hypothesis that pharyngeal provocation alters proximal and distal aerodigestive reflex coordination and kinetics in infants with hypoxic ischemic encephalopathy (HIE), compared with healthy controls. Specifically, we characterized the sensory-motor properties of pharyngeal provocation-induced effects on upper esophageal sphincter (UES) and lower esophageal sphincter (LES) reflexes. Ten orally fed controls (32.0 ± 1.5 wk gestation) and 25 infants with HIE (38.1 ± 0.4 wk gestation) were evaluated at 39.7 ± 0.9 and 41.9 ± 0.6 wk postmenstrual age respectively. Pharyngo-esophageal reflexes evoked upon graded water stimuli were tested using water-perfusion micromanometry methods. Analysis included sensory-motor characteristics of pharyngeal reflexive swallow (PRS), pharyngo-UES-contractile reflex (PUCR), esophageal body-waveform kinetics, and pharyngo-LES-relaxation reflex (PLESRR). For controls vs. infants with HIE, median appearance, pulse, grimace, activity, respiration (APGAR) scores were 6 vs. 1 at 1 min (P < 0.001) and 8 vs. 3 at 5 min (P < 0.001). Upon pharyngeal- stimulation, HIE infants (vs. controls) had frequent PUCR (P = 0.01); increased UES basal tone (P = 0.03); decreased LES basal tone (P = 0.002); increased pharyngeal-waveforms per stimulus (P = 0.03); decreased frequency of LES relaxation (P = 0.003); and decreased proximal esophageal contractile amplitude (P = 0.002), with prolonged proximal esophageal contractile duration (P = 0.008). Increased tonicity and reactivity of the UES and dysregulation of LES may provide the pathophysiological basis for pooling of secretions, improper bolus clearance, and aspiration risk. Deficits in function at the nuclear or supranuclear level involving glossopharyngeal and vagal neural networks and respiratory regulatory pathways involved with aerodigestive protection may be contributory. PMID:26272260

  4. Soft, fortified ice-cream for head and neck cancer patients: a useful first step in nutritional and swallowing difficulties associated with multi-modal management.

    PubMed

    Trinidade, Aaron; Martinelli, Katrina; Andreou, Zenon; Kothari, Prasad

    2012-04-01

    Patients with head and neck cancer have complex swallowing and nutritional concerns. Most patients are malnourished, and treatment modalities within the aerodigestive tract have profound effects on future swallowing and nutrition. The objective of this study is to investigate whether the introduction of fortified soft ice-cream to post-operative head and neck cancer patients would increase compliance with oral-feeding regimes. Using a questionnaire study, an ice-cream machine that produces fortified soft ice-cream was introduced onto our ward, and 30 patients were asked to fill out questionnaires based on their experience in addition to their oral-feeding regime. Results indicate that overall patient satisfaction and compliance with oral-feeding regimes increased: 77% felt that the taste was excellent and also felt that it was easy to eat; 60% felt that it eased the symptoms associated with their symptoms, in particular its cold temperature. We conclude from the results that the inability of patients undergoing multi-modal treatment for upper aerodigestive tract cancer to enjoy normal foods and its effects on their quality of life is underestimated. Providing a food to that is palatable, familiar and acceptable as it is safe and nutritionally sound can increase compliance with oral-feeding regimes. The ice-cream was safe to use in the early post-operative period, especially soothing in patients undergoing upper aerodigestive radiotherapy and high in protein and calorific content. Our practice may have wider benefits, including patients with oral and oropharyngeal infections, the elderly and patients with neurological dysphagia resulting from stroke. PMID:21935631

  5. Apnée lors d'une intubation difficile prévisible pour un volumineux kyste laryngé

    PubMed Central

    Zalagh, Mohammed; Hachimi, Moulay Ahmed; Boukhari, Ali; Attifi, Hicham; Hmidi, Mounir; Messary, Abdelhamid

    2014-01-01

    Les auteurs présentent un cas d'obstruction aiguë des voies aériennes supérieures au moment de la tentative d'une intubation endotrachéale difficile prévisible en rapport avec un volumineux kyste du larynx. A travers ce cas clinique, les auteurs insistent sur la coopération étroite entre médecin anesthésiste et chirurgien ORL en termes d’échanges d'informations pré-opératoires, en particulier les données de la fibroscopie et la tomodensitométrie. PMID:25767649

  6. A new 2.5D representation for lymph node detection using random sets of deep convolutional neural network observations.

    PubMed

    Roth, Holger R; Lu, Le; Seff, Ari; Cherry, Kevin M; Hoffman, Joanne; Wang, Shijun; Liu, Jiamin; Turkbey, Evrim; Summers, Ronald M

    2014-01-01

    Automated Lymph Node (LN) detection is an important clinical diagnostic task but very challenging due to the low contrast of surrounding structures in Computed Tomography (CT) and to their varying sizes, poses, shapes and sparsely distributed locations. State-of-the-art studies show the performance range of 52.9% sensitivity at 3.1 false-positives per volume (FP/vol.), or 60.9% at 6.1 FP/vol. for mediastinal LN, by one-shot boosting on 3D HAAR features. In this paper, we first operate a preliminary candidate generation stage, towards -100% sensitivity at the cost of high FP levels (-40 per patient), to harvest volumes of interest (VOI). Our 2.5D approach consequently decomposes any 3D VOI by resampling 2D reformatted orthogonal views N times, via scale, random translations, and rotations with respect to the VOI centroid coordinates. These random views are then used to train a deep Convolutional Neural Network (CNN) classifier. In testing, the CNN is employed to assign LN probabilities for all N random views that can be simply averaged (as a set) to compute the final classification probability per VOI. We validate the approach on two datasets: 90 CT volumes with 388 mediastinal LNs and 86 patients with 595 abdominal LNs. We achieve sensitivities of 70%/83% at 3 FP/vol. and 84%/90% at 6 FP/vol. in mediastinum and abdomen respectively, which drastically improves over the previous state-of-the-art work. PMID:25333158

  7. Prioritizing HIV Comparative Effectiveness Trials based on Value of Information: Generic vs. Brand-Name ART in the US

    PubMed Central

    Pei, Pamela P.; Weinstein, Milton C.; Li, X. Cynthia; Hughes, Michael D.; Paltiel, A. David; Hou, Taige; Parker, Robert A.; Gaynes, Melanie R.; Sax, Paul E.; Freedberg, Kenneth A.; Schackman, Bruce R.; Walensky, Rochelle P.

    2015-01-01

    Background Value of Information (VOI) analysis examines whether to acquire information before making a decision. We introduced VOI to the HIV audience, using the example of generic antiretroviral therapy (ART) in the US. Methods and Findings We used a mathematical model and probabilistic sensitivity analysis to generate probability distributions of survival (in quality-adjusted life years, QALYs) and cost for three potential first-line ART regimens: 3-pill generic, 2-pill generic, and 1-pill branded. These served as input for a comparison of two hypothetical two-arm trials: 3-pill generic vs. 1-pill branded; and 2-pill generic vs.1-pill branded. We modeled pre-trial uncertainty by defining probability distributions around key inputs, including 24-week HIV-RNA suppression and subsequent ART failure. We assumed that, without a trial, patients received the 1-pill branded strategy. Post-trial, we assumed that patients received the most cost-effective strategy. For both trials, we quantified the probability of changing to a generic-based regimen upon trial completion and the expected VOI in terms of improved health outcomes and costs. Assuming a willingness to pay threshold of $100,000/QALY, the 3-pill trial led to more treatment changes (84%) than the 2-pill trial (78%). Estimated VOI was $48,000 (3-pill trial) and $35,700 (2-pill trial) per future patient initiating ART. Conclusions A 3-pill trial of generic ART is more likely to lead to post-trial treatment changes and to provide more value than a 2-pill trial if policy decisions are based on cost-effectiveness. Value of Information analysis can identify trials likely to confer the greatest impact and value for HIV care. PMID:26651525

  8. Hypometabolism in Brain of Cognitively Normal Patients with Depressive Symptoms is Accompanied by Atrophy-Related Partial Volume Effects.

    PubMed

    Brendel, Matthias; Reinisch, Veronika; Kalinowski, Eva; Levin, Johannes; Delker, Andreas; Därr, Sonja; Pogarell, Oliver; Förster, Stefan; Bartenstein, Peter; Rominger, Axel; Alzheimer's Disease Neuroimaging Initiative

    2016-01-01

    Late life depression (LLD) even in subsyndromal stages shows high conversion rates from cognitively normal (CN) to mild cognitive impairment (MCI). Results of [(18)F]-fluorodesoxyglucose positron-emission-tomography (FDG-PET) were inconsistent in LLD patients, whereas atrophy was repeatedly described. Therefore, we set out to investigate FDG metabolism and the effect of atrophy correction (PVEC) in geriatric CN patients with depressive symptoms. 21 CN subjects with positive item for the depression category (DEP) in the Neuropsychiatric-Inventory-Questionnaire and 29 CN subjects with an absent depression item (NON-DEP) were selected from the ADNI cohort. FDG-PETs were analyzed in individual PET space using volumes-of-interest (VOI) and statistical-parametric-mapping (SPM) approaches. VOI- and MRI-based PVEC were applied to PET data. DEP subjects showed significant hypometabolism in fronto-temporal cortices and the posterior cingulate cortex (PCC) when contrasted against NON-DEP in uncorrected data. Both in VOI- and SPM-based approaches PVEC eliminated significance in PCC, while fronto-temporal regions remained significant or even attained significance such as in case of the left amygdala. Subsyndromally depressed CN subjects had decreased FDG metabolism in mood-related brain regions, which may be relevant to their elevated risk for conversion from CN to MCI. Methodological advances in PET analyses should be considered in future studies as PVEC relevantly changed results of FDG-PET for detecting apparent metabolic differences between DEP and NON-DEP subjects. Furthermore, VOI-based analyses in individual PET space will allow a more accurate consideration of variability in anatomy, especially in subcortical regions. PMID:26971944

  9. Partial volume effect estimation and correction in the aortic vascular wall in PET imaging

    NASA Astrophysics Data System (ADS)

    Burg, S.; Dupas, A.; Stute, S.; Dieudonné, A.; Huet, P.; Le Guludec, D.; Buvat, I.

    2013-11-01

    We evaluated the impact of partial volume effect (PVE) in the assessment of arterial diseases with 18FDG PET. An anthropomorphic digital phantom enabling the modeling of aorta related diseases like atherosclerosis and arteritis was used. Based on this phantom, we performed GATE Monte Carlo simulations to produce realistic PET images with a known organ segmentation and ground truth activity values. Images corresponding to 15 different activity-concentration ratios between the aortic wall and the blood and to 7 different wall thicknesses were generated. Using the PET images, we compared the theoretical wall-to-blood activity-concentration ratios (WBRs) with the measured WBRs obtained with five measurement methods: (1) measurement made by a physician (Expert), (2) automated measurement supposed to mimic the physician measurements (Max), (3) simple correction based on a recovery coefficient (Max-RC), (4) measurement based on an ideal VOI segmentation (Mean-VOI) and (5) measurement corrected for PVE using an ideal geometric transfer matrix (GTM) method. We found that Mean-VOI WBRs values were strongly affected by PVE. WBRs obtained by the physician measurement, by the Max method and by the Max-RC method were more accurate than WBRs obtained with the Mean-VOI approach. However Expert, Max and Max-RC WBRs strongly depended on the wall thickness. Only the GTM corrected WBRs did not depend on the wall thickness. Using the GTM method, we obtained more reproducible ratio values that could be compared across wall thickness. Yet, the feasibility of the implementation of a GTM-like method on real data remains to be studied.

  10. Computer-aided diagnosis: a 3D segmentation method for lung nodules in CT images by use of a spiral-scanning technique

    NASA Astrophysics Data System (ADS)

    Wang, Jiahui; Engelmann, Roger; Li, Qiang

    2008-03-01

    Lung nodule segmentation in computed tomography (CT) plays an important role in computer-aided detection, diagnosis, and quantification systems for lung cancer. In this study, we developed a simple but accurate nodule segmentation method in three-dimensional (3D) CT. First, a volume of interest (VOI) was determined at the location of a nodule. We then transformed the VOI into a two-dimensional (2D) image by use of a "spiral-scanning" technique, in which a radial line originating from the center of the VOI spirally scanned the VOI. The voxels scanned by the radial line were arranged sequentially to form a transformed 2D image. Because the surface of a nodule in 3D image became a curve in the transformed 2D image, the spiral-scanning technique considerably simplified our segmentation method and enabled us to obtain accurate segmentation results. We employed a dynamic programming technique to delineate the "optimal" outline of a nodule in the 2D image, which was transformed back into the 3D image space to provide the interior of the nodule. The proposed segmentation method was trained on the first and was tested on the second Lung Image Database Consortium (LIDC) datasets. An overlap between nodule regions provided by computer and by the radiologists was employed as a performance metric. The experimental results on the LIDC database demonstrated that our segmentation method provided relatively robust and accurate segmentation results with mean overlap values of 66% and 64% for the nodules in the first and second LIDC datasets, respectively, and would be useful for the quantification, detection, and diagnosis of lung cancer.

  11. Extranodal Natural Killer/T-Cell Lymphoma of the Nasal Type with Skin Metastases

    PubMed Central

    Akhrass, Fadi Al; Hensley, Brooklyn; Thomas, Lillian; Elsoueidi, Raymond

    2016-01-01

    Extranodal natural killer/T-cell lymphoma (ENKL) of the nasal type is a rare, clinically aggressive disease. ENKL of the nasal type is often localized in the upper aerodigestive tract, including the nasal cavity, nasopharynx, paranasal sinuses, tonsils, hypopharynx and larynx, and usually presents as stage I/II. Extranasal involvement can occur, and a common site of extranasal involvement or metastatic disease includes the skin. Identifying skin metastases is important for the appropriate staging and treatment. We report a case of ENKL of the nasal type that presented with localized disease and subsequent skin lesions that were consistent with skin metastases. PMID:26933411

  12. Vocal cord palsy as a presenting feature of sternoclavicular joint septic arthritis.

    PubMed

    Jamil, Fahad; Hussain, Khalid

    2015-01-01

    Sternoclavicular joint septic arthritis (SSA) is rare and often difficult to manage condition. The sternoclavicular joint is an unusual site of septic arthritis in healthy persons, but may be commonly involved in intravenous drug users, primary or secondary immunosuppressive disorders, infections or the presence of infected central lines. After thorough literature search, no cases have yet been reported on SSA leading to vocal cord palsy. The following case describes a male patient who presented to hospital with left vocal cord palsy and symptoms consistent with aero-digestive tract malignancy. Radiological examination and subsequent response to treatment demonstrated the only causative pathology to be an ipsilateral septic sternoclavicular joint. PMID:25583908

  13. Ocular manifestations in lipoid proteinosis: A rare clinical entity

    PubMed Central

    Kamath, Sumana J; Marthala, HimaBindu; Manapragada, BinduMadhavi

    2015-01-01

    Lipoid proteinosis is a rare autosomal recessive genodermatosis with abnormal lipid protein complexes deposition in different parts of the body, especially in the skin and mucus membranes of the upper aerodigestive tract. Though ocular involvement in lipoid proteinosis is rare, ophthalmologists may encounter diverse ocular complications accompanying this syndrome in clinical practice. We describe a case of lipoid proteinosis involving bilateral eyelids with pathognomonic moniliform blepharosis in a 33-year-old gentleman who presented with the complaints of itching of eye lids on and off since 10 years. PMID:26655007

  14. Vocal cord palsy as a presenting feature of sternoclavicular joint septic arthritis

    PubMed Central

    Jamil, Fahad; Hussain, Khalid

    2015-01-01

    Sternoclavicular joint septic arthritis (SSA) is rare and often difficult to manage condition. The sternoclavicular joint is an unusual site of septic arthritis in healthy persons, but may be commonly involved in intravenous drug users, primary or secondary immunosuppressive disorders, infections or the presence of infected central lines. After thorough literature search, no cases have yet been reported on SSA leading to vocal cord palsy. The following case describes a male patient who presented to hospital with left vocal cord palsy and symptoms consistent with aero-digestive tract malignancy. Radiological examination and subsequent response to treatment demonstrated the only causative pathology to be an ipsilateral septic sternoclavicular joint. PMID:25583908

  15. [Changes in the deglutition reflex during the perioperative period].

    PubMed

    de Larminat, V; Dureuil, B

    1994-01-01

    The swallowing reflex is one of the major mechanisms protecting the lungs against aspiration of foreign material. Its complex time course requires a perfect coordination with ventilation, as the aerodigestive crossroads are common for both functions. Physiological factors as ageing, as well as mechanical and pharmacological agents, may contribute to swallowing reflex alterations. Moreover, endotracheal intubation and most anaesthetic agents may impair the swallowing function and favour the occurrence of aspiration. This review discusses the normal swallowing process and its alterations by agents currently used in anaesthesia. Furthermore, the effect of intubation as well as changes related to co-existing diseases are considered. PMID:8092580

  16. An elderly man with acute anterior neck pain and odynophagia after a meal.

    PubMed

    Mohamad, I; Jaafar, R

    2013-01-01

    The upper aerodigestive tract, specifically the cricopharyngeal area, is the most common site of foreign body impaction. Anatomically, this area is the first constriction of the oesophagus. Fish bones, one of the most common foreign bodies encountered in the throat, tend to get stuck in this area. The movement of this sharp-edged foreign body upon swallowing will induce odynophagia and an acute onset of neck pain. We report a case of a healthy elderly man who complained of sudden anterior neck pain and odynophagia after eating yellowtail scad fish. PMID:25893057

  17. Primary myxoid liposarcoma of the supraglottic larynx

    PubMed Central

    Gleinser, David M; Font, Jean Paul; Clement, Cecilia G; Mohammed, Basim S; Underbrink, Michael P

    2010-01-01

    Sarcomas are a rare occurrence accounting for roughly 1% of all cancer cases reported. Of these, 9–18% will be identified as liposarcoma. Overall, only 4–9% of all liposarcomas occur in the head and neck region. As such, it is a rare event to see a primary liposarcoma of the aerodigestive tract. These tumors are typically misdiagnosed secondary to their indolent, asymptomatic course and similarities in appearance to other benign lesions. An understanding of these lesions will help clinicians appropriately manage their patients. We present a case of a 60-year male with a primary supraglottic myxoid liposarcoma, and provide relevant information about liposarcomas. PMID:21139957

  18. Surgical management in a rare case of basaloid squamous cell carcinoma of the maxilla

    PubMed Central

    Tuhar, I; Zamfirescu, D; Sl?vescu, D; Frunz?, A; Lasc?r, I

    2015-01-01

    Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive version of squamous cell carcinoma (SCC) that preferentially occurs in the upper aerodigestive tract. Since the first description by Wain SL et al., in 1986, only 21 cases with BSCC in the nasal cavity or in the paranasal cavity have been reported in the English literature. We present a case of BSCC arising in a paranasal sinus, a 51-year-old male patient with four months history of right cheek swelling and unilateral nasal obstruction, who underwent an operation and postoperative radiotherapy. Clinical, pathological and surgical findings in this case are presented along with a brief discussion of literature. PMID:25914753

  19. Otolaryngologic manifestations of Maffucci's syndrome.

    PubMed

    Sun, Gordon H; Myer, Charles M

    2009-07-01

    Maffucci's syndrome is an uncommon congenital disease marked by multiple vascular malformations and enchondromas throughout the body. Otolaryngologic manifestations are relatively rare but potentially can cause symptoms such as respiratory distress and dysphagia if the lesions appear in the upper aerodigestive tract or larynx. We report a case of a young woman who demonstrated a wide range of head and neck pathology associated with this unique disease, including sphenoid enchondroma, bilateral petrous apex lesions, and rarely reported laryngeal and hypopharyngeal vascular malformations, over a period of nearly 20 years. PMID:19394093

  20. Recurrent respiratory papillomatosis: a study of 24 cases.

    PubMed

    Majumder, S M; Ibrahim, M F; Huda, Q K; Bhattacharjee, N; Amin, M N

    1999-08-01

    24 cases of recurrent respiratory papillomatosis (RRP) in children were treated by surgical removal with cup forceps and followed up for variable periods between 1990-95. Most of the patients required multiple operations due to recurrence. No anaesthetic death or complication was recorded. Voice changes of different degrees were noted. Four patients has glottic web formation. The findings suggest that recurrence of RRP is very common & needs multiple session of surgery. For children with persistent and progressive voice change/cry, the necessity of precise & comprehensive endoscopic examination of the upper aerodigestive tract under general anesthesia (GA) is emphasized. PMID:11026935

  1. Iatrogenic phenol injury: a case report and review of medication safety and labeling practices with flexible laryngoscopy.

    PubMed

    Cote, Valerie; Prager, Jeremy D

    2014-10-01

    Medication errors can be reduced by following standards in patient identification and medication labeling. We present an investigation of a life-threatening event from medication error: A newborn that received intranasal phenol instead of topical anesthetic prior to flexible laryngoscopy. The patient required urgent intubation for respiratory distress and suffered chemical burns of the face, neck, and upper aerodigestive tract. The hospital course was prolonged and included intensive care, delayed oral feeding with enteral support, and the need for several endoscopies. Current standards of medication labeling are reviewed as well as evidence for and against using topical agents for flexible laryngoscopy. PMID:25103774

  2. An unusual case of suicidal asphyxia by smothering.

    PubMed

    Saint-Martin, P; Bouyssy, M; O'Byrne, P

    2007-01-01

    A case is presented of a 30-year-old man suffering from borderline personality disorder who committed suicide by means of smothering. He was hospitalized at the psychiatric department of a public hospital for several months and was found dead in the seclusion room. The death resulted from an obstruction of the upper aerodigestive tract after ingurgitation of pellets of toilet paper. A literature review revealed several cases of suicidal asphyxia by smothering of patients with a history of psychiatric illness. Our patient's operating process had not been reported before to our knowledge. PMID:16442335

  3. Examination of the patient with head and neck cancer.

    PubMed

    Georgopoulos, Rachel; Liu, Jeffrey C

    2015-07-01

    Head and neck cancer typically refers to epithelial malignancies of the upper aerodigestive tract and may include neoplasms of the thyroid, salivary glands, and soft tissue, bone sarcomas, and skin cancers. Two-thirds of patients present with advanced disease involving regional lymph nodes at the time of diagnosis. A thorough history and detailed examination are integral to oncologic staging and treatment planning. This article begins with an overview of the head and neck examination (with special attention to detailed findings with clinical implications), followed by a discussion of the major head and neck subsites, and clinical pearls surrounding the examination. PMID:25979391

  4. Current philosophy in the surgical management of neck metastases for head and neck squamous cell carcinoma.

    PubMed

    Coskun, H Hakan; Medina, Jesus E; Robbins, K Thomas; Silver, Carl E; Strojan, Primož; Teymoortash, Afshin; Pellitteri, Phillip K; Rodrigo, Juan P; Stoeckli, Sandro J; Shaha, Ashok R; Suárez, Carlos; Hartl, Dana M; de Bree, Remco; Takes, Robert P; Hamoir, Marc; Pitman, Karen T; Rinaldo, Alessandra; Ferlito, Alfio

    2015-06-01

    Neck dissection is an important treatment for metastases from upper aerodigestive carcinoma; an event that markedly reduces survival. Since its inception, the philosophy of the procedure has undergone significant change from one of radicalism to the current conservative approach. Furthermore, nonsurgical modalities have been introduced, and, in many situations, have supplanted neck surgery. The refinements of imaging the neck based on the concept of neck level involvement has encouraged new philosophies to evolve that seem to benefit patient outcomes particularly as this relates to diminished morbidity. The purpose of this review was to highlight the new paradigms for surgical removal of neck metastases using an evidence-based approach. PMID:24623715

  5. Interpretation des donnees de flux de chaleur et de gravite dans le bouclier Canadien

    NASA Astrophysics Data System (ADS)

    Cheng, Li Zhen

    2000-10-01

    Le champ geothermique du Bouclier Canadien est caracterise par un flux moyen de 41 mW·m-2, qui suggere une production de chaleur moyenne dans la croute comprise entre 0.7 et 0.8 muW·m-3. Le flux de chaleur relativement faible favorise la stabilite du bouclier et lui a permis de resister a la deformation tectonique. Les variations du flux de chaleur a la surface sont dominees par la composition de la croute. Un flux eleve implique generalement une composition felsique et il est d'autant plus faible que la croute devient plus mafique. La production de chaleur en surface n'est pas representative de la production moyenne de la croute. Le flux de chaleur dans le Boucher Canadien ne depend donc pas de la production de chaleur en surface, mais depend de la composition principale de la croute. L'interpretation combinee des donnees geophysiques nous permet de determiner les variations de composition d'echelle crustale a partir desquelles il est possible d'etablir la structure de la croute. L'etude detaillee de l'Orogene de Trans-Hudson et de la Sous-province d'Abitibi a montre que le flux de chaleur, la gravite et la sismique lorsqu'elles sont combinees fournissent des contraintes efficaces pour determiner l'architecture crustale. En general, la croute est trop resistante pour se deformer par fluage, excepte tres localement. Le mode de deformation de la lithosphere continentale depend de la composition et du gradient geothermique. Nous montrons que la lithosphere du Bouclier Canadien demeure principalement fragile jusqu'a une profondeur de plus de 150 km. Une deformation ductile pourrait cependant etre possible localement a la base de la, croute, comme dans la ceinture de Thompson par exemple. Si l'on admet que la lithosphere peut resister a des contraintes allant jusqu'a 20 MPa (taux de deformation 3˙ < 10-15 s-1), l'epaisseur de la lithosphere est de l'ordre de 300 km pour la ceinture de Thompson et est superieure a 300 km pour la sous-province d'Abitibi. La resistance maximum de la lithosphere est atteinte dans la partie superieure du manteau. La lithosphere du Bouclier Canadien est donc capable de supporter d'importantes contraintes tectoniques sans deformation notable. C'est le regime fragile qui controle le comportement rheologique de la lithosphere superieure du bouclier.

  6. Objective evaluation of reconstruction methods for quantitative SPECT imaging in the absence of ground truth

    NASA Astrophysics Data System (ADS)

    Jha, Abhinav K.; Song, Na; Caffo, Brian; Frey, Eric C.

    2015-03-01

    Quantitative single-photon emission computed tomography (SPECT) imaging is emerging as an important tool in clinical studies and biomedical research. There is thus a need for optimization and evaluation of systems and algorithms that are being developed for quantitative SPECT imaging. An appropriate objective method to evaluate these systems is by comparing their performance in the end task that is required in quantitative SPECT imaging, such as estimating the mean activity concentration in a volume of interest (VOI) in a patient image. This objective evaluation can be performed if the true value of the estimated parameter is known, i.e. we have a gold standard. However, very rarely is this gold standard known in human studies. Thus, no-gold-standard techniques to optimize and evaluate systems and algorithms in the absence of gold standard are required. In this work, we developed a no-gold-standard technique to objectively evaluate reconstruction methods used in quantitative SPECT when the parameter to be estimated is the mean activity concentration in a VOI. We studied the performance of the technique with realistic simulated image data generated from an object database consisting of five phantom anatomies with all possible combinations of five sets of organ uptakes, where each anatomy consisted of eight different organ VOIs. Results indicate that the method pro- vided accurate ranking of the reconstruction methods. We also demonstrated the application of consistency checks to test the no-gold-standard output.

  7. Improved intrinsic motion detection using time-of-flight PET.

    PubMed

    Xu, Jingyan; Tsui, Benjamin M W

    2015-10-01

    Intrinsic or data-driven respiratory and cardiac motion detection often track the center-of-mass (COM) change in PET data to derive a motion gating signal. The effectiveness of this method depends on the contrast of the moving target to the relatively stationary background. The stationary background leads to a reduced COM displacement in PET data. Further, the COM calculated using axially truncated PET data is biased. To improve intrinsic motion detection for motion compensated image reconstruction, we use the time-of-flight (TOF) PET data of the original object f(x) to calculate the non-TOF PET data of a volume-of-interest (VOI) weighted object f(x)w(x) . The VOI-weighting w(x) can be chosen to reduce contribution from the stationary background. The reduced background in f(x)w(x) leads to an observed increase in the COM displacement. We also derive rebinning equations to obtain the exact axial COM using axially truncated PET data. To assess the quality of the motion gating signal, we analyze the variance property of the COM using different methods, including with(out) VOI weighting and with(out) compensation for axial data truncation. Analytical simulations, phantom and patient data demonstrate the effectiveness of the proposed approach in identifying the motion phase and in deriving a gating signal to be used for motion-compensated image reconstruction. PMID:25897950

  8. Use of {open_quotes}value of information{close_quotes} concept in justification and ranking of subsurface appraisal

    SciTech Connect

    Demirmen, F.

    1996-12-31

    The {open_quotes}value of information{close_quotes} (VOI) concept can be applied to subsurface appraisal in petroleum exploration and production to provide an auditable, consistent criterion for justification of such activity. Based on this concept the {open_quotes}value{close_quotes} of subsurface appraisal can be defined as the difference in expected project (monetary) value with and without appraisal. Comparison of this value with the net appraisal cost provides a pragmatic decision tool for decision-making in subsurface appraisal. If the value is greater than the appraisal cost the appraisal is justified, otherwise it is not. Quantification of underlying uncertainty in probability form, and economic evaluation of alternative development scenarios as impacted by the uncertainty, are involved in the methodology. By extension of the concept, VOI can also be used as a ranking tool in a portfolio of subsurface appraisal activities. {open_quotes}Partial information{close_quotes} and unreliable information, both of which are common in practice, reduce the {open_quotes}value{close_quotes} of subsurface appraisal, and realistic evaluation of subsurface appraisal must take both of these effects into account. The VOI approach to subsurface appraisal helps avoid under- and overappraisal and could have a significant impact on upstream economics.

  9. From dysphonia to dysphoria: Mokken scaling shows a strong, reliable hierarchy of voice symptoms in the Voice Symptom Scale questionnaire.

    PubMed

    Deary, Ian J; Wilson, Janet A; Carding, Paul N; Mackenzie, Kenneth; Watson, Roger

    2010-01-01

    Symptoms of hoarseness (dysphonia) are common and often associated with psychological distress. The Voice Symptom Scale (VoiSS) is a 30-item self-completed questionnaire concerning voice and throat symptoms. Psychometric and clinical studies on the VoiSS show that it has good reliability and validity, and a clear factorial structure. The present article presents a further advance in voice measurement from the patient's point of view. To date, there has been no examination of whether voice-related symptoms form a hierarchy; that is, whether people who suffer voice problems progress through a reliable set of problems from mild to severe. To address this question, the technique of Mokken scaling was applied to the VoiSS in 480 patients with dysphonia. A strong and reliable Mokken scale--a symptom hierarchy--was found, which included 17 of the 30 items. This new information on dysphonia shows that voice symptoms progress from voice-oriented difficulties, through practical problems, to disturbances of social relationships and mood (dysphoria). The results add information about the structured phenomenology of voice problems, further establish the relationship between voice impairment and psychosocial impairment, and suggest practical applications in the assessment of dysphonic voices. PMID:20004302

  10. Patient-bounded extrapolation using low-dose priors for volume-of-interest imaging in C-arm CT

    SciTech Connect

    Xia, Y.; Maier, A.; Berger, M.; Hornegger, J.; Bauer, S.

    2015-04-15

    Purpose: Three-dimensional (3D) volume-of-interest (VOI) imaging with C-arm systems provides anatomical information in a predefined 3D target region at a considerably low x-ray dose. However, VOI imaging involves laterally truncated projections from which conventional reconstruction algorithms generally yield images with severe truncation artifacts. Heuristic based extrapolation methods, e.g., water cylinder extrapolation, typically rely on techniques that complete the truncated data by means of a continuity assumption and thus appear to be ad-hoc. It is our goal to improve the image quality of VOI imaging by exploiting existing patient-specific prior information in the workflow. Methods: A necessary initial step prior to a 3D acquisition is to isocenter the patient with respect to the target to be scanned. To this end, low-dose fluoroscopic x-ray acquisitions are usually applied from anterior–posterior (AP) and medio-lateral (ML) views. Based on this, the patient is isocentered by repositioning the table. In this work, we present a patient-bounded extrapolation method that makes use of these noncollimated fluoroscopic images to improve image quality in 3D VOI reconstruction. The algorithm first extracts the 2D patient contours from the noncollimated AP and ML fluoroscopic images. These 2D contours are then combined to estimate a volumetric model of the patient. Forward-projecting the shape of the model at the eventually acquired C-arm rotation views gives the patient boundary information in the projection domain. In this manner, we are in the position to substantially improve image quality by enforcing the extrapolated line profiles to end at the known patient boundaries, derived from the 3D shape model estimate. Results: The proposed method was evaluated on eight clinical datasets with different degrees of truncation. The proposed algorithm achieved a relative root mean square error (rRMSE) of about 1.0% with respect to the reference reconstruction on nontruncated data, even in the presence of severe truncation, compared to a rRMSE of 8.0% when applying a state-of-the-art heuristic extrapolation technique. Conclusions: The method we proposed in this paper leads to a major improvement in image quality for 3D C-arm based VOI imaging. It involves no additional radiation when using fluoroscopic images that are acquired during the patient isocentering process. The model estimation can be readily integrated into the existing interventional workflow without additional hardware.

  11. Interpretable whole-brain prediction analysis with GraphNet.

    PubMed

    Grosenick, Logan; Klingenberg, Brad; Katovich, Kiefer; Knutson, Brian; Taylor, Jonathan E

    2013-05-15

    Multivariate machine learning methods are increasingly used to analyze neuroimaging data, often replacing more traditional "mass univariate" techniques that fit data one voxel at a time. In the functional magnetic resonance imaging (fMRI) literature, this has led to broad application of "off-the-shelf" classification and regression methods. These generic approaches allow investigators to use ready-made algorithms to accurately decode perceptual, cognitive, or behavioral states from distributed patterns of neural activity. However, when applied to correlated whole-brain fMRI data these methods suffer from coefficient instability, are sensitive to outliers, and yield dense solutions that are hard to interpret without arbitrary thresholding. Here, we develop variants of the Graph-constrained Elastic-Net (GraphNet), a fast, whole-brain regression and classification method developed for spatially and temporally correlated data that automatically yields interpretable coefficient maps (Grosenick et al., 2009b). GraphNet methods yield sparse but structured solutions by combining structured graph constraints (based on knowledge about coefficient smoothness or connectivity) with a global sparsity-inducing prior that automatically selects important variables. Because GraphNet methods can efficiently fit regression or classification models to whole-brain, multiple time-point data sets and enhance classification accuracy relative to volume-of-interest (VOI) approaches, they eliminate the need for inherently biased VOI analyses and allow whole-brain fitting without the multiple comparison problems that plague mass univariate and roaming VOI ("searchlight") methods. As fMRI data are unlikely to be normally distributed, we (1) extend GraphNet to include robust loss functions that confer insensitivity to outliers, (2) equip them with "adaptive" penalties that asymptotically guarantee correct variable selection, and (3) develop a novel sparse structured Support Vector GraphNet classifier (SVGN). When applied to previously published data (Knutson et al., 2007), these efficient whole-brain methods significantly improved classification accuracy over previously reported VOI-based analyses on the same data (Grosenick et al., 2008; Knutson et al., 2007) while discovering task-related regions not documented in the original VOI approach. Critically, GraphNet estimates fit to the Knutson et al. (2007) data generalize well to out-of-sample data collected more than three years later on the same task but with different subjects and stimuli (Karmarkar et al., submitted for publication). By enabling robust and efficient selection of important voxels from whole-brain data taken over multiple time points (>100,000 "features"), these methods enable data-driven selection of brain areas that accurately predict single-trial behavior within and across individuals. PMID:23298747

  12. Cell scientist to watch - Virgile Viasnoff.

    PubMed

    2016-02-01

    Virgile earned his first degree in soft matter physics at the École Normale Superieure in Paris. He then moved to Johns Hopkins University in the USA to complete a Masters degree, before returning to Paris to pursue his PhD at the École supérieure de physique et de chimie industrielles (ESPCI) in Francois Lequeux's laboratory. In 2006, after two years as a postdoctoral fellow in the group of Amit Meller at Harvard, Vigile started his own lab at the Centre national de la recherche scientifique (CNRS) at ESPCI. Between 2010 and 2011, Virgile spent two years on sabbatical at the Mechanobiology Institute (MBI) at the University of Singapore. He now holds a dual appointment between CNRS and MBI, and his lab in Singapore investigates how the physical and biochemical parameters of the cellular microenvironment regulate cell-cell adhesion and cell fate. PMID:26834180

  13. 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

  14. Expression of P16 in NUT carcinomas with no association with human papillomavirus (HPV).

    PubMed

    Salles, Paulo Guilherme de Oliveira; Moura, Rafael de Deus; Menezes, Letícia M; Bacchi, Carlos E

    2014-04-01

    NUT carcinoma (NC) is a rare malignant neoplasm usually located in the midline, including the upper aerodigestive tract. NC is an aggressive and highly lethal type of carcinoma. It is defined by the rearrangement of the nuclear protein in the testis (NUT) gene on chromosome 15q14. In most cases, the NUT is involved in a balanced translocation with the BRD4 gene on chromosome 19p13.1, an event that creates a BRD4-NUT fusion gene. The relationship between the human papillomavirus (HPV), p16, and upper aerodigestive tract cancer has been long postulated. In this study, we evaluated the relationship of the p16 expression in 4 cases of NCs and its eventual association with HPV. All 4 cases presented typical histopathologic findings with nuclear positivity of the NUT protein and strong expression for p16. None of these cases, however, showed an association with HPV evaluated by polymerase chain reaction. Despite the expression of p16, this negative result for HPV indicates that HPV infection probably does not play a role in the pathogenesis of NC. PMID:24185123

  15. The Role of Narrow Band Imaging in the Detection of Recurrent Laryngeal and Hypopharyngeal Cancer after Curative Radiotherapy

    PubMed Central

    Zabrodsky, Michal; Plzak, Jan

    2014-01-01

    Narrow band imaging is considered a significant improvement in the possibility of detecting early mucosal lesion of the upper aerodigestive tract. Early detection of mucosal neoplastic lesions is of utmost importance for patients survival. There is evidence that, especially in patients previously treated by means of curative radiotherapy or chemoradiotherapy, the early detection rate of recurrent disease is quite low. The aim of this study was to prove whether the videoendoscopy coupled with NBI might help detect recurrent or secondary tumors of the upper aerodigestive tract. 66 patients previously treated by means of RT or CRT with curative intent were enrolled in the study. All patients underwent transnasal flexible videoendoscopy with NBI mode under local anesthesia. When a suspicious lesion was identified in an ambulatory setting, its nature was proved histologically. Many of these changes were not identifiable by means of conventional white light (WL) endoscopy. The accuracy, sensitivity, specificity, and positive and negative predictive value of the method are very high (88%, 92%, 76%, 96%, and 91%, resp.). Results demonstrate that outpatient transnasal endoscopy with NBI is an excellent method for the follow-up of patients with carcinomas of the larynx and the hypopharynx primarily treated with radiotherapy. PMID:25101264

  16. The Economic Value of Climate Science

    NASA Astrophysics Data System (ADS)

    Wielicki, B. A.; Cooke, R.; Young, D. F.; Mlynczak, M. G.

    2012-12-01

    While demonstrating the economic value of science is challenging, it can be more direct for some Earth observations. For example, suppose a climate science mission can yield decisive information on climate change within a shortened time frame. How much should society be willing to pay for this knowledge today? The US interagency memo on the social cost of carbon (SCC) provides a standard for valuing damages from carbon emissions. We illustrate how value of information (VOI) calculations can be used to monetize the relative value of different climate observations. We follow the SCC, stipulating uncertainty in climate sensitivity, using discount rates of 2.5%, 3% and 5%, and using one of the Integrated Assessment Models sanctioned in SCC (DICE, Nordhaus 2008). We consider three mitigation scenarios: Business as Usual (BAU), a moderate response (DICE Optimal), and a strong response (Stern). To illustrate results, suppose that we would switch from BAU to the Stern emissions path if we learn with 90% confidence that the decadal rate of temperature change reaches or exceeds 0.2 C/decade. Under the SCC assumptions, the year in which this happens, if it happens, depends on uncertain climate sensitivity and on the emissions path. The year in which we become 90% certain also depends on our Earth observations, their accuracy, and their completeness. The resolving power of a climate observing system cannot exceed climate system natural variability. All climate observations add noise to natural variability caused by observing limitations, including calibration errors and space/time sampling uncertainty. The basic concept is that more accurate observations can advance the time for societal decisions. The economic value of the resulting averted damages depends on the discount rate, and the years in which the damages occur. A new climate observation would be economically justified if the net present value (NPV) of the difference in averted damages, relative to the existing systems, exceeds the NPV of the system costs. We present illustrative results comparing the proposed CLARREO advance in satellite absolute calibration for climate change records to an existing system for detecting decadal temperature change and cloud feedback (i.e. climate sensitivity uncertainty). While CLARREO is used as an example, the value should be considered as relevant to an improved climate observing system, since societal decisions are unlikely to be based on one or a few observations. The VOI is found to depend on the required confidence level, the trigger value at which we would abandon the BAU emissions path, the path to which we switch, and the date at which the new system is launched. The VOI of CLARREO in this decision context is the surfeit of NPV of averted damages, relative to the existing system. Over all it is in the order of tens of trillions of US dollars. Among the noteworthy conclusions are (1) switching to either the DICE optimal or Stern emissions paths makes only a modest difference in the VOI of CLARREO, (2) raising the trigger value from 0.2C to 0.3C/decade, increases the VOI of CLARREO, while increasing the total NPV of climate damages, and (3) the choice of discount rate affects the VOI by a factor ~ 5. The results conclude that the economic value of advanced climate observing systems is dramatically larger than their cost, and argues for the continual enhancement of the SCC assessment process.

  17. Effect of denoising on supervised lung parenchymal clusters

    NASA Astrophysics Data System (ADS)

    Jayamani, Padmapriya; Raghunath, Sushravya; Rajagopalan, Srinivasan; Karwoski, Ronald A.; Bartholmai, Brian J.; Robb, Richard A.

    2012-03-01

    Denoising is a critical preconditioning step for quantitative analysis of medical images. Despite promises for more consistent diagnosis, denoising techniques are seldom explored in clinical settings. While this may be attributed to the esoteric nature of the parameter sensitve algorithms, lack of quantitative measures on their ecacy to enhance the clinical decision making is a primary cause of physician apathy. This paper addresses this issue by exploring the eect of denoising on the integrity of supervised lung parenchymal clusters. Multiple Volumes of Interests (VOIs) were selected across multiple high resolution CT scans to represent samples of dierent patterns (normal, emphysema, ground glass, honey combing and reticular). The VOIs were labeled through consensus of four radiologists. The original datasets were ltered by multiple denoising techniques (median ltering, anisotropic diusion, bilateral ltering and non-local means) and the corresponding ltered VOIs were extracted. Plurality of cluster indices based on multiple histogram-based pair-wise similarity measures were used to assess the quality of supervised clusters in the original and ltered space. The resultant rank orders were analyzed using the Borda criteria to nd the denoising-similarity measure combination that has the best cluster quality. Our exhaustive analyis reveals (a) for a number of similarity measures, the cluster quality is inferior in the ltered space; and (b) for measures that benet from denoising, a simple median ltering outperforms non-local means and bilateral ltering. Our study suggests the need to judiciously choose, if required, a denoising technique that does not deteriorate the integrity of supervised clusters.

  18. Cardiac imaging using a four-segment slant-hole collimator

    SciTech Connect

    Bal, G.; DiBella, E.V.R.; Gullberg, G.T.; Zeng, G.L.

    2005-09-27

    The main objective of this paper is to evaluate four segmentslant-hole (FSSH) SPECT for cardiac imaging. FSSH is a slant-holecollimator that is divided into four segments and arranged such that thephotons from the volume of interest (VOI)are projected four times forevery location of the detector. These multiple projections help toimprove the sensitivity of the photons from the VOI by a factor4(cos(sigma))3, where is the slant angle of the collimator. Anotheradvantage of FSSH SPECT is a reduction in the total scan time, since agantry rotation of pi-2sigma is sufficient to satisfy Orlov's condition.That means, for a slant angle of 30 degrees, a gantry rotation of 120degrees is sufficient to satisfy Orlov's condition and obtain a completedataset. In this paper, we evaluate and compare the reconstructed imagesobtained using an FSSH collimator, for a gantry rotation of 180 degreesand 120 degrees, with those obtained from a parallel-hole (PH) SPECTsystem using a 180 degree acquisition. The reconstructed images from thethree imaging geometries were compared in terms of average image noise,contrast, and percentage error, for seven different clinical count levelsand for multiple noise realizations in each case. The increase insensitivity of the FSSH system was found to translate into a proportionaldecrease in statistical noise for voxels in the VOI of the reconstructedimages. Finally, a physical phantom study was performed using a prototypeFSSH collimator. Our findings show that FSSH collimators have thepotential of being the collimator of choice for cardiac SPECT imaging.Though we explore the potential of FSSH collimators for cardiac imagingin this paper, the concept can be extended for imaging other organs suchas the breasts, kidney, and brain.

  19. Three-dimensional image registration of MR proximal femur images for the analysis of trabecular bone parameters

    NASA Astrophysics Data System (ADS)

    Blumenfeld, Janet; Studholme, Colin; Carballido-Gamio, Julio; Link, Thomas M.; Majumdar, Sharmila

    2008-03-01

    This study investigated the feasibility of automatic image registration of MR high-spatial resolution proximal femur trabecular bone images as well as the effects of gray-level interpolation and volume of interest (VOI) misalignment on MR-derived trabecular bone structure parameters. For six subjects, a baseline scan and a follow-up scan of the proximal femur were acquired on the same day. An automatic image registration technique, based on mutual information, utilized a baseline and a follow-up scan to compute transform parameters that aligned the two images. These parameters were subsequently used to transform the follow-up image with three different gray-level interpolators. Nearest neighbor interpolation and b-spline approximation did not significantly alter bone parameters, while linear interpolation significantly modified bone parameters (p<0.01). Improvement in image alignment due to the automatic registration was determined by visually inspecting difference images and 3D renderings. This work demonstrates the first application of automatic registration, without prior segmentation, of high-spatial resolution trabecular bone MR images of the proximal femur. Additionally, effects due to imprecise analysis volume alignment are investigated. Inherent heterogeneity in trabecular bone structure and imprecise positioning of the VOI along the slice (A/P) direction resulted in significant changes in bone parameters (p<0.01). Results suggest that automatic mutual information registration using nearest-neighbor gray-level interpolation to transform the final image ensures VOI alignment between baseline and follow-up images and does not compromise the integrity of MR-derived trabecular bone parameters.

  20. Estimation of dynamic time activity curves from dynamic cardiac SPECT imaging

    NASA Astrophysics Data System (ADS)

    Hossain, J.; Du, Y.; Links, J.; Rahmim, A.; Karakatsanis, N.; Akhbardeh, A.; Lyons, J.; Frey, E. C.

    2015-04-01

    Whole-heart coronary flow reserve (CFR) may be useful as an early predictor of cardiovascular disease or heart failure. Here we propose a simple method to extract the time-activity curve, an essential component needed for estimating the CFR, for a small number of compartments in the body, such as normal myocardium, blood pool, and ischemic myocardial regions, from SPECT data acquired with conventional cameras using slow rotation. We evaluated the method using a realistic simulation of 99mTc-teboroxime imaging. Uptake of 99mTc-teboroxime based on data from the literature were modeled. Data were simulated using the anatomically-realistic 3D NCAT phantom and an analytic projection code that realistically models attenuation, scatter, and the collimator-detector response. The proposed method was then applied to estimate time activity curves (TACs) for a set of 3D volumes of interest (VOIs) directly from the projections. We evaluated the accuracy and precision of estimated TACs and studied the effects of the presence of perfusion defects that were and were not modeled in the estimation procedure. The method produced good estimates of the myocardial and blood-pool TACS organ VOIs, with average weighted absolute biases of less than 5% for the myocardium and 10% for the blood pool when the true organ boundaries were known and the activity distributions in the organs were uniform. In the presence of unknown perfusion defects, the myocardial TAC was still estimated well (average weighted absolute bias <10%) when the total reduction in myocardial uptake (product of defect extent and severity) was ?5%. This indicates that the method was robust to modest model mismatch such as the presence of moderate perfusion defects and uptake nonuniformities. With larger defects where the defect VOI was included in the estimation procedure, the estimated normal myocardial and defect TACs were accurate (average weighted absolute bias ?5% for a defect with 25% extent and 100% severity).

  1. Risk constraint measures developed for the outcome-based strategy for tank waste management

    SciTech Connect

    Harper, B.L.; Gajewski, S.J.; Glantz, C.L.

    1996-09-01

    This report is one of a series of supporting documents for the outcome-based characterization strategy developed by PNNL. This report presents a set of proposed risk measures with risk constraint (acceptance) levels for use in the Value of Information process used in the NCS. The characterization strategy has developed a risk-based Value of Information (VOI) approach for comparing the cost-effectiveness of characterizing versus mitigating particular waste tanks or tank clusters. The preference between characterizing or mitigating in order to prevent an accident depends on the cost of those activities relative to the cost of the consequences of the accident. The consequences are defined as adverse impacts measured across a broad set of risk categories such as worker dose, public cancers, ecological harm, and sociocultural impacts. Within each risk measure, various {open_quotes}constraint levels{close_quotes} have been identified that reflect regulatory standards or conventionally negotiated thresholds of harm to Hanford resources and values. The cost of consequences includes the {open_quotes}costs{close_quote} of exceeding those constraint levels as well as a strictly linear costing per unit of impact within each of the risk measures. In actual application, VOI based-decision making is an iterative process, with a preliminary low-precision screen of potential technical options against the major risk constraints, followed by VOI analysis to determine the cost-effectiveness of gathering additional information and to select a preferred technical option, and finally a posterior screen to determine whether the preferred option meets all relevant risk constraints and acceptability criteria.

  2. Amyloid Burden in the Hippocampus and Default Mode Network

    PubMed Central

    Chang, Ya-Ting; Huang, Chi-Wei; Chang, Yen-Hsiang; Chen, Nai-Ching; Lin, Kun-Ju; Yan, Tzu-Chen; Chang, Wen-Neng; Chen, Sz-Fan; Lui, Chun-Chung; Lin, Pin-Hsuan; Chang, Chiung-Chih

    2015-01-01

    Abstract Amyloid load, as measured by florbetapir positron emission tomography (PET) standardized uptake value ratio (SUVr), has high specificity in the diagnosis of Alzheimer disease (AD). As the posterior cingulate cortex (PCC) represents densely amyloid-affected regions early in AD, we hypothesized that amyloid load within the key hubs of the default mode networks (DMN) may result in local or distant interconnected gray matter (GM) volume atrophy, thereby affecting cognitive performance. Thirty AD patients with a clinical dementia rating sum of box score ?2 were enrolled and underwent cognitive evaluation, 3-dimensional T1-weighted imaging and florbetapir PET. Volumes of interest (VOIs) included the hippocampus, lateral temporal region, and key hubs of the DMN [anterior cingulate cortex (ACC), PCC, posterior parietal, and precuneus]. The SUVr was calculated by florbetapir standard uptake value (SUV) within the T1-weighted image segmented GM VOIs divided by the cerebellar GM SUV. Our results suggested inverse correlations between ACC (??=??0.444, P?=?0.016) and PCC SUVr (??=??0.443, P?=?0.016) with PCC GM volume. In stepwise regression, the orientation scores were associated with PCC SUVr (??=?2.584, P?=?0.02) and posterior parietal volume (??=??0.446, P?=?0.04), whereas the word recall score was related to hippocampal volume (??=??0.391, P?=?0.04). After removing the patients with a hippocampal VOI below the lowest tertile and adjusting for age, an inverse correlation was found between hippocampal volume and SUVr in the ACC (partial ??=??0.639, P?=?0.002), precuneus (partial ??=??0.692, P?=?0.002), and lateral temporal SUVr (partial ??=??0.604, P?=?0.005). Our results suggest that amyloid burden within the key DMN regions may contribute to local and distant GM atrophy, and that this may explain the cognitive scores. PMID:25906109

  3. Fuzzy hidden Markov chains segmentation for volume determination and quantitation in PET

    NASA Astrophysics Data System (ADS)

    Hatt, M.; Lamare, F.; Boussion, N.; Turzo, A.; Collet, C.; Salzenstein, F.; Roux, C.; Jarritt, P.; Carson, K.; Cheze-LeRest, C.; Visvikis, D.

    2007-07-01

    Accurate volume of interest (VOI) estimation in PET is crucial in different oncology applications such as response to therapy evaluation and radiotherapy treatment planning. The objective of our study was to evaluate the performance of the proposed algorithm for automatic lesion volume delineation; namely the fuzzy hidden Markov chains (FHMC), with that of current state of the art in clinical practice threshold based techniques. As the classical hidden Markov chain (HMC) algorithm, FHMC takes into account noise, voxel intensity and spatial correlation, in order to classify a voxel as background or functional VOI. However the novelty of the fuzzy model consists of the inclusion of an estimation of imprecision, which should subsequently lead to a better modelling of the 'fuzzy' nature of the object of interest boundaries in emission tomography data. The performance of the algorithms has been assessed on both simulated and acquired datasets of the IEC phantom, covering a large range of spherical lesion sizes (from 10 to 37 mm), contrast ratios (4:1 and 8:1) and image noise levels. Both lesion activity recovery and VOI determination tasks were assessed in reconstructed images using two different voxel sizes (8 mm3 and 64 mm3). In order to account for both the functional volume location and its size, the concept of % classification errors was introduced in the evaluation of volume segmentation using the simulated datasets. Results reveal that FHMC performs substantially better than the threshold based methodology for functional volume determination or activity concentration recovery considering a contrast ratio of 4:1 and lesion sizes of <28 mm. Furthermore differences between classification and volume estimation errors evaluated were smaller for the segmented volumes provided by the FHMC algorithm. Finally, the performance of the automatic algorithms was less susceptible to image noise levels in comparison to the threshold based techniques. The analysis of both simulated and acquired datasets led to similar results and conclusions as far as the performance of segmentation algorithms under evaluation is concerned.

  4. Measuring the Value of Earth Observation Information with the Gravity Research and Climate Experiment (GRACE) Satellite

    NASA Astrophysics Data System (ADS)

    Bernknopf, R.; Kuwayama, Y.; Brookshire, D.; Macauley, M.; Zaitchik, B.; Pesko, S.; Vail, P.

    2014-12-01

    Determining how much to invest in earth observation technology depends in part on the value of information (VOI) that can be derived from the observations. We design a framework and then evaluate the value-in-use of the NASA Gravity Research and Climate Experiment (GRACE) for regional water use and reliability in the presence of drought. As a technology that allows measurement of water storage, the GRACE Data Assimilation System (DAS) provides information that is qualitatively different from that generated by other water data sources. It provides a global, reproducible grid of changes in surface and subsurface water resources on a frequent and regular basis. Major damages from recent events such as the 2012 Midwest drought and the ongoing drought in California motivate the need to understand the VOI from remotely sensed data such as that derived from GRACE DAS. Our conceptual framework models a dynamic risk management problem in agriculture. We base the framework on information from stakeholders and subject experts. The economic case for GRACE DAS involves providing better water availability information. In the model, individuals have a "willingness to pay" (wtp) for GRACE DAS - essentially, wtp is an expression of savings in reduced agricultural input costs and for costs that are influenced by regional policy decisions. Our hypothesis is that improvements in decision making can be achieved with GRACE DAS measurements of water storage relative to data collected from groundwater monitoring wells and soil moisture monitors that would be relied on in the absence of GRACE DAS. The VOI is estimated as a comparison of outcomes. The California wine grape industry has features that allow it to be a good case study and a basis for extrapolation to other economic sectors. We model water use in this sector as a sequential decision highlighting the attributes of GRACE DAS input as information for within-season production decisions as well as for longer-term water reliability.

  5. The influence of tumor oxygenation on 18F-FDG (Fluorine-18 Deoxyglucose) uptake: A mouse study using positron emission tomography (PET)

    PubMed Central

    Chan, Linda W; Hapdey, Sebastien; English, Sean; Seidel, Jurgen; Carson, Joann; Sowers, Anastasia L; Krishna, Murali C; Green, Michael V; Mitchell, James B; Bacharach, Stephen L

    2006-01-01

    Background This study investigated whether changing a tumor's oxygenation would alter tumor metabolism, and thus uptake of 18F-FDG (fluorine-18 deoxyglucose), a marker for glucose metabolism using positron emission tomography (PET). Results Tumor-bearing mice (squamous cell carcinoma) maintained at 37°C were studied while breathing either normal air or carbogen (95% O2, 5% CO2), known to significantly oxygenate tumors. Tumor activity was measured within an automatically determined volume of interest (VOI). Activity was corrected for the arterial input function as estimated from image and blood-derived data. Tumor FDG uptake was initially evaluated for tumor-bearing animals breathing only air (2 animals) or only carbogen (2 animals). Subsequently, 5 animals were studied using two sequential 18F-FDG injections administered to the same tumor-bearing mouse, 60 min apart; the first injection on one gas (air or carbogen) and the second on the other gas. When examining the entire tumor VOI, there was no significant difference of 18F-FDG uptake between mice breathing either air or carbogen (i.e. air/carbogen ratio near unity). However, when only the highest 18F-FDG uptake regions of the tumor were considered (small VOIs), there was a modest (21%), but significant increase in the air/carbogen ratio suggesting that in these potentially most hypoxic regions of the tumor, 18F-FDG uptake and hence glucose metabolism, may be reduced by increasing tumor oxygenation. Conclusion Tumor 18F-FDG uptake may be reduced by increases in tumor oxygenation and thus may provide a means to further enhance 18F-FDG functional imaging. PMID:16722588

  6. A global-scale map of isoprene and volatile organic iodine in surface seawater of the Arctic, Northwest Pacific, Indian, and Southern Oceans

    NASA Astrophysics Data System (ADS)

    Ooki, Atsushi; Nomura, Daiki; Nishino, Shigeto; Kikuchi, Takashi; Yokouchi, Yoko

    2015-06-01

    Isoprene (C5H8) and three volatile organic iodine compounds (VOIs: CH3I, C2H5I, and CH2ClI) in surface seawater were measured in the western Arctic, Northwest Pacific, Indian, and Southern Oceans during the period 2008-2012. These compounds are believed to play an important role in the marine atmospheric chemistry after their emission. The measurements were performed with high time-resolution (1-6 h intervals) using an online equilibrator gas chromatography mass spectrometer. C5H8 was most abundant in high-productivity transitional waters and eutrophic tropical waters. The chlorophyll-a normalized production rates of C5H8 were high in the warm subtropical and tropical waters, suggesting the existence of a high emitter of C5H8 in the biological community of the warm waters. High concentrations of the three VOIs in highly productive transitional water were attributed to biological productions. For CH3I, the highest concentrations were widely distributed in the basin area of the oligotrophic subtropical NW Pacific, probably due to photochemical production and/or high emission rates from phytoplankton. In contrast, the lowest concentrations of C2H5I in subtropical waters were attributed to photochemical removal. Enhancement of CH2ClI concentrations in the shelf-slope areas of the Chukchi Sea and the transitional waters of the NW Pacific in winter suggested that vertical mixing with subsurface waters by regional upwelling or winter cooling acts to increase the CH2ClI concentrations in surface layer. Sea-air flux calculations revealed that the fluxes of CH2ClI were the highest among the three VOIs in shelf-slope areas; the CH3I flux was highest in basin areas.

  7. Differences in Brainstem Fiber Tract Response to Radiation: A Longitudinal Diffusion Tensor Imaging Study

    SciTech Connect

    Uh, Jinsoo; Merchant, Thomas E.; Li, Yimei; Feng, Tianshu; Gajjar, Amar; Ogg, Robert J.; Hua, Chiaho

    2013-06-01

    Purpose: To determine whether radiation-induced changes in white matter tracts are uniform across the brainstem. Methods and Materials: We analyzed serial diffusion tensor imaging data, acquired before radiation therapy and over 48 to 72 months of follow-up, from 42 pediatric patients (age 6-20 years) with medulloblastoma. FSL software (FMRIB, Oxford, UK) was used to calculate fractional anisotropy (FA) and axial, radial, and mean diffusivities. For a consistent identification of volumes of interest (VOIs), the parametric maps of each patient were transformed to a standard brain space (MNI152), on which we identified VOIs including corticospinal tract (CST), medial lemniscus (ML), transverse pontine fiber (TPF), and middle cerebellar peduncle (MCP) at the level of pons. Temporal changes of DTI parameters in VOIs were compared using a linear mixed effect model. Results: Radiation-induced white matter injury was marked by a decline in FA after treatment. The decline was often accompanied by decreased axial diffusivity, increased radial diffusivity, or both. This implied axonal damage and demyelination. We observed that the magnitude of the changes was not always uniform across substructures of the brainstem. Specifically, the changes in DTI parameters for TPF were more pronounced than in other regions (P<.001 for FA) despite similarities in the distribution of dose. We did not find a significant difference among CST, ML, and MCP in these patients (P>.093 for all parameters). Conclusions: Changes in the structural integrity of white matter tracts, assessed by DTI, were not uniform across the brainstem after radiation therapy. These results support a role for tract-based assessment in radiation treatment planning and determination of brainstem tolerance.

  8. Experimental realization of fluence field modulated CT using digital beam attenuation

    PubMed Central

    Szczykutowicz, TP; Mistretta, CA

    2014-01-01

    Purpose Tailoring CT scan acquisition parameters to individual patients is a topic of much research in the CT imaging community. It is now common place to find automatically adjusted tube current options for modern CT scanners. In addition, the use of beam shaping filters, commonly called bowtie filters, is available on most CT systems and allows for different body regions to receive different incident x-ray fluence distributions. However, no method currently exists which allows for the form of the incident x-ray fluence distribution to change as a function of view angle. This study represents the first experimental realization of fluence field modulated CT (FFMCT) for a c-arm geometry CT scan. Methods: X-ray fluence modulation is accomplished using a digital beam attenuator (DBA). The device is composed of 10 iron wedge pairs that modulate the thickness of iron x-rays must traverse before reaching a patient. Using this device, experimental data was taken using a Siemens Zeego c-arm scanner. Scans were performed on a cylindrical polyethylene phantom and on two different sections of an anthropomorphic phantom. The DBA was used to equalize the x-ray fluence striking the detector for each scan. Non DBA, or “flat field” scans were also acquired of the same phantom objects for comparison. In addition, a scan was performed in which the DBA was used to enable volume of interest (VOI) imaging. In VOI, only a small sub-volume within a patient receives full dose and the rest of the patient receives a much lower dose. Data corrections unique to using a piece-wise constant modulator were also developed. Results The feasibility of FFMCT implemented using a DBA device has been demonstrated. Initial results suggest dose reductions of up to 3.6 times relative to “flat field” CT. In addition to dose reduction, the DBA enables a large improvement in image noise uniformity and the ability to provide regionally enhanced signal to noise using VOI imaging techniques. Conclusions The results presented in this paper take the field of FFMCT from the theoretical stage to that of possible clinical implementation. FFMCT, as shown in this paper, can reduce patient dose while maintaining or improving image quality. In addition, the DBA has been experimentally shown to be well suited to implement entirely new imaging methods like photon counting and VOI imaging. PMID:24556823

  9. Segmentation of pulmonary nodules in three-dimensional CT images by use of a spiral-scanning technique

    SciTech Connect

    Wang Jiahui; Engelmann, Roger; Li Qiang

    2007-12-15

    Accurate segmentation of pulmonary nodules in computed tomography (CT) is an important and difficult task for computer-aided diagnosis of lung cancer. Therefore, the authors developed a novel automated method for accurate segmentation of nodules in three-dimensional (3D) CT. First, a volume of interest (VOI) was determined at the location of a nodule. To simplify nodule segmentation, the 3D VOI was transformed into a two-dimensional (2D) image by use of a key 'spiral-scanning' technique, in which a number of radial lines originating from the center of the VOI spirally scanned the VOI from the 'north pole' to the 'south pole'. The voxels scanned by the radial lines provided a transformed 2D image. Because the surface of a nodule in the 3D image became a curve in the transformed 2D image, the spiral-scanning technique considerably simplified the segmentation method and enabled reliable segmentation results to be obtained. A dynamic programming technique was employed to delineate the 'optimal' outline of a nodule in the 2D image, which corresponded to the surface of the nodule in the 3D image. The optimal outline was then transformed back into 3D image space to provide the surface of the nodule. An overlap between nodule regions provided by computer and by the radiologists was employed as a performance metric for evaluating the segmentation method. The database included two Lung Imaging Database Consortium (LIDC) data sets that contained 23 and 86 CT scans, respectively, with 23 and 73 nodules that were 3 mm or larger in diameter. For the two data sets, six and four radiologists manually delineated the outlines of the nodules as reference standards in a performance evaluation for nodule segmentation. The segmentation method was trained on the first and was tested on the second LIDC data sets. The mean overlap values were 66% and 64% for the nodules in the first and second LIDC data sets, respectively, which represented a higher performance level than those of two existing segmentation methods that were also evaluated by use of the LIDC data sets. The segmentation method provided relatively reliable results for pulmonary nodule segmentation and would be useful for lung cancer quantification, detection, and diagnosis.

  10. Experimental realization of fluence field modulated CT using digital beam attenuation.

    PubMed

    Szczykutowicz, T P; Mistretta, C A

    2014-03-01

    Tailoring CT scan acquisition parameters to individual patients is a topic of much research in the CT imaging community. It is now common place to find automatically adjusted tube current options for modern CT scanners. In addition, the use of beam shaping filters, commonly called bowtie filters, is available on most CT systems and allows for different body regions to receive different incident x-ray fluence distributions. However, no method currently exists which allows for the form of the incident x-ray fluence distribution to change as a function of the view angle. This study represents the first experimental realization of fluence field modulated CT (FFMCT) for a c-arm geometry CT scan. X-ray fluence modulation is accomplished using a digital beam attenuator (DBA). The device is composed of ten iron wedge pairs that modulate the thickness of iron, the x-rays must traverse before reaching a patient. Using this device, experimental data was taken using a Siemens Zeego c-arm scanner. Scans were performed on a cylindrical polyethylene phantom and on two different sections of an anthropomorphic phantom. The DBA was used to equalize the x-ray fluence striking the detector for each scan. Non DBA, or 'flat field' scans were also acquired of the same phantom objects for comparison. In addition, a scan was performed in which the DBA was used to enable volume of interest (VOI) imaging. In VOI, only a small sub-volume within a patient receives full dose and the rest of the patient receives a much lower dose. Data corrections unique to using a piece-wise constant modulator were also developed. The feasibility of FFMCT implemented using a DBA device has been demonstrated. Initial results suggest dose reductions of up to 3.6 times relative to 'flat field' CT. In addition to dose reduction, the DBA enables a large improvement in image noise uniformity and the ability to provide regionally enhanced signal to noise using VOI imaging techniques. The results presented in this paper take the field of FFMCT from the theoretical stage to that of possible clinical implementation. FFMCT, as shown in this paper, can reduce the patient dose while maintaining or improving image quality. In addition, the DBA has been experimentally shown to be well suited to implement entirely new imaging methods like photon counting and VOI imaging. PMID:24556823

  11. Experimental realization of fluence field modulated CT using digital beam attenuation

    NASA Astrophysics Data System (ADS)

    Szczykutowicz, T. P.; Mistretta, C. A.

    2014-03-01

    Tailoring CT scan acquisition parameters to individual patients is a topic of much research in the CT imaging community. It is now common place to find automatically adjusted tube current options for modern CT scanners. In addition, the use of beam shaping filters, commonly called bowtie filters, is available on most CT systems and allows for different body regions to receive different incident x-ray fluence distributions. However, no method currently exists which allows for the form of the incident x-ray fluence distribution to change as a function of the view angle. This study represents the first experimental realization of fluence field modulated CT (FFMCT) for a c-arm geometry CT scan. X-ray fluence modulation is accomplished using a digital beam attenuator (DBA). The device is composed of ten iron wedge pairs that modulate the thickness of iron, the x-rays must traverse before reaching a patient. Using this device, experimental data was taken using a Siemens Zeego c-arm scanner. Scans were performed on a cylindrical polyethylene phantom and on two different sections of an anthropomorphic phantom. The DBA was used to equalize the x-ray fluence striking the detector for each scan. Non DBA, or ‘flat field’ scans were also acquired of the same phantom objects for comparison. In addition, a scan was performed in which the DBA was used to enable volume of interest (VOI) imaging. In VOI, only a small sub-volume within a patient receives full dose and the rest of the patient receives a much lower dose. Data corrections unique to using a piece-wise constant modulator were also developed. The feasibility of FFMCT implemented using a DBA device has been demonstrated. Initial results suggest dose reductions of up to 3.6 times relative to ‘flat field’ CT. In addition to dose reduction, the DBA enables a large improvement in image noise uniformity and the ability to provide regionally enhanced signal to noise using VOI imaging techniques. The results presented in this paper take the field of FFMCT from the theoretical stage to that of possible clinical implementation. FFMCT, as shown in this paper, can reduce the patient dose while maintaining or improving image quality. In addition, the DBA has been experimentally shown to be well suited to implement entirely new imaging methods like photon counting and VOI imaging.

  12. Effect of Volume-of-Interest Misregistration on Quantitative Planar Activity and Dose Estimation

    PubMed Central

    Song, N.; He, B.; Frey, E. C.

    2010-01-01

    In targeted radionuclide therapy (TRT), dose estimation is essential for treatment planning and tumor dose response studies. Dose estimates are typically based on a time series of whole body conjugate view planar or SPECT scans of the patient acquired after administration of a planning dose. Quantifying the activity in the organs from these studies is an essential part of dose estimation. The Quantitative Planar (QPlanar) processing method involves accurate compensation for image degrading factors and correction for organ and background overlap via the combination of computational models of the image formation process and 3D volumes of interest defining the organs to be quantified. When the organ VOIs are accurately defined, the method intrinsically compensates for attenuation, scatter, and partial volume effects, as well as overlap with other organs and the background. However, alignment between the 3D organ volume of interest (VOIs) used in QPlanar processing and the true organ projections in the planar images is required. The goal of this research was to study the effects of VOI misregistration on the accuracy and precision of organ activity estimates obtained using the QPlanar method. In this work, we modeled the degree of residual misregistration that would be expected after an automated registration procedure by randomly misaligning 3D SPECT/CT images, from which the VOI information was derived, and planar images. Mutual information based image registration was used to align the realistic simulated 3D SPECT images with the 2D planar images. The residual image misregistration was used to simulate realistic levels of misregistration and allow investigation of the effects of misregistration on the accuracy and precision of the QPlanar method. We observed that accurate registration is especially important for small organs or ones with low activity concentrations compared to neighboring organs. In addition, residual misregistration gave rise to a loss of precision in the activity estimates that was on the order of the loss of precision due to Poisson noise in the projection data. These results serve as a lower bound on the effects of misregistration on the accuracy and precision of QPlanar activity estimate and demonstrate that misregistration errors must be taken into account when assessing the overall precision of organ dose estimates. PMID:20798459

  13. Tracking tumor boundary in MV-EPID images without implanted markers: A feasibility study

    SciTech Connect

    Zhang, Xiaoyong Homma, Noriyasu; Ichiji, Kei; Takai, Yoshihiro; Yoshizawa, Makoto

    2015-05-15

    Purpose: To develop a markerless tracking algorithm to track the tumor boundary in megavoltage (MV)-electronic portal imaging device (EPID) images for image-guided radiation therapy. Methods: A level set method (LSM)-based algorithm is developed to track tumor boundary in EPID image sequences. Given an EPID image sequence, an initial curve is manually specified in the first frame. Driven by a region-scalable energy fitting function, the initial curve automatically evolves toward the tumor boundary and stops on the desired boundary while the energy function reaches its minimum. For the subsequent frames, the tracking algorithm updates the initial curve by using the tracking result in the previous frame and reuses the LSM to detect the tumor boundary in the subsequent frame so that the tracking processing can be continued without user intervention. The tracking algorithm is tested on three image datasets, including a 4-D phantom EPID image sequence, four digitally deformable phantom image sequences with different noise levels, and four clinical EPID image sequences acquired in lung cancer treatment. The tracking accuracy is evaluated based on two metrics: centroid localization error (CLE) and volume overlap index (VOI) between the tracking result and the ground truth. Results: For the 4-D phantom image sequence, the CLE is 0.23 ± 0.20 mm, and VOI is 95.6% ± 0.2%. For the digital phantom image sequences, the total CLE and VOI are 0.11 ± 0.08 mm and 96.7% ± 0.7%, respectively. In addition, for the clinical EPID image sequences, the proposed algorithm achieves 0.32 ± 0.77 mm in the CLE and 72.1% ± 5.5% in the VOI. These results demonstrate the effectiveness of the authors’ proposed method both in tumor localization and boundary tracking in EPID images. In addition, compared with two existing tracking algorithms, the proposed method achieves a higher accuracy in tumor localization. Conclusions: In this paper, the authors presented a feasibility study of tracking tumor boundary in EPID images by using a LSM-based algorithm. Experimental results conducted on phantom and clinical EPID images demonstrated the effectiveness of the tracking algorithm for visible tumor target. Compared with previous tracking methods, the authors’ algorithm has the potential to improve the tracking accuracy in radiation therapy. In addition, real-time tumor boundary information within the irradiation field will be potentially useful for further applications, such as adaptive beam delivery, dose evaluation.

  14. Segmentation of pulmonary nodules in three-dimensional CT images by use of a spiral-scanning technique.

    PubMed

    Wang, Jiahui; Engelmann, Roger; Li, Qiang

    2007-12-01

    Accurate segmentation of pulmonary nodules in computed tomography (CT) is an important and difficult task for computer-aided diagnosis of lung cancer. Therefore, the authors developed a novel automated method for accurate segmentation of nodules in three-dimensional (3D) CT. First, a volume of interest (VOI) was determined at the location of a nodule. To simplify nodule segmentation, the 3D VOI was transformed into a two-dimensional (2D) image by use of a key "spiral-scanning" technique, in which a number of radial lines originating from the center of the VOI spirally scanned the VOI from the "north pole" to the "south pole." The voxels scanned by the radial lines provided a transformed 2D image. Because the surface of a nodule in the 3D image became a curve in the transformed 2D image, the spiral-scanning technique considerably simplified the segmentation method and enabled reliable segmentation results to be obtained. A dynamic programming technique was employed to delineate the "optimal" outline of a nodule in the 2D image, which corresponded to the surface of the nodule in the 3D image. The optimal outline was then transformed back into 3D image space to provide the surface of the nodule. An overlap between nodule regions provided by computer and by the radiologists was employed as a performance metric for evaluating the segmentation method. The database included two Lung Imaging Database Consortium (LIDC) data sets that contained 23 and 86 CT scans, respectively, with 23 and 73 nodules that were 3 mm or larger in diameter. For the two data sets, six and four radiologists manually delineated the outlines of the nodules as reference standards in a performance evaluation for nodule segmentation. The segmentation method was trained on the first and was tested on the second LIDC data sets. The mean overlap values were 66% and 64% for the nodules in the first and second LIDC data sets, respectively, which represented a higher performance level than those of two existing segmentation methods that were also evaluated by use of the LIDC data sets. The segmentation method provided relatively reliable results for pulmonary nodule segmentation and would be useful for lung cancer quantification, detection, and diagnosis. PMID:18196795

  15. Improved quantification for local regions of interest in preclinical PET imaging

    NASA Astrophysics Data System (ADS)

    Cal-González, J.; Moore, S. C.; Park, M.-A.; Herraiz, J. L.; Vaquero, J. J.; Desco, M.; Udias, J. M.

    2015-09-01

    In Positron Emission Tomography, there are several causes of quantitative inaccuracy, such as partial volume or spillover effects. The impact of these effects is greater when using radionuclides that have a large positron range, e.g. 68Ga and 124I, which have been increasingly used in the clinic. We have implemented and evaluated a local projection algorithm (LPA), originally evaluated for SPECT, to compensate for both partial-volume and spillover effects in PET. This method is based on the use of a high-resolution CT or MR image, co-registered with a PET image, which permits a high-resolution segmentation of a few tissues within a volume of interest (VOI) centered on a region within which tissue-activity values need to be estimated. The additional boundary information is used to obtain improved activity estimates for each tissue within the VOI, by solving a simple inversion problem. We implemented this algorithm for the preclinical Argus PET/CT scanner and assessed its performance using the radionuclides 18F, 68Ga and 124I. We also evaluated and compared the results obtained when it was applied during the iterative reconstruction, as well as after the reconstruction as a postprocessing procedure. In addition, we studied how LPA can help to reduce the ‘spillover contamination’, which causes inaccurate quantification of lesions in the immediate neighborhood of large, ‘hot’ sources. Quantification was significantly improved by using LPA, which provided more accurate ratios of lesion-to-background activity concentration for hot and cold regions. For 18F, the contrast was improved from 3.0 to 4.0 in hot lesions (when the true ratio was 4.0) and from 0.16 to 0.06 in cold lesions (true ratio  =  0.0), when using the LPA postprocessing. Furthermore, activity values estimated within the VOI using LPA during reconstruction were slightly more accurate than those obtained by post-processing, while also visually improving the image contrast and uniformity within the VOI.

  16. Automated volume of interest delineation and rendering of cone beam CT images in interventional cardiology

    NASA Astrophysics Data System (ADS)

    Lorenz, Cristian; Schäfer, Dirk; Eshuis, Peter; Carroll, John; Grass, Michael

    2012-02-01

    Interventional C-arm systems allow the efficient acquisition of 3D cone beam CT images. They can be used for intervention planning, navigation, and outcome assessment. We present a fast and completely automated volume of interest (VOI) delineation for cardiac interventions, covering the whole visceral cavity including mediastinum and lungs but leaving out rib-cage and spine. The problem is addressed in a model based approach. The procedure has been evaluated on 22 patient cases and achieves an average surface error below 2mm. The method is able to cope with varying image intensities, varying truncations due to the limited reconstruction volume, and partially with heavy metal and motion artifacts.

  17. Evaluation of ROI methods for quantitative FDOPA PET images

    SciTech Connect

    Yu, D.C.; Lin, K.P.; Yang, J.; Huang, S.C.

    1995-12-31

    Issues about the accuracy of region of interest (ROI) definition methods for FDOPA PET studies were investigated. An MRI-based ROI method and manually defined ROI method were compared using a computer simulated brain phantom and four real PET studies. The results indicate the error or discrepancy between MRI-based ROI and manually defined ROI is small ({le} 5%) at different head orientations and different noise levels. The VOI is not sensitive to the orientation, but the mid-plane ROI is also fairly reliable.

  18. ESA's Venus Express to reach final destination

    NASA Astrophysics Data System (ADS)

    2006-04-01

    First step: catching Venus To begin to explore our Earth’s hot and hazy sister planet, Venus Express must complete a critical first step, the most challenging one following launch. This involves a set of complex operations and manoeuvres that will inject the spacecraft into orbit. The Venus Orbit Insertion (VOI) manoeuvre allows the spacecraft to reduce its speed relative to Venus, so that it can be captured by the planet’s gravitation. The manoeuvre is a critical one which must proceed at precisely the right place and time. The VOI phase officially started on 4 April and will not be completed until 13 April. It is split into three main sub-phases. The first consists in preparing or initialising the spacecraft for the actual capture manoeuvre so as to avoid the risk of the spacecraft going into safe mode, should parameters unrelated to VOI go off-range. The capture manoeuvre itself consists of a main-engine burn lasting about 50 minutes on the morning of 11 April starting at 09:17 (Central European Summer Time). This is the second main VOI sub-phase. The final sub-phase will be restoring all spacecraft functions, notably resuming communications with Earth and uplinking the commands to be executed during the preliminary ‘capture’ orbit. Orbital capture is controlled by an automatic sequence of predefined commands, uploaded to the spacecraft four days prior to VOI. This sequence is the minimum set needed to perform the main-engine burn. All spacecraft operations are controlled and commanded by the ground control team located at ESA’s European Spacecraft Operations Centre (ESOC) in Darmstadt, Germany. Timeeline of major VOI events (some times subject to change) 4 Aprilacecraft transmitter connected to low gain antenna is switched on. During its interplanetary cruise and during the scientific part of the mission to come, Venus Express communicates with Earth by means of its two high gain antennas. However, during the orbit capture phase (11 April), these two antennas become unusable because of the spacecraft’s required orientation at that time. The low gain antenna, carrying a feeble but instantly recognisable signal, will be transmitting throughout all VOI manoeuvres. This will allow ground controllers to monitor the velocity change during the burn, using NASA’s Deep Space Network’s 70-metre antenna near Madrid, Spain. No other means of communication with the Earth is possible during the capture burn. 5 and 9 April, targeting control manoeuvres. Two time slots are available to adjust course if needed. Given the high accuracy of the course correction performed end of March, Venus Express is currently on the right trajectory for a successful capture into orbit and it is therefore unlikely that either of these two extra slots will be required. 10 to 11 April, final preparations for VOI manoeuvre. 24 to 12 hours before VOI, spacecraft controllers will command Venus Express into its final configuration for the burn. Over the final 12 hours, they will monitor its status, ready to deal with any contingencies requiring last-minute trajectory correction or any revising of the main-engine burn duration. 11 April, 08:03 (CEST), ‘slew’ manoeuvre. This manoeuvre lasts about half an hour and rotates Venus Express so that the main engine faces the direction of motion. Thanks to this, the burn will slow down (rather than accelerate) the spacecraft. 11 April, 09:17 (CEST), main-engine burn starts. A few minutes after firing of the spacecraft thrusters to make sure the propellant settles in the feed lines to the main engine, the latter will begin its 50-minute long burn, ending at 10:07. This thrust will reduce the initial velocity of 29 000 kilometres per hour (in relation to Venus) by 15 percent, allowing capture. Venus Express will settle into its preliminary, elongated nine-day orbit. On capture, it will be at about 120 million kilometres from the Earth and, at its nearest point, within 400 km of the surface of Venus. During the burn, at 09:45 (CEST), Venus Express will disappear behind the planet and will not be visi

  19. Risk estimation and value-of-information analysis for three proposed genetic screening programs for chronic beryllium disease prevention

    SciTech Connect

    Bartell, S.M.; Ponce, R.A.; Takaro, T.K.; Zerbe, R.O.; Omenn, G.S.; Faustman, E.M.

    2000-02-01

    Genetic differences (polymorphisms) among members of a population are thought to influence susceptibility to various environmental exposures. In practice, however, this information is rarely incorporated into quantitative risk assessment and risk management. The authors describe an analytic framework for predicting the risk reduction and value-of-information (VOI) resulting from specific risk management applications of genetic biomarkers, and they apply the framework to the example of occupational chronic beryllium disease (CBD), an immune-mediated pulmonary granulomatous disease. One described Human Leukocyte Antigen gene variant, HLA-DP{beta}1*0201, contains a substitution of glutamate for lysine at position 69 that appears to have high sensitivity ({approximately}94%) but low specificity ({approximately}70%) with respect to CBD among individuals occupationally exposed to respirable beryllium. The expected postintervention CBD prevalence rates for using the genetic variant (1) as a required job placement screen, (2) as a medical screen for semiannual in place of annual lymphocyte proliferation testing, or (3) as a voluntary job placement screen are 0.08%, 0.8%, and 0.6%, respectively, in a hypothetical cohort with 1% baseline CBD prevalence. VOI analysis is used to examine the reduction in total social cost, calculated as the net value of disease reduction and financial expenditures, expected for proposed CBD intervention programs based on the genetic susceptibility test. For the example cohort the expected net VOI per beryllium worker for genetically based testing and intervention is $13,000, $1,800, and $5,100, respectively, based on a health valuation of $1.45 million per CBD case avoided. VOI results for alternative CBD valuations are also presented. Despite large parameter uncertainty, probabilistic analysis predicts generally positive utility for each of the three evaluated programs when avoidance of a CBD case is valued at $1 million or higher. Although the utility of a proposed risk management program may be evaluated solely in terms of risk reduction and financial costs, decisions about genetic testing and program implementation must also consider serious social, legal, and ethical factors.

  20. Pulmonary nodule registration in serial CT scans based on rib anatomy and nodule template matching

    SciTech Connect

    Shi Jiazheng; Sahiner, Berkman; Chan, H.-P.; Hadjiiski, Lubomir; Zhou, C.; Cascade, Philip N.; Bogot, Naama; Kazerooni, Ella A.; Wu, Y.-T.; Wei, J.

    2007-04-15

    An automated method is being developed in order to identify corresponding nodules in serial thoracic CT scans for interval change analysis. The method uses the rib centerlines as the reference for initial nodule registration. A spatially adaptive rib segmentation method first locates the regions where the ribs join the spine, which define the starting locations for rib tracking. Each rib is tracked and locally segmented by expectation-maximization. The ribs are automatically labeled, and the centerlines are estimated using skeletonization. For a given nodule in the source scan, the closest three ribs are identified. A three-dimensional (3D) rigid affine transformation guided by simplex optimization aligns the centerlines of each of the three rib pairs in the source and target CT volumes. Automatically defined control points along the centerlines of the three ribs in the source scan and the registered ribs in the target scan are used to guide an initial registration using a second 3D rigid affine transformation. A search volume of interest (VOI) is then located in the target scan. Nodule candidate locations within the search VOI are identified as regions with high Hessian responses. The initial registration is refined by searching for the maximum cross-correlation between the nodule template from the source scan and the candidate locations. The method was evaluated on 48 CT scans from 20 patients. Experienced radiologists identified 101 pairs of corresponding nodules. Three metrics were used for performance evaluation. The first metric was the Euclidean distance between the nodule centers identified by the radiologist and the computer registration, the second metric was a volume overlap measure between the nodule VOIs identified by the radiologist and the computer registration, and the third metric was the hit rate, which measures the fraction of nodules whose centroid computed by the computer registration in the target scan falls within the VOI identified by the radiologist. The average Euclidean distance error was 2.7{+-}3.3 mm. Only two pairs had an error larger than 10 mm. The average volume overlap measure was 0.71{+-}0.24. Eighty-three of the 101 pairs had ratios larger than 0.5, and only two pairs had no overlap. The final hit rate was 93/101.

  1. Digital tomosynthesis mammography: intra- and interplane artifact reduction for high-contrast objects on reconstructed slices using a priori 3D geometrical information

    NASA Astrophysics Data System (ADS)

    Ge, Jun; Chan, Heang-Ping; Sahiner, Berkman; Zhang, Yiheng; Wei, Jun; Hadjiiski, Lubomir M.; Zhou, Chuan

    2007-03-01

    We are developing a computerized technique to reduce intra- and interplane ghosting artifacts caused by high-contrast objects such as dense microcalcifications (MCs) or metal markers on the reconstructed slices of digital tomosynthesis mammography (DTM). In this study, we designed a constrained iterative artifact reduction method based on a priori 3D information of individual MCs. We first segmented individual MCs on projection views (PVs) using an automated MC detection system. The centroid and the contrast profile of the individual MCs in the 3D breast volume were estimated from the backprojection of the segmented individual MCs on high-resolution (0.1 mm isotropic voxel size) reconstructed DTM slices. An isolated volume of interest (VOI) containing one or a few MCs is then modeled as a high-contrast object embedded in a local homogeneous background. A shift-variant 3D impulse response matrix (IRM) of the projection-reconstruction (PR) system for the extracted VOI was calculated using the DTM geometry and the reconstruction algorithm. The PR system for this VOI is characterized by a system of linear equations. A constrained iterative method was used to solve these equations for the effective linear attenuation coefficients (eLACs) within the isolated VOI. Spatial constraint and positivity constraint were used in this method. Finally, the intra- and interplane artifacts on the whole breast volume resulting from the MC were calculated using the corresponding impulse responses and subsequently subtracted from the original reconstructed slices. The performance of our artifact-reduction method was evaluated using a computer-simulated MC phantom, as well as phantom images and patient DTMs obtained with IRB approval. A GE prototype DTM system that acquires 21 PVs in 3º increments over a +/-30º range was used for image acquisition in this study. For the computer-simulated MC phantom, the eLACs can be estimated accurately, thus the interplane artifacts were effectively removed. For MCs in phantom and patient DTMs, our method reduced the artifacts but also created small over-corrected areas in some cases. Potential reasons for this may include: the simplified mathematical modeling of the forward projection process, and the amplified noise in the solution of the system of linear equations.

  2. Creation of an atlas of filter positions for fluence field modulated CT

    SciTech Connect

    Szczykutowicz, Timothy P.; Hermus, James

    2015-04-15

    Purpose: Fluence field modulated CT (FFMCT) and volume of interest (VOI) CT imaging applications require adjustment of the profile of the x-ray fluence incident on a patient as a function of view angle. Since current FFMCT prototypes can theoretically take on an infinite number of configurations, measuring a calibration data set for all possible positions would not be feasible. The present work details a methodology for calculating an atlas of configurations that will span all likely body regions, patient sizes, patient positioning, and imaging modes. The hypothesis is that there exists a finite number of unique modulator configurations that effectively span the infinite number of possible fluence profiles with minimal loss in performance. Methods: CT images of a head, shoulder, thorax, abdominal, wrist, and leg anatomical slices were dilated and contracted to model small, medium, and large sized patients. Additionally, the images were positioned from iso-center by three different amounts. The modulator configurations required to compensate for each image were computed assuming a FFMCT prototype, digital beam attenuator, (DBA), was set to equalize the detector exposure. Each atlas configuration should be different from the other atlas configurations. The degree of difference was quantified using the sum of the absolute differences in filter thickness between configurations. Using this metric, a set of unique wedge configurations for which no two configurations have a metric value smaller than some threshold can be constructed. Differences in the total number of incident photons between the unconstrained filters and the atlas were studied as a function of the number of atlas positions for each anatomical site and size/off-centering combination. Results: By varying the threshold used in creating the atlas, it was found that roughly 322 atlas positions provided an incident number of photons within 20% of using 19 440 unique filters (the number of atlas entries ranged from 7213 to 1). Additionally, for VOI applications implemented with a single VOI region, the number of required filter configurations was expressed in a simple closed form solution. Conclusions: The methodology proposed in this work will enable DBA-FFMCT and DBA-VOI imaging in the clinic without the need for patient specific air-scans to be performed. In addition, the methodology proposed here is directly applicable to other modulator designs such as piecewise linear, TomoTherapy multi leaf collimators, 2D fluid arrays, and inverse geometry CT.

  3. Radiation therapy for head and neck cancers in the elderly.

    PubMed

    Lusinchi, A; Bourhis, J; Wibault, P; Le Ridant, A M; Eschwege, F

    1990-04-01

    Three hundred and thirty-one patients, aged more than 70 years, were treated for an upper aerodigestive tract carcinoma from 1978 to 1983. Larynx accounted for 28% of the primary sites, oropharynx for 27%, and the oral cavity for 16%. One-third of these patients had a contraindication to anesthesia. The treatment was consistent with our protocols in only half of the cases. Fifty-nine patients underwent a radiosurgical combination; 249 underwent an exclusive irradiation with a curative intent. Fifty-four patients underwent a palliative irradiation, which lead up to a "curative dose" in half of the cases. The immediate and long-term tolerance of the irradiation was good. The local control was 71% for patients treated with a curative intent and 19% for the palliatively irradiated patients. Five-year survival of the population was 33%. No significant relationship between age, general status, and the carcinologic outcome could be observed. PMID:2323971

  4. [Detection strategies and risk factors in oral cancers].

    PubMed

    Scutariu, Mihaela-Monica; Voroneanu, Maria; Ursache, Maria

    2007-01-01

    Current methods used by health providers in early detection of oral cancers have some shortcomings, this is why, besides the clinical examination that combines the study of the head and neck, oral cavity, and the evaluation of general health status, now are available new ones, like intra oral camera, digital imaging, and computerized expert systems which offer new opportunities for clinically significant data collection, analysis, storing and use. Oral cancers are part of the upper aero-digestive cancers therefore they share the same epidemiologic features and risk factors. Main risk factors are tobacco and alcohol consumption. In the last decades, compared to men, women are increasingly exposed to these risk factors. Oral diagnostic specialties can offer a pro-active influence in the research of oral cancers and both professional and oral research associations can participate in establishing new strategies in oral cancers early detection. PMID:17595871

  5. Hypoxia Imaging Endoscopy Equipped with Laser Light Source from Preclinical Live Animal Study to First-In-Human Subject Research

    PubMed Central

    Kaneko, Kazuhiro; Yamaguchi, Hiroshi; Saito, Takaaki; Yano, Tomonori; Oono, Yasuhiro; Ikematsu, Hiroaki; Nomura, Shogo; Sato, Akihiro; Kojima, Motohiro; Esumi, Hiroyasu; Ochiai, Atsushi

    2014-01-01

    A goal in next-generation endoscopy is to develop functional imaging techniques to open up new opportunities for cancer diagnosis. Although spatial and temporal information on hypoxia is crucial for understanding cancer physiology and expected to be useful for cancer diagnosis, existing techniques using fluorescent indicators have limitations due to low spatial resolution and invasive administration. To overcome these problems, we developed an imaging technology based on hemoglobin oxygen saturation in both the tumor and surrounding mucosa using a laser endoscope system, and conducted the first human subject research for patients with aero-digestive tract cancer. The oxygen saturation map overlapped the images of cancerous lesions and indicated highly heterogeneous features of oxygen supply in the tumor. The hypoxic region of the tumor surface was found in both early cancer and cancer precursors. This technology illustrates a novel aspect of cancer biology as a potential biomarker and can be widely utilized in cancer diagnosis. PMID:24915532

  6. Young adults with head and neck cancer express increased susceptibility to mutagen-induced chromosome damage

    SciTech Connect

    Schantz, S.P.; Hsu, T.C.; Ainslie, N.; Moser, R.P. )

    1989-12-15

    Factors that contribute to an increased prevalence of squamous cell carcinoma of the upper aerodigestive tract among young adults in the United States remain unknown. A potential etiologic factor may relate to a genetically controlled sensitivity to environmental carcinogens. This study, therefore, examined 20 young adult patients who had squamous cell carcinoma for mutagen-induced chromosome sensitivity. Lymphocytes from respective patients were cultured, exposed to the clastogen bleomycin, arrested during metaphase, and examined quantitatively for chromosome breakage. The young adult population with squamous cell carcinoma expressed a significantly increased number of bleomycin-induced chromosome breaks per cell. Furthermore, among the study patients, chromosome sensitivity was most apparent in the non-tobacco users and in patients less than 30 years of age. The expression of such chromosome fragility following mutagen exposure should be considered in epidemiologic studies that intend to define risk factors for development of head and neck cancer.

  7. Genetic progression model for head and neck cancer: implications for field cancerization.

    PubMed

    Califano, J; van der Riet, P; Westra, W; Nawroz, H; Clayman, G; Piantadosi, S; Corio, R; Lee, D; Greenberg, B; Koch, W; Sidransky, D

    1996-06-01

    A genetic progression model of head and neck squamous cell carcinoma has not yet been elucidated, and the genetic basis for "field cancerization" of the aerodigestive tract has also remained obscure. Eighty-seven lesions of the head and neck, including preinvasive lesions and benign lesions associated with carcinogen exposure, were tested using microsatellite analysis for allelic loss at 10 major chromosomal loci which have been defined previously. The spectrum of chromosomal loss progressively increased at each histopathological step from benign hyperplasia to dysplasia to carcinoma in situ to invasive cancer. Adjacent areas of tissue with different histopathological appearance shared common genetic changes, but the more histopathologically advanced areas exhibited additional genetic alterations. Abnormal mucosal cells surrounding preinvasive and microinvasive lesions shared common genetic alterations with those lesions and thus appear to arise from a single progenitor clone. Based on these findings, the local clinical phenomenon of field cancerization seems to involve the expansion and migration of clonally related preneoplastic cells. PMID:8653682

  8. Lingual tonsillectomy for refractory paroxysmal cough.

    PubMed

    Lewis, M; McClay, J E; Schochet, P

    2000-06-01

    Historically, the lingual tonsils are the most neglected members of Waldeyer's ring. They are often overlooked even in a thorough head and neck exam because of their anatomic location and the ambiguous constellation of symptoms which they produce when they are diseased or enlarged. The lingual tonsils have been reported to be associated with a variety of upper aerodigestive tract symptoms including odynophagia, dysphagia, otalgia, globus, halitosis, chronic cough, and dyspnea. Many patients with lingual tonsillar pathology may undergo extensive work-up for some of these non-specific upper airway complaints by their primary physician before referral to an otolaryngologist. Consequently, the diagnosis of lingual tonsillar disease requires a high index of suspicion and a thorough physical exam including evaluation of the tongue base and hypophaynx with indirect mirror or fiberoptic exam. In order to draw attention to this frequently unrecognized entity, we present a case report of a child with chronic cough resulting from lingual tonsillar hypertrophy. PMID:10862927

  9. [Laryngeal and pharyngeal actinomycosis].

    PubMed

    Schumann, R; Lorenz, K J; Tisch, M; Maier, H

    2010-08-01

    Cervicofacial actinomycosis is an uncommon infection and in most cases odontogenic in origin. Pharyngeal and/or laryngeal lesions, usually occurring secondary to mucosal trauma, are very rare and may mimic a malignant tumor. In such cases, which represent less than 1% of all cases, the differential diagnosis with upper aerodigestive tract malignancy remains challenging. We report a case of actinomycosis in a 56-year-old male patient who presented with an extensive, centrally necrotic mass in the oropharynx, hypopharynx and larynx region suspected to be a tumor. The lesion was diagnosed 6 months following accidental ingestion of an ear of corn and ultimately proved to be cervicofacial actinomycosis. The clinical and pathological features and current aspects of the diagnosis and treatment of cervicofacial actinomycosis are discussed. PMID:20593159

  10. Comparative analysis of the safety of endotracheal tubes with the KTP laser.

    PubMed

    Fried, M P; Mallampati, S R; Caminear, D S

    1989-07-01

    The KTP laser has been used increasingly to treat various disorders of the upper aerodigestive tract. To establish the relative safety of the endotracheal tubes that are currently available, we performed laboratory testing of these tubes by exposing them to the KTP laser in an oxygen-rich environment. Based on our observations, tubes that were all metal or metal-wrapped endotracheal tubes were determined to be the safest. The advantage of using the all-metal tube was that it did not need wrapping. This tube also has a second distal cuff, which would allow for continued ventilation if the proximal cuff becomes disrupted. However, under these circumstances, insertion of a new nondisrupted tube is advised. PMID:2747398

  11. Absent upper blind Pouch in a case of tracheo-esophageal fistula.

    PubMed

    Harjai, Man Mohan; Badal, Sachendra; Khanna, Sangeeta; Singh, Ajit Kumar

    2015-01-01

    A common upper airway and digestive tract is a rare congenital anomaly that is usually fatal and its exact incidence is not known. It is a diagnostic challenge as it requires high index of suspicion. It should be considered in a neonate with respiratory distress in a non-vigorous baby requiring endotracheal intubation, which is difficult even in expert hand. We present a newborn with suspected tracheo-esophageal fistula that was diagnosed intraoperatively to have absent upper blind pouch of the esophagus and on autopsy found to have laryngeal atresia with absent vocal cords and a common aerodigestive tract continuing distally with trachea. The neonate was ventilated with endotracheal tube (ETT) placement which in retrospect we came to know that it was in the esophagus. The neonate also had associated multiple congenital anomalies of VACTERL association. The importance of teamwork between neonatologist, pediatric surgeon, anesthesiologist, and radiologist is highlighted for diagnosis and management of such rare cases. PMID:25552830

  12. CT findings of accidental fish bone ingestion and its complications.

    PubMed

    Venkatesh, Sandeep Halagatti; Venkatanarasimha Karaddi, Nanda Kumar

    2016-01-01

    Fish bone is one of the most common accidentally ingested foreign bodies, and patients commonly present to the emergency department with nonspecific symptoms. Fortunately, most of them are asymptomatic and exit the gastrointestinal tract spontaneously. However, fish bones can get impacted in any part of the aerodigestive tract and cause symptoms. Occasionally, they are asymptomatic initially after ingestion and may present remotely at a later date with serious complications such as gastrointestinal tract perforation, obstruction, and abscess formation. Radiographs are most often negative. High degree of clinical suspicion and familiarity with CT appearance can help to detect fish bone along with any associated complications, and direct further management. We describe and illustrate various CT presentations of ingested fish bone and its complications. PMID:26714057

  13. Feasibility and clinical outcomes of transoral robotic surgery and transoral robot-assisted carbon dioxide laser for hypopharyngeal carcinoma.

    PubMed

    Durmus, Kasim; Kucur, Cuneyt; Uysal, Ismail O; Dziegielewski, Peter T; Ozer, Enver

    2015-01-01

    Transoral robotic surgery (TORS) has been used as a novel procedure for squamous cell carcinoma of the laryngopharyngeal cancers with encouraging outcomes. The safety, feasibility, and efficacy regarding this approach have previously been demonstrated. There are several studies proposing the benefit of combining TORS with carbon dioxide (CO2) laser in resecting upper aerodigestive tract tumors. We report a series of patients with hypopharyngeal carcinoma treated with primary TORS with or without the flexible carbon dioxide (CO2) laser. All TORS resections were completed without any intraoperative complication. None required conversion to an open procedure. Clinical outcomes in this preliminary analysis indicate that magnified view, 3D visualization with the wristed instruments and tremor reduction technology of robotic experience, allow en bloc resection of early stage hypopharyngeal cancers. TORS with CO2 laser is a promising, minimally invasive surgical alternative for the treatment of hypopharyngeal tumors with comparable oncologic outcomes. PMID:25478973

  14. Pathogenesis and therapeutic intervention of oral submucous fibrosis

    PubMed Central

    Yoithapprabhunath, Thukanaykanpalayam Ragunathan; Maheswaran, Thangadurai; Dineshshankar, Janardhanam; Anusushanth, Abraham; Sindhuja, Pandian; Sitra, Govindasamy

    2013-01-01

    Oral submucous fibrosis (OSF) is a chronic, progressive, potentially malignant condition affecting the oral cavity and frequently involving the upper part of the aerodigestive tract including the oropharynx and the upper part of the esophagus. It is characterized by juxtaepithelial inflammatory reaction and progressive fibrosis of lamina propria, leading to stiffening of the oral mucosa eventually causing trismus. This condition is associated with significant morbidity and high risk of malignancy. Over the years, several drugs and combinations have been tried for the treatment of submucous fibrosis, but with limited success, because of its unclear molecular pathogenesis. Till date, there are no known effective treatments for OSF. The aim of this article is to emphasize on the molecular changes taking place in OSF and possible therapeutic interventions. PMID:23946584

  15. Pediatric radiation oncology

    SciTech Connect

    Halperin, E.C.; Kun, L.E.; Constine, L.S.; Tarbell, N.J.

    1989-01-01

    This text covers all aspects of radiation therapy for treatment of pediatric cancer. The book describes the proper use of irradiation in each of the malignancies of childhood, including tumors that are rarely encountered in adult practice. These include acute leukemia; supratentorial brain tumors; tumors of the posterior fossa of the brain and spinal canal; retinoblastoma and optic nerve glioma; neuroblastoma; Hodgkin's disease; malignant lymphoma; Ewing's sarcoma; osteosarcoma; rhabdomyosarcoma; Desmoid tumor; Wilms' tumor; liver and biliary tumors; germ cell and stromal cell tumors of the gonads; endocrine, aerodigestive tract, and breast tumors; Langerhans' cell histiocytosis; and skin cancer and hemangiomas. For each type of malignancy, the authors describe the epidemiology, common presenting signs and symptoms, staging, and proper diagnostic workup. Particular attention is given to the indications for radiation therapy and the planning of a course of radiotherapy, including the optimal radiation dose, field size, and technique.

  16. PubMed Central

    ORSI, A.; MARTINI, M.; ICARDI, G.

    2013-01-01

    Summary Human Papillomavirus (HPV) has a significant impact in male's health, as cause of clinical manifestations ranging from genital warts to several cancers of the anogenital and aero-digestive tract. HPV types which most frequently affect men are 6,11,16 and 18, included in the HPV quadrivalent vaccine, recently approved for use in males by Food and Drug Administration (FDA) and European Medicines Agency (EMA). Although several data about the safety and efficacy of quadrivalent vaccine are available, the implementation of proper immunization plans dedicate to male's population cannot ignore the knowledge of the characteristics of the disease in men, which in some aspects should be clarify, in particular clearance of type-specific HPV infections and transmission dynamics. Purpose of this review is to summarise the main information about the burden and the natural history of the HPV related disease in males. PMID:24396983

  17. Facial, Cervical, and Mediastinal Emphysema of the Clarinet Player: Case Report

    PubMed Central

    Biçer, Yusuf Özgür; Kesgin, Selcan; Tezcan, Erkan; Köyba??, Serap

    2014-01-01

    Background: Cervicofacial emphysema may arise due to the leakage of air from a defect in the aerodigestive tract to the fascial layers of neck and face. Rarely, it may be caused by insufflation of air through the Stensen’s duct. Case Report: We present a case with diffuse facial, cervical and mediastinal emphysema due to playing a wind instrument immediately after a facial trauma. There was no mucosal defect or laceration noticed by examination which could explain the origin of the emphysema. Despite the widespread cervicofacial emphysema with mediastinal involvement, the patient significantly improved within 48 hours without any intervention. Conclusion: Even though cervicofacial emphysema ameliorates spontaneously, increased care must be taken, especially when there is pneumomediastinum and/or pneumothorax. PMID:25667794

  18. CT-clinical approach to patients with symptoms related to the V, VII, IX-XII cranial nerves and cervical sympathetics

    SciTech Connect

    Kalovidouris, A.; Mancuso, A.A.; Dillon, W.

    1984-06-01

    Forty-three patients who had signs and symptoms possibly related to the extracranial course of cranial nerves V, VII, IX, X-XII, and the cervical sympathetics were examined prospectively using high resolution CT to obtain images of thin sections during rapid drip infusion of contrast material. Anatomic areas in the scan protocols included the posterior fossa, cavernous and paranasal sinuses, skull base, temporal bone, nasopharynx, parotid gland, tongue base, and neck. Nine of the 23 patients with possible fifth nerve deficits had extracranial structural lesions that explained the symptoms; none of these nine, however, had typical trigeminal neuralgia. Of eight patients with peripheral seventh nerve abnormalities, two had positive findings on scans. Of five patients presenting with referred ear pain, three had carcinoma of the upper aerodigestive tract. The authors' experience suggests that patients at high risk for structural lesions responsible for cranial nerve deficits can be selected by clinical criteria. Protocols for each clinical setting are presented.

  19. Dysphagia in the high-risk infant: potential factors and mechanisms.

    PubMed

    Jadcherla, Sudarshan

    2016-02-01

    Neonatal dysphagia, or abnormalities of swallowing, represent a major global problem, and consequences of dysfunctional feeding patterns carry over into infancy and toddler age groups. Growth, development, and independent feeding skills are all delayed among high-risk infants. Such a group comprises premature birth, low-birth-weight, congenital anomalies, perinatal asphyxia, postsurgical, and sepsis categories. The conflict between pathophysiologic and pragmatic feeding strategies remains a major conundrum and is largely due to a lack of validated diagnostic approaches amid heterogeneity of the patient phenotype. Thus, well-tested feeding management strategies that can be generalizable are lacking. Furthermore, the aerodigestive symptoms and signs, potential risk factors, and contributory etiologies remain nonspecific. This article presents mechanistic evidence related to the pathophysiologic basis of neonatal dysphagia as well as potential opportunities to improve feeding abilities and long-term development. PMID:26791178

  20. Ablation of dermal and mucosal lesions with a new CO2 laser application system

    NASA Astrophysics Data System (ADS)

    Jovanovic, Sergije; Sedlmaier, Benedikt W.; Fuehrer, Ariane

    1997-05-01

    Laser treatment of skin changes has become common practice in recent years. The high absorption of the wavelength of the carbon-dioxide laser (10600 nm) is responsible for its low penetration depth in biological tissue. Shortening the exposure time minimizes thermic side effects such as carbonization and coagulation. This effect can be achieved with the SilkTouchTM scanner 767, since the focused laser beam is moved over a defined area by rapidly rotating mirrors. This enables controlled and reliable removal of certain dermal lesions, particularly hypertrophic scars, scars after common acne, wrinkles, rhinophyma and benign neoplasms like verruca vulgaris. Cosmetically favorable reepithelialization of the lasered surfaces results within a very short period of time. Benign mucosal changes of the upper aerodigestive tract can also be treated. Ablation is less traumatic for papillomas, fibromas, hyperplasias in the area of Waldeyer's tonsillar ring and certain laryngotracheal pathologies. Clinical examples demonstrate the advantages of this new mode of application.

  1. CT findings of accidental fish bone ingestion and its complications

    PubMed Central

    Venkatesh, Sandeep Halagatti; Karaddi, Nanda Kumar Venkatanarasimha

    2016-01-01

    Fish bone is one of the most common accidentally ingested foreign bodies, and patients commonly present to the emergency department with nonspecific symptoms. Fortunately, most of them are asymptomatic and exit the gastrointestinal tract spontaneously. However, fish bones can get impacted in any part of the aerodigestive tract and cause symptoms. Occasionally, they are asymptomatic initially after ingestion and may present remotely at a later date with serious complications such as gastrointestinal tract perforation, obstruction, and abscess formation. Radiographs are most often negative. High degree of clinical suspicion and familiarity with CT appearance can help to detect fish bone along with any associated complications, and direct further management. We describe and illustrate various CT presentations of ingested fish bone and its complications. PMID:26714057

  2. Recurrent respiratory papillomatosis: current and future perspectives

    PubMed Central

    Carifi, Marco; Napolitano, Domenico; Morandi, Morando; Dall’Olio, Danilo

    2015-01-01

    Although recurrent respiratory papillomatosis is a benign disease of the upper aerodigestive tract caused by infection with human papillomavirus, the disease process is unpredictable, ranging from mild disease and spontaneous remission to an aggressive disease with pulmonary spread and requirement for frequent surgical debulking procedures. It can present a protracted clinical course and cause potentially life-threatening compromise of the airways. Over recent decades, a number of alternative medical therapies to standard surgical treatment have been investigated, with modest outcomes overall. Currently, some additional therapies are being explored, together with novel surgical instrumentation that can help to avoid inevitable long-term stenotic complications, ultimately affecting quality of life. Hopefully, clinicians might soon be able to significantly improve the quality of treatment and outcomes for patients affected with recurrent respiratory papillomatosis, with human papillomavirus vaccination having a potentially important role. PMID:25999724

  3. Gastroesophageal reflux disease.

    PubMed

    Gelfand, M D

    1991-07-01

    Gastroesophageal reflux disease, usually manifested by frequent heartburn, occurs in approximately 10% of our adult population. The presence of a hiatal hernia is usually associated with, but does not necessarily cause, LES dysfunction, allowing acid reflux to produce esophageal and aerodigestive symptoms. The mucosa can be extensively damaged and, ultimately, a columnar lining, termed Barrett's esophagus, a premalignant condition, can develop. Treatment with H2-antagonists has been nirvana to some patients, but has proved only partially helpful to others. Adjunctive agents may increase relief and may help heal erosive esophagitis in some patients, but side effects and cost limit their use. Maintenance therapy with full doses is required, as the relapse rate for this chronic condition is high. Omeprazole temporarily heals almost everyone with otherwise resistant GERD, but it is currently used only on a short-term basis unless surgery, eminently successful in well-selected patients, is contraindicated. PMID:2072796

  4. Primary localized laryngeal amyloidosis presenting with dysphonia: a case report.

    PubMed

    Chow, Vanessa; Gardner, Kate; Howlett, David

    2012-01-01

    Localized laryngeal amyloidosis is a rare disease with poorly understood aetiology. The commonest symptom at presentation is dysphonia and for a correct diagnosis of amyloidosis to be made a high index of suspicion is needed [Fraihat A, Ardah A. Laryngeal amyloidosis: a case report. J R Med Serv 2005;17:57-9; Passerotti GH, Caniello M, Hachiya A, Santoro PP, Imamura R, Tsuji DH. Multiple sited amyloidosis in the upper aerodigestive tract: case report and literature review. Rev Bras Otorrinolaringol 2008;74:462-6]. We present a case of a 48-year-old male who was investigated over a 5-year period for persistent and progressive hoarseness of voice before the accurate diagnosis of localized amyloidosis was reached. Management of this case consisted of local treatment with endoscopic carbon dioxide laser excision of laryngeal lesions to good effect and exclusion of systemic disease with yearly follow-up for monitoring disease progression. PMID:24968392

  5. The absence of Harvey ras mutations during development and progression of squamous cell carcinomas of the head and neck.

    PubMed Central

    Clark, L. J.; Edington, K.; Swan, I. R.; McLay, K. A.; Newlands, W. J.; Wills, L. C.; Young, H. A.; Johnston, P. W.; Mitchell, R.; Robertson, G.

    1993-01-01

    We have examined the incidence of Harvey ras mutations in human squamous cell carcinomas (SCC) of the upper aerodigestive tract using the polymerase chain reaction (PCR) followed by direct sequencing. No mutations were detected at codons 12, 13, 59 or 61 of this gene in any of six papillomas, five erythroplakias, 56 squamous cell carcinomas, and 16 SCC cell lines. Some of the SCC were lymph node metastases (three) or tumours which had recurred following radiotherapy (seven). We conclude that Harvey ras mutations are not a common event in the pathogenesis or recurrence of SCCs from Caucasian subjects, in contrast to the situation with Indian populations (Saranath et al., 1991). Images Figure 1 PMID:8353052

  6. "Now you see it...now you don't." Carmoisine vital dye facilitates complete removal of cutaneous neoplasia by intraoperative visual enhancement.

    PubMed

    Murphy, K D J; Hall, P N

    2003-09-01

    Patients presenting for excision of squamous cell carcinomata, including Bowen's disease, in sun-damaged skin often present with poorly defined, morphoeic or multifocal neoplasms, the extent of which can be difficult to identify intraoperatively. Use of vital staining has been commonly used to aid identification and appropriate excision of squamous lesions of the oral cavity and upper aerodigestive tract but has not been readily adopted for cutaneous lesions. We report a case of a morphoeic squamous cell neoplasm of the web space and fingers to illustrate the merits of vital staining cutaneous squamous neoplasms with the simple dye Carmoisine E122. This assists with intraoperative tumour identification and facilitates adequate oncological resection and appropriately planned reconstruction. By comparison with other methods such as Mohs, it is a simple, cheap, and rapid aid that may be used by surgeons of all grades to improve identification of the extent of the neoplasm, without special equipment. PMID:12946382

  7. Removal of a Wire Brush Bristle from the Hypopharynx Using Suspension, Microscope, and Fluoroscopy

    PubMed Central

    Naunheim, Matthew R.; Dedmon, Matthew M.; Mori, Matthew C.; Sedaghat, Ahmad R.; Dowdall, Jayme R.

    2015-01-01

    Wire brush bristles are an increasingly recognized hazard that can present as a foreign body in the aerodigestive tract. Due to their small size and tendency to become embedded in surrounding tissue, these small metallic bristles present a unique operative challenge to otolaryngologists. Here we present a case of a 40-year-old woman who underwent endoscopic extraction of a wire bristle from the posterior pharyngeal wall using suspension, microscopy, and C-arm fluoroscopy. We believe this is the first published case of an endoscopic removal of a buried foreign body in the hypopharynx using these methods of localization concurrently. By leveraging multiple techniques for visualization, surgeons can avoid open exploration while ensuring complete removal of the object. Additionally, this case highlights the importance of regulatory oversight and consumer awareness of the hazards of grill brushes. PMID:25649460

  8. The role of transnasal oesophagoscopy in the management of globus pharyngeus and non-progressive dysphagia.

    PubMed

    Sanyaolu, L N; Jemah, A; Stew, B; Ingrams, D R

    2016-01-01

    Introduction Transnasal oesophagoscopy is a relatively new method of examining the upper aerodigestive tract via the nasal passage as an outpatient procedure without the need for sedation. It has been shown to be a well tolerated, safe and accurate technique, that can therefore be used in the investigation of patients thought to have globus pharyngeus and other non sinister causes of dysphagia. Methods A total of 150 consecutive patients undergoing transnasal oesophagoscopy were analysed retrospectively. Results The main indications for this procedure were non-progressive dysphagia (n=68, 45%) and globus pharyngeus (n=60, 40%). Transnasal oesophagoscopy was normal in 65% of patients and 42% of patients were discharged from clinic at the same appointment with no further investigation. The most common positive findings were laryngeal erythema (13%) and oesophagitis (10%). Conclusions Transnasal oesophagoscopy is a useful adjunct to the management of patients with the symptoms of globus pharyngeus and non-progressive dysphagia. PMID:26688400

  9. Structure crustale et anomalies du champ de gravite dans l'est du Canada

    NASA Astrophysics Data System (ADS)

    Telmat, Hamid

    Cette these presente les resultats d'etudes gravimetriques menees dans le Bouclier canadien. Les mesures du champ de gravite recoltees le long et a proximite de divers transects Lithoprobe y sont interpretees. Chacun des chapitres de cette these est un article publie ou soumis. Le premier article presente l'interpretation gravimetrique le long de la ligne sismique 52 de Lithoprobe, dans la province de Grenville. A l'echelle regionale, la modelisation de l'anomalie de Bouguer invoque un amincissement crustal au sud du front de Grenville sous le terrane allochtone du reservoir Cabonga. Cet amincissement, localise au niveau de la croute inferieure, peut etre associe a une extension post-orogenique. Le modele gravimetrique a aussi permis de mettre en evidence des caracteristiques majeures non revelees par les donnees sismiques, telle que la zone de contact subverticale entre les terranes du reservoir de Cabonga et du reservoir Dozois. La rampe de Baskatong representerait une discontinuite majeure le long de laquelle, les terranes proterozoiques furent accretes. Par ailleurs, un modele de l'anomalie residuelle, dans la partie nord du profil, met en evidence trois corps gabbroiques peu profonds. Le second article presente des modeles crustaux du nord de la province du Superieur a la lumiere de nouvelles donnees de gravite recoltees le long d'un transect traversant les sous-provinces de Nemiscau et La Grande. L'interpretation de l'anomalie de Bouguer pour le nord de l'Abitibi et l'Opatica, invoque un epaississement crustal. Pour les sous-provinces de Nemiscau et La Grande, l'interpretation gravimetrique invoque une densite de la croute superieure plus elevee qu'en Abitibi et en Opatica. Un leger epaississement crustal est observe dans la sous-province de La Grande. Des sequences supracrustales mafiques sont aussi mises en evidence a l'extremite nord du profil dans la sous-province de La Grande. La signature gravimetrique associee a la variation laterale de densite et les evidences de terrain indiquent un pendage vers le nord des principales frontieres tectoniques. Le troisieme chapitre fait l'objet d'une etude du champ de pesanteur au dessus de la region de la baie d'Ungava a partir de donnees satellite et de nouvelles donnees recoltees le long de la cote sud de la baie. Un leve gravimetrique partant de la baie aux Feuilles, dans la province du Superieur, traversant l'Orogene du Nouveau Quebec (ONQ), et finissant pres de la riviere George dans le craton de Rae, a ete realise. L'interpretation des donnees acquises a permis de fournir des modeles de densite. Ces modeles mettent en evidence un epaississement crustal sous l'ONQ et un amincissement sous le terrane de Kuujjuaq, a l'est de l'orogene. Alors que plus a l'est, dans le craton de Rae, une anomalie negative de quelques dix milligals est correlee avec les extensions vers le nord de la zone de cisaillement de la riviere George (ZCRG) et du batholite de De Pas. L'orientation des structures sur les modeles de gravite suggere un chevauchement du craton de Rae au dessus de l'ONQ. (Abstract shortened by UMI.)

  10. Safety and Efficacy of Oral Feeding in Infants with BPD on Nasal CPAP.

    PubMed

    Hanin, Melissa; Nuthakki, Sushma; Malkar, Manish B; Jadcherla, Sudarshan R

    2015-04-01

    Safety and efficacy of oral feeding was examined in infants with bronchopulmonary dysplasia (BPD) on nasal continuous positive airway pressure (NCPAP). We hypothesized that repetitive oral feeding enhances aero-digestive outcomes and reduces resource utilization. Data from infants with BPD (37-42 weeks post menstrual age) that were orally fed while on NCPAP (n = 26) were compared with those that were exclusively gavage fed on NCPAP (n = 27). Subject assignment was random and physician practice based. Specifically, we compared the differences in aero-digestive milestones, resource utilization, and safety metrics. Demographic characteristics such as gender distribution, gestational age, and birth weight, clinical characteristics such as frequency of intraventricular hemorrhage and patent ductus arteriosus needing surgical ligation were similar in both groups (p > 0.05). Characteristics of respiratory support and airway milestones were similar in both groups (p > 0.05). However, infants in NCPAP-oral fed group had earlier acquisition of full oral feeding milestone by 17 days (median) versus infants who were not orally fed during NCPAP (p < 0.05). Discharge weights and the frequency of gastrostomy tube placement were also similar in both groups (p > 0.05). There were no tracheostomies in either group. There was no incidence of clinically significant aspiration pneumonia in infants during the period of the oral feeding while on NCPAP. Controlled introduction of oral feedings in infants with BPD during NCPAP is safe and may accelerate the acquisition of oral feeding milestones. PMID:25380678

  11. Radiation Doses to Structures Within and Adjacent to the Larynx are Correlated With Long-Term Diet- and Speech-Related Quality of Life

    SciTech Connect

    Dornfeld, Ken . E-mail: kenneth-dornfeld@uiowa.edu; Simmons, Joel R.; Karnell, Lucy; Karnell, Michael; Funk, Gerry; Yao Min; Wacha, Judith; Zimmerman, Bridget; Buatti, John M.

    2007-07-01

    Purpose: To test the hypothesis that radiation dose to key sites in the upper aerodigestive tract is associated with long-term functional outcome after (chemo)radiotherapy for head-and-neck cancers. Methods and Materials: This study examined the outcome for 27 patients treated with intensity-modulated radiotherapy for definitive management of their head-and-neck cancer who were disease free for at least 1 year after treatment. Head-and-neck cancer-specific quality of life (QoL) was assessed before treatment and at 1 year after treatment. Type of diet tolerated, presence of a feeding tube, and degree of weight loss 1 year after treatment were also used as outcome measures. Radiation doses delivered to various points along the upper aerodigestive tract, including base of tongue, lateral pharyngeal walls, and laryngeal structures, were determined from each treatment plan. Radiation doses for each of these points were tested for correlation with outcome measures. Results: Higher doses delivered to the aryepiglottic folds, false vocal cords, and lateral pharyngeal walls near the false cords correlated with a more restrictive diet, and higher doses to the aryepiglottic folds correlated with greater weight loss (p < 0.05) 1 year after therapy. Better posttreatment speech QoL scores were associated with lower doses delivered to structures within and surrounding the larynx. Conclusion: Our data show an inverse relationship between radiation dose delivered to laryngeal structures and speech and diet and QoL outcomes after definitive (chemo)radiation treatment. These findings suggest that efforts to deliver lower doses to laryngeal structures may improve outcomes after definitive (chemo)radiation therapy.

  12. Adherence to Mediterranean diet and risk of cancer: a systematic review and meta-analysis of observational studies.

    PubMed

    Schwingshackl, Lukas; Hoffmann, Georg

    2014-10-15

    The aim of this research study was to meta-analyze the effects of adherence to Mediterranean diet (MD) on overall cancer risk, and different cancer types. Literature search was performed using the electronic databases MEDLINE, SCOPUS and EMBASE until January 10, 2014. Inclusion criteria were cohort or case-control studies. Study specific risk ratios (RRs) were pooled using a random effect model by the Cochrane software package Review Manager 5.2. Twenty-one cohort studies including 1,368,736 subjects and 12 case-control studies with 62,725 subjects met the objectives and were enclosed for meta-analyses. The highest adherence to MD category resulted in a significantly risk reduction for overall cancer mortality/incidence (cohort; RR: 0.90, 95% CI 0.86-0.95, p < 0.0001; I(2) = 55%), colorectal (cohort/case-control; RR: 0.86, 95% CI 0.80-0.93, p < 0.0001; I(2) = 62%], prostate (cohort/case-control; RR: 0.96, 95% CI 0.92-0.99, p = 0.03; I(2) = 0%) and aerodigestive cancer (cohort/case-control; RR: 0.44, 95% CI 0.26-0.77, p = 0.003; I(2) = 83%). Nonsignificant changes could be observed for breast cancer, gastric cancer and pancreatic cancer. The Egger regression tests provided limited evidence of substantial publication bias. High adherence to a MD is associated with a significant reduction in the risk of overall cancer mortality (10%), colorectal cancer (14%), prostate cancer (4%) and aerodigestive cancer (56%). PMID:24599882

  13. The effects of internal radiation exposure on cancer mortality in nuclear workers at Rocketdyne/Atomics International.

    PubMed Central

    Ritz, B; Morgenstern, H; Crawford-Brown, D; Young, B

    2000-01-01

    We examined the effects of chronic exposure to radionuclides, primarily uranium and mixed-fission products, on cancer mortality in a retrospective cohort study of workers enrolled in the radiation-monitoring program of a nuclear research and development facility. Between 1950 and 1994, 2,297 workers were monitored for internal radiation exposures, and 441 workers died, 134 (30.4%) of them from cancer as the underlying cause. We calculated internal lung-dose estimates based on urinalysis and whole-body and lung counts reported for individual workers. We examined cancer mortality of workers exposed at different cumulative lung-dose levels using complete risk-set analysis for cohort data, adjusting for age, pay type, time since first radiation monitored, and external radiation. In addition, we examined the potential for confounding due to chemical exposures and smoking, explored whether external radiation exposure modifies the effects of internal exposure, and estimated effects after excluding exposures likely to have been unrelated to disease onset. Dose-response relations were observed for death from hemato- and lymphopoietic cancers and from upper aerodigestive tract cancers, adjusting for age, time since first monitored, pay type, and external (gamma) radiation dose. No association was found for other cancers, including cancers of the lung. Despite the small number of exposed deaths from specific cancer types and possible bias due to measurement error and confounding, the positive findings and strong dose-response gradients observed suggest carcinogenic effects of internal radiation to the upper aerodigestive tract and the blood and lymph system in this occupational cohort. However, causal inferences require replication of our results in other populations or confirmation with an extended follow-up of this cohort. PMID:10964795

  14. Impact of Personalized Feeding Program in 100 NICU Infants: Pathophysiology-based Approach for Better Outcomes

    PubMed Central

    Jadcherla, Sudarshan R.; Peng, Juan; Moore, Rebecca; Saavedra, Jason; Shepherd, Edward; Fernandez, Soledad; Erdman, Steven H.; DiLorenzo, Carlo

    2013-01-01

    Objectives In neonatal intensive care unit infants referred for home-tube feeding methods, we evaluated the effect of an innovative diagnostic and management approach on feeding outcomes at discharge and 1 year, by comparing data from historical controls; we hypothesized that clinical and aerodigestive motility characteristics at evaluation were predictive of feeding outcomes at discharge; we assessed the economic impact of feeding outcomes. Patients and Methods Patients (N = 100) who were referred for development of long-term feeding management strategy at 46.4 ± 13.1 weeks’ postmenstrual age were compared with 50 historical controls that received routine care. The focused approach included swallow-integrated pharyngoesophageal manometry, individualized feeding strategy, and prospective follow-up. Feeding success was defined as ability to achieve oral feedings at discharge and 1 year. Motility characteristics were evaluated in relation to feeding success or failure at discharge. Results Higher feeding success was achieved in the innovative feeding program (vs historical controls) at discharge (51% vs 10%, P < 0.0001) and at 1 year (84.3% vs 42.9%, P < 0.0001), at a reduced economic burden (P < 0.05). Contributing factors to the innovative program’s feeding success (vs feeding failure) were earlier evaluation and discharge (both P < 0.05), greater peristaltic reflex-frequency to provocation (P < 0.05), normal pharyngeal manometry (P < 0.05), oral feeding challenge success (P < 0.05), and suck-swallow-breath-esophageal swallow sequence (P < 0.05). Probability of feeding success demonstrated a prediction rate of 79.6%. Conclusions Short-term and long-term feeding outcomes in complex neonates can be significantly improved with innovative feeding strategies at a reduced cost. Clinical and aerodigestive motility characteristics were predictive of outcomes. PMID:21694638

  15. Le changement comme tradition dans la recherche et la formation a la recherche en biotechnologie et en peripherie Etude de cas en sciences de la sante, sciences naturelles et genie

    NASA Astrophysics Data System (ADS)

    Bourque, Claude Julie

    Le champ de la recherche scientifique et de la formation a la recherche est traverse depuis quelques dizaines d'annees par plusieurs courants et discours associes au changement, mais peu de travaux empiriques permettent de comprendre ce qui change concretement. C'est la contribution originale de cette these au champ de l'education, plus specifiquement a l'etude sociologique de l'enseignement superieur ou sont concentrees les activites liees a la triade thematique du programme doctoral dans lequel elle a ete produite : recherche, formation et pratique. L'enquete-terrain a ete realisee en 2009 et 2010 aupres de 808 repondants affilies a 60 etablissements au Quebec et a produit un vaste materiau de nature mixte (donnees quantitatives et qualitatives). Un portrait de la nebuleuse biotechnologique qui touche les secteurs des sciences de la sante, des sciences naturelles et du genie a ete realise. Ce domaine concerne des dizaines de disciplines et se revele de nature transdisciplinaire, mais les pratiques n'y sont pas davantage marquees par le changement que celles d'autres domaines connexes. Les dynamiques sociales ont fait l'objet d'analyses comparatives dans quatre contextes: le choix des programmes, des objets et des methodes, le financement, la diffusion et la planification de la carriere. Les resultats indiquent que les echanges entre les agents traditionnellement situes au coeur des activites de recherche dominent ces dynamiques dans tous les contextes etudies. L'etude des representations au fondement des pratiques a revele l'existence de trois ecoles de pensee qui coexistent dans le champ scientifique: academique, pragmatique et economiste. Ces ecoles permettent de categoriser les agents en fonction des zones de fractures qui marquent leurs oppositions tout en identifiant ce qu'ils ont en commun. Les representations et les pratiques liees a la formation temoignent d'un habitus plutot homogene, alors que les contradictions semblent plus souvent ancrees dans des luttes universitaires que scientifiques, concentrees sur la negociation du capital scientifique, symbolique et economique en jeu dans la formation doctorale, dans les carrieres auxquelles elle mene, et dans les qualites du titre de Ph.D. Au final, la confusion entre des logiques opposees peut etre reduite en reinterpretant le changement comme tradition du champ scientifique. Mots-cles Sociologie, education, enseignement superieur, science et technologie, biotechnologie, formation doctorale, champ scientifique, reseaux sociaux

  16. Conception d'un circuit d'etouffement pour photodiodes a avalanche en mode geiger pour integration heterogene 3d

    NASA Astrophysics Data System (ADS)

    Boisvert, Alexandre

    Le Groupe de Recherche en Appareillage Medical de Sherbrooke (GRAMS) travaille actuellement sur un programme de recherche portant sur des photodiodes a avalanche mono-photoniques (PAMP) operees en mode Geiger en vue d'une application a la tomographie d'emission par positrons (TEP). Pour operer dans ce mode; la PAMP, ou SPAD selon l'acronyme anglais (Single Photon Avalanche Diode), requiert un circuit d'etouffement (CE) pour, d'une part, arreter l'avalanche pouvant causer sa destruction et, d'autre part. la reinitialiser en mode d'attente d'un nouveau photon. Le role de ce CE comprend egalement une electronique de communication vers les etages de traitement avance de signaux. La performance temporelle optimale du CE est realisee lorsqu'il est juxtapose a la PAMP. Cependant, cela entraine une reduction de la surface photosensible ; un element crucial en imagerie. L'integration 3D, a base d'interconnexions verticales, offre une solution elegante et performante a cette problematique par l'empilement de circuits integres possedant differentes fonctions (PAMP, CE et traitement avance de signaux). Dans l'approche proposee, des circuits d'etouffement de 50 pm x 50 pm realises sur une technologie CMOS 130 mn 3D Tezzaron, contenant chacun 112 transistors, sont matrices afin de correspondre a une matrice de PAMP localisee sur une couche electronique superieure. Chaque circuit d'etouffement possede une gigue temporelle de 7,47 ps RMS selon des simulations faites avec le logiciel Cadence. Le CE a la flexibilite d'ajuster les temps d'etouffement et de recharge pour la PAMP tout en presentant une faible consommation de puissance (~ 0,33 mW a 33 Mcps). La conception du PAMP necessite de supporter des tensions superieures aux 3,3 V de la technologie. Pour repondre a ce probleme, des transistors a drain etendu (DEMOS) ont ete realises. En raison de retards de production par Ies fabricants, les circuits n'ont pu etre testes physiquement par des mesures. Les resultats de ce memoire sont par consequent bases sur des resultats de simulations avec le logiciel Cadence. Mots-cles : Circuit d'etouffement, Photodiodes a avalanche monophotoniques (PAMP), Single Photon Avalanche Diode (SPAD), Integration 3D heterogene, Drain-Extended MOS (DEMOS), CMOS 130 nm 3D Tezzaron/Chartered, Tomographie d'emission par positrons (TEP)

  17. Elaboration d'un dosimetre a fibres scintillantes

    NASA Astrophysics Data System (ADS)

    Archambault, Louis

    Le but de ce travail est de developper un dosimetre constitue d'une matrice de petits scintillateurs plastiques. Ce dosimetre doit presenter une bonne precision et reproductibilite pour satisfaire aux exigences imposees par des techniques de radiotherapie de pointe comme la radiotherapie d'intensite modulee, la radiochirurgie et la tomotherapie. Le desavantage majeur de cette forme de dosimetrie est la presence de bruit produit par l'effet de la radiation sur la fibre optique transportant la lumiere de scintillation jusqu'au photodetecteur. Pour en reduire l'impact, une etude approfondie des dosimetres a scintillation a ete effectuee. Commencant par une modelisation theorique de la collecte et du guidage lumineux, ce travail a ete suivi d'une comparaison experimentale de plusieurs scintillateurs plastiques, de methodes de couplage, de photodetecteurs et de techniques de filtrage. Ces etudes ont permis de choisir les fibres scintillantes pour leur gain de signal de 50% relativement aux autres scintillateurs plastiques. La camera CCD est le photodetecteur le plus adapte pour ce projet etant donne une sensibilite et une stabilite suffisantes, une capacite d'evaluer 3000 signaux dosimetriques simultanement et un systeme de separation chromatique. Apres la selection des meilleures composantes, un dosimetre a ete developpe pour etudier la performance des techniques de filtrage. Il a ete demontre que, apres utilisation du meilleur filtrage, une precision superieure a 1% pouvait etre atteinte. Un dosimetre a trois detecteurs de volumes differents (0,0014, 0,0034 et 0,0083 cm 3) a demontre une linearite face a des taux de doses allant de 10 a 600 cGy/min et pour des temps d'integration entre 0,05 et 50 s. Une reproductibilite superieure a 1% a ete observee pour des doses minimales de 45, 35 et 20 cGy respectivement pour le petit, le moyen et le grand detecteur. Une matrice de 10 detecteurs espaces de 5 mm sur une ligne a ensuite ete realisee. Ce dosimetre s'est montre adapte pour l'evaluation precise et rapide de patrons de doses. Meme si un modele abordable de camera CCD a ete utilise, il a ete possible de developper un dosimetre precis, reproductible et de haute resolution spatiale possedant les excellentes proprietes des scintillateurs plastiques.

  18. Mesiotemporal volume loss associated with disorder severity: a VBM study in borderline personality disorder.

    PubMed

    Labudda, Kirsten; Kreisel, Stefan; Beblo, Thomas; Mertens, Markus; Kurlandchikov, Oleg; Bien, Christian G; Driessen, Martin; Woermann, Friedrich G

    2013-01-01

    Results of MRI volumetry in Borderline Personality Disorder (BPD) are inconsistent. Some, but not all, studies reported decreased hippocampus, amygdala, and/or prefrontal volumes. In the current study, we used rater-independent voxel-based morphometry (VBM) in 33 female BPD patients and 33 healthy women. We measured gray matter (GM) volumes of the whole brain and of three volumes of interest (VOI), i.e., the hippocampus/parahippocampal gyrus, the amygdala and the anterior cingulate gyrus (ACC). Analyses were conducted using lifetime diagnoses of posttraumatic stress disorder (PTSD) and major depression (MD) as covariates. We used adversive childhood experiences and the numbers of BPD criteria (as an indicator of disorder severity) to investigate associations with GM volumes. We did not find volume differences between BPD patients and healthy subject, neither of the whole brain nor of the three VOIs, independent of presence or absence of comorbid PTSD and MD. We also did not find a relationship between childhood maltreatment and the patients' brain volumes. However, within the patient group, the number of BPD criteria fulfilled was inversely correlated with left hippocampal/parahippocampal volume (x=-32, y=-23, z=-18, k=496, t=5.08, p=.007). Consequently, mesiotemporal GM volumes do not seem to differentiate patients from healthy subjects, but might be associated with symptom severity within the BPD group. PMID:24367606

  19. Mesiotemporal Volume Loss Associated with Disorder Severity: A VBM Study in Borderline Personality Disorder

    PubMed Central

    Beblo, Thomas; Mertens, Markus; Kurlandchikov, Oleg; Bien, Christian G.; Driessen, Martin; Woermann, Friedrich G.

    2013-01-01

    Results of MRI volumetry in Borderline Personality Disorder (BPD) are inconsistent. Some, but not all, studies reported decreased hippocampus, amygdala, and/or prefrontal volumes. In the current study, we used rater-independent voxel-based morphometry (VBM) in 33 female BPD patients and 33 healthy women. We measured gray matter (GM) volumes of the whole brain and of three volumes of interest (VOI), i.e., the hippocampus/parahippocampal gyrus, the amygdala and the anterior cingulate gyrus (ACC). Analyses were conducted using lifetime diagnoses of posttraumatic stress disorder (PTSD) and major depression (MD) as covariates. We used adversive childhood experiences and the numbers of BPD criteria (as an indicator of disorder severity) to investigate associations with GM volumes. We did not find volume differences between BPD patients and healthy subject, neither of the whole brain nor of the three VOIs, independent of presence or absence of comorbid PTSD and MD. We also did not find a relationship between childhood maltreatment and the patients’ brain volumes. However, within the patient group, the number of BPD criteria fulfilled was inversely correlated with left hippocampal/parahippocampal volume (x=-32, y=-23, z=-18, k=496, t=5.08, p=.007). Consequently, mesiotemporal GM volumes do not seem to differentiate patients from healthy subjects, but might be associated with symptom severity within the BPD group. PMID:24367606

  20. Quantification of trabecular spatial orientation from low-resolution images.

    PubMed

    Lenaerts, L; Wirth, A J; van Lenthe, G H

    2015-01-01

    No accepted methodology exists to assess trabecular bone orientation from clinical CT scans. The aim of this study was to test the hypothesis that the distribution of grey values in clinical CT images is related to the underlying trabecular architecture and that this distribution can be used to identify the principal directions and local anisotropy of trabecular bone. Fourteen trabecular bone samples were extracted from high-resolution (30 ?m) micro-CT scans of seven human femoral heads. Trabecular orientations and local anisotropy were calculated using grey-level deviation (GLD), a novel method providing a measure of the three-dimensional distribution of image grey values. This was repeated for different image resolutions down to 300 ?m and for volumes of interest (VOIs) ranging from 1 to 7 mm. Outcomes were compared with the principal mechanical directions and with mean intercept length (MIL) as calculated for the segmented 30-?m images. For the 30-?m images, GLD predicted the mechanical principal directions equally well as MIL. For the 300-?m images, which are resolutions that can be obtained in vivo using clinical CT, only a small increase (3°-6°) in the deviation from the mechanical orientations was found. VOIs of 5 mm resulted in a robust quantification of the orientation. We conclude that GLD can quantify structural bone parameters from low-resolution CT images. PMID:24787095

  1. A Sparse Representation Based Method to Classify Pulmonary Patterns of Diffuse Lung Diseases

    PubMed Central

    Xu, Rui; Tachibana, Rie; Kido, Shoji

    2015-01-01

    We applied and optimized the sparse representation (SR) approaches in the computer-aided diagnosis (CAD) to classify normal tissues and five kinds of diffuse lung disease (DLD) patterns: consolidation, ground-glass opacity, honeycombing, emphysema, and nodule. By using the K-SVD which is based on the singular value decomposition (SVD) and orthogonal matching pursuit (OMP), it can achieve a satisfied recognition rate, but too much time was spent in the experiment. To reduce the runtime of the method, the K-Means algorithm was substituted for the K-SVD, and the OMP was simplified by searching the desired atoms at one time (OMP1). We proposed three SR based methods for evaluation: SR1 (K-SVD+OMP), SR2 (K-Means+OMP), and SR3 (K-Means+OMP1). 1161 volumes of interest (VOIs) were used to optimize the parameters and train each method, and 1049 VOIs were adopted to evaluate the performances of the methods. The SR based methods were powerful to recognize the DLD patterns (SR1: 96.1%, SR2: 95.6%, SR3: 96.4%) and significantly better than the baseline methods. Furthermore, when the K-Means and OMP1 were applied, the runtime of the SR based methods can be reduced by 98.2% and 55.2%, respectively. Therefore, we thought that the method using the K-Means and OMP1 (SR3) was efficient for the CAD of the DLDs. PMID:25821509

  2. Feature-ranking-based Alzheimer's disease classification from structural MRI.

    PubMed

    Beheshti, Iman; Demirel, Hasan

    2016-04-01

    High-dimensional classification approaches have been widely used to investigate magnetic resonance imaging (MRI) data for automatic classification of Alzheimer's disease (AD). This paper describes the use of t-test based feature-ranking approach as part of a novel feature selection procedure, where the number of top features is determined using the Fisher Criterion. The proposed classification system involves five systematic levels. First, voxel-based morphometry technique is used to compare the global and local differences of gray matter in patients with AD versus healthy controls (HCs). The significant local differences in gray matter volume are then selected as volumes of interests (VOIs). Second, the voxel clusters are employed as VOIs, where each voxel is considered to be a feature. Third, all the features are ranked using t-test scores. In this regard, the Fisher Criterion between the AD and HC groups is calculated for a changing number of ranked features, where the vector size maximizing the Fisher Criterion is selected as the optimal number of top discriminative features. Fourth, the classification is performed using support vector machine. Finally, data fusion methods among atrophy clusters are used to improve the classification performance. The experimental results indicate that the performance of the proposed system could compete well with the state-of-the-art techniques reported in the literature. PMID:26657976

  3. Iterative image reconstruction in helical cone-beam x-ray CT using a stored system matrix approach.

    PubMed

    Xu, Jingyan; Tsui, Benjamin M W

    2012-06-01

    We present a stored system matrix (SM) approach for iterative x-ray CT image reconstruction with helical cone-beam geometry. Because of the symmetry of a helical source trajectory, it is sufficient to calculate and store the SM entries for one transaxial slice only and for all source positions illuminating the slice. This is made possible by (1) selecting the reconstruction slice thickness to be an integer multiple of the source translation per projection view, and (2) discretizing the 3D reconstruction volume on a rotated stack of slices. Using the proposed method, the memory requirement for reconstructing a full field-of-view of clinical scanners is manageable on current computing platforms. The same storage principle can be generalized and applied to volume-of-interest (VOI) image reconstruction for helical cone-beam CT. In this case, the stored SM entries correspond to a partial- or full-ring region on one transaxial slice, and for all source positions illuminating the ring. The size and location of the ring depend on the size and the location of the VOI and the scan geometry. We demonstrate by both computer simulations and clinical patient data the speed and efficacy of iterative image reconstruction using the stored SM approach. PMID:22581218

  4. Iterative image reconstruction in helical cone-beam x-ray CT using a stored system matrix approach

    NASA Astrophysics Data System (ADS)

    Xu, Jingyan; Tsui, Benjamin M. W.

    2012-06-01

    We present a stored system matrix (SM) approach for iterative x-ray CT image reconstruction with helical cone-beam geometry. Because of the symmetry of a helical source trajectory, it is sufficient to calculate and store the SM entries for one transaxial slice only and for all source positions illuminating the slice. This is made possible by (1) selecting the reconstruction slice thickness to be an integer multiple of the source translation per projection view, and (2) discretizing the 3D reconstruction volume on a rotated stack of slices. Using the proposed method, the memory requirement for reconstructing a full field-of-view of clinical scanners is manageable on current computing platforms. The same storage principle can be generalized and applied to volume-of-interest (VOI) image reconstruction for helical cone-beam CT. In this case, the stored SM entries correspond to a partial- or full-ring region on one transaxial slice, and for all source positions illuminating the ring. The size and location of the ring depend on the size and the location of the VOI and the scan geometry. We demonstrate by both computer simulations and clinical patient data the speed and efficacy of iterative image reconstruction using the stored SM approach.

  5. Using anisotropic 3D Minkowski functionals for trabecular bone characterization and biomechanical strength prediction in proximal femur specimens

    NASA Astrophysics Data System (ADS)

    Nagarajan, Mahesh B.; De, Titas; Lochmüller, Eva-Maria; Eckstein, Felix; Wismüller, Axel

    2014-04-01

    The ability of Anisotropic Minkowski Functionals (AMFs) to capture local anisotropy while evaluating topological properties of the underlying gray-level structures has been previously demonstrated. We evaluate the ability of this approach to characterize local structure properties of trabecular bone micro-architecture in ex vivo proximal femur specimens, as visualized on multi-detector CT, for purposes of biomechanical bone strength prediction. To this end, volumetric AMFs were computed locally for each voxel of volumes of interest (VOI) extracted from the femoral head of 146 specimens. The local anisotropy captured by such AMFs was quantified using a fractional anisotropy measure; the magnitude and direction of anisotropy at every pixel was stored in histograms that served as a feature vectors that characterized the VOIs. A linear multi-regression analysis algorithm was used to predict the failure load (FL) from the feature sets; the predicted FL was compared to the true FL determined through biomechanical testing. The prediction performance was measured by the root mean square error (RMSE) for each feature set. The best prediction performance was obtained from the fractional anisotropy histogram of AMF Euler Characteristic (RMSE = 1.01 ± 0.13), which was significantly better than MDCT-derived mean BMD (RMSE = 1.12 ± 0.16, p<0.05). We conclude that such anisotropic Minkowski Functionals can capture valuable information regarding regional trabecular bone quality and contribute to improved bone strength prediction, which is important for improving the clinical assessment of osteoporotic fracture risk.

  6. Interobserver and Intraobserver Reproducibility with Volume Dynamic Contrast Enhanced Computed Tomography (DCE-CT) in Gastroesophageal Junction Cancer.

    PubMed

    Lundsgaard Hansen, Martin; Fallentin, Eva; Axelsen, Thomas; Lauridsen, Carsten; Norling, Rikke; Svendsen, Lars Bo; Nielsen, Michael Bachmann

    2016-01-01

    The purpose of this study was to assess inter- and intra-observer reproducibility of three different analytic methods to evaluate quantitative dynamic contrast-enhanced computed tomography (DCE-CT) measures from gastroesophageal junctional cancer. Twenty-five DCE-CT studies with gastroesophageal junction cancer were selected from a previous longitudinal study. Three radiologists independently reviewed all scans, and one repeated the analysis eight months later for intraobserver analysis. Review of the scans consisted of three analysis methods: (I) Four, fixed small sized regions of interest (2-dimensional (2D) fixed ROIs) placed in the tumor periphery, (II) 2-dimensional regions of interest (2D-ROI) along the tumor border in the tumor center, and (III) 3-dimensional volumes of interest (3D-VOI) containing the entire tumor volume. Arterial flow, blood volume and permeability (k(trans)) were recorded for each observation. Inter- and intra-observer variability were assessed by Intraclass Correlation Coefficient (ICC) and Bland-Altman statistics. Interobserver ICC was excellent for arterial flow (0.88), for blood volume (0.89) and for permeability (0.91) with 3D-VOI analysis. The 95% limits of agreement were narrower for 3D analysis compared to 2D analysis. Three-dimensional volume DCE-CT analysis of gastroesophageal junction cancer provides higher inter- and intra-observer reproducibility with narrower limits of agreement between readers compared to 2D analysis. PMID:26838804

  7. In vivo proton MR spectroscopy of primary tumours, nodal and recurrent disease of the extracranial head and neck.

    PubMed

    Bisdas, Sotirios; Baghi, Mehran; Huebner, Frank; Mueller, Cindy; Knecht, Rainald; Vorbuchner, Marianne; Ruff, Jan; Gstoettner, Wolfgang; Vogl, Thomas J

    2007-01-01

    Benign and malignant neoplasms as well as metastatic lymph nodes of 39 patients were examined using localized single voxel magnetic resonance spectroscopy (MRS) [repetition time (TR) 1500, echo time (TE) 135) at 1.5 T. New techniques with simultaneous correction of motion artefacts during the acquisition, three-dimensional saturation pulses, respiratory triggering and smaller volume of interest (VOI) size, were applied. Ratios of peak areas under the choline (Cho) and creatine (Cr) resonances were estimated in all cases and compared with those from samples of normal tissue. Ninety one spectra were acquired in 39 patients, 63 of which were suitable for further evaluation. The smallest VOI was 0.40 cm(3). The Cho/Cr ratios in all malignant neoplasms (mean: 5.2, range: 1.7-17.8) were significantly elevated relative to those in the normal muscle structures (mean: 0.9, range: 0.2-1.4), while those in the benign neoplasms were elevated (mean: 24.4, range: 1.4-59.7) with respect to those in the malignant ones. The average Cho/Cr ratio in the metastatic lymph nodes was significantly higher (mean: 4.8, range: 3.3-5.6) than that for benign lymphoid hyperplasia (mean: 2.2, range: 1.0-3.0). MRS measurements were able to differentiate recurrent disease from post-therapeutic tissue changes in 11 out of 13 patients. PMID:16703309

  8. Optical data self-routing using address decoding

    NASA Astrophysics Data System (ADS)

    Koppa, P.; Chavel, P.; Oudar, J. L.; Kuszelewicz, R.; Schnell, J. Ph.; Pocholle, J. P.

    1994-12-01

    We present an optoelectronic self-routing packet switch for digital data commutation applications. The routing of the input data is determined by the optical decoding of the destination address coded in the packet header preceding the data bits. As proof of the operating principle, a one input 64 output demonstration system was built. The experiment is based on the association of two 8 × 8 arrays of GaAs/GaAlAs multiple quantum well electro-optical modulators and optical bistable devices. We have demonstrated the optical address decoding in our first experiments by operating individually the channels of the set-up. Nous présentons un autocommutateur optoélectronique pour signaux numériques organisés en paquets de bits. Le routage des paquets entrant dans le commutateur est déterminé par le décodage optique de l'adresse de destination présente dans l'en-tête de chaque paquet. Pour valider ce principe, un système démonstrateur de commutation d'une voie d'entrée vers 64 voies de sortie a été construit. L'expérience est basée sur l'association d'une matrice de 8 × 8 modulateurs électro-optiques et d'un composant bistable optique à structure de puits quantiques multiples en GaAs/GaAlAs. L'opération de décodage d'adresses a été montrée par nos premières expériences sur les voies du système prises une par une.

  9. Using PET/CT Bone Scan Dynamic Data to Evaluate Tibia Remodeling When a Taylor Spatial Frame Is Used: Short and Longer Term Differences

    PubMed Central

    Lundblad, Henrik; Maguire, Gerald Q.; Karlsson-Thur, Charlotte; Jonsson, Cathrine; Noz, Marilyn E.; Zeleznik, Michael P.; Jacobsson, Hans; Weidenhielm, Lars

    2015-01-01

    Eighteen consecutive patients, treated with a Taylor Spatial Frame for complex tibia conditions, gave their informed consent to undergo Na18F? PET/CT bone scans. We present a Patlak-like analysis utilizing an approximated blood time-activity curve eliminating the need for blood aliquots. Additionally, standardized uptake values (SUV) derived from dynamic acquisitions were compared to this Patlak-like approach. Spherical volumes of interest (VOIs) were drawn to include broken bone, other (normal) bone, and muscle. The SUVm(t) (m = max, mean) and a series of slopes were computed as (SUVm(ti) ? SUVm(tj))/(ti ? tj), for pairs of time values ti and tj. A Patlak-like analysis was performed for the same time values by computing ((VOIp(ti)/VOIe(ti))?(VOIp(tj)/VOIe(tj)))/(ti ? tj), where p = broken bone, other bone, and muscle and e = expected activity in a VOI. Paired comparisons between Patlak-like and SUVm slopes showed good agreement by both linear regression and correlation coefficient analysis (r = 84%, rs = 78%-SUVmax, r = 92%, and rs = 91%-SUVmean), suggesting static scans could substitute for dynamic studies. Patlak-like slope differences of 0.1?min?1 or greater between examinations and SUVmax differences of ~5 usually indicated good remodeling progress, while negative Patlak-like slope differences of ?0.06?min?1 usually indicated poor remodeling progress in this cohort. PMID:26436093

  10. Optimising the reward of appraisal drilling

    SciTech Connect

    Gdula, J.

    1996-12-31

    Management of the uncertainties associated with the development of a hydrocarbon resource is essential to minimize economic risk. In many instances these uncertainties can only be reduced by appraisal drilling. This presentation illustrates the efforts being made to manage uncertainty by determining its impact on overall project profitability. The Value of Information (VOI) approach is described. VOI aims at quantifying the benefits of appraisal by determining its economic reward in terms of its contribution to a development plan which is economically robust over the uncertainty range. Appraisal drilling costs can be reduced by combining appraisal and development objectives in one well. The growing use of horizontal drilling technology has resulted in novel approaches to appraisal. As examples, in the Osprey and Brent Fields (UK North Sea) wells were designed to satisfy both appraisal and development objectives. In Osprey, a well was drilled from a central production platform to provide water injection support in a satellite structure while at the same time appraising the saddle area between the two structures. In Brent, horizontal wells are used to appraise and develop the so called slump blocks, characterized by being highly faulted and compartmentalized. Another increasingly common application of horizontal wells is for the flank appraisal of hydrocarbon bearing structure. Examples from the Rabi Field (Gabon) and Batan Field (Nigeria) show how appraisal was achieved by extending the reach of horizontal development wells from the central core of the structures.

  11. Optimising the reward of appraisal drilling

    SciTech Connect

    Gdula, J.

    1996-01-01

    Management of the uncertainties associated with the development of a hydrocarbon resource is essential to minimize economic risk. In many instances these uncertainties can only be reduced by appraisal drilling. This presentation illustrates the efforts being made to manage uncertainty by determining its impact on overall project profitability. The Value of Information (VOI) approach is described. VOI aims at quantifying the benefits of appraisal by determining its economic reward in terms of its contribution to a development plan which is economically robust over the uncertainty range. Appraisal drilling costs can be reduced by combining appraisal and development objectives in one well. The growing use of horizontal drilling technology has resulted in novel approaches to appraisal. As examples, in the Osprey and Brent Fields (UK North Sea) wells were designed to satisfy both appraisal and development objectives. In Osprey, a well was drilled from a central production platform to provide water injection support in a satellite structure while at the same time appraising the saddle area between the two structures. In Brent, horizontal wells are used to appraise and develop the so called slump blocks, characterized by being highly faulted and compartmentalized. Another increasingly common application of horizontal wells is for the flank appraisal of hydrocarbon bearing structure. Examples from the Rabi Field (Gabon) and Batan Field (Nigeria) show how appraisal was achieved by extending the reach of horizontal development wells from the central core of the structures.

  12. Normal regional distribution of cerebral blood flow in dogs: comparison between (99m) Tc-ethylcysteinate dimer and (99m) Tc- hexamethylpropylene amine oxime single photon emission computed tomography.

    PubMed

    Adriaens, Antita; Polis, Ingeborgh; Waelbers, Tim; Vandermeulen, Eva; Dobbeleir, André; De Spiegeleer, Bart; Peremans, Kathelijne

    2013-01-01

    Functional imaging provides important insights into canine brain pathologies such as behavioral problems. Two (99m) Tc-labeled single photon emission computed tomography (SPECT) cerebral blood flow tracers-ethylcysteinate dimer (ECD) and hexamethylpropylene amine oxime (HMPAO)-are commonly used in human medicine and have been used previously in dogs but intrasubject comparison of both tracers in dogs is lacking. Therefore, this study investigated whether regional distribution differences between both tracers occur in dogs as is reported in humans. Eight beagles underwent two SPECT examinations first with (99m) Tc-ECD and followed by (99m) Tc-HMPAO. SPECT scanning was performed with a triple head gamma camera equipped with ultrahigh resolution parallel hole collimators. Images were reconstructed using filtered backprojection with a Butterworth filter. Emission data were fitted to a template permitting semiquantification using predefined regions or volumes of interest (VOIs). For each VOI, perfusion indices were calculated by normalizing the regional counts per voxel to total brain counts per voxel. The obtained perfusion indices for each region for both tracers were compared with a paired Student's T-test. Significant (P < 0.05) regional differences were seen in the subcortical region and the cerebellum. Both tracers can be used to visualize regional cerebral blood flow in dogs, however, due to the observed regional differences, they are not entirely interchangeable. PMID:23496105

  13. Estimating the benefits of land imagery in environmental applications: a case study in nonpoint source pollution of groundwater

    USGS Publications Warehouse

    Bernknopf, Richard L.; Forney, William M.; Raunikar, Ronald P.; Mishra, Shruti K.

    2012-01-01

    Moderate-resolution land imagery (MRLI) is crucial to a more complete assessment of the cumulative, landscape-level effect of agricultural land use and land cover on environmental quality. If this improved assessment yields a net social benefit, then that benefit reflects the value of information (VOI) from MRLI. Environmental quality and the capacity to provide ecosystem services evolve because of human actions, changing natural conditions, and their interaction with natural physical processes. The human actions, in turn, are constrained and redirected by many institutions and regulations such as agricultural, energy, and environmental policies. We present a general framework for bringing together sociologic, biologic, physical, hydrologic, and geologic processes at meaningful scales to interpret environmental implications of MRLI applications. We set out a specific application using MRLI observations to identify crop planting patterns and thus estimate surface management activities that influence groundwater resources over a regional landscape. We tailor the application to the characteristics of nonpoint source groundwater pollution hazards in Iowa to illustrate a general framework in a land use-hydrologic-economic system. In the example, MRLI VOI derives from reducing the risk of both losses to agricultural production and damage to human health and other consequences of contaminated groundwater.

  14. A homogeneous superconducting magnet design using a hybrid optimization algorithm

    NASA Astrophysics Data System (ADS)

    Ni, Zhipeng; Wang, Qiuliang; Liu, Feng; Yan, Luguang

    2013-12-01

    This paper employs a hybrid optimization algorithm with a combination of linear programming (LP) and nonlinear programming (NLP) to design the highly homogeneous superconducting magnets for magnetic resonance imaging (MRI). The whole work is divided into two stages. The first LP stage provides a global optimal current map with several non-zero current clusters, and the mathematical model for the LP was updated by taking into account the maximum axial and radial magnetic field strength limitations. In the second NLP stage, the non-zero current clusters were discretized into practical solenoids. The superconducting conductor consumption was set as the objective function both in the LP and NLP stages to minimize the construction cost. In addition, the peak-peak homogeneity over the volume of imaging (VOI), the scope of 5 Gauss fringe field, and maximum magnetic field strength within superconducting coils were set as constraints. The detailed design process for a dedicated 3.0 T animal MRI scanner was presented. The homogeneous magnet produces a magnetic field quality of 6.0 ppm peak-peak homogeneity over a 16 cm by 18 cm elliptical VOI, and the 5 Gauss fringe field was limited within a 1.5 m by 2.0 m elliptical region.

  15. Predicting the biomechanical strength of proximal femur specimens with Minkowski functionals and support vector regression

    NASA Astrophysics Data System (ADS)

    Yang, Chien-Chun; Nagarajan, Mahesh B.; Huber, Markus B.; Carballido-Gamio, Julio; Bauer, Jan S.; Baum, Thomas; Eckstein, Felix; Lochmüller, Eva-Maria; Link, Thomas M.; Wismüller, Axel

    2014-03-01

    Regional trabecular bone quality estimation for purposes of femoral bone strength prediction is important for improving the clinical assessment of osteoporotic fracture risk. In this study, we explore the ability of 3D Minkowski Functionals derived from multi-detector computed tomography (MDCT) images of proximal femur specimens in predicting their corresponding biomechanical strength. MDCT scans were acquired for 50 proximal femur specimens harvested from human cadavers. An automated volume of interest (VOI)-fitting algorithm was used to define a consistent volume in the femoral head of each specimen. In these VOIs, the trabecular bone micro-architecture was characterized by statistical moments of its BMD distribution and by topological features derived from Minkowski Functionals. A linear multiregression analysis and a support vector regression (SVR) algorithm with a linear kernel were used to predict the failure load (FL) from the feature sets; the predicted FL was compared to the true FL determined through biomechanical testing. The prediction performance was measured by the root mean square error (RMSE) for each feature set. The best prediction result was obtained from the Minkowski Functional surface used in combination with SVR, which had the lowest prediction error (RMSE = 0.939 ± 0.345) and which was significantly lower than mean BMD (RMSE = 1.075 ± 0.279, p<0.005). Our results indicate that the biomechanical strength prediction can be significantly improved in proximal femur specimens with Minkowski Functionals extracted from on MDCT images used in conjunction with support vector regression.

  16. Insula Volume and Salience Network Are Associated with Memory Decline in Parkinson Disease: Complementary Analyses of Voxel-Based Morphometry versus Volume of Interest

    PubMed Central

    Lu, Yan-Ting; Chang, Wen-Neng; Chang, Chiung-Chih; Lu, Cheng-Hsien; Chen, Nai-Ching; Huang, Chi-Wei; Chang, Ya-Ting

    2016-01-01

    Objective. We investigated structural brain change in subjects with a clinical diagnosis of Parkinson disease with mild cognitive impairment (PD-MCI) and examined its relationship with memory impairment. Methods. Twenty-three PD-MCI patients were enrolled and underwent cognitive evaluation and 3-dimensional T1-weighted imaging. Voxel-based morphometry (VBM) was used to assess brain-behavior correlations and examine the relationship between insula and memory score. VOI methods replicated results obtained from VBM. Results. VBM uncovered the notion that memory scores were positively correlated with the gray matter (GM) density in the insular cortex and a significant positive correlation between overall cognitive performance and concentration of GM within the lateral temporal cortex. In VOI analyses, our results suggested a positive correlation between the insula and composite free-recall verbal memory (ρ = 0.617, P = 0.003) and the delayed free-recall verbal memory subdomain (ρ = 0.725, P < 0.001). Furthermore, we found a positive correlation between the insula and caudate (σ = 0.570, P = 0.006) and putamen volume (σ = 0.683, P < 0.001). Conclusions. In patients with PD-MCI, atrophic changes in the insula may be related to memory deficits, and the brain-behavior correlation may be associated with atrophic change in the striatum within the salience network. PMID:26998378

  17. A Monte Carlo investigation of dual-energy-window scatter correction for volume-of-interest quantification in 99Tcm SPECT.

    PubMed

    Luo, J Q; Koral, K F; Ljungberg, M; Floyd, C E; Jaszczak, R J

    1995-01-01

    Using Monte Carlo simulation of 99Tcm single-photon-emission computed tomography (SPECT), we investigate the effects of tissue-background activity, tumour location, patient size, uncertainty of energy windows, and definition of tumour region on the accuracy of quantification. The dual-energy-window method of correction for Compton scattering is employed and the multiplier which yields correct activity for the VI as a whole calculated. The model is usually a sphere containing radioactive water located within a cylinder filled with a more dilute solution of radioactivity. Two simulation codes are employed. Reconstruction is by ML-EM algorithm with attenuation compensation. The scatter multiplier depends only slightly on the sphere location or the cylinder diameter. It also depends little on whether correction is before or after reconstruction. At low background level, it changes with VOI size, but not at higher background. For a geometrical VOI, it is 1.25 at zero background, decreases sharply to 0.56 for equal concentrations, and is 0.44 when the background concentration is very large. Quantification is accurate (less than 9% error) if the test background is reasonably close to that used in setting the universal scatter-multiplier value, or if the test backgrounds are always large and so is the universal-value background, but not if the test backgrounds cover a large range of values including zero. Results largely agree with those from experiment after the experimental data with background is re-evaluated with prejudice. PMID:7708840

  18. A sparse representation based method to classify pulmonary patterns of diffuse lung diseases.

    PubMed

    Zhao, Wei; Xu, Rui; Hirano, Yasushi; Tachibana, Rie; Kido, Shoji

    2015-01-01

    We applied and optimized the sparse representation (SR) approaches in the computer-aided diagnosis (CAD) to classify normal tissues and five kinds of diffuse lung disease (DLD) patterns: consolidation, ground-glass opacity, honeycombing, emphysema, and nodule. By using the K-SVD which is based on the singular value decomposition (SVD) and orthogonal matching pursuit (OMP), it can achieve a satisfied recognition rate, but too much time was spent in the experiment. To reduce the runtime of the method, the K-Means algorithm was substituted for the K-SVD, and the OMP was simplified by searching the desired atoms at one time (OMP1). We proposed three SR based methods for evaluation: SR1 (K-SVD+OMP), SR2 (K-Means+OMP), and SR3 (K-Means+OMP1). 1161 volumes of interest (VOIs) were used to optimize the parameters and train each method, and 1049 VOIs were adopted to evaluate the performances of the methods. The SR based methods were powerful to recognize the DLD patterns (SR1: 96.1%, SR2: 95.6%, SR3: 96.4%) and significantly better than the baseline methods. Furthermore, when the K-Means and OMP1 were applied, the runtime of the SR based methods can be reduced by 98.2% and 55.2%, respectively. Therefore, we thought that the method using the K-Means and OMP1 (SR3) was efficient for the CAD of the DLDs. PMID:25821509

  19. VizieR Online Data Catalog: Catalogue of the Brightest Stars (Ochsenbein+ 1988)

    NASA Astrophysics Data System (ADS)

    Ochsenbein, F.; Halbwachs, J. L.

    1999-02-01

    Ce catalogue fournit des donnees sur les 1628 etoiles brillantes de magnitude allant jusqu'a 5.01 contenues dans le "catalogue des etoiles les plus brillantes" de F. Ochsenbein et co. (1984), lui-meme derive de la 4eme edition du "Bright Star Catalogue" (Hoffleit 1982). Il differe de la version originale imprimee par les points suivants: - les designations des etoiles dane le catalogue Hipparcos, ainsi que les positions Hipparcos, exprimees dans l'International Celestial Reference System (ICRS), ont ete rajoutees (A) - les valeurs des parallaxes et mouvements propres ont ete remplacees par les valeurs du catalogue Hipparcos pour la quasi-totalite des etoiles (A) - les distances en annees-lumieres ont ete calculees (A) - les coordonnees ecliptiques ont ete ajoutees aux donnees astrometriques. - la photometrie UBVRI a ete extraite du catalogue de Lanz (1986); ceci explique que trois etoiles soient de magnitude superieure a 5.00 (HR 3229, HR 4392 et HR 6161). De plus, afin de faciliter les traitements par programme, on donne la valeur 99.99 en cas de mesure manquante (99.999 pour l'uvbyHbeta). - la lettre grecque "delta", qui apparaissait dans les types spectraux sous la forme codee "<04>" est maintenant ecrite en toutes lettres. - une colonne donnant la classe de luminosite en chiffre arabe a ete ajoutee a l'ecriture classique du type spectral. - le nombre de composantes des etoiles doubles visuelles (2) est donne explicitement. (A) indique les donnees ajoutees dans la version 'A'

  20. Design and fabrication of intake manifold for formula SAE (Society of Automotive Engineers) race car

    NASA Astrophysics Data System (ADS)

    Dore, Sylvie; Lavallee, Patrice

    1997-01-01

    Every year, a group of students from Ecole de technologie superieure (ETS) in Montreal design and build a formula-type race car and compete in the Formula SAE competition. In this paper, we examine the design and fabrication of the ir intake system, A number of constraints challenge the designers. For example, to ensure the security of amateur drivers, motors are restrained to 600 cc and a circular restriction of 20 mm in diameter is placed at the entry of the system. Under these conditions, it is important to optimize the quality of the air/fuel mixture which depends mostly on the air intake system. A theoretical analysis reduced the field of possible runner length. However, the influence of runner configuration, plenum shape and size can only be determined experimentally. Polyacrylic functional prototypes were produced and tested on a dynamometric bench. A stereolithography model representing the inner passageways of the optimal intake manifold was built and used as a positive for a polyurethane mold. A composite lamination process was used to laminate the pre-production prototype over a molded wax plug. The major advantage of this approach over craftsmanship or even machining is the time saved to make the mold and the unlimited complexity of the shape permitted by the rapid prototyping systems.

  1. Turonian ammonite faunas from the southern Corbières, Aude, France

    NASA Astrophysics Data System (ADS)

    Kennedy, William James; Bilotte, Michel; Melchior, Patrice

    2015-12-01

    The Turonian successions of the southern Corbieres comprise three transgressive-regressive cycles in which ammonites occur in three intervals. The lowest comes from the glauconitic basal transgressive unit of the first cycle, and comprises 21 species, including Kamerunoceras douvillei (Pervinquiere, 1907), Kamerunoceras turoniense (d'Orbigny, 1850), Spathites (Jeanrogericeras) revelerianus (Courtiller, 1860), Spathites (Jeanrogericeras) combesi (d'Orbigny, 1856), Mammites nodosoides (Schluter, 1871), Mammites powelli Kennedy, Wright and Hancock, 1987, Fagesia tevestensis (Peron, 1896), Neoptychites cephalotus (Coutiller, 1860), Thomasites rollandi (Thomas and Peron, 1889), Wrightoceras wallsi Reyment, 1954, and Choffaticeras (Choffaticeras) quaasi (Peron, 1904). This is a Lower Turonian assemblage referred to the Mammites nodosoides Zone, although the possibility that elements from the preceding Fagesia catinus Zone are also present cannot be excluded. The fauna from the transgressive glauconitic interval of the succeeding cycle comprises nine species, including Romaniceras (Romaniceras) mexicanum Jones, 1938, Romaniceras (Yubariceras) ornatissimum (Stoliczka, 1864), Pseudotissotia galliennei (d'Orbigny, 1850), Collignoniceras woollgari (Mantell, 1822) sensu lato, Coilopoceras springeri Hyatt, 1903, and Eubostrychoceras (Eubostrychoceras) saxonicum (Schluter, 1872). They indicate the Middle Turonian Romaniceras (R.) mexicanum and R. (Y.) ornatissimum zones. The highest fauna, from the Marnes superieurs de Saint-Louis of the Saint-Louis syncline, is: Subprionocyclus sp. juv., Prionocyclus sp. and Worthoceras cf. rochatianum (d'Orbigny, 1850). The Subprionocyclus are minute individuals that resemble S. bravaisianus (d'Orbigny, 1841), and suggest the presence of the lower Upper Turonian bravaisianus Zone.

  2. Virtual firm in biomedical education: a very successful experience.

    PubMed

    Butterlin, Nadia; Flores, Steeven; Guyon, Florent; Blagosklonov, Oleg

    2014-01-01

    In May 2006, the Institut Superieur d'Ingenieurs de Franche-Comté (ISIFC) launched its own virtual firm, which was named Biotika® by students. Virtual means that this company has no real legal status. It is a pedagogic model; however, the situation scenario for the ISIFC student engineers is real. They are currently working in real conditions on the development of new medical devices and on the modernization of medical products. The need for these innovative medical devices was identified by the students during their second-year (6 weeks) internship in hospitals. Biotika® is open between March and December every year. The students are "recruited" following an imitation job interview and each is then entrusted with a mission (engineer, project manager etc.) in one of the company's four departments: Research & Design, Quality-regulatory affairs, Clinical investigations, and Public relations-marketing. The personnel of Biotika® work on the development of innovative medical devices and/or the preparation of CE or FDA certification for 2 days per week. Since its launch, Biotika® has developed eight products and obtained many grants and prizes from French research and governmental organizations. It is also certified ISO 13485. PMID:25571157

  3. Reconnaissance Invariante des Formes avec le Filtre de Fourier-Mellin et un Reseau Neuronique

    NASA Astrophysics Data System (ADS)

    Lejeune, Claude

    Le filtre de Fourier-Mellin est applique a un ensemble d'objets pour generer des vecteurs invariants sous translation, rotation et changement d'echelle. C'est la premiere methode permettant d'obtenir ces trois invariants simultanement. Le calcul des vecteurs invariants est fait numeriquement et optiquement. Les vecteurs ainsi obtenus sont utilises comme entrees dans un reseau neuronique backpropagation pour faire la classification des prototypes qui lui sont presentes. Les dimensions des vecteurs invariants sont tres petites par rapport aux objets d'entree et permettent d'utiliser un reseau possedant un nombre restreint de connexions. Il devient possible d'entrai ner le reseau dans des temps relativement courts sur un ordinateur du type PC. Une fois le reseau entrai ne, nous lui presentons des vecteurs invariants provenant d'objets se retrouvant dans l'ensemble d'entrai nement mais ayant subi des rotations et des changements d'echelle. Ce nouveau groupe represente l'ensemble de rappel. La performance de la methode est tres bonne avec des taux de succes superieurs a 85%.

  4. MO-C-17A-08: Evaluation of Lung Deformation Using Three Dimensional Strain Maps

    SciTech Connect

    Cui, T; Huang, Q; Miller, W; Zhong, X; Yin, F; Cai, J

    2014-06-15

    Purpose: To develop a systematic approach to generate three dimensional (3D) strain maps of lung using the displacement vector field (DVF) during the respiratory deformation, and to demonstrate its application in evaluating deformable image registration (DIR). Methods: A DVF based strain tensor at each voxel of interest (VOI) was calculated from the relative displacements between the VOI and each of the six nearest neighbors. The maximum and minimum stretches of a VOI can be determined by the principal strains (E{sub 1}, E{sub 2} and E{sub 3}), which are the eigenvalues and the corresponding strain tensors. Two healthy volunteers enrolled in this study under IRB-approved protocol, each was scanned using 3D Hyperpolarized He-3 tagging-MRI and 3D proton-MRI with TrueFISP sequence at the endof- inhalation (EOI) and the end-of-exhalation (EOE) phases. 3D DVFs of tagging- and proton-MRI were obtained by the direct measurements of the tagging grid trajectory and by the DIR method implemented in commercial software. Results: 3D strain maps were successfully generated for all DVFs. The principal strain E1s were calculated as 0.43±0.05 and 0.17±0.25 for tagging-MRI and proton-MRI, respectively. The large values of E{sub 1} indicate the predominant lung motion in the superior-inferior (SI) direction. Given that the DVFs from the tagging images are considered as the ground truth, the discrepancies in the DIR-based strain maps suggest the inaccuracy of the DIR algorithm. In the E{sub 1} maps of tagging-MRI for subject 1, the fissures were distinguishable by the larger values (0.49±0.02) from the adjacent tissues (0.41±0.03) due to the larger relative displacement between the lung lobes. Conclusion: We have successfully developed a methodology to generate DVF-based 3D strain maps of lung. It can potentially enable us to better understand the pulmonary biomechanics and to evaluate and improve the DIR algorithms for the lung deformation. We are currently studying more subjects to evaluate this tool.

  5. EQPlanar: A Maximum-Likelihood Method for Accurate Organ Activity Estimation from Whole Body Planar Projections

    PubMed Central

    Song, N.; He, B.; Wahl, R. L.; Frey, E. C.

    2012-01-01

    Optimizing targeted radionuclide therapy (TRT) requires patient-specific estimation of organ doses. The organ doses are estimated from quantitative nuclear medicine imaging studies, many of which involve planar wholebody scans. We have previously developed the Quantitative Planar (QPlanar) processing method and demonstrated its ability to provide more accurate activity estimates than conventional geometric-mean based planar (CPlanar) processing methods using physical phantom and simulation studies. The QPlanar method uses the maximum likelihood-expectation maximization (ML-EM) algorithm, 3D organ VOIs, and rigorous models of physical image degrading factors to estimate organ activities. However, the QPlanar method requires alignment between the 3D organ VOIs and the 2D planar projections and assumes uniform activity distribution in each VOI. This makes application to patients challenging. As a result, in this paper we propose an extended QPlanar (EQPlanar) method that provides independent-organ rigid registration and includes multiple background regions. We have validated this method using both Monte Carlo simulation and patient data. In the simulation study, we evaluated the precision and accuracy of the method in comparison to the original QPlanar method. For the patient studies, we compared organ activity estimates at 24 hours after injection with those from conventional geometric mean based planar quantification using a 24 hour post-injection quantitative SPECT reconstruction as the gold standard. We also compared the goodness of fit of the measured and estimated projections obtained from EQPlanar method to those from the original method at 4 other time points where gold standard data was not available. In the simulation study, more accurate activity estimates were provided by the EQPlanar method for all the organs at all the time points compared with the QPlanar method. Based on the patient data, we concluded that the EQPlanar method provided a substantial increase in accuracy of organ activity estimates from 24 hr planar images compared to the CPlanar using 24 hr SPECT as the golden standard. For other time points, where no golden standard is available, better agreement between estimated and measured projections was observed by using EQPlanar method compared to the QPlanar method. This phenomenon is consistent with the improvement in goodness of fit seen in both simulation data and 24 hr patient data. Therefore, this indicates the improved reliability of organ activity estimates obtained though EQPlanar method. PMID:21813961

  6. Fuzzy hidden Markov chains segmentation for volume determination and quantitation in PET

    PubMed Central

    Hatt, Mathieu; Lamare, Frédéric; Boussion, Nicolas; Roux, Christian; Turzo, Alexandre; Cheze-Lerest, Catherine; Jarritt, Peter; Carson, Kathryn; Salzenstein, Fabien; Collet, Christophe; Visvikis, Dimitris

    2007-01-01

    Accurate volume of interest (VOI) estimation in PET is crucial in different oncology applications such as response to therapy evaluation and radiotherapy treatment planning. The objective of our study was to evaluate the performance of the proposed algorithm for automatic lesion volume delineation; namely the Fuzzy Hidden Markov Chains (FHMC), with that of current state of the art in clinical practice threshold based techniques. As the classical Hidden Markov Chain (HMC) algorithm, FHMC takes into account noise, voxel’s intensity and spatial correlation, in order to classify a voxel as background or functional VOI. However the novelty of the fuzzy model consists of the inclusion of an estimation of imprecision, which should subsequently lead to a better modelling of the “fuzzy” nature of the object on interest boundaries in emission tomography data. The performance of the algorithms has been assessed on both simulated and acquired datasets of the IEC phantom, covering a large range of spherical lesion sizes (from 10 to 37mm), contrast ratios (4:1 and 8:1) and image noise levels. Both lesion activity recovery and VOI determination tasks were assessed in reconstructed images using two different voxel sizes (8mm3 and 64mm3). In order to account for both the functional volume location and its size, the concept of % classification errors was introduced in the evaluation of volume segmentation using the simulated datasets. Results reveal that FHMC performs substantially better than the threshold based methodology for functional volume determination or activity concentration recovery considering a contrast ratio of 4:1 and lesion sizes of <28mm. Furthermore differences between classification and volume estimation errors evaluated were smaller for the segmented volumes provided by the FHMC algorithm. Finally, the performance of the automatic algorithms was less susceptible to image noise levels in comparison to the threshold based techniques. The analysis of both simulated and acquired datasets led to similar results and conclusions as far as the performance of segmentation algorithms under evaluation is concerned. PMID:17664555

  7. MO-C-17A-02: A Novel Method for Evaluating Hepatic Stiffness Based On 4D-MRI and Deformable Image Registration

    SciTech Connect

    Cui, T; Liang, X; Czito, B; Palta, M; Bashir, M; Yin, F; Cai, J

    2014-06-15

    Purpose: Quantitative imaging of hepatic stiffness has significant potential in radiation therapy, ranging from treatment planning to response assessment. This study aims to develop a novel, noninvasive method to quantify liver stiffness with 3D strains liver maps using 4D-MRI and deformable image registration (DIR). Methods: Five patients with liver cancer were imaged with an institutionally developed 4D-MRI technique under an IRB-approved protocol. Displacement vector fields (DVFs) across the liver were generated via DIR of different phases of 4D-MRI. Strain tensor at each voxel of interest (VOI) was computed from the relative displacements between the VOI and each of the six adjacent voxels. Three principal strains (E{sub 1}, E{sub 2} and E{sub 3}) of the VOI were derived as the eigenvalue of the strain tensor, which represent the magnitudes of the maximum and minimum stretches. Strain tensors for two regions of interest (ROIs) were calculated and compared for each patient, one within the tumor (ROI{sub 1}) and the other in normal liver distant from the heart (ROI{sub 2}). Results: 3D strain maps were successfully generated fort each respiratory phase of 4D-MRI for all patients. Liver deformations induced by both respiration and cardiac motion were observed. Differences in strain values adjacent to the distant from the heart indicate significant deformation caused by cardiac expansion during diastole. The large E{sub 1}/E{sub 2} (∼2) and E{sub 1}/E{sub 2} (∼10) ratios reflect the predominance of liver deformation in the superior-inferior direction. The mean E{sub 1} in ROI{sub 1} (0.12±0.10) was smaller than in ROI{sub 2} (0.15±0.12), reflecting a higher degree of stiffness of the cirrhotic tumor. Conclusion: We have successfully developed a novel method for quantitatively evaluating regional hepatic stiffness based on DIR of 4D-MRI. Our initial findings indicate that liver strain is heterogeneous, and liver tumors may have lower principal strain values than normal liver. Thorough validation of our method is warranted in future studies. NIH (1R21CA165384-01A1)

  8. Transfer of normal 99mTc-ECD brain SPET databases between different gamma cameras.

    PubMed

    Van Laere, K; Koole, M; Versijpt, J; Vandenberghe, S; Brans, B; D'Asseler, Y; De Winter, O; Kalmar, A; Dierckx, R

    2001-04-01

    A stereotactic, normal perfusion database is imperative for optimal clinical brain single-photon emission tomography (SPET). However, interdepartmental use of normal data necessitates accurate transferability of these data sets. The aim of this study was to investigate transfer of three normal perfusion databases obtained in the same large population of healthy volunteers who underwent sequential scanning using multihead gamma cameras with different resolution. Eighty-nine healthy adults (46 females, 43 males; aged 20-81 years) were thoroughly screened by history, biochemistry, physical and full neurological examination, neuropsychological testing and magnetic resonance imaging. After injection of 925 MBq technetium-99m labelled ethyl cysteinate dimer (ECD) under standard conditions, 101 scans were acquired from all subjects (12 repeat studies) on a triple-head Toshiba GCA-9300A (measured average FWHM 8.1 mm). Ninety-one sequential scans were performed on a dual-head Elscint Helix camera (FWHM 9.6 mm) and 22 subjects also underwent imaging on a triple-head Prism 3000 (FWHM 9.6 mm). Images were transferred to the same processing platform and reconstructed by filtered back-projection with the same Butterworth filter (order 8, cut-off 0.9 cycles/cm) and uniform Sorensen attenuation correction (mu = 0.09). After automated rigid intrasubject registration, all subjects were automatically reoriented to a stereotactic template by a nine-parameter affine transformation. The databases were analysed using 35 predefined volumes of interest (VOIs) with normalisation on total VOI counts. For comparison, the high-resolution data were smoothed with a 3D Gaussian kernel to achieve more similar spatial resolution. Hoffman phantom measurements were conducted on all cameras. Partial volume effects after smoothing varied between -6.5% and 10%, depending on VOI size. Between-camera reproducibility was 2.5% and 2.7% for the Toshiba camera versus the Helix and the Prism database, respectively. The highest reduction in between-camera variability was achieved by resolution adjustment in combination with linear washout correction and a Hoffman phantom-based correction. In conclusion, transfer of normal perfusion data between multihead gamma cameras can be accurately achieved, thereby enabling widespread interdepartmental use, which is likely to have a positive impact on the diagnostic capabilities of clinical brain perfusion SPET. PMID:11357493

  9. Analysis of real-time reservoir monitoring : reservoirs, strategies, & modeling.

    SciTech Connect

    Mani, Seethambal S.; van Bloemen Waanders, Bart Gustaaf; Cooper, Scott Patrick; Jakaboski, Blake Elaine; Normann, Randy Allen; Jennings, Jim; Gilbert, Bob; Lake, Larry W.; Weiss, Chester Joseph; Lorenz, John Clay; Elbring, Gregory Jay; Wheeler, Mary Fanett; Thomas, Sunil G.; Rightley, Michael J.; Rodriguez, Adolfo; Klie, Hector; Banchs, Rafael; Nunez, Emilio J.; Jablonowski, Chris

    2006-11-01

    The project objective was to detail better ways to assess and exploit intelligent oil and gas field information through improved modeling, sensor technology, and process control to increase ultimate recovery of domestic hydrocarbons. To meet this objective we investigated the use of permanent downhole sensors systems (Smart Wells) whose data is fed real-time into computational reservoir models that are integrated with optimized production control systems. The project utilized a three-pronged approach (1) a value of information analysis to address the economic advantages, (2) reservoir simulation modeling and control optimization to prove the capability, and (3) evaluation of new generation sensor packaging to survive the borehole environment for long periods of time. The Value of Information (VOI) decision tree method was developed and used to assess the economic advantage of using the proposed technology; the VOI demonstrated the increased subsurface resolution through additional sensor data. Our findings show that the VOI studies are a practical means of ascertaining the value associated with a technology, in this case application of sensors to production. The procedure acknowledges the uncertainty in predictions but nevertheless assigns monetary value to the predictions. The best aspect of the procedure is that it builds consensus within interdisciplinary teams The reservoir simulation and modeling aspect of the project was developed to show the capability of exploiting sensor information both for reservoir characterization and to optimize control of the production system. Our findings indicate history matching is improved as more information is added to the objective function, clearly indicating that sensor information can help in reducing the uncertainty associated with reservoir characterization. Additional findings and approaches used are described in detail within the report. The next generation sensors aspect of the project evaluated sensors and packaging survivability issues. Our findings indicate that packaging represents the most significant technical challenge associated with application of sensors in the downhole environment for long periods (5+ years) of time. These issues are described in detail within the report. The impact of successful reservoir monitoring programs and coincident improved reservoir management is measured by the production of additional oil and gas volumes from existing reservoirs, revitalization of nearly depleted reservoirs, possible re-establishment of already abandoned reservoirs, and improved economics for all cases. Smart Well monitoring provides the means to understand how a reservoir process is developing and to provide active reservoir management. At the same time it also provides data for developing high-fidelity simulation models. This work has been a joint effort with Sandia National Laboratories and UT-Austin's Bureau of Economic Geology, Department of Petroleum and Geosystems Engineering, and the Institute of Computational and Engineering Mathematics.

  10. Dynamic PET/CT measurements of induced positron activity in a prostate cancer patient after 50-MV photon radiation therapy

    PubMed Central

    2013-01-01

    Background The purpose of this work was to reveal the research interest value of positron emission tomography (PET) imaging in visualizing the induced tissue activity post high-energy photon radiation treatment. More specifically, the focus was on the possibility of retrieving data such as tissue composition and physical half-lives from dynamic PET acquisitions, as positron-emitting radionuclides such as 15O, 11C, and 13N are produced in vivo during radiation treatment with high-energy photons (>15 MeV). The type, amount, and distribution of induced positron-emitting radionuclides depend on the irradiated tissue cross section, the photon spectrum, and the possible perfusion-driven washout. Methods A 62-year-old man diagnosed with prostate cancer was referred for palliative radiation treatment of the pelvis minor. A total dose of 8 Gy was given using high-energy photon beams (50 MV) with a racetrack microtron, and 7 min after the end of irradiation, the patient was positioned in a PET/computed tomography (CT) camera, and a list-mode acquisition was performed for 30 min. Two volumes of interests (VOIs) were positioned on the dynamic PET/CT images, one in the urinary bladder and the other in the subcutaneous fat. Analysis of the measured relative count rate was performed in order to compute the tissue compositions and physical half-lives in the two regions. Results Dynamic analysis from the two VOIs showed that the decay constants of activated oxygen and carbon could be deduced. Calculation of tissue composition from analyzing the VOI containing subcutaneous fat only moderately agreed with that of the tabulated International Commission on Radiation Units & Measurements (ICRU) data of the adipose tissue. However, the same analysis for the bladder showed a good agreement with that of the tabulated ICRU data. Conclusions PET can be used in visualizing the induced activity post high-energy photon radiation treatment. Despite the very low count rate in this specific application, wherein 7 min after treatment was about 5% of that of a standard 18F-FDG PET scan, the distribution of activated tissue elements (15O and 11C) could be calculated from the dynamic PET data. One possible future application of this method could possibly be to measure and determine the tumor tissue composition in order to identify any hypoxic or necrotic region, which is information that can be used in the ongoing therapy planning process. Trial registration The official name of the trial committee of this study is ‘Regionala etikprövningsnämnden i Stockholm’ (FE 289, Stockholm, SE-17177, Sweden). The unique identifying number is 2011/1789-31/2. PMID:23343347

  11. Could 18 F-DPA-714 PET imaging be interesting to use in the early post-stroke period?

    PubMed Central

    2014-01-01

    Background Cerebral stroke is a severe and frequent condition that requires rapid and reliable diagnosis. If administered shortly after the first symptoms manifest themselves, IV thrombolysis has been shown to increase the functional prognosis by restoring brain reperfusion. However, a better understanding of the pathophysiology of stroke should help to identify potential new therapeutic targets. Stroke is known to induce an inflammatory brain reaction that involves overexpression of the 18-kDa translocator protein (TSPO) in glial cells and infiltrated leukocytes, which can be visualised by positron emission tomography (PET). We aimed to evaluate post-stroke neuroinflammation using the PET TSPO radioligand 18 F-DPA-714. Methods Nine patients underwent 18 F-DPA-714 PET and magnetic resonance imaging (MRI) between 8 and 18 days after the ictus. Co-registration of MRI and PET images was used to define three volumes of interest (VOIs): core infarction, contralateral region, and cerebellum ipsilateral to the stroke lesion. Time activity curves were obtained from each VOI, and ratios of mean and maximum activities between the VOIs were calculated. Results We observed an increased uptake of 18 F-DPA-714 co-localised with the infarct tissue and extension beyond the region corresponding to the damage in the blood brain barrier. No correlation was identified between 18 F-DPA-714 uptake and infarct volume. 18 F-DPA-714 uptake in ischemic lesion (mainly associated with TSPO expression in the infarct area and in the surrounding neighbourhood) slowly decreased from 10 min pi to the end of the PET acquisition, remaining higher than that in both contralateral region and ipsilateral cerebellum. Conclusion Our results show that 18 F-DPA-714 uptake after acute ischemia is mainly associated with TSPO expression in the infarct area and in the surrounding neighbourhood. We also demonstrated that the kinetics of 18 F-DPA-714 differs in injured tissue compared to normal tissue. Therefore, 18 F-DPA-714 may be useful in assessing the extent of neuroinflammation associated with acute stroke and could also help to predict clinical outcomes and functional recovery, as well as to assess therapeutic strategies, such as the use of neuroprotective/anti-inflammatory drugs. PMID:25006546

  12. An economic value of remote-sensing information—Application to agricultural production and maintaining groundwater quality

    USGS Publications Warehouse

    Forney, William M.; Raunikar, Ronald P.; Bernknopf, Richard L.; Mishra, Shruti K.

    2012-01-01

    Does remote-sensing information provide economic benefits to society, and can a value be assigned to those benefits? Can resource management and policy decisions be better informed by coupling past and present Earth observations with groundwater nitrate measurements? Using an integrated assessment approach, the U.S. Geological Survey (USGS) applied an established conceptual framework to answer these questions, as well as to estimate the value of information (VOI) for remote-sensing imagery. The approach uses moderate-resolution land-imagery (MRLI) data from the Landsat and Advanced Wide Field Sensor satellites that has been classified by the National Agricultural Statistics Service into the Cropland Data Layer (CDL). Within the constraint of the U.S. Environmental Protection Agency's public health threshold for potable groundwater resources, the USGS modeled the relation between a population of the CDL's land uses and dynamic nitrate (NO3-) contamination of aquifers in a case study region in northeastern Iowa. Employing various multiscaled, multitemporal geospatial datasets with MRLI to maximize the value of agricultural production, the approach develops and uses multiple environmental science models to address dynamic nitrogen loading and transport at specified distances from specific sites (wells) and at landscape scales (for example, across 35 counties and two aquifers). In addition to the ecosystem service of potable groundwater, this effort focuses on the use of MRLI for the management of the major land uses in the study region-the production of corn and soybeans, which can impact groundwater quality. Derived methods and results include (1) economic and dynamic nitrate-pollution models, (2) probabilities of the survival of groundwater, and (3) a VOI for remote sensing. For the northeastern Iowa study region, the marginal benefit of the MRLI VOI (in 2010 dollars) is $858 million ±$197 million annualized, which corresponds to a net present value of $38.1 billion ±$8.8 billion for that flow of benefits in perpetuity. Given that these economic estimates are derived from one case study in a part of only one State, the estimates provide a lower estimate related to the potential value of the Landsat Data Continuity Mission.

  13. Ferret Thoracic Anatomy by 2-Deoxy-2-(18F)Fluoro-D-Glucose (18F-FDG) Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT) Imaging

    PubMed Central

    Wu, Albert; Zheng, Huaiyu; Kraenzle, Jennifer; Biller, Ashley; Vanover, Carol D.; Proctor, Mary; Sherwood, Leslie; Steffen, Marlene; Ng, Chin; Mollura, Daniel J.; Jonsson, Colleen B.

    2013-01-01

    The domestic ferret (Mustela putorius furo) has been a long-standing animal model used in the evaluation and treatment of human diseases. Molecular imaging techniques such as 2-deoxy-2-(18F)fluoro-D-glucose (18F-FDG) positron emission tomography (PET) would be an invaluable method of tracking disease in vivo, but this technique has not been reported in the literature. Thus, the aim of this study was to establish baseline imaging characteristics of PET/computed tomography (CT) with 18F-FDG in the ferret model. Twelve healthy female ferrets were anesthetized and underwent combined PET/CT scanning. After the images were fused, volumes of interest (VOIs) were generated in the liver, heart, thymus, and bilateral lung fields. For each VOI, standardized uptake values (SUVs) were calculated. Additional comparisons were made between radiotracer uptake periods (60, 90, and >90 minutes), intravenous and intraperitoneal injections of 18F-FDG, and respiratory gated and ungated acquisitions. Pulmonary structures and the surrounding thoracic and upper abdominal anatomy were readily identified on the CT scans of all ferrets and were successfully fused with PET. VOIs were created in various tissues with the following SUV calculations: heart (maximum standardized uptake value [SUVMax] 8.60, mean standardized uptake value [SUVMean] 5.42), thymus (SUVMax 3.86, SUVMean 2.59), liver (SUVMax 1.37, SUVMean 0.99), right lung (SUVMax 0.92, SUVMean 0.56), and left lung (SUVMax 0.88, SUVMean 0.51). Sixty- to 90-minute uptake periods were sufficient to separate tissues based on background SUV activity. No gross differences in image quality were seen between intraperitoneal and intravenous injections of 18F-FDG. Respiratory gating also did not have a significant impact on image quality of lung parenchyma. The authors concluded that 18F-FDG PET and CT imaging can be performed successfully in normal healthy ferrets with the parameters identified in this study. They obtained similar imaging features and uptake measurements with and without respiratory gating as well as with intraperitoneal and intravenous 18F-FDG injections. 18F-FDG PET and CT can be a valuable resource for the in vivo tracking of disease progression in future studies that employ the ferret model. PMID:23382267

  14. Errors in MR-based attenuation correction for brain imaging with PET/MR scanners

    NASA Astrophysics Data System (ADS)

    Rota Kops, Elena; Herzog, Hans

    2013-02-01

    AimAttenuation correction of PET data acquired by hybrid MR/PET scanners remains a challenge, even if several methods for brain and whole-body measurements have been developed recently. A template-based attenuation correction for brain imaging proposed by our group is easy to handle and delivers reliable attenuation maps in a short time. However, some potential error sources are analyzed in this study. We investigated the choice of template reference head among all the available data (error A), and possible skull anomalies of the specific patient, such as discontinuities due to surgery (error B). Materials and methodsAn anatomical MR measurement and a 2-bed-position transmission scan covering the whole head and neck region were performed in eight normal subjects (4 females, 4 males). Error A: Taking alternatively one of the eight heads as reference, eight different templates were created by nonlinearly registering the images to the reference and calculating the average. Eight patients (4 females, 4 males; 4 with brain lesions, 4 w/o brain lesions) were measured in the Siemens BrainPET/MR scanner. The eight templates were used to generate the patients' attenuation maps required for reconstruction. ROI and VOI atlas-based comparisons were performed employing all the reconstructed images. Error B: CT-based attenuation maps of two volunteers were manipulated by manually inserting several skull lesions and filling a nasal cavity. The corresponding attenuation coefficients were substituted with the water's coefficient (0.096/cm). ResultsError A: The mean SUVs over the eight templates pairs for all eight patients and all VOIs did not differ significantly one from each other. Standard deviations up to 1.24% were found. Error B: After reconstruction of the volunteers' BrainPET data with the CT-based attenuation maps without and with skull anomalies, a VOI-atlas analysis was performed revealing very little influence of the skull lesions (less than 3%), while the filled nasal cavity yielded an overestimation in cerebellum up to 5%. ConclusionsThe present error analysis confirms that our template-based attenuation method provides reliable attenuation corrections of PET brain imaging measured in PET/MR scanners.

  15. Exact BPF and FBP algorithms for nonstandard saddle curves

    SciTech Connect

    Yu Hengyong; Zhao Shiying; Ye Yangbo; Wang Ge

    2005-11-15

    A hot topic in cone-beam CT research is exact cone-beam reconstruction from a general scanning trajectory. Particularly, a nonstandard saddle curve attracts attention, as this construct allows the continuous periodic scanning of a volume-of-interest (VOI). Here we evaluate two algorithms for reconstruction from data collected along a nonstandard saddle curve, which are in the filtered backprojection (FBP) and backprojection filtration (BPF) formats, respectively. Both the algorithms are implemented in a chord-based coordinate system. Then, a rebinning procedure is utilized to transform the reconstructed results into the natural coordinate system. The simulation results demonstrate that the FBP algorithm produces better image quality than the BPF algorithm, while both the algorithms exhibit similar noise characteristics.

  16. Computed Tomography Image Compressibility and Limitations of Compression Ratio-Based Guidelines.

    PubMed

    Pambrun, Jean-François; Noumeir, Rita

    2015-12-01

    Finding optimal compression levels for diagnostic imaging is not an easy task. Significant compressibility variations exist between modalities, but little is known about compressibility variations within modalities. Moreover, compressibility is affected by acquisition parameters. In this study, we evaluate the compressibility of thousands of computed tomography (CT) slices acquired with different slice thicknesses, exposures, reconstruction filters, slice collimations, and pitches. We demonstrate that exposure, slice thickness, and reconstruction filters have a significant impact on image compressibility due to an increased high frequency content and a lower acquisition signal-to-noise ratio. We also show that compression ratio is not a good fidelity measure. Therefore, guidelines based on compression ratio should ideally be replaced with other compression measures better correlated with image fidelity. Value-of-interest (VOI) transformations also affect the perception of quality. We have studied the effect of value-of-interest transformation and found significant masking of artifacts when window is widened. PMID:25804842

  17. Le contrôle des infections au cabinet du pédiatre

    PubMed Central

    2008-01-01

    RÉSUMÉ La transmission des infections au cabinet du pédiatre est de plus en plus préoccupante. Le présent document expose les voies de transmission des infections et les principes sous-jacents aux mesures actuelles pour contrôler les infections. Pour prévenir les infections, il faut bien concevoir le cabinet et adopter des politiques administratives et de triage convenables, de même que des pratiques de base pour les soins de tous les patients (p. ex., hygiène des mains, port de gants, de masques, de lunettes de protection et d’une blouse d’hôpital pour des interventions précises; nettoyage, désinfection et stérilisation convenables des surfaces et du matériel, y compris les jouets, et techniques d’asepsie en cas d’interventions effractives) et des précautions additionnelles en cas d’infections précises. Le personnel doit avoir reçu les vaccins pertinents, et les personnes infectées doivent respecter les politiques de restriction au travail.

  18. La prévention des infections par le virus respiratoire syncytial

    PubMed Central

    Robinson, JL

    2011-01-01

    RÉSUMÉ L’infection par le virus respiratoire syncytial (VRS) est la principale cause d’infections des voies respiratoires inférieures chez les jeunes enfants. Le palivizumab, un anticorps monoclonal anti-VRS, réduit le taux d’hospitalisation des enfants à haut risque mais est très coûteux. Le présent document de principes remplace les trois précédents documents de principes de la Société canadienne de pédiatrie sur le sujet et est mis à jour principalement pour traiter des récentes modifications aux lignes directrices de l’American Academy of Pediatrics dans le contexte canadien. Il contient une analyse des publications ainsi que des recommandations au sujet de l’utilisation du palivizumab chez les enfants à haut risque

  19. Corps étranger métallique inhalé: 36 mois d’évolution intrabronchique chez un enfant de 8 ans

    PubMed Central

    Mupepe, Alexis Kumba; Mukuku, Olivier; Bagale, Yves; Ruhindiza, Bienvenu Mukuku

    2014-01-01

    Les corps étrangers dans les voies respiratoires constituent une urgence relativement fréquente chez les enfants. Nous présentons ici le cas d'une fillette de 8 ans qui avait inhalé un clou que la radiographie avait localisé dans la bronche droite. L’évolution est marquée par une symptomatologie muette et une migration vers le bas de ce clou. Ne disposant pas d’équipement pour une chirurgie adaptée, le malade vit encore avec ce corps étranger en lui. La nature et l’évolution clinique et paraclinique rapportées ici en constituent l'intérêt. PMID:25422700

  20. A 13C-NMR study of exopolysaccharide synthesis in Rhizobium meliloti Su47 strain

    NASA Astrophysics Data System (ADS)

    Tavernier, P.; Portais, J.-C.; Besson, I.; Courtois, J.; Courtois, B.; Barbotin, J.-N.

    1998-02-01

    Metabolic pathways implied in the synthesis of succinoglycan produced by the Su47 strain of R. meliloti were evaluated by 13C-NMR spectroscopy after incubation with [1{-}13C] or [2{-}13C] glucose. The biosynthesis of this polymer by R. meliloti from glucose occurred by a direct polymerisation of the introduced glucose and by the pentose phosphate pathway. Les voies métaboliques impliquées dans la synthèse du succinoglycane produit par la souche Su47 de R. meliloti ont été évaluées par la spectroscopie de RMN du carbone 13 après incubation des cellules avec du [1{-}13C] ou [2{-}13C] glucose. La biosynthèse de ce polymère à partir du glucose se produit par polymérisation directe du glucose et par la voie des pentoses phosphate.

  1. Les Troubles Respiratoires Chez Le Brule

    PubMed Central

    Fassi Fihri, J.; Ezzoubi, M.; Boukind, E.H.

    2010-01-01

    Summary A travers une revue de la littérature, cet article se propose d'exposer les particularités des troubles respiratoires chez le brûlé. Ces troubles sont liés à un mécanisme direct, lorsque l'arbre respiratoire est lésé par le transfert d'énergie thermique du à la brûlure et/ou par un mécanisme indirect, lorsque la fonction respiratoire et ventilatoire du poumon est perturbée par les phénomènes loco-régionaux ou généraux du brûlé. Ces troubles respiratoires sont aggravés par l'inhalation des gaz contenus dans la fumée d'incendie. Le diagnostic de ces troubles est clinique et paraclinique. Il doit être précoce et continu. Les patients nécessitent de différents moyens thérapeutiques tels que l'oxygénothérapie, la libération des voies respiratoires, l'amélioration de la mécanique ventilatoire et de la fonction respiratoire, l'antibiothérapie ou la chirurgie des séquelles. Cette prise en charge doit nécessairement être multidisciplinaire. PMID:21991224

  2. Simulation modeling to derive the value-of-information for risky animal disease-import decisions.

    PubMed

    Disney, W Terry; Peters, Mark A

    2003-11-12

    Simulation modeling can be used in aiding decision-makers in deciding when to invest in additional research and when the risky animal disease-import decision should go forward. Simulation modeling to evaluate value-of-information (VOI) techniques provides a robust, objective and transparent framework for assisting decision-makers in making risky animal and animal product decisions. In this analysis, the hypothetical risk from poultry disease in chicken-meat imports was modeled. Economic criteria were used to quantify alternative confidence-increasing decisions regarding potential import testing and additional research requirements. In our hypothetical example, additional information about poultry disease in the exporting country (either by requiring additional export-flock surveillance that results in no sign of disease, or by conducting additional research into lack of disease transmittal through chicken-meat ingestion) captured >75% of the value-of-information attainable regarding the chicken-meat-import decision. PMID:14554141

  3. Développement de matériaux pour les piles à combustibles SOFC

    NASA Astrophysics Data System (ADS)

    Dubourdieu, G.; Gauthier, G.; Henry, J. Y.; Sanchette, F.; Delépine, J.; Lefebvre-Joud, F.

    2002-04-01

    Dans le cadre des nouveaux programmes du CEA dédiés aux Nouvelles Technologies pour l'Energie, l'un des axes concerne les piles à combustible haute température et tout solide (SOFC). Deux voies de recherche sont présentées ici ; l'une traite de l'élaboration d'électrolytes connus - de type zircone yttriée - en couche mince, par des techniques de dépôt PVD ou CVD à injection, ceci dans le but d'un fonctionnement à plus basse température. L'autre a trait au développement de matériaux d'anode compatibles avec l'utilisation directe du méthane à la place de l'hydrogène. Les chromates de lanthane substitué par le strontium, dont une méthode de synthèse sous forme de poudres très divisées est présentée ici, semblent être des matériaux prometteurs pour cette application, à condition qu'ils ne subissent pas de dégradation en fonctionnement.

  4. Assessment of tumour response with 18F-fluorodeoxyglucose positron emission tomography using three-dimensional measures compared to SUVmax—a phantom study

    NASA Astrophysics Data System (ADS)

    Boucek, J. A.; Francis, R. J.; Jones, C. G.; Khan, N.; Turlach, B. A.; Green, A. J.

    2008-08-01

    SUVmax is currently the most common semi-quantitative method of response assessment on FDG PET. By defining the tumour volume of interest (VOI), a measure of total glycolytic volume (TGV) may be obtained. We aimed to comprehensively examine, in a phantom setting, the accuracy of TGV in reflecting actual lesion activity and to compare TGV with SUVmax for response assessment. The algorithms for VOI generation from which TGV was derived included fixed threshold techniques at 50% of maximum (MAX50), 70% of maximum (MAX70), an adaptive threshold of 50% of (maximum + background)/2 (BM50) and a semi-automated iterative region-growing algorithm, GRAB. Comparison with both actual lesion activity and response scenarios was performed. SUVmax correlated poorly with actual lesion activity (r = 0.651) and change in lesion activity (r = 0.605). In a response matrix scenario SUVmax performed poorly when all scenarios were considered, but performed well when only clinically likely scenarios were included. The TGV derived using MAX50 and MAX70 algorithms performed poorly in evaluation of lesion change. The TGV derived from BM50 and GRAB algorithms however performed extremely well in correlation with actual lesion activity (r = 0.993 and r = 0.982, respectively), change in lesion activity (r = 0.972 and r = 0.963, respectively) and in the response scenario matrix. TGVGRAB demonstrated narrow confidence bands when modelled with actual lesion activity. Measures of TGV generated by iterative algorithms such as GRAB show potential for increased sensitivity of metabolic response monitoring compared to SUVmax, which may have important implications for improved patient care.

  5. Noninvasive image derived heart input function for CMRglc measurements in small animal slow infusion FDG PET studies.

    PubMed

    Xiong, Guoming; Paul, Cumming; Todica, Andrei; Hacker, Marcus; Bartenstein, Peter; Böning, Guido

    2012-12-01

    Absolute quantitation of the cerebral metabolic rate for glucose (CMRglc) can be obtained in positron emission tomography (PET) studies when serial measurements of the arterial [(18)F]-fluoro-deoxyglucose (FDG) input are available. Since this is not always practical in PET studies of rodents, there has been considerable interest in defining an image-derived input function (IDIF) by placing a volume of interest (VOI) within the left ventricle of the heart. However, spill-in arising from trapping of FDG in the myocardium often leads to progressive contamination of the IDIF, which propagates to underestimation of the magnitude of CMRglc. We therefore developed a novel, non-invasive method for correcting the IDIF without scaling to a blood sample. To this end, we first obtained serial arterial samples and dynamic FDG-PET data of the head and heart in a group of eight anaesthetized rats. We fitted a bi-exponential function to the serial measurements of the IDIF, and then used the linear graphical Gjedde-Patlak method to describe the accumulation in myocardium. We next estimated the magnitude of myocardial spill-in reaching the left ventricle VOI by assuming a Gaussian point-spread function, and corrected the measured IDIF for this estimated spill-in. Finally, we calculated parametric maps of CMRglc using the corrected IDIF, and for the sake of comparison, relative to serial blood sampling from the femoral artery. The uncorrected IDIF resulted in 20% underestimation of the magnitude of CMRglc relative to the gold standard arterial input method. However, there was no bias with the corrected IDIF, which was robust to the variable extent of myocardial tracer uptake, such that there was a very high correlation between individual CMRglc measurements using the corrected IDIF with gold-standard arterial input results. Based on simulation, we furthermore find that electrocardiogram-gating, i.e. ECG-gating is not necessary for IDIF quantitation using our approach. PMID:23160517

  6. Abnormal White Matter Integrity in Adolescents with Internet Addiction Disorder: A Tract-Based Spatial Statistics Study

    PubMed Central

    Qin, Lindi; Zhao, Zhimin; Xu, Jianrong; Lei, Hao

    2012-01-01

    Background Internet addiction disorder (IAD) is currently becoming a serious mental health issue around the globe. Previous studies regarding IAD were mainly focused on associated psychological examinations. However, there are few studies on brain structure and function about IAD. In this study, we used diffusion tensor imaging (DTI) to investigate white matter integrity in adolescents with IAD. Methodology/Principal Findings Seventeen IAD subjects and sixteen healthy controls without IAD participated in this study. Whole brain voxel-wise analysis of fractional anisotropy (FA) was performed by tract-based spatial statistics (TBSS) to localize abnormal white matter regions between groups. TBSS demonstrated that IAD had significantly lower FA than controls throughout the brain, including the orbito-frontal white matter, corpus callosum, cingulum, inferior fronto-occipital fasciculus, and corona radiation, internal and external capsules, while exhibiting no areas of higher FA. Volume-of-interest (VOI) analysis was used to detect changes of diffusivity indices in the regions showing FA abnormalities. In most VOIs, FA reductions were caused by an increase in radial diffusivity while no changes in axial diffusivity. Correlation analysis was performed to assess the relationship between FA and behavioral measures within the IAD group. Significantly negative correlations were found between FA values in the left genu of the corpus callosum and the Screen for Child Anxiety Related Emotional Disorders, and between FA values in the left external capsule and the Young's Internet addiction scale. Conclusions Our findings suggest that IAD demonstrated widespread reductions of FA in major white matter pathways and such abnormal white matter structure may be linked to some behavioral impairments. In addition, white matter integrity may serve as a potential new treatment target and FA may be as a qualified biomarker to understand the underlying neural mechanisms of injury or to assess the effectiveness of specific early interventions in IAD. PMID:22253926

  7. Progressive White Matter Microstructure Damage in Male Chronic Heroin Dependent Individuals: A DTI and TBSS Study

    PubMed Central

    Su, Huanhuan; Lv, Xiaofei; Zhang, Xuelin; Tian, Junzhang; Zhuo, Fuzhen

    2013-01-01

    Background To investigate the WM microstructure deficits in heroin dependent individuals (HDIs) with different length of heroin dependence, and to investigate whether these WM deficits can be related to the duration of heroin use and to decision-making deficits in HDIs. Methodology/Principal Findings Thirty-six HDIs [including eighteen sHDIs (duration of heroin dependent is less than 10 years) and eighteen lHDIs (duration of dependent is between 10?20 years)] and sixteen healthy controls participated in this study. Whole brain voxel-wise analysis of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (Da) and radial diffusivity (Dr) were performed by tract-based spatial statistics (TBSS) to localize abnormal WM regions among groups. TBSS demonstrated that sHDIs had significantly lower FA than controls in right orbito-frontal WM, bilateral temporal WM and right parietal WM. The lHDIs had significantly lower FA throughout the brain compared with the controls and sHDIs. The lHDIs had significantly lower Da than controls in bilateral inferior frontaloccipital fasciculus, bilateral splenium of corpus callosum, left inferior longitudinal fasciculus, and had significantly higher Dr than controls in bilateral uncinatus fasciculus, bilateral inferior frontaloccipital fasciculus and bilateral cortical spinal fasciculus. Volume-of-interest (VOI) analyses detect the changes of diffusivity indices in the regions with FA abnormalities revealed by control vs sHDIs. In most VOIs, FA reductions were caused by the increase in Dr as well as the decrease in Da. Correlation analysis was used to assess the relationship between FA and behavioral measures in HDIs and controls available. Significantly positively correlations were found between the FA values in the right orbital-frontal WM, right parietal WM and IGT performance. Conclusions The extent and severity of WM integrity deficits in HDIs was associated with the length of heroin dependent. Furthermore, abnormal WM microstructure may correlate with decision-making impairments in HDIs. PMID:23650554

  8. Noninvasive image derived heart input function for CMRglc measurements in small animal slow infusion FDG PET studies

    NASA Astrophysics Data System (ADS)

    Xiong, Guoming; Cumming, Paul; Todica, Andrei; Hacker, Marcus; Bartenstein, Peter; Böning, Guido

    2012-12-01

    Absolute quantitation of the cerebral metabolic rate for glucose (CMRglc) can be obtained in positron emission tomography (PET) studies when serial measurements of the arterial [18F]-fluoro-deoxyglucose (FDG) input are available. Since this is not always practical in PET studies of rodents, there has been considerable interest in defining an image-derived input function (IDIF) by placing a volume of interest (VOI) within the left ventricle of the heart. However, spill-in arising from trapping of FDG in the myocardium often leads to progressive contamination of the IDIF, which propagates to underestimation of the magnitude of CMRglc. We therefore developed a novel, non-invasive method for correcting the IDIF without scaling to a blood sample. To this end, we first obtained serial arterial samples and dynamic FDG-PET data of the head and heart in a group of eight anaesthetized rats. We fitted a bi-exponential function to the serial measurements of the IDIF, and then used the linear graphical Gjedde-Patlak method to describe the accumulation in myocardium. We next estimated the magnitude of myocardial spill-in reaching the left ventricle VOI by assuming a Gaussian point-spread function, and corrected the measured IDIF for this estimated spill-in. Finally, we calculated parametric maps of CMRglc using the corrected IDIF, and for the sake of comparison, relative to serial blood sampling from the femoral artery. The uncorrected IDIF resulted in 20% underestimation of the magnitude of CMRglc relative to the gold standard arterial input method. However, there was no bias with the corrected IDIF, which was robust to the variable extent of myocardial tracer uptake, such that there was a very high correlation between individual CMRglc measurements using the corrected IDIF with gold-standard arterial input results. Based on simulation, we furthermore find that electrocardiogram-gating, i.e. ECG-gating is not necessary for IDIF quantitation using our approach.

  9. Selective coding with controlled quality decay for 2D and 3D images in a JPEG2000 framework

    NASA Astrophysics Data System (ADS)

    Signoroni, Alberto; Lazzaroni, Fabio; Leonardi, Riccardo

    2003-06-01

    This paper presents some ideas which extend the functionality and the application fields of a spatially selective coding within a JPEG2000 framework. At first, the image quality drop between the Regions of Interest (ROI) and the background (BG) is considered. In a conventional approach, the reconstructed image quality steeply drops along the ROI boundary; however, this effect could be considered or perceived objectionable in some use cases. A simple quality decay management is proposed here, which makes use of concentric ROI with different scaling factors. This allows the technique to be perfectly consistent with the JPEG2000 part 2 ROI definition and description. Another considered issue is the extension of the selective ROI coding to a 3D Volume of Interest coding. This extension is currently under consideration for the part 10 of JPEG2000, JP3D. An easy and effective 2D to 3D extension for the VOI definition and description is proposed here: a VOI is defined by a set composition of ROI generated solids, where ROI are defined along one or more volume cutting direction, and is described by the relative set of ROI parameters. Moreover, the quality decay management can be applied to this extension. The proposed techniques could have a significant impact on the selective coding of medical images and volumes. Image quality issues are very important but very critical factors in that field, which also constitutes the dominant market for 3D applications. Therefore, some experiments are presented on medical images and volumes in order evaluate the benefits of the proposed approaches in terms of diagnostic quality improvement with respect to a conventional ROI coding usage.

  10. Probability distribution function-based classification of structural MRI for the detection of Alzheimer's disease.

    PubMed

    Beheshti, I; Demirel, H

    2015-09-01

    High-dimensional classification methods have been a major target of machine learning for the automatic classification of patients who suffer from Alzheimer's disease (AD). One major issue of automatic classification is the feature-selection method from high-dimensional data. In this paper, a novel approach for statistical feature reduction and selection in high-dimensional magnetic resonance imaging (MRI) data based on the probability distribution function (PDF) is introduced. To develop an automatic computer-aided diagnosis (CAD) technique, this research explores the statistical patterns extracted from structural MRI (sMRI) data on four systematic levels. First, global and local differences of gray matter in patients with AD compared to healthy controls (HCs) using the voxel-based morphometric (VBM) technique with 3-Tesla 3D T1-weighted MRI are investigated. Second, feature extraction based on the voxel clusters detected by VBM on sMRI and voxel values as volume of interest (VOI) is used. Third, a novel statistical feature-selection process is employed, utilizing the PDF of the VOI to represent statistical patterns of the respective high-dimensional sMRI sample. Finally, the proposed feature-selection method for early detection of AD with support vector machine (SVM) classifiers compared to other standard feature selection methods, such as partial least squares (PLS) techniques, is assessed. The performance of the proposed technique is evaluated using 130 AD and 130 HC MRI data from the ADNI dataset with 10-fold cross validation(1). The results show that the PDF-based feature selection approach is a reliable technique that is highly competitive with respect to the state-of-the-art techniques in classifying AD from high-dimensional sMRI samples. PMID:26226415

  11. Levothyroxine effects on depressive symptoms and limbic glucose metabolism in bipolar disorder: a randomized, placebo-controlled positron emission tomography study

    PubMed Central

    Bauer, M; Berman, S; Stamm, T; Plotkin, M; Adli, M; Pilhatsch, M; London, E D; Hellemann, G S; Whybrow, P C; Schlagenhauf, F

    2016-01-01

    Adding supraphysiologic doses of levothyroxine (L-T4) to standard treatment for bipolar depression shows promise, but the mechanisms underlying clinical improvement are unknown. In a previous pilot study, L-T4 treatment reduced depression scores and activity within the anterior limbic network. Here we extended this work in a randomized, double-blind, placebo-controlled study of patients with bipolar depression. Cerebral glucose metabolism was assessed with positron emission tomography and [F-18]fluorodeoxyglucose before and after 6 weeks of treatment with L-T4 (n=15) or placebo (n=10) in 12 volumes of interest (VOIs): the bilateral thalamus, amygdala, hippocampus, dorsal striatum and ventral striatum, and midline cerebellar vermis and subgenual cingulate cortex. Radioactivity in the VOIs, normalized to whole-brain radioactivity was taken as a surrogate index of glucose metabolism, and markers of thyroid function were assayed. Changes in brain activity and their association with clinical response were assessed using statistical parametric mapping. Adjunctive L-T4 treatment produced a significant decline in depression scores during the 6-week treatment. In patients treated with L-T4, we found a significant decrease in regional activity at P<0.05 after Bonferroni correction in the left thalamus, right amygdala, right hippocampus, left ventral striatum and the right dorsal striatum. Decreases in the left thalamus, left dorsal striatum and the subgenual cingulate were correlated with a reduction in depression scores (P<0.05 after Bonferroni correction). Placebo treatment was associated with a significant decrease in activity only in the right amygdala, and no region had a change in activity that was correlated with change in depression scores. The groups differed significantly in the relationship between the changes in depression scores and in activity in the thalamus bilaterally and the left ventral striatum. The findings provide evidence that administration of supraphysiologic thyroid hormone improves depressive symptoms in patients with bipolar disorder by modulating function in components of the anterior limbic network. PMID:25600111

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

    SciTech Connect

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

    2014-08-15

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

  13. Integrating Dimension Reduction and Out-of-Sample Extension in Automated Classification of Ex Vivo Human Patellar Cartilage on Phase Contrast X-Ray Computed Tomography

    PubMed Central

    Nagarajan, Mahesh B.; Coan, Paola; Huber, Markus B.; Diemoz, Paul C.; Wismüller, Axel

    2015-01-01

    Phase contrast X-ray computed tomography (PCI-CT) has been demonstrated as a novel imaging technique that can visualize human cartilage with high spatial resolution and soft tissue contrast. Different textural approaches have been previously investigated for characterizing chondrocyte organization on PCI-CT to enable classification of healthy and osteoarthritic cartilage. However, the large size of feature sets extracted in such studies motivates an investigation into algorithmic feature reduction for computing efficient feature representations without compromising their discriminatory power. For this purpose, geometrical feature sets derived from the scaling index method (SIM) were extracted from 1392 volumes of interest (VOI) annotated on PCI-CT images of ex vivo human patellar cartilage specimens. The extracted feature sets were subject to linear and non-linear dimension reduction techniques as well as feature selection based on evaluation of mutual information criteria. The reduced feature set was subsequently used in a machine learning task with support vector regression to classify VOIs as healthy or osteoarthritic; classification performance was evaluated using the area under the receiver-operating characteristic (ROC) curve (AUC). Our results show that the classification performance achieved by 9-D SIM-derived geometric feature sets (AUC: 0.96 ± 0.02) can be maintained with 2-D representations computed from both dimension reduction and feature selection (AUC values as high as 0.97 ± 0.02). Thus, such feature reduction techniques can offer a high degree of compaction to large feature sets extracted from PCI-CT images while maintaining their ability to characterize the underlying chondrocyte patterns. PMID:25710875

  14. Deformable planning CT to cone-beam CT image registration in head-and-neck cancer

    SciTech Connect

    Hou Jidong; Guerrero, Mariana; Chen, Wenjuan; D'Souza, Warren D.

    2011-04-15

    Purpose: The purpose of this work was to implement and validate a deformable CT to cone-beam computed tomography (CBCT) image registration method in head-and-neck cancer to eventually facilitate automatic target delineation on CBCT. Methods: Twelve head-and-neck cancer patients underwent a planning CT and weekly CBCT during the 5-7 week treatment period. The 12 planning CT images (moving images) of these patients were registered to their weekly CBCT images (fixed images) via the symmetric force Demons algorithm and using a multiresolution scheme. Histogram matching was used to compensate for the intensity difference between the two types of images. Using nine known anatomic points as registration targets, the accuracy of the registration was evaluated using the target registration error (TRE). In addition, region-of-interest (ROI) contours drawn on the planning CT were morphed to the CBCT images and the volume overlap index (VOI) between registered contours and manually delineated contours was evaluated. Results: The mean TRE value of the nine target points was less than 3.0 mm, the slice thickness of the planning CT. Of the 369 target points evaluated for registration accuracy, the average TRE value was 2.6{+-}0.6 mm. The mean TRE for bony tissue targets was 2.4{+-}0.2 mm, while the mean TRE for soft tissue targets was 2.8{+-}0.2 mm. The average VOI between the registered and manually delineated ROI contours was 76.2{+-}4.6%, which is consistent with that reported in previous studies. Conclusions: The authors have implemented and validated a deformable image registration method to register planning CT images to weekly CBCT images in head-and-neck cancer cases. The accuracy of the TRE values suggests that they can be used as a promising tool for automatic target delineation on CBCT.

  15. A Wrench fault system and nappe emplacement in Southern Kenya and Northern Tanzania.- A key area for Pan-African continental collision in East Africa?

    NASA Astrophysics Data System (ADS)

    Bauernhofer, A.; Wallbrecher, E.; Hauzenberger, C.; Fritz, H.; Loizenbauer, J.; Hoinkes, G.; Muhongo, S.; Mathu, E.

    2003-04-01

    In the Voi Area of Southern Kenya, the granulite facies rocks of the Taita Hills and the Tsavo East National Park (Galana River) can be divided into three structural domains: The Galana-East unit consists of an intercalation of flat lying metapelites and marbles of continental margin origin. These metasediments can be traced further east to the Umba Steppe (Between Mombasa and Tanga). Galana-West consists of a N-S oriented wrench fault zone with vertical foliation planes and horizontal stretching lineation. Numerous shear sense indicators always show sinistral shear sense. Amphibolites of MORB affinity are involved in this wrench fault zone. To the west, this zone is bordered by calc-alkaline metatonalites of the Sagala Hills. The westernmost unit consists of the Taita Hills. They form an imbricated pile of southwestward thrusted nappe sheets containing metapelites, marbles, and ultramafics. The Taita Hills may be explained as part of an accretionary wedge. Southwestward nappe thrusting is also the prominent structure in the Pare and Usambara Mountains of Northern Tanzania. The following model may may explain these observations: The Southern Kenya -- Northern Tanzania section of the Mozambique Belt is the result of continental collision tectonics. Remnants of an island arc and of an accretionary wedge that occur at least in the Voi area may be part of a former subduction zone. An oceanic domain between an eastern passive continental margin and a western terrane, now represented by the Tanzanian granulite belt has been closed incorporating island arc and accretionary wedge material. Oblique convergence of two continental blocks is suggested from wrench tectonics. The age of convergent tectonics is 530 -- 580 Ma, dated by Sm-Nd garnet-whole rock analysis. This is interpreted as the age of peak metamorphism.

  16. Simulation of realistic abnormal SPECT brain perfusion images: application in semi-quantitative analysis

    NASA Astrophysics Data System (ADS)

    Ward, T.; Fleming, J. S.; Hoffmann, S. M. A.; Kemp, P. M.

    2005-11-01

    Simulation is useful in the validation of functional image analysis methods, particularly when considering the number of analysis techniques currently available lacking thorough validation. Problems exist with current simulation methods due to long run times or unrealistic results making it problematic to generate complete datasets. A method is presented for simulating known abnormalities within normal brain SPECT images using a measured point spread function (PSF), and incorporating a stereotactic atlas of the brain for anatomical positioning. This allows for the simulation of realistic images through the use of prior information regarding disease progression. SPECT images of cerebral perfusion have been generated consisting of a control database and a group of simulated abnormal subjects that are to be used in a UK audit of analysis methods. The abnormality is defined in the stereotactic space, then transformed to the individual subject space, convolved with a measured PSF and removed from the normal subject image. The dataset was analysed using SPM99 (Wellcome Department of Imaging Neuroscience, University College, London) and the MarsBaR volume of interest (VOI) analysis toolbox. The results were evaluated by comparison with the known ground truth. The analysis showed improvement when using a smoothing kernel equal to system resolution over the slightly larger kernel used routinely. Significant correlation was found between effective volume of a simulated abnormality and the detected size using SPM99. Improvements in VOI analysis sensitivity were found when using the region median over the region mean. The method and dataset provide an efficient methodology for use in the comparison and cross validation of semi-quantitative analysis methods in brain SPECT, and allow the optimization of analysis parameters.

  17. Volumetric quantitative characterization of human patellar cartilage with topological and geometrical features on phase-contrast X-ray computed tomography.

    PubMed

    Nagarajan, Mahesh B; Coan, Paola; Huber, Markus B; Diemoz, Paul C; Wismüller, Axel

    2015-11-01

    Phase-contrast X-ray computed tomography (PCI-CT) has attracted significant interest in recent years for its ability to provide significantly improved image contrast in low absorbing materials such as soft biological tissue. In the research context of cartilage imaging, previous studies have demonstrated the ability of PCI-CT to visualize structural details of human patellar cartilage matrix and capture changes to chondrocyte organization induced by osteoarthritis. This study evaluates the use of geometrical and topological features for volumetric characterization of such chondrocyte patterns in the presence (or absence) of osteoarthritic damage. Geometrical features derived from the scaling index method (SIM) and topological features derived from Minkowski Functionals were extracted from 1392 volumes of interest (VOI) annotated on PCI-CT images of ex vivo human patellar cartilage specimens. These features were subsequently used in a machine learning task with support vector regression to classify VOIs as healthy or osteoarthritic; classification performance was evaluated using the area under the receiver operating characteristic curve (AUC). Our results show that the classification performance of SIM-derived geometrical features (AUC: 0.90 ± 0.09) is significantly better than Minkowski Functionals volume (AUC: 0.54 ± 0.02), surface (AUC: 0.72 ± 0.06), mean breadth (AUC: 0.74 ± 0.06) and Euler characteristic (AUC: 0.78 ± 0.04) ([Formula: see text]). These results suggest that such geometrical features can provide a detailed characterization of the chondrocyte organization in the cartilage matrix in an automated manner, while also enabling classification of cartilage as healthy or osteoarthritic with high accuracy. Such features could potentially serve as diagnostic imaging markers for evaluating osteoarthritis progression and its response to different therapeutic intervention strategies. PMID:26142112

  18. Levothyroxine effects on depressive symptoms and limbic glucose metabolism in bipolar disorder: a randomized, placebo-controlled positron emission tomography study.

    PubMed

    Bauer, M; Berman, S; Stamm, T; Plotkin, M; Adli, M; Pilhatsch, M; London, E D; Hellemann, G S; Whybrow, P C; Schlagenhauf, F

    2016-02-01

    Adding supraphysiologic doses of levothyroxine (L-T4) to standard treatment for bipolar depression shows promise, but the mechanisms underlying clinical improvement are unknown. In a previous pilot study, L-T4 treatment reduced depression scores and activity within the anterior limbic network. Here we extended this work in a randomized, double-blind, placebo-controlled study of patients with bipolar depression. Cerebral glucose metabolism was assessed with positron emission tomography and [F-18]fluorodeoxyglucose before and after 6 weeks of treatment with L-T4 (n=15) or placebo (n=10) in 12 volumes of interest (VOIs): the bilateral thalamus, amygdala, hippocampus, dorsal striatum and ventral striatum, and midline cerebellar vermis and subgenual cingulate cortex. Radioactivity in the VOIs, normalized to whole-brain radioactivity was taken as a surrogate index of glucose metabolism, and markers of thyroid function were assayed. Changes in brain activity and their association with clinical response were assessed using statistical parametric mapping. Adjunctive L-T4 treatment produced a significant decline in depression scores during the 6-week treatment. In patients treated with L-T4, we found a significant decrease in regional activity at P<0.05 after Bonferroni correction in the left thalamus, right amygdala, right hippocampus, left ventral striatum and the right dorsal striatum. Decreases in the left thalamus, left dorsal striatum and the subgenual cingulate were correlated with a reduction in depression scores (P<0.05 after Bonferroni correction). Placebo treatment was associated with a significant decrease in activity only in the right amygdala, and no region had a change in activity that was correlated with change in depression scores. The groups differed significantly in the relationship between the changes in depression scores and in activity in the thalamus bilaterally and the left ventral striatum. The findings provide evidence that administration of supraphysiologic thyroid hormone improves depressive symptoms in patients with bipolar disorder by modulating function in components of the anterior limbic network. PMID:25600111

  19. "First pain" in humans: convergent and specific forebrain responses

    PubMed Central

    2010-01-01

    Background Brief heat stimuli that excite nociceptors innervated by finely myelinated (A?) fibers evoke an initial, sharp, well-localized pain ("first pain") that is distinguishable from the delayed, less intense, more prolonged dull pain attributed to nociceptors innervated by unmyelinated (C) fibers ("second pain"). In the present study, we address the question of whether a brief, noxious heat stimulus that excites cutaneous A? fibers activates a distinct set of forebrain structures preferentially in addition to those with similar responses to converging input from C fibers. Heat stimuli at two temperatures were applied to the dorsum of the left hand of healthy volunteers in a functional brain imaging (fMRI) paradigm and responses analyzed in a set of volumes of interest (VOI). Results Brief 41°C stimuli were painless and evoked only C fiber responses, but 51°C stimuli were at pain threshold and preferentially evoked A? fiber responses. Most VOI responded to both intensities of stimulation. However, within volumes of interest, a contrast analysis and comparison of BOLD response latencies showed that the bilateral anterior insulae, the contralateral hippocampus, and the ipsilateral posterior insula were preferentially activated by painful heat stimulation that excited A? fibers. Conclusions These findings show that two sets of forebrain structures mediate the initial sharp pain evoked by brief cutaneous heat stimulation: those responding preferentially to the brief stimulation of A? heat nociceptors and those with similar responses to converging inputs from the painless stimulation of C fibers. Our results suggest a unique and specific physiological basis, at the forebrain level, for the "first pain" sensation that has long been attributed to A? fiber stimulation and support the concept that both specific and convergent mechanisms act concurrently to mediate pain. PMID:21083897

  20. Automatic anatomy partitioning of the torso region on CT images by using multiple organ localizations with a group-wise calibration technique

    NASA Astrophysics Data System (ADS)

    Zhou, Xiangrong; Morita, Syoichi; Zhou, Xinxin; Chen, Huayue; Hara, Takeshi; Yokoyama, Ryujiro; Kanematsu, Masayuki; Hoshi, Hiroaki; Fujita, Hiroshi

    2015-03-01

    This paper describes an automatic approach for anatomy partitioning on three-dimensional (3D) computedtomography (CT) images that divide the human torso into several volume-of-interesting (VOI) images based on anatomical definition. The proposed approach combines several individual detections of organ-location with a groupwise organ-location calibration and correction to achieve an automatic and robust multiple-organ localization task. The essence of the proposed method is to jointly detect the 3D minimum bounding box for each type of organ shown on CT images based on intra-organ-image-textures and inter-organ-spatial-relationship in the anatomy. Machine-learning-based template matching and generalized Hough transform-based point-distribution estimation are used in the detection and calibration processes. We apply this approach to the automatic partitioning of a torso region on CT images, which are divided into 35 VOIs presenting major organ regions and tissues required by routine diagnosis in clinical medicine. A database containing 4,300 patient cases of high-resolution 3D torso CT images is used for training and performance evaluations. We confirmed that the proposed method was successful in target organ localization on more than 95% of CT cases. Only two organs (gallbladder and pancreas) showed a lower success rate: 71 and 78% respectively. In addition, we applied this approach to another database that included 287 patient cases of whole-body CT images scanned for positron emission tomography (PET) studies and used for additional performance evaluation. The experimental results showed that no significant difference between the anatomy partitioning results from those two databases except regarding the spleen. All experimental results showed that the proposed approach was efficient and useful in accomplishing localization tasks for major organs and tissues on CT images scanned using different protocols.

  1. NEUROFEEDBACK USING FUNCTIONAL SPECTROSCOPY.

    PubMed

    Hinds, Oliver; Wighton, Paul; Tisdall, M Dylan; Hess, Aaron; Breiter, Hans; van der Kouwe, André

    2014-06-01

    Neurofeedback based on real-time measurement of the blood oxygenation level-dependent (BOLD) signal has potential for treatment of neurological disorders and behavioral enhancement. Commonly employed methods are based on functional magnetic resonance imaging (fMRI) sequences that sacrifice speed and accuracy for whole-brain coverage, which is unnecessary in most applications. We present multi-voxel functional spectroscopy (MVFS): a system for computing the BOLD signal from multiple volumes of interest (VOI) in real-time that improves speed and accuracy of neurofeedback. MVFS consists of a functional spectroscopy (FS) pulse sequence, a BOLD reconstruction component, a neural activation estimator, and a stimulus system. The FS pulse sequence is a single-voxel, magnetic resonance spectroscopy sequence without water suppression that has been extended to allow acquisition of a different VOI at each repetition and real-time subject head motion compensation. The BOLD reconstruction component determines the T2* decay rate, which is directly related to BOLD signal strength. The neural activation estimator discounts nuisance signals and scales the activation relative to the amount of ROI noise. Finally, the neurofeedback system presents neural activation-dependent stimuli to experimental subjects with an overall delay of less than 1s. Here we present the MVFS system, validation of certain components, examples of its usage in a practical application, and a direct comparison of FS and echo-planar imaging BOLD measurements. We conclude that in the context of realtime BOLD imaging, MVFS can provide superior accuracy and temporal resolution compared with standard fMRI methods. PMID:24999293

  2. Dissociable Roles of Right Inferior Frontal Cortex and Anterior Insula in Inhibitory Control: Evidence from Intrinsic and Task-Related Functional Parcellation, Connectivity, and Response Profile Analyses across Multiple Datasets

    PubMed Central

    Ryali, Srikanth; Chen, Tianwen; Li, Chiang-Shan R.

    2014-01-01

    The right inferior frontal cortex (rIFC) and the right anterior insula (rAI) have been implicated consistently in inhibitory control, but their differential roles are poorly understood. Here we use multiple quantitative techniques to dissociate the functional organization and roles of the rAI and rIFC. We first conducted a meta-analysis of 70 published inhibitory control studies to generate a commonly activated right fronto-opercular cortex volume of interest (VOI). We then segmented this VOI using two types of features: (1) intrinsic brain activity; and (2) stop-signal task-evoked hemodynamic response profiles. In both cases, segmentation algorithms identified two stable and distinct clusters encompassing the rAI and rIFC. The rAI and rIFC clusters exhibited several distinct functional characteristics. First, the rAI showed stronger intrinsic and task-evoked functional connectivity with the anterior cingulate cortex, whereas the rIFC had stronger intrinsic and task-evoked functional connectivity with dorsomedial prefrontal and lateral fronto-parietal cortices. Second, the rAI showed greater activation than the rIFC during Unsuccessful, but not Successful, Stop trials, and multivoxel response profiles in the rAI, but not the rIFC, accurately differentiated between Successful and Unsuccessful Stop trials. Third, activation in the rIFC, but not rAI, predicted individual differences in inhibitory control abilities. Crucially, these findings were replicated in two independent cohorts of human participants. Together, our findings provide novel quantitative evidence for the dissociable roles of the rAI and rIFC in inhibitory control. We suggest that the rAI is particularly important for detecting behaviorally salient events, whereas the rIFC is more involved in implementing inhibitory control. PMID:25355218

  3. PET imaging of brain inflammation during early epileptogenesis in a rat model of temporal lobe epilepsy

    PubMed Central

    2012-01-01

    Background Recently, inflammatory cascades have been suggested as a target for epilepsy therapy. Positron emission tomography (PET) imaging offers the unique possibility to evaluate brain inflammation longitudinally in a non-invasive translational manner. This study investigated brain inflammation during early epileptogenesis in the post-kainic acid-induced status epilepticus (KASE) model with post-mortem histology and in vivo with [18F]-PBR111 PET. Methods Status epilepticus (SE) was induced (N = 13) by low-dose injections of KA, while controls (N = 9) received saline. Translocator protein (TSPO) expression and microglia activation were assessed with [125I]-CLINDE autoradiography and OX-42 immunohistochemistry, respectively, 7 days post-SE. In a subgroup of rats, [18F]-PBR111 PET imaging with metabolite-corrected input function was performed before post-mortem evaluation. [18F]-PBR111 volume of distribution (Vt) in volume of interests (VOIs) was quantified by means of kinetic modelling and a VOI/metabolite-corrected plasma activity ratio. Results Animals with substantial SE showed huge overexpression of TSPO in vitro in relevant brain regions such as the hippocampus and amygdala (P < 0.001), while animals with mild symptoms displayed a smaller increase in TSPO in amygdala only (P < 0.001). TSPO expression was associated with OX-42 signal but without obvious cell loss. Similar in vivo [18F]-PBR111 increases in Vt and the simplified ratio were found in key regions such as the hippocampus (P < 0.05) and amygdala (P < 0.01). Conclusion Both post-mortem and in vivo methods substantiate that the brain regions important in seizure generation display significant brain inflammation during epileptogenesis in the KASE model. This work enables future longitudinal investigation of the role of brain inflammation during epileptogenesis and evaluation of anti-inflammatory treatments. PMID:23136853

  4. Interactive Dose Shaping - efficient strategies for CPU-based real-time treatment planning

    NASA Astrophysics Data System (ADS)

    Ziegenhein, P.; Kamerling, C. P.; Oelfke, U.

    2014-03-01

    Conventional intensity modulated radiation therapy (IMRT) treatment planning is based on the traditional concept of iterative optimization using an objective function specified by dose volume histogram constraints for pre-segmented VOIs. This indirect approach suffers from unavoidable shortcomings: i) The control of local dose features is limited to segmented VOIs. ii) Any objective function is a mathematical measure of the plan quality, i.e., is not able to define the clinically optimal treatment plan. iii) Adapting an existing plan to changed patient anatomy as detected by IGRT procedures is difficult. To overcome these shortcomings, we introduce the method of Interactive Dose Shaping (IDS) as a new paradigm for IMRT treatment planning. IDS allows for a direct and interactive manipulation of local dose features in real-time. The key element driving the IDS process is a two-step Dose Modification and Recovery (DMR) strategy: A local dose modification is initiated by the user which translates into modified fluence patterns. This also affects existing desired dose features elsewhere which is compensated by a heuristic recovery process. The IDS paradigm was implemented together with a CPU-based ultra-fast dose calculation and a 3D GUI for dose manipulation and visualization. A local dose feature can be implemented via the DMR strategy within 1-2 seconds. By imposing a series of local dose features, equal plan qualities could be achieved compared to conventional planning for prostate and head and neck cases within 1-2 minutes. The idea of Interactive Dose Shaping for treatment planning has been introduced and first applications of this concept have been realized.

  5. Automatic pulmonary vessel segmentation in 3D computed tomographic pulmonary angiographic (CTPA) images

    NASA Astrophysics Data System (ADS)

    Zhou, Chuan; Chan, Heang-Ping; Hadjiiski, Lubomir M.; Patel, Smita; Cascade, Philip N.; Sahiner, Berkman; Wei, Jun; Ge, Jun; Kazerooni, Ella A.

    2006-03-01

    Automatic and accurate segmentation of the pulmonary vessels in 3D computed tomographic angiographic images (CTPA) is an essential step for computerized detection of pulmonary embolism (PE) because PEs only occur inside the pulmonary arteries. We are developing an automated method to segment the pulmonary vessels in 3D CTPA images. The lung region is first extracted using thresholding and morphological operations. 3D multiscale filters in combination with a newly developed response function derived from the eigenvalues of Hessian matrices are used to enhance all vascular structures including the vessel bifurcations and suppress non-vessel structures such as the lymphoid tissues surrounding the vessels. At each scale, a volume of interest (VOI) containing the response function value at each voxel is defined. The voxels with a high response indicate that there is an enhanced vessel whose size matches the given filter scale. A hierarchical expectation-maximization (EM) estimation is then applied to the VOI to segment the vessel by extracting the high response voxels at this single scale. The vessel tree is finally reconstructed by combining the segmented vessels at all scales based on a "connected component" analysis. Two experienced thoracic radiologists provided the gold standard of pulmonary arteries by manually tracking the arterial tree and marking the center of the vessels using a computer graphical user interface. Two CTPA cases containing PEs were used to evaluate the performance. One of these two cases also contained other lung diseases. The accuracy of vessel tree segmentation was evaluated by the percentage of the "gold standard" vessel center points overlapping with the segmented vessels. The result shows that 97.3% (1868/1920) and 92.0% (2277/2476) of the manually marked center points overlapped with the segmented vessels for the cases without and with other lung disease, respectively. The results demonstrate that vessel segmentation using our method is not degraded by PE occlusion and the vessels can be accurately extracted.

  6. Computerized detection of pulmonary embolism in computed tomographic pulmonary angiography (CTPA): improvement of vessel segmentation

    NASA Astrophysics Data System (ADS)

    Zhou, Chuan; Chan, Heang-Ping; Kuriakose, Jean W.; Chughtai, Aamer; Hadjiiski, Lubomir M.; Wei, Jun; Patel, Smita; Kazerooni, Ella A.

    2011-03-01

    Vessel segmentation is a fundamental step in an automated pulmonary embolism (PE) detection system. The purpose of this study is to improve the segmentation scheme for pulmonary vessels affected by PE and other lung diseases. We have developed a multiscale hierarchical vessel enhancement and segmentation (MHES) method for pulmonary vessel tree extraction based on the analysis of eigenvalues of Hessian matrices. However, it is difficult to segment the pulmonary vessels accurately when the vessel is occluded by PEs and/or surrounded by lymphoid tissues or lung diseases. In this study, we developed a method that combines MHES with level set refinement (MHES-LSR) to improve vessel segmentation accuracy. The level set was designed to propagate the initial object contours to the regions with relatively high gray-level, high gradient, and high compactness as measured by the smoothness of the curvature along vessel boundaries. Two and eight CTPA scans were randomly selected as training and test data sets, respectively. Forty volumes of interest (VOI) containing "representative" vessels were manually segmented by a radiologist experienced in CTPA interpretation and used as reference standard. The results show that, for the 32 test VOIs, the average percentage volume error relative to the reference standard was improved from 31.7+/-10.9% using the MHES method to 7.7+/-4.7% using the MHES-LSR method. The correlation between the computer-segmented vessel volume and the reference standard was improved from 0.954 to 0.986. The accuracy of vessel segmentation was improved significantly (p<0.05). The MHES-LSR method may have the potential to improve PE detection.

  7. Intensive Case Finding and Isoniazid Preventative Therapy in HIV Infected Individuals in Africa: Economic Model and Value of Information Analysis

    PubMed Central

    Maheswaran, Hendramoorthy; Barton, Pelham

    2012-01-01

    Background Tuberculosis (TB) accounts of much of the morbidity and mortality associated with HIV. We evaluate the cost-effectiveness of different strategies to actively screen for TB disease in HIV positive individuals, where isoniazid preventative therapy (IPT) is given to those screening negative, and use value of information analysis (VOI) to identify future research priorities. Methodology/ Principal Findings We built an individual sampling model to investigate the costs (2010 US Dollars) and consequences of screening for TB, and providing TB treatment or IPT in adults testing HIV positive in Sub-Saharan Africa. A systematic review and meta-analysis was conducted to assess performance of the nine different TB screening strategies evaluated. Probabilistic sensitivity analysis was conducted to incorporate decision uncertainty, and expected value of perfect information for the entire model and for groups of parameters was calculated. Screening all HIV infected individuals with sputum microscopy was the least costly strategy, with other strategies not cost-effective at WHO recommended thresholds. Screening those with TB symptoms with sputum microscopy and CXR would be cost-effective at a threshold ICER of $7,800 per quality-adjusted life year (QALY), but associated with significant uncertainty. VOI analysis suggests further information would be of value. Conclusions/ Significance Resource-constrained countries in sub-Saharan Africa wishing to scale up TB preventative services in their HIV infected populations should consider expanding laboratory facilities to enable increased screening for TB with sputum microscopy, whilst improved estimates of the TB prevalence in the population to be screened are needed, as it may influence the optimal strategy. PMID:22291958

  8. Predicting the biomechanical strength of proximal femur specimens with bone mineral density features and support vector regression

    NASA Astrophysics Data System (ADS)

    Huber, Markus B.; Yang, Chien-Chun; Carballido-Gamio, Julio; Bauer, Jan S.; Baum, Thomas; Nagarajan, Mahesh B.; Eckstein, Felix; Lochmüller, Eva; Majumdar, Sharmila; Link, Thomas M.; Wismüller, Axel

    2012-03-01

    To improve the clinical assessment of osteoporotic hip fracture risk, recent computer-aided diagnosis systems explore new approaches to estimate the local trabecular bone quality beyond bone density alone to predict femoral bone strength. In this context, statistical bone mineral density (BMD) features extracted from multi-detector computed tomography (MDCT) images of proximal femur specimens and different function approximations methods were compared in their ability to predict the biomechanical strength. MDCT scans were acquired in 146 proximal femur specimens harvested from human cadavers. The femurs' failure load (FL) was determined through biomechanical testing. An automated volume of interest (VOI)-fitting algorithm was used to define a consistent volume in the femoral head of each specimen. In these VOIs, the trabecular bone was represented by statistical moments of the BMD distribution and by pairwise spatial occurrence of BMD values using the gray-level co-occurrence (GLCM) approach. A linear multi-regression analysis (MultiReg) and a support vector regression algorithm with a linear kernel (SVRlin) were used to predict the FL from the image feature sets. The prediction performance was measured by the root mean square error (RMSE) for each image feature on independent test sets; in addition the coefficient of determination R2 was calculated. The best prediction result was obtained with a GLCM feature set using SVRlin, which had the lowest prediction error (RSME = 1.040+/-0.143, R2 = 0.544) and which was significantly lower that the standard approach of using BMD.mean and MultiReg (RSME = 1.093+/-0.133, R2 = 0.490, p<0.0001). The combined sets including BMD.mean and GLCM features had a similar or slightly lower performance than using only GLCM features. The results indicate that the performance of high-dimensional BMD features extracted from MDCT images in predicting the biomechanical strength of proximal femur specimens can be significantly improved by using support vector regression.

  9. A minimally interactive method to segment enlarged lymph nodes in 3D thoracic CT images using a rotatable spiral-scanning technique

    NASA Astrophysics Data System (ADS)

    Wang, Lei; Moltz, Jan H.; Bornemann, Lars; Hahn, Horst K.

    2012-03-01

    Precise size measurement of enlarged lymph nodes is a significant indicator for diagnosing malignancy, follow-up and therapy monitoring of cancer diseases. The presence of diverse sizes and shapes, inhomogeneous enhancement and the adjacency to neighboring structures with similar intensities, make the segmentation task challenging. We present a semi-automatic approach requiring minimal user interactions to fast and robustly segment the enlarged lymph nodes. First, a stroke approximating the largest diameter of a specific lymph node is drawn manually from which a volume of interest (VOI) is determined. Second, Based on the statistical analysis of the intensities on the dilated stroke area, a region growing procedure is utilized within the VOI to create an initial segmentation of the target lymph node. Third, a rotatable spiral-scanning technique is proposed to resample the 3D boundary surface of the lymph node to a 2D boundary contour in a transformed polar image. The boundary contour is found by seeking the optimal path in 2D polar image with dynamic programming algorithm and eventually transformed back to 3D. Ultimately, the boundary surface of the lymph node is determined using an interpolation scheme followed by post-processing steps. To test the robustness and efficiency of our method, a quantitative evaluation was conducted with a dataset of 315 lymph nodes acquired from 79 patients with lymphoma and melanoma. Compared to the reference segmentations, an average Dice coefficient of 0.88 with a standard deviation of 0.08, and an average absolute surface distance of 0.54mm with a standard deviation of 0.48mm, were achieved.

  10. Prefrontal Lobe Brain Reserve Capacity with Resistance to Higher Global Amyloid Load and White Matter Hyperintensity Burden in Mild Stage Alzheimer’s Disease

    PubMed Central

    Chang, Ya-Ting; Huang, Chi-Wei; Chen, Nai-Ching; Lin, Kun-Ju; Huang, Shu-Hua; Chang, Yen-Hsiang; Hsu, Shih-Wei; Chang, Wen-Neng; Lui, Chun-Chung; Hsu, Che-Wei; Chang, Chiung-Chih

    2016-01-01

    Background Amyloid deposition and white matter lesions (WMLs) in Alzheimer's disease (AD) are both considered clinically significant while a larger brain volume is thought to provide greater brain reserve (BR) against these pathological effects. This study identified the topography showing BR in patients with mild AD and explored the clinical balances among BR, amyloid, and WMLs burden. Methods Thirty patients with AD were enrolled, and AV-45 positron emission tomography was conducted to measure the regional standardized uptake value ratio (SUVr) in 8 cortical volumes-of- interests (VOIs). The quantitative WMLs burden was measured from magnetic resonance imaging while the normalized VOIs volumes represented BR in this study. The cognitive test represented major clinical correlates. Results Significant correlations between the prefrontal volume and global (r = 0.470, p = 0.024), but not regional (r = 0.264, p = 0.223) AV-45 SUVr were found. AD patients having larger regional volume in the superior- (r = 0.572, p = 0.004), superior medial- (r = 0.443, p = 0.034), and middle-prefrontal (r = 0.448, p = 0.032) regions had higher global AV-45 SUVr. For global WML loads, the prefrontal (r = -0.458, p = 0.019) and hippocampal volume (r = -0.469, p = 0.016) showed significant correlations while the prefrontal (r = -0.417, p = 0.043) or hippocampal volume (r = -0.422, p = 0.04) also predicted better composite memory scores. There were no interactions between amyloid SUVr and WML loads on the prefrontal volume. Conclusions BR of the prefrontal region might modulate the adverse global pathological burden caused by amyloid deposition. While prefrontal volume positively associated with hippocampal volume, WMLs had an adverse impact on the hippocampal volume that predicts memory performance in mild stage AD. PMID:26872386

  11. Computer-aided detection of breast masses in digital breast tomosynthesis (DBT): improvement of false positive reduction by optimization of object segmentation

    NASA Astrophysics Data System (ADS)

    Wei, Jun; Chan, Heang-Ping; Sahiner, Berkman; Hadjiiski, Lubomir M.; Helvie, Mark A.; Zhou, Chuan; Lu, Yao

    2011-03-01

    DBT is a promising new imaging modality that may improve the sensitivity and specificity for breast cancer detection. However, DBT could only provide quasi-3D information with limited resolution along the depth (Z) direction because tomosynthesis only has limited angular information for reconstruction. Our purpose of this study is to develop a mass segmentation method for a computer-aided detection system in DBT. A data set of 50 two-view DBTs was collected with a GE prototype system. We reconstructed the DBTs using a simultaneous algebraic reconstruction technique (SART). Mass candidates including true and false masses were identified by 3D gradient field analysis. Two-stage 3D clustering followed by active contour segmentation was applied to a volume of interest (VOI) at each candidate location. We compared a fixed-Z approach, in which the Z dimension of the VOI was pre-determined, to an adaptive-Z approach, in which Z was determined by the object diameter (D) on the X-Y plane obtained from the first-stage clustering. We studied the effect of Z ranging from D to D+8 slices, centered at the central slice, in the second stage. Features were extracted on the individual slices of the segmented 3D object and averaged over all slices for both approaches. Linear discriminant analysis with stepwise feature selection was trained with a leave-one-case-out method to differentiate true from false masses in each feature space. With proper optimization of the adaptive-Z approach, the classification accuracy was significantly improved (p<0.0001) in comparison with the fixed-Z approach. The improved differentiation of true from false masses will be useful for false positive reduction in an automated mass detection system.

  12. The impact of breast structure on lesion detection in breast tomosynthesis

    NASA Astrophysics Data System (ADS)

    Kiarashi, Nooshin; Nolte, Loren W.; Lo, Joseph Y.; Segars, William P.; Ghate, Sujata V.; Samei, Ehsan

    2015-03-01

    Virtual clinical trials (VCT) can be carefully designed to inform, orient, or potentially replace clinical trials. The focus of this study was to demonstrate the capability of the sophisticated tools that can be used in the design, implementation, and performance analysis of VCTs, through characterization of the effect of background tissue density and heterogeneity on the detection of irregular masses in digital breast tomosynthesis. Twenty breast phantoms from the extended cardiactorso (XCAT) family, generated based on dedicated breast computed tomography of human subjects, were used to extract a total of 2173 volumes of interest (VOI) from simulated tomosynthesis images. Five different lesions, modeled after human subject tomosynthesis images, were embedded in the breasts, for a total of 6×2173 VOIs with and without lesions. Effects of background tissue density and heterogeneity on the detection of the lesions were studied by implementing a doubly composite hypothesis signal detection theory paradigm with location known exactly, lesion known exactly, and background known statistically. The results indicated that the detection performance as measured by the area under the receiver operating characteristic curve (ROC) deteriorated as density was increased, yielding findings consistent with clinical studies. The detection performance varied substantially across the twenty breasts. Furthermore, the log-likelihood ratio under H0 and H1 seemed to be affected by background tissue density and heterogeneity differently. Considering background tissue variability can change the outcomes of a VCT and is hence of crucial importance. The XCAT breast phantoms can address this concern by offering realistic modeling of background tissue variability based on a wide range of human subjects.

  13. Croissance epitaxiale de GaAs sur substrats de Ge par epitaxie par faisceaux chimiques

    NASA Astrophysics Data System (ADS)

    Belanger, Simon

    La situation energetique et les enjeux environnementaux auxquels la societe est confrontee entrainent un interet grandissant pour la production d'electricite a partir de l'energie solaire. Parmi les technologies actuellement disponibles, la filiere du photovoltaique a concentrateur solaire (CPV pour concentrator photovoltaics) possede un rendement superieur et mi potentiel interessant a condition que ses couts de production soient competitifs. La methode d'epitaxie par faisceaux chimiques (CBE pour chemical beam epitaxy) possede plusieurs caracteristiques qui la rendent interessante pour la production a grande echelle de cellules photovoltaiques a jonctions multiples a base de semi-conducteurs III-V. Ce type de cellule possede la meilleure efficacite atteinte a ce jour et est utilise sur les satellites et les systemes photovoltaiques a concentrateur solaire (CPV) les plus efficaces. Une des principales forces de la technique CBE se trouve dans son potentiel d'efficacite d'utilisation des materiaux source qui est superieur a celui de la technique d'epitaxie qui est couramment utilisee pour la production a grande echelle de ces cellules. Ce memoire de maitrise presente les travaux effectues dans le but d'evaluer le potentiel de la technique CBE pour realiser la croissance de couches de GaAs sur des substrats de Ge. Cette croissance constitue la premiere etape de fabrication de nombreux modeles de cellules solaires a haute performance decrites plus haut. La realisation de ce projet a necessite le developpement d'un procede de preparation de surface pour les substrats de germanium, la realisation de nombreuses sceances de croissance epitaxiale et la caracterisation des materiaux obtenus par microscopie optique, microscopie a force atomique (AFM), diffraction des rayons-X a haute resolution (HRXRD), microscopie electronique a transmission (TEM), photoluminescence a basse temperature (LTPL) et spectrometrie de masse des ions secondaires (SIMS). Les experiences ont permis de confirmer l'efficacite du procede de preparation de surface et d'identifier les conditions de croissance optimales. Les resultats de caracterisation indiquent que les materiaux obtenus presentent une tres faible rugosite de surface, une bonne qualite cristalline et un dopage residuel relativement important. De plus, l'interface GaAs/Ge possede une faible densite de defauts. Finalement, la diffusion d'arsenic dans le substrat de germanium est comparable aux valeurs trouvees dans la litterature pour la croissance a basse temperature avec les autres procedes d'epitaxie courants. Ces resultats confirment que la technique d'epitaxie par faisceaux chimiques (CBE) permet de produire des couches de GaAs sur Ge de qualite adequate pour la fabrication de cellules solaires a haute performance. L'apport a la communaute scientifique a ete maximise par le biais de la redaction d'un article soumis a la revue Journal of Crystal Growth et la presentation des travaux a la conference Photovoltaics Canada 2010 . Mots-cles : Epitaxie par jets chimiques, Chemical beam epitaxy, CBE, MOMBE, Germanium, GaAs, Ge

  14. Etude sur les tendons en materiaux composites et leur application aux ancrages postcontraints

    NASA Astrophysics Data System (ADS)

    Chennouf, Adil

    L'objectif general de la presente these est d'evaluer le comportement a l'arrachement et au fluage d'ancrages injectes constitues de tendons en materiaux composites afin d'etablir des recommandations plus appropriees et realistes pour le dimensionnement et la conception. Quatre types de tendons en materiaux composites, deux a base de fibres d'aramide et deux a base de fibres de carbone, ont ete utilises dans l'etude. Les travaux de recherche de cette these ont porte notamment sur: (I) Une caracterisation physique et mecanique des tendons en materiaux composites utilises dans l'etude. (II) Une etude en laboratoire sur les coulis de scellement. La premiere etape de cette etude a concerne le developpement d'un coulis de scellement performant adapte aux tendons en materiaux composites et a differentes situations d'injection. La seconde etape a traite des essais de caracterisations physique et mecanique du coulis de scellement developpe comparativement a trois coulis de scellement usuels d'un meme rapport E/L de 0,4. (III) Une etude sur des modeles reduits d'ancrages injectes. (IV) Une etude sur des modeles d'ancrages a grande echelle. La synthese de ces etudes a permis d'enoncer les principales conclusions suivantes: (1) Les valeurs moyennes des charges de rupture des tendons en materiaux composites ont ete de 1% a 29% superieures a celles specifiees par les manufacturiers. (2) L'etude sur les coulis de scellement a permis le developpement de coulis de ciment repondant aux criteres fixes, soient une grande stabilite, une bonne fluidite, une legere expansion et de bonnes caracteristiques mecaniques. (3) Les tendons en materiaux composites ont montre des contraintes d'adherence maximum superieures a celles des tendons en acier. (4) Le type de fibre, la configuration et le fini de surface des tendons en materiaux composites gouvernent leur resistance a l'adherence. (5) L'introduction de sable et d'autres ajouts comme les fines de silice et la poudre d'aluminium au coulis de ciment a permis d'ameliorer la resistance a l'adherence. (6) Il existe une relation lineaire entre la charge maximum et la longueur ancree des tendons. Des equations sont proposees. (7) La capacite a l'arrachement des ancrages injectes augmente avec l'augmentation du module d'elasticite du milieu encaissant. (8) Les mono-tendons et multi-tendons en materiaux composites injectes sur 1000 mm ont montre des comportements a l'arrachement acceptables conformement aux codes. (9) Les rigidites apparentes des tendons a base de fibres d'aramide sont de trois a cinq fois inferieures a celles des tendons a base de fibres de carbone. (10) L'amorce de la decohesion en haut de la zone ancree ne semble se produire qu'au-dela d'une charge de 0,35 fpu pour les tendons a base de fibres de carbone alors qu'elle prend naissance des l'application de la charge pour les tendons a base de fibres d'aramide. (11) Le taux de fluage depend du niveau de chargement ainsi que des caracteristiques geometriques et mecaniques de l'ancrage (type de fibres, fini de surface, nombre de tendons, etc.). (12) Des equations regissant le comportement au fluage des tendons en materiaux composites ont ete etablies pour une periode d'essai de 60 mn. (Abstract shortened by UMI.)

  15. Mesure de la Polarisation des Lambda Produits dans les Collisions Positron-Electron AU Lep a L'aide du Detecteur Opal

    NASA Astrophysics Data System (ADS)

    Vandenplas, Denis

    Le Modele Standard est le cadre theorique general qui, jusqu'a present, a permis l'interpretation de tous les resultats experimentaux en physique des hautes energies. Cette theorie decrit, entre autres, la production d'une paire de particules elementaires, formee d'un quark et d'un antiquark, a partir de la desintegration de l'un des bosons mediateurs de l'interaction faible, le Z^0. Cependant, dans ce cas precis, la transformation subsequente des quarks primaires en particules reelles, un processus appele hadronisation, n'est decrite qu'a l'aide de modeles phenomenologiques. Afin de sonder les mecanismes de l'hadronisation, cette these presente la mesure du transfert du spin d'un quark etrange primaire a une particule appelee Lambda lors des desintegrations hadroniques du Z^0. L'etude a ete realisee dans le cadre de la collaboration OPAL, une des quatre experiences menees au collisionneur LEP, la ou des electrons et des positrons sont acceleres jusqu'a une energie commune, sqrt{s} = {rm E_ {cm}}, voisine de l'energie de production du rm Z^0, M_{Z ^0} egale a 91.3 GeV. La theorie electrofaible precise la direction du spin, c'est-a-dire la polarisation, d'un quark etrange primaire provenant de la desintegration d'un Z ^0. Quant a lui, le modele des quarks etablit que l'orientation du spin d'un Lambda est directement reliee a la polarisation du quark etrange dont il provient. La question est de determiner dans quelle mesure la polarisation du quark primaire est transmise au Lambda a la suite du processus de l'hadronisation, decrit dans le cadre de la ChromoDynamique Quantique. Une estimation, qui tient compte de tous ces differents aspects theoriques, evalue a 30% la polarisation des Lambda dont l'impulsion est superieure a 15 GeV/c. La mesure experimentale de la polarisation repose sur l'identification des Lambda a partir de la reconstitution de la desintegration Lambdato ppi^-. Ce processus, qui se deroule par le biais de l'interaction faible, viole la parite car le proton est emis dans une direction precise par rapport au spin du Lambda . L'evaluation de la distribution de l'angle de desintegration du proton est utilisee afin de determiner l'orientation du spin du Lambda, c'est-a-dire sa polarisation. La mesure experimentale etablit pour les Lambda, dont l'impulsion est superieure a 15 GeV/c, une polarisation de l'ordre de -29.3 +/- 9.9 (erreur statistique) +/- 3.6 (erreur systematique) % en accord avec l'estimation effectuee dans le cadre du Modele Standard.

  16. Voltammetry of L-cysteine and 2-mercaptopyridine on a self-assembled phospholipid monolayer

    NASA Astrophysics Data System (ADS)

    Herrero, R.; Barriada, J. L.; Moncelli, M. R.; López-Fonseca, J. M.; Sastre de Vicente, M. E.

    1999-09-01

    The redox behaviour of 2-mercaptopyridine and the aminoacid L-cysteine was studied through a self-assembled monolayer of dioleoylphosphatidylcholine adsorbed on mercury by using cyclic voltammetry. 2-Mercaptopyridine penetrates into monolayer in the zone of stability of the phospholipid layer and shows an quasi-reversible behaviour while reversibility is observed in the absence of a monolayer. This fact is reflected in the occurrence of voltammetric peaks in the above mentioned region of potentials. Conversely, cysteine was found not to penetrate in the lipid layer as long as the latter behaves like a half-membrane. Voltammetric signal of cysteine was only obtained when the potential was scanned to values positive to -0.2 V. Beyond this potential the cyclic voltammograms show a series of anodic peaks, due to a rearrangement of the lipid film and to the formation of Hg(RS)2, followed by three cathodic peaks when the scan is reversal. The behaviour of these peaks was analized. Le comportement voltampérometrique de la 2-mercaptopyridine et de l'aminoacid L-cysteine a eté etudié sur l'électrode de mercure couverte par une monocouche de dioleoylphosphatidylcholine. Pour la 2-mercaptopyridine on peut constater la pénétration de ce composé dans la zone de stabilité de la monocouche. La constante de vitesse a eté calculée seulement pour des basses concentrations. Lorsque la concentration augmente le comportement devient très compliqué. Par contre, pour la cysteine on observe seulement un signal de courant pour des potentiels superieurs à -0.2V oú la monocouche de phospholipide ne peut pas être considerée très stable. La differente structure chimique des deux substances permet de rendre compte du different comportement voltammetrique observé.

  17. Long-term autonomous spectrophotometry applied to the measurement of CO2 at the sea surface on board a drifting buoy

    NASA Astrophysics Data System (ADS)

    Wadsworth, Alain; Delignieres, R.; Durand, Ch.

    1995-09-01

    It is now well accepted that the increase of atmospheric greenhouse effect gases, particularly carbon dioxide, has an important impact on our climatic system, even if the true effect of the development of human industrial activities is not totally assessed. It is then necessary to have a good overall knowledge of the carbon dioxide cycle, and more particularly the fluxes exchanged the three CO2 tanks: atmosphere, ocean, and continental biosphere. Since the ocean is the biggest carbon tank (60 times the atmosphere tank), it constitutes an important potenetial well for the atmospheric CO2. However, the data available show an uncertainty of ca. 30% on the estimated flux. It is then important to assess the quantity of CO2 at the surface of the ocean, and the corresponding atmosphere/ocean flux. The possible future atmospheric CO2 concentration corresponding to different industrial emission scenarii can then be assessed. The method measurement of the CO2 at the sea surface use spectro- photometry of a sensitive dye, housed in a tank which has walls immersed in the sea water. The spectro-photometer especially designed, patented, and build-up by IFP has been developed with special emphasis on high accuracy, rugged construction, ease of operation without maintenance, and calibration over a period of time of over one year. The leading idea was to have as few internal moving parts as possible by the use of fiber optics, and internal calibration by the use of internal reference channels. Ancillary data are also measured. Data is transmitted to the processing center via ARGOS. The equipment described is part of the EUREKA CARIOCA project (EU 819), supported by the French Ministere de l'Enseignement Superieur et de la Recherche (93 W 0011) and UK's DTI. The partners are: LODYC, LGE, INSU, SERPE-IESM, France), and Chelsea Instruments (UK).

  18. Simulation d'ecoulements internes compressibles laminaires et turbulents par une methode d'elements finis

    NASA Astrophysics Data System (ADS)

    Rebaine, Ali

    1997-08-01

    Ce travail consiste en la simulation numerique des ecoulements internes compressibles bidimensionnels laminaires et turbulents. On s'interesse, particulierement, aux ecoulements dans les ejecteurs supersoniques. Les equations de Navier-Stokes sont formulees sous forme conservative et utilisent, comme variables independantes, les variables dites enthalpiques a savoir: la pression statique, la quantite de mouvement et l'enthalpie totale specifique. Une formulation variationnelle stable des equations de Navier-Stokes est utilisee. Elle est base sur la methode SUPG (Streamline Upwinding Petrov Galerkin) et utilise un operateur de capture des forts gradients. Un modele de turbulence, pour la simulation des ecoulements dans les ejecteurs, est mis au point. Il consiste a separer deux regions distinctes: une region proche de la paroi solide, ou le modele de Baldwin et Lomax est utilise et l'autre, loin de la paroi, ou une formulation nouvelle, basee sur le modele de Schlichting pour les jets, est proposee. Une technique de calcul de la viscosite turbulente, sur un maillage non structure, est implementee. La discretisation dans l'espace de la forme variationnelle est faite a l'aide de la methode des elements finis en utilisant une approximation mixte: quadratique pour les composantes de la quantite de mouvement et de la vitesse et lineaire pour le reste des variables. La discretisation temporelle est effectuee par une methode de differences finies en utilisant le schema d'Euler implicite. Le systeme matriciel, resultant de la discretisation spatio-temporelle, est resolu a l'aide de l'algorithme GMRES en utilisant un preconditionneur diagonal. Les validations numeriques ont ete menees sur plusieurs types de tuyeres et ejecteurs. La principale validation consiste en la simulation de l'ecoulement dans l'ejecteur teste au centre de recherche NASA Lewis. Les resultats obtenus sont tres comparables avec ceux des travaux anterieurs et sont nettement superieurs concernant les ecoulements turbulents dans les ejecteurs.

  19. Elaboration du Ge mesoporeux et etude de ses proprietes physico-chimiques en vue d'applications photovoltaiques

    NASA Astrophysics Data System (ADS)

    Tutashkonko, Sergii

    Le sujet de cette these porte sur l'elaboration du nouveau nanomateriau par la gravure electrochimique bipolaire (BEE) --- le Ge mesoporeux et sur l'analyse de ses proprietes physico-chimiques en vue de son utilisation dans des applications photovoltaiques. La formation du Ge mesoporeux par gravure electrochimique a ete precedemment rapportee dans la litterature. Cependant, le verrou technologique important des procedes de fabrication existants consistait a obtenir des couches epaisses (superieure a 500 nm) du Ge mesoporeux a la morphologie parfaitement controlee. En effet, la caracterisation physico-chimique des couches minces est beaucoup plus compliquee et le nombre de leurs applications possibles est fortement limite. Nous avons developpe un modele electrochimique qui decrit les mecanismes principaux de formation des pores ce qui nous a permis de realiser des structures epaisses du Ge mesoporeux (jusqu'au 10 mum) ayant la porosite ajustable dans une large gamme de 15% a 60%. En plus, la formation des nanostructures poreuses aux morphologies variables et bien controlees est desormais devenue possible. Enfin, la maitrise de tous ces parametres a ouvert la voie extremement prometteuse vers la realisation des structures poreuses a multi-couches a base de Ge pour des nombreuses applications innovantes et multidisciplinaires grace a la flexibilite technologique actuelle atteinte. En particulier, dans le cadre de cette these, les couches du Ge mesoporeux ont ete optimisees dans le but de realiser le procede de transfert de couches minces d'une cellule solaire a triple jonctions via une couche sacrificielle en Ge poreux. Mots-cles : Germanium meso-poreux, Gravure electrochimique bipolaire, Electrochimie des semi-conducteurs, Report des couches minces, Cellule photovoltaique

  20. Quantification du champ electromagnetique et description quantique de la generation du second harmonique a l'interieur d'une microcavite

    NASA Astrophysics Data System (ADS)

    Collette, Marc

    L'existence de particules virtuelles qui surgissent spontanement du vide pour disparaitre tres peu de temps apres leur apparition (les fluctuations du vide) trouve son origine dans le principe d'incertitude de Heisenberg. Par ailleurs, on sait que le phenomene de resonance par confinement explique l'amplification de l'intensite lumineuse a l'interieur d'une cavite ouverte aux frequences de resonances de celle-ci. C'est pourquoi le taux d'apparition des photons virtuels au sein des modes propres d'une cavite est lui aussi amplifie par le resonateur. Mathematiquement, cet effet quantique est decrit par l'existence d'un commutateur " anomal " entre les operateurs d'annihilation et de creation des photons. Nous decrivons les consequences de ce commutateur sur la generation du second harmonique optique (GSH), un processus photonique ou, dans un materiau optiquement non lineaire, deux photons de meme energie fusionnent pour n'en former qu'un seul. On commence ce travail avec un traitement complet et original sur la quantification du champ electromagnetique. On montre ensuite que les fluctuations du vide stimulent le signal de la GSH a l'interieur du milieu confine. Cependant, on constate aussi que les fluctuations du vide jouent le role d'un inhibiteur au declenchement du processus, c'est-a-dire que le seuil de la GSH augmente (il est superieur au seuil minimal de deux photons seulement). En conclusion, les mecanismes intimes de certains processus optiques non lineaires doivent etre reconsideres lorsqu'ils surviennent en presence d'un confinement electromagnetique.

  1. Retinoic acid induces cells cultured from oral squamous cell carcinomas to become anti-angiogenic.

    PubMed Central

    Lingen, M. W.; Polverini, P. J.; Bouck, N. P.

    1996-01-01

    Retinoids have shown great promise as chemopreventive against the development of squamous cell carcinomas of the upper aerodigestive tract. However, the exact mechanism by which they block new tumors from arising is unknown. Here, we report that 13-cis- and all-trans-retinoic acid, used at clinically achievable doses of 10(-6) mol/L or less, can directly and specifically affect cell lines cultured from oral squamous cell carcinomas, inducing them to switch from an angiogenic to an anti-angiogenic phenotype. Although retinoic-acid-treated and untreated tumor cells make the same amount of interleukin-8, the major inducer of neovascularization produced by such tumor lines, they vary in production of inhibitory activity. Only the retinoic-acid-treated cells produce a potent angio-inhibitory activity that is able to block in vitro migration of endothelial cells toward tumor cell conditioned media and to halt neovascularization induced by such media in the rat cornea. Anti-angiogenic activity is induced in the tumor cells by low doses of retinoids in the absence of toxicity with a kinetics that suggest that it could be contributing to the effectiveness of the retinoids as chemopreventive agents. Images Figure 6 PMID:8686749

  2. Expression of podoplanin and prognosis in oropharyngeal cancer.

    PubMed

    Preuss, Simon F; Anagiotos, Andreas; Seuthe, Inga M C; Drebber, Uta; Wedemeyer, Inga; Kreppel, Matthias; Semrau, Robert; Eslick, Guy D; Klussmann, Jens Peter; Huebbers, Christian U

    2015-07-01

    It has been shown that podoplanin expression is associated with carcinoma of the aerodigestive tract. Recent studies indicate that podoplanin may serve as a prognostic biomarker in oral carcinoma. In order to provide evidence on the role of podoplanin in oropharyngeal squamous cell carcinoma, we evaluated the prognostic impact of podoplanin in these patients. We analyzed formalin-fixed tissue samples from 107 consecutive patients with oropharyngeal squamous cell carcinoma. HPV typing and immunohistochemical staining for both p16 and podoplanin were performed. Expression of podoplanin was seen in 38.3% of all cases. We found no correlation of the podoplanin scores with either p16 expression or with HPV status. There was no significant correlation of podoplanin expression with the staging variables T, N, M, and tumor grading. Podoplanin expression did neither influence the 5-year overall survival nor the 5-year disease-free survival. Concluding, we could not find a prognostic role of podoplanin expression neither in the HPV-positive cases nor in the HPV-negative cases. It appears that podoplanin is not expressed as often in oropharyngeal cancer compared to oral cancer. We could not show any relation of lymph node metastases and podoplanin expression in this homogenous cohort of tumors. PMID:24880471

  3. Ethanol versus Phytochemicals in Wine: Oral Cancer Risk in a Light Drinking Perspective.

    PubMed

    Varoni, Elena M; Lodi, Giovanni; Iriti, Marcello

    2015-01-01

    This narrative review aims to summarize the current controversy on the balance between ethanol and phytochemicals in wine, focusing on light drinking and oral cancer. Extensive literature search included PUBMED and EMBASE databases to identify in human studies and systematic reviews (up to March 2015), which contributed to elucidate this issue. Independently from the type of beverage, meta-analyses considering light drinking (≤1 drinks/day or ≤12.5 g/day of ethanol) reported relative risks (RR) for oral, oro-pharyngeal, or upper aero-digestive tract cancers, ranging from 1.0 to 1.3. One meta-analysis measured the overall wine-specific RR, which corresponded to 2.1. Although little evidence exists on light wine intake, phytochemicals seem not to affect oral cancer risk, being probably present below the effective dosages and/or due to their low bioavailability. As expected, the risk of oral cancer, even in light drinking conditions, increases when associated with smoking habit and high-risk genotypes of alcohol and aldehyde dehydrogenases. PMID:26225960

  4. The mucosal immune system: From dentistry to vaccine development.

    PubMed

    Kiyono, Hiroshi; Azegami, Tatsuhiko

    2015-01-01

    The oral cavity is the beginning of the aero-digestive tract, which is covered by mucosal epithelium continuously under the threat of invasion of pathogens, it is thus protected by the mucosal immune system. In the early phase of our scientific efforts for the demonstration of mucosal immune system, dental science was one of major driving forces due to their foreseeability to use oral immunity for the control of oral diseases. The mucosal immune system is divided functionally into, but interconnected inductive and effector sites. Intestinal Peyer's patches (PPs) are an inductive site containing antigen-sampling M cells and immunocompetent cells required to initiate antigen-specific immune responses. At effector sites, PP-originated antigen-specific IgA B cells become plasma cells to produce polymeric IgA and form secretory IgA by binding to poly-Ig receptor expressed on epithelial cells for protective immunity. The development of new-generation mucosal vaccines, including the rice-based oral vaccine MucoRice, on the basis of the coordinated mucosal immune system is a promising strategy for the control of mucosal infectious diseases. PMID:26460320

  5. Pharmacological recruitment of aldehyde dehydrogenase 3A1 (ALDH3A1) to assist ALDH2 in acetaldehyde and ethanol metabolism in vivo

    PubMed Central

    Chen, Che-Hong; Cruz, Leslie A.; Mochly-Rosen, Daria

    2015-01-01

    Correcting a genetic mutation that leads to a loss of function has been a challenge. One such mutation is in aldehyde dehydrogenase 2 (ALDH2), denoted ALDH2*2. This mutation is present in ?0.6 billion East Asians and results in accumulation of toxic acetaldehyde after consumption of ethanol. To temporarily increase metabolism of acetaldehyde in vivo, we describe an approach in which a pharmacologic agent recruited another ALDH to metabolize acetaldehyde. We focused on ALDH3A1, which is enriched in the upper aerodigestive track, and identified Alda-89 as a small molecule that enables ALDH3A1 to metabolize acetaldehyde. When given together with the ALDH2-specific activator, Alda-1, Alda-89 reduced acetaldehyde-induced behavioral impairment by causing a rapid reduction in blood ethanol and acetaldehyde levels after acute ethanol intoxication in both wild-type and ALDH2-deficient, ALDH2*1/*2, heterozygotic knock-in mice. The use of a pharmacologic agent to recruit an enzyme to metabolize a substrate that it usually does not metabolize may represent a novel means to temporarily increase elimination of toxic agents in vivo. PMID:25713355

  6. Clinicopathological predictors of lymphatic metastasis in HNSCC: implications for molecular mechanisms of metastatic disease

    PubMed Central

    Goldson, Tovë M.; Han, Yimei; Knight, Kristen B.; Weiss, Heidi L.; Resto, Vicente A.

    2010-01-01

    Lymphatic metastasis is associated with up to a 50% decrease in survival, yet the molecular mechanisms driving their establishment remain poorly understood. This study assessed clinicopathological characteristics correlated to nodal metastasis among patients with head and neck squamous cell carcinoma for the identification of pathways on which to focus molecular studies. Pathology records were queried for cases diagnosed with invasive squamous cell cancer of the upper aerodigestive tract between 1993 and 2003. Charts and pathology reports were scored for 16 characteristics. The univariate association of each variable with lymph node status was assessed. Based on the univariate analysis, a multiple logistic regression model was developed to assess the simultaneous association of variables with lymph node status. Of the 644 cases identified, 234 had a surgical specimen analyzed. All variables were scored for 185 of the 234 cases. Multivariate stepwise regression analysis identified clinical stage (p = 0.0269), pathologic stage (p = 0.0162), grade (p = 0.0094), lymphovascular invasion (p = 0.0393), and family history of cancer (p = 0.0079) as independently predictive of lymphatic metastases. Our study confirms that grade, pathologic stage, clinical stage, and lymphovascular invasion are predictors of regional metastasis. These correlations suggest that studying the molecular mechanisms of differentiation, interstitial pressure at the primary tumor site, and peritumoral lymphangiogenesis may provide insight into lymphatic metastasis. Additionally, we identified family history of cancer as a new predictor of lymphatic metastasis. Thus, genetic analysis of families with cancer, irrespective of type, may identify genes important for regional metastasis. PMID:20734920

  7. Optical coherence tomography and confocal endomicroscopy for rhinologic pathologies: a pilot study

    NASA Astrophysics Data System (ADS)

    Olzowy, B.; Starke, N.; Schuldt, T.; Hüttmann, G.; Lankenau, E.; Just, T.

    2013-06-01

    Optical coherence tomography (OCT) and confocal endomicroscopy (CEM) have a well-established potential for early diagnosis of pre-malignant and early malignant lesions of the upper aerodigestive tract mucosa. Additional applications in ENT-diagnostics might facilitate a more widespread use by making the investment into the devices more economic. Both imaging techniques might also provide valuable information in nasal pathologies. OCT images were generated with a surgical microscope (Möller-Wedel Hi-R 1000) with an integrated high-speed-OCT camera (Optomedical GmbH). For the CEM a Heidelberg Retina tomograph II scanner (Heidelberg Engineering GmbH) was used. Both during sinus surgery in vivo and from removed material ex vivo OCT and CEM images were taken and correlated with histopathological analysis after hematoxylin and eosin staining. Patients with inverted papillomas and chronic rhinosinusitis (CRS) were evaluated. Inverted papillomas show a variably thick epithelial layer on OCT and densely packed epithelial cells on CEM. They can be clearly distinguished from nasal polyps that show a very thin epithelial layer upon loose subepithelial tissue. In CRS CEM can distinguish areas with intact from areas with destroyed ciliated epithelium by directly visualizing ciliary movement. OCT sometimes showed thin superficial dense structures that might correspond to biofilms. OCT and CEM might provide valuable information in the follow-up care of patients with inverted papillomas and in diagnostics of CRS.

  8. Case Report: Bazex Syndrome Associated With Pulmonary Adenocarcinoma

    PubMed Central

    Zhao, Jing; Zhang, Xilin; Chen, Zhuo; Wu, Jian-hua

    2016-01-01

    Abstract Bazex syndrome, a rare paraneoplastic syndrome characterized by psoriasiform eruptions, palmoplantar keratosis, and symmetric onychodystrophy, is most prevalent with squamous cell carcinomas of the upper aerodigestive tract. Here, we reported an uncommon case of Bazex syndrome about an 83-year-old man with pulmonary adenocarcinoma and osseous metastasis, Physical examination found psoriasiform eruptions on the nose, cheeks, ears, knees, and the dorsa of interphalangeal joints, along with plantar keratosis and symmetric onychodystrophy involving hands and feet. Imaging analyses pulmonary adenocarcinoma with both local metastatic nodules and osseous metastasis. Symptomatic treatment with topical corticosteroids and oral retinoids showed no improvement. A 4-month follow-up showed that Gefitinib, an epidermal growth factor receptor tyrosine kinase inhibitor, successfully reduced primary tumor size and alleviated cutaneous lesions. Our report here highlighted a potential correlation between pulmonary adenocarcinoma and Bazex syndrome, which is characterized by hallmark nail destruction and preferential involvement of body extremities. Moreover, etiological therapy against underlying malignancy is essential for treating paraneoplastic Bazex syndrome. PMID:26765420

  9. An epidemiologic review of marijuana and cancer: an update

    PubMed Central

    Huang, Yu-Hui Jenny; Zhang, Zuo-Feng; Tashkin, Donald P.; Feng, Bingjian; Straif, Kurt; Hashibe, Mia

    2014-01-01

    Marijuana use is legal in two states and additional states are considering legalization. Approximately 18 million Americans are current marijuana users. There is currently no consensus on whether marijuana use is associated with cancer risk. Our objective is to review the epidemiologic studies on this possible association. We identified 34 epidemiologic studies on upper aerodigestive tract cancers (n=11), lung cancer (n=6), testicular cancer (n=3), childhood cancers (n=6), all cancers (n=1), anal cancer (n=1), penile cancer (n=1), non-Hodgkin's lymphoma (n=2), malignant primary gliomas(n=1), bladder cancer (n=1), and Kaposi's sarcoma (n=1). Studies on head and neck cancer reported increased and decreased risks, possibly because there is no association, or because risks differ by HPV status or geographic differences. The lung cancer studies largely appear not to support an association with marijuana use, possibly because of the smaller amounts of marijuana regularly smoked compared to tobacco. Three testicular cancer case-control studies reported increased risks with marijuana use (summary odds ratios 1.56 (95%CI=1.09-2.23) for higher frequency; 1.50 (95%=1.08-2.09) for ≥10 years). For other cancer sites, there is still insufficient data to make any conclusions. Considering that marijuana use may change due to legalization, well-designed studies on marijuana use and cancer are warranted. PMID:25587109

  10. Location of metastases in cancer of unknown primary are not random and signal familial clustering

    PubMed Central

    Hemminki, Kari; Sundquist, Kristina; Sundquist, Jan; Hemminki, Akseli; Ji, Jianguang

    2016-01-01

    Cancer of unknown primary (CUP) is a fatal disease diagnosed through metastases. It shows intriguing familial clustering with certain defined primary cancers. Here we examine whether metastatic location in CUP patients is related to primary non-CUP cancers in relatives based on the Swedish Cancer Registry. Standardized incidence ratios (SIRs) were calculated for CUP patients defined by metastatic location depending on cancer in their first degree relatives. SIRs for CUP were high in association with liver (3.94), ovarian (3.41), lung (2.43) and colorectal cancers (1.83) in relatives. The SIR was 1.63 for CUP with metastases in the abdomen when a relative was diagnosed with ovarian cancer. CUP with liver metastases associated with liver (1.44) cancer in relatives. CUP with head and neck region metastases associated with relatives’ esophageal (2.87) cancer. CUP metastases in the thorax associated with a relative’s cancers in the upper aerodigestive tract (2.14) and lung (1.74). The findings, matching metastatic location in CUP and primary cancer in relatives, could be reconciled if these cases of CUP constitute a phenotypically modified primary lacking tissue identification, resulting from epitope immunoediting. Alternatively, CUP metastases arise in a genetically favored tissue environment (soil) promoting growth of both primary cancers and metastases (seeds). PMID:26956545

  11. Alcohol, DNA Methylation, and Cancer

    PubMed Central

    Varela-Rey, Marta; Woodhoo, Ashwin; Martinez-Chantar, Maria-Luz; Mato, José M.; Lu, Shelly C.

    2013-01-01

    Cancer is one of the most significant diseases associated with chronic alcohol consumption, and chronic drinking is a strong risk factor for cancer, particularly of the upper aerodigestive tract, liver, colorectum, and breast. Several factors contribute to alcohol-induced cancer development (i.e., carcinogenesis), including the actions of acetaldehyde, the first and primary metabolite of ethanol, and oxidative stress. However, increasing evidence suggests that aberrant patterns of DNA methylation, an important epigenetic mechanism of transcriptional control, also could be part of the pathogenetic mechanisms that lead to alcohol-induced cancer development. The effects of alcohol on global and local DNA methylation patterns likely are mediated by its ability to interfere with the availability of the principal biological methyl donor, S-adenosylmethionine (SAMe), as well as pathways related to it. Several mechanisms may mediate the effects of alcohol on DNA methylation, including reduced folate levels and inhibition of key enzymes in one-carbon metabolism that ultimately lead to lower SAMe levels, as well as inhibition of activity and expression of enzymes involved in DNA methylation (i.e., DNA methyltransferases). Finally, variations (i.e., polymorphisms) of several genes involved in one-carbon metabolism also modulate the risk of alcohol-associated carcinogenesis. PMID:24313162

  12. Radiographic imaging of human papillomavirus related carcinomas of the oropharynx.

    PubMed

    Corey, Amanda S; Hudgins, Patricia A

    2012-07-01

    Imaging, especially contrast-enhanced computed tomography (CECT) for anatomy and positron emission tomography (PET) with labeled (18)F fluorodeoxyglucose for physiologic detail, is critical for staging carcinomas of the oropharynx. As the incidence of human papillomavirus (HPV) infection and related carcinomas of the tonsil and base of tongue (BOT) increases, experience with CECT and PET for staging HPV+ tumors is growing. No imaging modality, however, can determine whether the tumor is HPV+. There are some unique challenges posed by HPV+ oropharyngeal squamous cell carcinoma (SCC). In most locations of the head and neck, a malignancy enhances more than surrounding normal structures, which facilitates tumor mapping. Unfortunately, normal lymphoid tissue of the oropharynx, in the BOT and palatine tonsillar fossa, enhances on CECT and gadolinium enhanced magnetic resonance imaging in a manner similar to SCC. The primary tumor may be small or even occult at presentation, and easily over-looked on CECT. PET coupled with CECT has made a true "unknown primary" very rare, as the metabolically active tumor is almost always detectable on PET. The nodal metastases, so common with HPV+ SCC, can be truly cystic; and as such, can be misdiagnosed as a second branchial cleft cyst, a congenital benign lesion. These pitfalls, coupled with the complex anatomy of the upper aerodigestive tract, make staging these tumors difficult. In this monograph we describe the anatomy of the oropharynx and review the imaging modalities available for staging. Figures highlight the points raised in the text. PMID:22782221

  13. Assessment of Margins in Transoral Laser and Robotic Surgery

    PubMed Central

    Hamzany, Yaniv; Brasnu, Daniel; Shpitzer, Thomas; Shvero, Jacob

    2014-01-01

    The growing practice of endoscopic surgery has changed the therapeutic management of selected head and neck cancers. Although a negative surgical margin in resection of neoplasm is the most important surgical principle in oncologic surgery, controversies exist regarding assessment and interpretation of the status of margin resection. The aim of this review was to summarize the literature considering the assessment and feasibility of negative margins in transoral laser microsurgery (TLM) and transoral robotic surgery (TORS). Free margin status is being approached differently in vocal cord cancer (1–2 mm) compared with other sites in the upper aerodigestive tract (2–5 mm). Exposure, orientation of the pathological specimen, and co-operation with the pathologist are crucial principles needed to be followed in transoral surgery. Piecemeal resection to better expose deep tumor involvement and biopsies taken from surgical margins surrounding site of resection can improve margin assessment. High rates of negative surgical margins can be achieved with TLM and TORS. Adjuvant treatment decision should take into consideration also the surgeon’s judgment with regard to the completeness of tumor resection. PMID:24808954

  14. Membrane association and destabilization by Aggregatibacter actinomycetemcomitans leukotoxin requires changes in secondary structures.

    PubMed

    Walters, M J; Brown, A C; Edrington, T C; Baranwal, S; Du, Y; Lally, E T; Boesze-Battaglia, K

    2013-10-01

    Aggregatibacter actinomycetemcomitans is a common inhabitant of the upper aerodigestive tract of humans and non-human primates and is associated with disseminated infections, including lung and brain abscesses, pediatric infective endocarditis, and localized aggressive periodontitis. Aggregatibacter actinomycetemcomitans secretes a repeats-in-toxin protein, leukotoxin, which exclusively kills lymphocyte function-associated antigen-1-bearing cells. The toxin's pathological mechanism is not fully understood; however, experimental evidence indicates that it involves the association with and subsequent destabilization of the target cell's plasma membrane. We have long hypothesized that leukotoxin secondary structure is strongly correlated with membrane association and destabilization. In this study, we tested this hypothesis by analysing lipid-induced changes in leukotoxin conformation. Upon incubation of leukotoxin with lipids that favor leukotoxin-membrane association, we observed an increase in leukotoxin α-helical content that was not observed with lipids that favor membrane destabilization. The change in leukotoxin conformation after incubation with these lipids suggests that membrane binding and membrane destabilization have distinct secondary structural requirements, suggesting that they are independent events. These studies provide insight into the mechanism of cell damage that leads to disease progression by A. actinomycetemcomitans. PMID:23678967

  15. Probe-based confocal laser endomicroscopy in head and neck malignancies: early preclinical experience

    NASA Astrophysics Data System (ADS)

    Englhard, Anna; Girschick, Susanne; Mack, Brigitte; Volgger, Veronika; Gires, Oliver; Conderman, Christian; Stepp, Herbert; Betz, Christian Stephan

    2013-06-01

    Background: Malignancies of the upper aerodigestive tract (UADT) are conventionally diagnosed by white light endoscopy, biopsy and histopathology. Probe-based Confocal Laser Endomicroscopy (pCLE) is a novel non-invasive technique which offers in vivo surface and sub-surface imaging of tissue. It produces pictures of cellular architecture comparable to histology without the need for biopsy. It has already been successfully used in different clinical subspecialties to help in the diagnosis and treatment planning of inflammatory and neoplastic diseases. PCLE needs to be used in combination with specific or non-specific contrast agents. In this study we evaluated the potential use of pCLE in combination with non-specific and specific contrast agents to distinguish between healthy mucosa and invasive carcinoma. Methods: Tissue samples from healthy mucosa and squamous cell carcinoma of the head and neck were taken during surgery. After topical application of three different contrast agents, samples were examined using different pCLE-probes and a Confocal Laser Scanning Microscope (CLSM). Images were then compared to the corresponding histological slides and cryosections. Results: Initial results show that pCLE in combination with fluorophores allows visualization of cellular and structural components. Imaging of different layers was possible using three distinct pCLEprobes. Conclusion: pCLE is a promising non-invasive technique that may be a useful adjunct in the evaluation, diagnosis and treatment planning of head and neck malignancies.

  16. Constitutional CHEK2 mutations are associated with a decreased risk of lung and laryngeal cancers.

    PubMed

    Cybulski, Cezary; Masojc, Bartlomiej; Oszutowska, Dorota; Jaworowska, Ewa; Grodzki, Tomasz; Waloszczyk, Piotr; Serwatowski, Piotr; Pankowski, Juliusz; Huzarski, Tomasz; Byrski, Tomasz; Górski, Bohdan; Jakubowska, Anna; Debniak, Tadeusz; Wokolorczyk, Dominika; Gronwald, Jacek; Tarnowska, Czeslawa; Serrano-Fernández, Pablo; Lubinski, Jan; Narod, Steven A

    2008-04-01

    Mutations in the CHEK2 gene have been associated with increased risks of breast, prostate and colon cancer. In contrast, a previous report suggests that individuals with the I157T missense variant of the CHEK2 gene might be at decreased risk of lung cancer and upper aero-digestive cancers. To confirm this hypothesis, we genotyped 895 cases of lung cancer, 430 cases of laryngeal cancer and 6391 controls from Poland for four founder alleles in the CHEK2 gene, each of which has been associated with an increased risk of cancer at several sites. The presence of a CHEK2 mutation was protective against both lung cancer [odds ratio (OR) = 0.3; 95% confidence interval (CI) 0.2-0.5; P = 3 x 10(-8)] and laryngeal cancer (OR = 0.6; 95% CI 0.3-0.99; P = 0.05). The basis of the protective effect is unknown, but may relate to the reduced viability of lung cancer cells with a CHEK2 mutation. Lung cancers frequently possess other defects in genes in the DNA damage response pathway (e.g. p53 mutations) and have a high level of genotoxic DNA damage induced by tobacco smoke. We speculate that lung cancer cells with impaired CHEK2 function undergo increased rates of cell death. PMID:18281249

  17. Multiple myeloma with multiple and bulky extramedullary plasmacytomas as initial presentation.

    PubMed

    SAWADA, Takeshi; NAJIMA, Yuho; OHASHI, Kazuteru; KATO, Ikuma; MIYAZAWA, Maho; NAKANO, Mikako; KOBAYASHI, Takeshi; YAMASHITA, Takuya; AKIYAMA, Hideki; SAKAMAKI, Hisashi

    2009-11-01

    We herein describe a rare case of multiple myeloma with an aggressive clinical course and the unusual manifestation of multiple organ involvement by plasma cells. A 58-year-old man noted difficulty in walking due to progressive swelling of his left lower limb. CT scan revealed a huge mass in the inguinal region in addition to masses located on the head, and in the aero-digestive tract and spinal canal. The pathological diagnosis of plasmacytoma was made on biopsied specimens of these masses, while plasma cells did not increase (5.8%) in aspirated bone marrow obtained at the same time. Serum IgG level was 6,387 mg/dl and immunoelectrophoresis demonstrated monoclonal IgG-kappa in the serum. Chemotherapy with vincristine, adriamycin, dexamethasone, subsequent high-dose cyclophosphamide, and irradiation involving both thoracic vertebral canal and inguinal regions resulted in improvement of initial symptoms. However, the patient relapsed soon after; new lesions developed in various parts of the body, including the left thigh and body trunk. Salvage therapy including bortezomib was no longer effective, and he eventually died 10 months after the initial diagnosis. Autopsy revealed the diffuse involvement of plasma cells of multiple organs, including the liver, spleen, abdominal lymph node, and bone marrow in addition to the left leg. PMID:20009440

  18. Locally advanced thyroid cancer: therapeutic options.

    PubMed

    Avenia, Nicola; Ragusa, Mark; Monacelli, Massimo; Calzolari, Filippo; Daddi, Niccolò; Di Carlo, Luciana; Semeraro, Antonia; Puma, Francesco

    2004-01-01

    The authors report on their experience in the management of thyroid cancer, with specific regard to advanced disease. Thyroid carcinomas behave differently according to: pathology, sex, age, grading and size. Differentiated lesions have a favourable outlook, while for less-differentiated tumours the prognosis is dismal. Extent of resection, lymphectomy technique and management of advanced disease remain matters of debate. Of particular interest are those neoplasms invading the upper aerodigestive tract, characterised by a worse prognosis in the case of differentiated tumours (1-6%), indicating an exceedingly aggressive behaviour in what is usually a slowly evolving disease. Surgery, with a curative intent or for palliation, is mandatory. The tumour progressively invades the tracheal lumen and is seldom manageable by alternative, non-surgical methods, and in any case only for short periods of time. Total thyroidectomy with tracheal resection and anastomosis is the surgical technique of choice and, when combined with radiometabolic therapy and/or external radiotherapy, yields survival data comparable with those relating to less advanced differentiated lesions. Tracheal stents and tracheotomy improve the quality of life. Laser therapy is indicated in cases of asphyxia, and as a preliminary step with a view to subsequent radical or palliative treatments. PMID:15452988

  19. Long-term outcomes of reversal of laryngotracheal separation.

    PubMed

    Zocratto, Orlando B; Savassi-Rocha, Paulo R; Paixão, Rafael M

    2011-06-01

    The aim of this study was to evaluate the long-term outcomes of the reversal of laryngotracheal separation (LTS) in patients who underwent extensive resection of tumors located in the upper aerodigestive tract. We performed a retrospective analysis of the medical records of eight patients who had LTS reversal. The operation was successful in six patients who were followed up for a period of 17-99 months (mean = 46.3 ± 26.2). The mean interval between LTS and surgical reversal was 16.6 ± 9.1 months. Four patients had postoperative complications: mild to moderate transient aspiration in two, tracheal stenosis in one, and severe aspiration followed by tracheal stenosis in one. In the last two cases, surgical reversal was not successful. The patients whose surgery was effective maintained oral feeding and comprehensible speech until the end of the follow-up period. We conclude that reversal of LTS is technically simple and, when successful, permits the return to oral feeding and comprehensible speech for an indefinite period of time. However, the frequency of complications and inefficacy of LTS reversal should not be overlooked. PMID:20614223

  20. Cancer of the head and neck.

    PubMed Central

    Tobias, J. S.

    1994-01-01

    Cancers of the upper aerodigestive tract, collectively known as head and neck cancers, arise from a multiplicity of sites. In the West, excess tobacco and alcohol consumption are the most important of the known predisposing factors; elsewhere in the world, notably in India and China, the aetiology, pattern of primary sites, and clinical behaviour are different. Clinically these tumours pose exceptional problems in management, and skilled multidisciplinary teams are necessary in order to achieve the highest level of service and research. Historically, surgery and radiotherapy have been the most important treatment modalities; chemotherapy is now increasingly employed but not yet fully established. Successful rehabilitation of patients with head and neck cancers requires access to high quality speech therapists and other support staff with training in functional pharyngeal disorders. Current research efforts are largely directed towards defining the proper role of chemotherapy and assessing the possible advantage of unconventional radiation approaches. In recent years the roles of primary, reconstructive, and salvage surgery have also become better defined. Many patients are suitable for randomisation into ongoing prospective clinical trials which have been specifically designed to address these issues. Images FIG 3 FIG 4 FIG 5 PMID:8173406

  1. Effects of radiation therapy in microvascular anastomoses

    SciTech Connect

    Fried, M.P.

    1985-07-01

    The otolaryngologist, as a head and neck surgeon, commonly cares for patients with upper aerodigestive tract malignancies. Therapy of these neoplasms often requires wide excision. One standard reconstructive procedure utilizes pedicled regional flaps, both dermal and myodermal which have some disadvantages. The shortcomings of these pedicled regional flaps have led to the use of the vascularized free flap in certain cases. The occasional case may lead to catastrophe if microanastomoses fail when combined with radiation. Notwithstanding, many surgical series have reported success when radiation has been given. The present investigation was undertaken to assess the effects of radiation therapy on microvascular anastomoses when radiation is administered pre- or postoperatively or when nonradiated tissue is transferred to an irradiated recipient site. These effects were observed serially in an experimental rat model using a tubed superficial epigastric flap that adequately reflected tissue viability and vascular patency. The histologic changes were then noted over a three month period after completion of both radiation and surgery. This study adds credence to the observation of the lack of deleterious effects of radiation on experimental microvascular anastomotic patency whether the radiation is given before or after surgery or if radiated tissue is approximated to nonradiated vessels.

  2. Estimating the optimal threshold for a diagnostic biomarker in case of complex biomarker distributions

    PubMed Central

    2014-01-01

    Background Estimating the optimal threshold (and especially the confidence interval) of a quantitative biomarker to be used as a diagnostic test is essential for medical decision-making. This is often done with simple methods that are not always reliable. More advanced methods work well but only for biomarkers with very simple distributions. In fact, biomarker distributions are often complex because of a natural heterogeneity in marker expression and other heterogeneities due to various disease stages, laboratory equipments, etc. Methods are required to estimate a biomarker optimal threshold in case of heterogeneity and complex distributions. Methods A previously described Bayesian method developed for normally distributed biomarkers is applied to two flexible distributions; namely, a Student-t and a mixture of Dirichlet processes. Here, numerical studies assess the adequacy of the previous method with both distributions. Two applications are presented: the diagnosis of treatment failure after prostate cancer treated by ultrasound and the early diagnosis of cancers of the upper aerodigestive tract. Results Bayesian inference provided reliable credible intervals in terms of bias and coverage probability. The two distributions analysed gave meaningful clinical interpretations in both applications. Conclusions Reliable methods can be used to estimate a biomarker optimal threshold, even in case of complex distributions. PMID:24927622

  3. Hereditary and environmental risk factors; clinical and laboratory risk matters for head and neck, especially oral, cancer and precancer.

    PubMed

    Johnson, N W; Warnakulasuriy, S; Tavassoli, M

    1996-02-01

    The continuing high incidence and mortality of squamous cell carcinoma of the upper aerodigestive tract in South Asia, parts of France and central Europe, together with a rising incidence and mortality from a lower base elsewhere in the Western world, stimulates continuing research on risk factors and risk markers. Tobaccos (smoked and smokeless), heavy alcohol consumption, and areca nut remain the dominant risk factors, with confirmation of the protective effects of diets rich in antioxidants. There is emerging evidence of a small, but real, risk associated with occupational and other air pollution, and with family, part of which may be hereditary. Markers in peripheral blood and saliva are underexploited. Clinical staging and histological grading methods continue to be refined, with improved prognostic value, much aided by newer and simpler methods for estimating cell proliferation and apoptosis. Data on the significance of viral genes are still inadequate, but there is good progress describing the epidemiology of chromosomal abnormalities and abberations of a growing list of oncogenes and tumour suppressor genes. Unfortunately, as yet, these have only limited longitudinal or prognostic data. PMID:8664810

  4. Case of childhood laryngeal papillomatosis with metastatic carcinoma esophagus in adulthood

    PubMed Central

    Shetty, Nishitha; Prabhash, Kumar; Joshi, Amit; Sayed, Suhail I.; Sharma, Shilpi; Noronha, Vanita; Deshmukh, Anuja; Chaukar, Devendra; Kane, S.; Gopal; D’cruz, Anil K.

    2013-01-01

    A young male patient was diagnosed to have laryngeal papillomas at the age of 3 years for which he underwent permanent tracheostomy and also multiple surgical and laser excision procedures. Then, later in life, the patient had progressive breathlessness and dysphagia. On examination, he had supraclavicular lymphadenopathy showing squamous carcinoma pathology. Since laryngeal papillomas have a high propensity to transform into laryngeal squamous cell carcinoma, he was first evaluated for laryngeal carcinoma which was negative. Esophagoscopy showed a growth in the esophagus, the biopsy of which was positive for squamous malignant cells. Patient was then started on palliative chemotherapy with combination of paclitaxel and carboplatin, and at progression with weekly nanoxel with stable disease. This is a rare case of childhood laryngeal papillomatosis progressing to metastatic esophageal carcinoma. This case has been presented to highlight the fact that patients with laryngeal papillomas are not only at high risk of progressing to laryngeal carcinoma but can also have other malignancies of the upper aerodigestive tract and lung. Most of them have been correlated to human papilloma virus (HPV), but in our patient HPV DNA was negative. PMID:23878486

  5. Lipoma of the larynx: a case report

    PubMed Central

    De Vincentiis, M; Greco, A; Mascelli, A; Soldo, P; Zambetti, G

    2010-01-01

    Summary Lipoma is a benign tumour of mesenchymal origin with a very rare occurrence in the upper aero-digestive tract. To date, approximately 100 cases have been described in the literature. This lesion has a slow growth and, therefore, can present with various symptoms due to the mass effect with obstruction and compression on neighbouring structures, including dysphagia for liquid and solid food, dyspnoea and hoarseness. For a precise pre-operative diagnosis, indirect or direct laryngoscopy (flexible fibre-optic laryngoscopy) can be employed or, if necessary, also imaging techniques such as computed tomography scan and magnetic resonance imaging scan. These offer more useful information for better treatment planning. Surgery is the treatment of choice and includes endoscopic techniques and an external surgical approach (cervicotomy). It is very important to completely remove these benign neoplasms in order to avoid local recurrence. The present report refering to a case of laryngeal lipoma removed through an external surgical approach, aims to demonstrate that the choice of an external surgical approach is required for complete surgical removal of a large lipoma in order to prevent any possible recurrence. Furthermore, it is useful to keep in mind the possibility of recurrence of lipomas after long free intervals; therefore, it is mandatory to observe these patients at long-term follow-up. PMID:20559475

  6. Head and Neck Cancer: An Overview

    PubMed Central

    Stepnick, David; Gilpin, David

    2010-01-01

    Ablative surgery for malignancies of the upper aerodigestive tract is the most common reason why the reconstructive surgeon is called upon to reconstruct adult head and neck defects. An understanding of the pathophysiology and treatment of head and neck malignancy is vital to the reconstructive surgeon so that restoration of both form and function can be achieved. It is important to understand the behavior of cancers of each head and neck subsite, as staging and ultimately the treatment of tumors from each subsite is different. Historically, the standard treatment of head and neck cancer was surgery and/or primary radiation therapy with surgical salvage for failure. Beginning in the 1980s, advances in chemotherapy and concurrent delivery with radiation offered new options to standard surgical therapy. Over the past two decades, the concept of organ preservation using chemotherapy together with radiation therapy has been definitively established. Yet, even with the strides made over these two decades with chemoradiation, surgical treatment of head and neck cancer and reconstruction thereof will be an important treatment option for the foreseeable future. Therefore, the relationship between the extirpative and reconstructive surgeon is vital, and a clear understanding of the biology and behavior of head and neck malignancy is crucial to successful patient outcomes. PMID:22550431

  7. Prognostic significance of Ki-67 antigen expression in extranodal natural killer/T-cell lymphoma, nasal type.

    PubMed

    Jiang, Li; Li, Pengfei; Wang, Hua; Liu, Jun; Zhang, Xinke; Qiu, Huijuan; Zhang, Bei

    2014-10-01

    Extranodal natural killer (NK)/T-cell lymphoma, nasal-type (ENKTL) is a clinically heterogeneous disease with poor prognosis and requires risk stratification in affected patients. Recent studies have shown that Ki-67 may serve as a prognostic marker in certain types of lymphoma. We analyzed Ki-67 expression and its correlation with prognosis in 182 patients with ENKTL from January 2002 to June 2013. The patients were classified into two groups through a median value: low (<60%) versus high Ki-67 (?60%). High Ki-67 expression was more common in patients with B symptoms (p=0.02), bulky disease (p=0.001), and extraupper aerodigestive tract NK/T-cell lymphoma (p=0.001). High Ki-67 expression was significantly associated with poor overall survival (p<0.0001) and progression-free survival (p<0.0001). For patients with low-risk IPI or KPI, Ki-67 at diagnosis could contribute to distinguish patients with favorable outcomes from those with poor outcomes. The results of multivariate analysis showed that the high Ki-67 expression is an independent prognostic factor for overall survival and progression-free survival. (OS, p=0.001; PFS, p=0.003). Our data showed that Ki-67 is an effective prognostic indicator of survival in ENKTL patients. This prognostic index may be helpful in identifying high-risk patients with ENKTL. PMID:25204411

  8. [A case of basaloid squamous cell carcinoma of rectosigmoid colon].

    PubMed

    Ha, Tae Hwan; Jeon, Tae Joo; Park, Ji Young; Jang, Yong Ho; Kim, Deok Hee; Ryu, Mi Jin; Sinn, Dong Hyun; Oh, Tae Hoon

    2013-12-01

    Basaloid squamous cell carcinoma is a rare and aggressive variant of squamous cell carcinoma, which mostly occurs in the upper aerodigestive tracts. Basaloid squamous cell carcinoma also typically arises in the anal canal, but is extremely rare in the lower gastrointestinal tract. A 70-year-old man presented with loose stool and intermittent hematochezia 2 months ago. Colonoscopy showed an ulceroinfiltrative mass on the rectosigmoid colon from 16 cm to 18 cm above the anal verge. Conventional colonoscope could not pass through the lesion but it was possible with pediatric colonoscope. Abdominal CT scan showed 1.6 cm sized wall thickening with circumferential luminal narrowing in the rectosigmoid colon and multiple ill-defined low density masses in both lobes of the liver. Therefore, colon cancer with liver metastasis was suspected. However, basaloid cells were noted on histologic examination, and they were weakly positive for synaptophysin on immunohistochemical study. After palliative lower anterior resection, histologic examination of the resected specimen revealed basaloid differentiation with keratin pearls, and tumor cells were positively stained with high molecular weighted cytokeratin (34BE12) and CK 5/6. Thus, the patient was finally diagnosed with basaloid squamous cell carcinoma of rectosigmoid colon with distant metastases. PMID:24365738

  9. Preliminary oncological results of endosopic laser surgery in advanced head and neck tumors

    NASA Astrophysics Data System (ADS)

    Baker-Schreyer, Antonio; Sadick, Haneen; Juncker, Cathrine; Bergler, Wolfgang; Hoermann, Karl

    1998-01-01

    Lasersurgery has established itself in the treatment of minor tumors (T1 - T2) of the upper aerodigestive tract. However, advanced carcinomas of the head and neck (T3 - T4) are generally treated with conventional surgical procedures which include pharyngolaryngectomy. The purpose of this study was to evaluate the oncological outcome of endoscopic lasersurgery in advanced head and neck tumors and to compare the results with conventional surgical procedures. Between January 1994 to December 1996, 86 patients with advanced squamous cell carcinomas of the larynx and hypopharynx underwent endoscopic lasersurgery instead of pharyngolaryngectomy as a curative measure. Besides the recurrence and survival rate, the necessity of tracheostomy, postoperative complications and the mean duration of hospitalization were documented. The results showed that the recurrence and survival rate were similar or even better after conventional pharyngolaryngectomy, whereas the patients' postoperative rehabilitation was better after lasersurgery. In this contribution the indication for lasersurgical intervention or pharyngolaryngectomy in advanced carcinomas of the head and neck is discussed.

  10. European Code against Cancer 4th Edition: Diet and cancer.

    PubMed

    Norat, Teresa; Scoccianti, Chiara; Boutron-Ruault, Marie-Christine; Anderson, Annie; Berrino, Franco; Cecchini, Michele; Espina, Carolina; Key, Tim; Leitzmann, Michael; Powers, Hilary; Wiseman, Martin; Romieu, Isabelle

    2015-12-01

    Lifestyle factors, including diet, have long been recognised as potentially important determinants of cancer risk. In addition to the significant role diet plays in affecting body fatness, a risk factor for several cancers, experimental studies have indicated that diet may influence the cancer process in several ways. Prospective studies have shown that dietary patterns characterised by higher intakes of fruits, vegetables, and whole-grain foods, and lower intakes of red and processed meats and salt, are related to reduced risks of death and cancer, and that a healthy diet can improve overall survival after diagnosis of breast and colorectal cancers. There is evidence that high intakes of fruit and vegetables may reduce the risk of cancers of the aerodigestive tract, and the evidence that dietary fibre protects against colorectal cancer is convincing. Red and processed meats increase the risk of colorectal cancer. Diets rich in high-calorie foods, such as fatty and sugary foods, may lead to increased calorie intake, thereby promoting obesity and leading to an increased risk of cancer. There is some evidence that sugary drinks are related to an increased risk of pancreatic cancer. Taking this evidence into account, the 4th edition of the European Code against Cancer recommends that people have a healthy diet to reduce their risk of cancer: they should eat plenty of whole grains, pulses, vegetables and fruits; limit high-calorie foods (foods high in sugar or fat); avoid sugary drinks and processed meat; and limit red meat and foods high in salt. PMID:26164653

  11. Aggregatibacter actinomycetemcomitans leukotoxin cytotoxicity occurs through bilayer destabilization

    PubMed Central

    Brown, Angela C.; Boesze-Battaglia, Kathleen; Du, Yurong; Stefano, Frank P.; Kieba, Irene R.; Epand, Raquel F.; Kakalis, Lazaros; Yeagle, Philip L.; Epand, Richard M.; Lally, Edward T.

    2012-01-01

    Summary The Gram-negative bacterium, Aggregatibacter actinomycetemcomitans, is a common inhabitant of the human upper aerodigestive tract. The organism produces an RTX (Repeats in ToXin) toxin (LtxA) that kills human white blood cells. LtxA is believed to be a membrane-damaging toxin, but details of the cell surface interaction for this and several other RTX toxins have yet to be elucidated. Initial morphological studies suggested that LtxA was bending the target cell membrane. Because the ability of a membrane to bend is a function of its lipid composition, we assessed the proficiency of LtxA to release of a fluorescent dye from a panel of liposomes composed of various lipids. Liposomes composed of lipids that form nonlamellar phases were susceptible to LtxA-induced damage while liposomes composed of lipids that do not form non-bilayer structures were not. Differential scanning calorimetry demonstrated that the toxin decreased the temperature at which the lipid transitions from a bilayer to a nonlamellar phase, while 31P nuclear magnetic resonance studies showed that the LtxA-induced transition from a bilayer to an inverted hexagonal phase occurs through the formation of an isotropic intermediate phase. These results indicate that LtxA cytotoxicity occurs through a process of membrane destabilization. PMID:22309134

  12. Pneumomediastinum in Blunt Chest Trauma: A Case Report and Review of the Literature

    PubMed Central

    Mansella, Gregory; Bingisser, Roland; Nickel, Christian H.

    2014-01-01

    Blunt trauma is the most common mechanism of injury in patients with pneumomediastinum and may occur in up to 10% of patients with severe blunt thoracic and cervical trauma. In this case report we present a 24-year-old man with pneumomediastinum due to blunt chest trauma after jumping from a bridge into a river. He complained of persistent retrosternal pain with exacerbation during deep inspiration. Physical examination showed only a slight tenderness of the sternum and the extended Focused Assessment with Sonography for Trauma (e-FAST) was normal. Pneumomediastinum was suspected by chest X-ray and confirmed by computed tomography, which showed a lung contusion as probable cause of the pneumomediastinum due to the “Mackling effect.” Sonographic findings consistent with pneumomediastinum, like the “air gap” sign, are helpful for quick bedside diagnosis, but the diagnostic criteria are not yet as well established as for pneumothorax. This present case shows that despite minimal findings in physical examination and a normal e-FAST a pneumomediastinum is still possible in a patient with chest pain after blunt chest trauma. Therefore, pneumomediastinum should always be considered to prevent missing major aerodigestive injuries, which can be associated with a high mortality rate. PMID:25114811

  13. An epidemiologic review of marijuana and cancer: an update.

    PubMed

    Huang, Yu-Hui Jenny; Zhang, Zuo-Feng; Tashkin, Donald P; Feng, Bingjian; Straif, Kurt; Hashibe, Mia

    2015-01-01

    Marijuana use is legal in two states and additional states are considering legalization. Approximately 18 million Americans are current marijuana users. There is currently no consensus on whether marijuana use is associated with cancer risk. Our objective is to review the epidemiologic studies on this possible association. We identified 34 epidemiologic studies on upper aerodigestive tract cancers (n = 11), lung cancer (n = 6), testicular cancer (n = 3), childhood cancers (n = 6), all cancers (n = 1), anal cancer (n = 1), penile cancer (n = 1), non-Hodgkin lymphoma (n = 2), malignant primary gliomas (n = 1), bladder cancer (n = 1), and Kaposi sarcoma (n = 1). Studies on head and neck cancer reported increased and decreased risks, possibly because there is no association, or because risks differ by human papillomavirus status or geographic differences. The lung cancer studies largely appear not to support an association with marijuana use, possibly because of the smaller amounts of marijuana regularly smoked compared with tobacco. Three testicular cancer case-control studies reported increased risks with marijuana use [summary ORs, 1.56; 95% confidence interval (CI), 1.09-2.23 for higher frequency and 1.50 (95% CI, 1.08-2.09) for ?10 years]. For other cancer sites, there is still insufficient data to make any conclusions. Considering that marijuana use may change due to legalization, well-designed studies on marijuana use and cancer are warranted. PMID:25587109

  14. Aspartame, low-calorie sweeteners and disease: regulatory safety and epidemiological issues.

    PubMed

    Marinovich, Marina; Galli, Corrado L; Bosetti, Cristina; Gallus, Silvano; La Vecchia, Carlo

    2013-10-01

    Aspartame is a synthetic sweetener that has been used safely in food for more than 30 years. Its safety has been evaluated by various regulatory agencies in accordance with procedures internationally recognized, and decisions have been revised and updated regularly. The present review summarizes the most relevant conclusions of epidemiological studies concerning the use of low-calorie sweeteners (mainly aspartame), published between January 1990 and November 2012. In the Nurses' Health study and the Health Professionals Followup study some excess risk of Hodgkin lymphoma and multiple myeloma was found in men but not in women; no association was found with leukemia. In the NIH-AARP Diet and Health Study, there was no association between aspartame and haematopoietic neoplasms. US case-control studies of brain and haematopoietic neoplasms also showed no association. The NIH-AARP Diet and Health Study and case-control studies from California showed no association with pancreatic cancer, and a case-control study from Denmark found no relation with breast cancer risk. Italian case-control studies conducted in 1991-2008 reported no consistent association for cancers of the upper aerodigestive tract, digestive tract, breast, endometrium, ovary, prostate, and kidney. Low calorie sweeteners were not consistently related to vascular events and preterm deliveries. PMID:23891579

  15. Inhibition of LtxA toxicity by blocking cholesterol binding with peptides.

    PubMed

    Brown, A C; Koufos, E; Balashova, N V; Boesze-Battaglia, K; Lally, E T

    2016-02-01

    The leukotoxin (LtxA) produced by Aggregatibacter actinomycetemcomitans kills host immune cells, allowing the bacterium to establish an ecological niche in the upper aerodigestive tract of its human host. The interaction of LtxA with human immune cells is both complex and multifaceted, involving membrane lipids as well as cell-surface proteins. In the initial encounter with the host cell, LtxA associates with lymphocyte function-associated antigen-1, a cell surface adhesion glycoprotein. However, we have also demonstrated that the toxin associates strongly with the plasma membrane lipids, specifically cholesterol. This association with cholesterol is regulated by a cholesterol recognition amino acid consensus (CRAC) motif, with a sequence of (334) LEEYSKR(340) , in the N-terminal region of the toxin. Here, we have demonstrated that removal of cholesterol from the plasma membrane or mutation of the LtxA CRAC motif inhibits the activity of the toxin in THP-1 cells. To inhibit LtxA activity, we designed a short peptide corresponding to the CRAC(336) motif of LtxA (CRAC(336WT) ). This peptide binds to cholesterol and thereby inhibits the toxicity of LtxA in THP-1 cells. Previously, we showed that this peptide inhibits LtxA toxicity against Jn.9 (Jurkat) cells, indicating that peptides derived from the cholesterol-binding site of LtxA may have a potential clinical applicability in controlling infections of repeats-in-toxin-producing organisms. PMID:26352738

  16. Traditional and Modern Uses of Natural Honey in Human Diseases: A Review

    PubMed Central

    Eteraf-Oskouei, Tahereh; Najafi, Moslem

    2013-01-01

    Honey is a by-product of flower nectar and the upper aero-digestive tract of the honey bee, which is concentrated through a dehydration process inside the bee hive. Honey has a very complex chemical composition that varies depending on the botanical source. It has been used both as food and medicine since ancient times. Human use of honey is traced to some 8000 years ago as depicted by Stone Age paintings. In addition to important role of natural honey in the traditional medicine, during the past few decades, it was subjected to laboratory and clinical investigations by several research groups and it has found a place in modern medicine. Honey has been reported to have an inhibitory effect on around 60 species of bacteria, some species of fungi and viruses. Antioxidant capacity of honey is important in many disease conditions and is due to a wide range of compounds including phenolics, peptides, organic acids, enzymes, and Maillard reaction products. Honey has also been used in some gastrointestinal, cardiovascular, inflammatory and neoplastic states. This review covers the composition, physico-chemical properties and the most important uses of natural honey in human diseases. PMID:23997898

  17. Microarchitecture of irradiated bone: comparison with healthy bone

    NASA Astrophysics Data System (ADS)

    Bléry, Pauline; Amouriq, Yves; Guédon, Jeanpierre; Pilet, Paul; Normand, Nicolas; Durand, Nicolas; Espitalier, Florent; Arlicot, Aurore; Malard, Olivier; Weiss, Pierre

    2012-03-01

    The squamous cell carcinomas of the upper aero-digestive tract represent about ten percent of cancers. External radiation therapy leads to esthetic and functional consequences, and to a decrease of the bone mechanical abilities. For these patients, the oral prosthetic rehabilitation, including possibilities of dental implant placement, is difficult. The effects of radiotherapy on bone microarchitecture parameters are not well known. Thus, the purpose of this study is to assess the effects of external radiation on bone micro architecture in an experimental model of 25 rats using micro CT. 15 rats were irradiated on the hind limbs by a single dose of 20 Grays, and 10 rats were non irradiated. Images of irradiated and healthy bone were compared. Bone microarchitecture parameters (including trabecular thickness, trabecular number, trabecular separation, connectivity density and tissue and bone volume) between irradiated and non-irradiated bones were calculated and compared using a Mann and Whitney test. After 7 and 12 weeks, images of irradiated and healthy bone are different. Differences on the irradiated and the healthy bone populations exhibit a statistical significance. Trabecular number, connectivity density and closed porosity are less important on irradiated bone. Trabecular thickness and separation increase for irradiated bone. These parameters indicate a decrease of irradiated bone properties. Finally, the external irradiation induces changes on the bone micro architecture. This knowledge is of prime importance for better oral prosthetic rehabilitation, including implant placement.

  18. Polymeric implant materials for the reconstruction of tracheal and pharyngeal mucosal defects in head and neck surgery

    PubMed Central

    Rickert, Dorothee

    2011-01-01

    The existing therapeutical options for the tracheal and pharyngeal reconstruction by use of implant materials are described. Inspite of a multitude of options and the availability of very different materials none of these methods applied for tracheal reconstruction were successfully introduced into the clinical routine. Essential problems are insufficiencies of anastomoses, stenoses, lack of mucociliary clearance and vascularisation. The advances in Tissue Engineering (TE) offer new therapeutical options also in the field of the reconstructive surgery of the trachea. In pharyngeal reconstruction far reaching developments cannot be recognized at the moment which would allow to give a prognosis of their success in clinical application. A new polymeric implant material consisting of multiblock copolymers was applied in our own work which was regarded as a promising material for the reconstruction of the upper aerodigestive tract (ADT) due to its physicochemical characteristics. In order to test this material for applications in the ADT under extreme chemical, enzymatical, bacterial and mechanical conditions we applied it for the reconstruction of a complete defect of the gastric wall in an animal model. In none of the animals tested either gastrointestinal complications or negative systemic events occurred, however, there was a multilayered regeneration of the gastric wall implying a regular structured mucosa. In future the advanced stem cell technology will allow further progress in the reconstruction of different kind of tissues also in the field of head and neck surgery following the principles of Tissue Engineering. PMID:22073099

  19. New Insights into the Enigma of Immunoglobulin D

    PubMed Central

    Chen, Kang; Cerutti, Andrea

    2011-01-01

    Summary Immunoglobulin D (IgD) has remained a mysterious antibody class for almost half a century. IgD was initially thought to be a recently evolved Ig isotype expressed only by some mammalian species, but recent discoveries in fishes and amphibians demonstrate that IgD was present in the ancestor of all jawed vertebrates and has important immunological functions. The structure of IgD has been very dynamic throughout evolution. Mammals can express IgD through alternative splicing and class switch recombination (CSR). Active cell-dependent and T-cell-independent IgM-to-IgD class switching takes place in a unique subset of human B cells from the upper aerodigestive mucosa, which provides a layer of mucosal protection by interacting with many pathogens and their virulence factors. Circulating IgD can bind to myeloid cells such as basophils and induce antimicrobial, inflammatory, and B-cell-stimulating factors upon cross-linking, which contributes to immune surveillance but also inflammation and tissue damage when this pathway is overactivated under pathological conditions. Recent research shows that IgD is an important immunomodulator that orchestrates an ancestral surveillance system at the interface between immunity and inflammation. PMID:20727035

  20. Location of metastases in cancer of unknown primary are not random and signal familial clustering.

    PubMed

    Hemminki, Kari; Sundquist, Kristina; Sundquist, Jan; Hemminki, Akseli; Ji, Jianguang

    2016-01-01

    Cancer of unknown primary (CUP) is a fatal disease diagnosed through metastases. It shows intriguing familial clustering with certain defined primary cancers. Here we examine whether metastatic location in CUP patients is related to primary non-CUP cancers in relatives based on the Swedish Cancer Registry. Standardized incidence ratios (SIRs) were calculated for CUP patients defined by metastatic location depending on cancer in their first degree relatives. SIRs for CUP were high in association with liver (3.94), ovarian (3.41), lung (2.43) and colorectal cancers (1.83) in relatives. The SIR was 1.63 for CUP with metastases in the abdomen when a relative was diagnosed with ovarian cancer. CUP with liver metastases associated with liver (1.44) cancer in relatives. CUP with head and neck region metastases associated with relatives' esophageal (2.87) cancer. CUP metastases in the thorax associated with a relative's cancers in the upper aerodigestive tract (2.14) and lung (1.74). The findings, matching metastatic location in CUP and primary cancer in relatives, could be reconciled if these cases of CUP constitute a phenotypically modified primary lacking tissue identification, resulting from epitope immunoediting. Alternatively, CUP metastases arise in a genetically favored tissue environment (soil) promoting growth of both primary cancers and metastases (seeds). PMID:26956545

  1. Pharmacokinetics of meso-(tetrahydroxyphenyl)chlorin (m-THPC) studied by fluorescence spectroscopy on early cancer of the cheek pouch mucosa of Golden Syrian hamsters

    NASA Astrophysics Data System (ADS)

    Glanzmann, Thomas M.; Theumann, Jean-Francois; Braichotte, Daniel; Forrer, Martin; Wagnieres, Georges A.; van den Bergh, Hubert; Andrejevic-Blant, Snezana; Savary, Jean-Francois; Monnier, Philippe

    1995-01-01

    Golden Syrian hamsters are evaluated as an animal model for phototherapy of early squamous cell carcinomas of the mucosa of the upper aerodigestive tract, the esophagus and the tracheobronchial tree. Carcinomas of this type are induced on the hamster cheek pouch mucosa by the application of the carcinogen 7,12 DMBA. For phototherapeutic experiments on the animals we utilized meso- (tetrahydoxyphenyl)chlorin (mTHPC). The same drug is currently in phase I, II clinical trials for ENT patients with superficial squamous cell carcinomas. By means of light induced fluorescence (LIF) we measured in vivo the kinetics of the uptake and removal of mTHPC in the normal and tumoral cheek mucosa and in the skin. The photodynamic therapy (PDT) reaction of the tissue after excitation of the photosensitizer by laser light at 652 nm was studied. Both pharmacokinetics and PDT efficacy are compared between animal model and clinical results with special emphasis on selectivity between normal and tumoral mucosa. These first experiments show that this tumor model in the hamster cheek pouch seems to be suitable for tests of a number of PDT variables of new photosensitizers preceding their clinical application as well as for optimization of the multiple parameters of clinical phototherapy.

  2. Inhibition and regression of tumors in hamster DMBA model following laser microvascular targeting

    NASA Astrophysics Data System (ADS)

    McMillan, Kathleen; Wang, Zhi; Shapshay, Stanley M.

    1998-07-01

    Vascular targeting is a recent approach to cancer therapy that aims at damaging tumor vasculature to induce tumor cell hypoxia and subsequent cell death. Squamous cell cancer arises in the superficial mucosal and cutaneous epithelial layers, and tumor microvasculature therefore may be particularly well suited for targeting by selective photothermolysis. An initial evaluation of the effect of selective eradication of microvasculature on tumor development was undertaken here using the chemically-induced hamster cheek pouch model and a 585 nm pulsed dye laser. In a first group of 6 hamsters, progression of premalignant mucosal lesions was compared between control and laser treatment groups, and laser-induced regression of established tumors was evaluated. In a second group of 12 hamsters, the number of laser treatments required to produce complete regression of tumors of the buccal mucosa was determined. The effect of the laser on tumors appearing on the skin in these animals was also investigated. These experiments showed that laser treatment inhibited tumor development and caused complete regression of established tumors 10 mm3 or smaller. Photothermal microvascular targeting may be useful in treating dyplasia and early tumors of the upper aerodigestive tract and skin, with fewer adverse sequelae than existing modalities.

  3. Ethanol versus Phytochemicals in Wine: Oral Cancer Risk in a Light Drinking Perspective

    PubMed Central

    Varoni, Elena M.; Lodi, Giovanni; Iriti, Marcello

    2015-01-01

    This narrative review aims to summarize the current controversy on the balance between ethanol and phytochemicals in wine, focusing on light drinking and oral cancer. Extensive literature search included PUBMED and EMBASE databases to identify in human studies and systematic reviews (up to March 2015), which contributed to elucidate this issue. Independently from the type of beverage, meta-analyses considering light drinking (≤1 drinks/day or ≤12.5 g/day of ethanol) reported relative risks (RR) for oral, oro-pharyngeal, or upper aero-digestive tract cancers, ranging from 1.0 to 1.3. One meta-analysis measured the overall wine-specific RR, which corresponded to 2.1. Although little evidence exists on light wine intake, phytochemicals seem not to affect oral cancer risk, being probably present below the effective dosages and/or due to their low bioavailability. As expected, the risk of oral cancer, even in light drinking conditions, increases when associated with smoking habit and high-risk genotypes of alcohol and aldehyde dehydrogenases. PMID:26225960

  4. Curcumin and other polyphenolic compounds in head and neck cancer chemoprevention.

    PubMed

    Baumeister, Philipp; Reiter, Maximilian; Harréus, Ulrich

    2012-01-01

    Despite clear results of observational studies linking a diet rich in fruits and vegetables to a decreased cancer risk, large interventional trials evaluating the impact of dietary micronutrient supplementation, mostly vitamins, could not show any beneficial effects. Today it has become clear that a single micronutrient, given in supernutritional doses, cannot match cancer preventive effects of whole fruits and vegetables. In this regard polyphenols came into focus, not only because of their antioxidant potential but also because of their ability to interact with molecular targets within the cells. Because polyphenols occur in many foods and beverages in high concentration and evidence for their anticancer activity is best for tissues they can come into direct contact with, field cancerization predestines upper aerodigestive tract epithelium for cancer chemoprevention by polyphenols. In this paper, we summarize cancer chemopreventive attempts with emphasis on head and neck carcinogenesis and discuss some methodological issues. We present data regarding antimutagenic effects of curcumin and epigallocatechin-3-gallate in human oropharyngeal mucosa cultures exposed to cigarette smoke condensate. PMID:22690273

  5. Curcumin and Other Polyphenolic Compounds in Head and Neck Cancer Chemoprevention

    PubMed Central

    Baumeister, Philipp; Reiter, Maximilian; Harréus, Ulrich

    2012-01-01

    Despite clear results of observational studies linking a diet rich in fruits and vegetables to a decreased cancer risk, large interventional trials evaluating the impact of dietary micronutrient supplementation, mostly vitamins, could not show any beneficial effects. Today it has become clear that a single micronutrient, given in supernutritional doses, cannot match cancer preventive effects of whole fruits and vegetables. In this regard polyphenols came into focus, not only because of their antioxidant potential but also because of their ability to interact with molecular targets within the cells. Because polyphenols occur in many foods and beverages in high concentration and evidence for their anticancer activity is best for tissues they can come into direct contact with, field cancerization predestines upper aerodigestive tract epithelium for cancer chemoprevention by polyphenols. In this paper, we summarize cancer chemopreventive attempts with emphasis on head and neck carcinogenesis and discuss some methodological issues. We present data regarding antimutagenic effects of curcumin and epigallocatechin-3-gallate in human oropharyngeal mucosa cultures exposed to cigarette smoke condensate. PMID:22690273

  6. Upper and Lower Esophageal Sphincter Kinetics are Modified During Maturation: Effect of Pharyngeal Stimulus in Premature Infants

    PubMed Central

    Jadcherla, Sudarshan R.; Shubert, Theresa R.; Gulati, Ish K.; Jensen, Preceousa S.; Wei, Lai; Shaker, Reza

    2014-01-01

    Background We hypothesized that changes in proximal and distal esophageal sphincter kinetics evoked upon pharyngeal provocation undergo longitudinal maturation. Methods Pharyngeal stimulation-induced reflexes were characterized using novel pharyngoesophageal motility methods in 19 healthy premature neonates, studied at 34.7 ± 0.8 wks (time-1), and 39.3 ± 1.1 wks postmenstrual age (time-2). Graded volumes of air (290 infusions) and sterile water (172 infusions) were infused to define sensory-motor characteristics of upstream (pharyngeal reflexive swallow, PRS) and downstream (pharyngo-lower esophageal sphincter relaxation reflex, PLESRR) esophageal reflexes. Data displayed as mean ± SE. Results Threshold volumes were similar with air and water for PRS and PLESRR at time-1 and time-2. Multiple PRS responses were noted with water stimulus, and were different between the media (time-1 vs. air, P< 0.0001; time-2 vs. air, P =0.0003). Dose response relationships for water were significant (P<0.01 for PRS and PLESRR time-1 and time-2), but not with air. Conclusions Significantly, the recruitment frequency of PRS and PLESRR increases with maturation, liquid is a superior medium for evoking such swallowing reflexes, and stimulus-response relationships for these reflexes are evident. These changes in aerodigestive protective reflexive activity may indicate differences in modulation of excitatory and inhibitory pathways during longitudinal postnatal maturation. PMID:25279989

  7. Methylation as a biomarker for head and neck cancer.

    PubMed

    Arantes, L M R B; de Carvalho, A C; Melendez, M E; Carvalho, A L; Goloni-Bertollo, E M

    2014-06-01

    Head and neck cancer is a collective term that describes malignant tumors of the oral cavity, pharynx, and larynx characterized by high incidence and mortality rates. Although most HNSCC originate from the mucosal surface of the upper aerodigestive tract, where they can be easily detected during a routine clinical examination. Often the definitive diagnosis is delayed because of the difficulty in differentiating from other similar lesions. Activation of proto-oncogenes and inactivation of tumor suppressor genes are the major molecular alterations involved in carcinogenesis. In addition, epigenetic changes can alter the expression of critical genes important in the development of a variety of cancers. The detection of aberrant gene promoter methylation as a tool for the detection of tumors or its use as prognostic marker have been described for many different cancers including HNSCC. The search for biomarkers has as its main aim the evaluation and measurement of the status of normal and pathological biological processes as well as pharmacological responses to certain treatments. The tracking of these biomarkers is an important part for the identification of individuals in the early stages of head and neck cancer for its diagnostic and prognostic relevance reflecting in high survival rates, better quality of life and less cost to the healthcare system. Therefore, assuming that cancer results from genetic and epigenetic changes, analyzes based on gene methylation profile in combination with the pathological diagnosis would be useful in predicting the behavior of these head and neck tumors. PMID:24656975

  8. Button Battery Foreign Bodies in Children: Hazards, Management, and Recommendations

    PubMed Central

    Thabet, Mohammed Hossam; Basha, Waleed Mohamed; Askar, Sherif

    2013-01-01

    Objective. The demand and usage of button batteries have risen. They are frequently inadvertently placed by children in their ears or noses and occasionally are swallowed and lodged along the upper aerodigestive tract. The purpose of this work is to study the different presentations of button battery foreign bodies and present our experience in the diagnosis and management of this hazardous problem in children. Patients and Methods. This study included 13 patients. The diagnostic protocol was comprised of a thorough history, head and neck physical examination, and appropriate radiographic evaluation. The button batteries were emergently extracted under general anesthesia. Results. The average follow-up period was 4.3 months. Five patients had a nasal button battery. Four patients had an esophageal button battery. Three patients had a button battery in the stomach. One patient had a button battery impacted in the left external ear canal. Apart from a nasal septal perforation and a tympanic membrane perforation, no major complications were detected. Conclusion. Early detection is the key in the management of button battery foreign bodies. They have a distinctive appearance on radiography, and its prompt removal is mandatory, especially for batteries lodged in the esophagus. Physicians must recognize the hazardous potential and serious implications of such an accident. There is a need for more public education about this serious problem. PMID:23936851

  9. Aspects of nitrogen dioxide toxicity in environmental urban concentrations in human nasal epithelium

    SciTech Connect

    Koehler, C.; Ginzkey, C.; Friehs, G.; Hackenberg, S.; Froelich, K.; Scherzed, A.; Burghartz, M.; Kessler, M.; Kleinsasser, N.

    2010-06-01

    Cytotoxicity and genotoxicity of nitrogen dioxide (NO{sub 2}) as part of urban exhaust pollution are widely discussed as potential hazards to human health. This study focuses on toxic effects of NO{sub 2} in realistic environmental concentrations with respect to the current limit values in a human target tissue of volatile xenobiotics, the epithelium of the upper aerodigestive tract. Nasal epithelial cells of 10 patients were cultured as an air-liquid interface and exposed to 0.01 ppm NO{sub 2}, 0.1 ppm NO{sub 2}, 1 ppm NO{sub 2}, 10 ppm NO{sub 2} and synthetic air for half an hour. After exposure, genotoxicity was evaluated by the alkaline single-cell microgel electophoresis (Comet) assay and by induction of micronuclei in the micronucleus test. Depression of proliferation and cytotoxic effects were determined using the micronucleus assay and trypan blue exclusion assay, respectively. The experiments revealed genotoxic effects by DNA fragmentation starting at 0.01 ppm NO{sub 2} in the Comet assay, but no micronucleus inductions, no changes in proliferation, no signs of necrosis or apoptosis in the micronucleus assay, nor did the trypan blue exclusion assay show any changes in viability. The present data reveal a possible genotoxicity of NO{sub 2} in urban concentrations in a screening test. However, permanent DNA damage as indicated by the induction of micronuclei was not observed. Further research should elucidate the effects of prolonged exposure.

  10. Induction chemotherapy with cis-platinum and 5-fluorouracil for squamous cell carcinoma of the head and neck.

    PubMed Central

    Thyss, A.; Schneider, M.; Santini, J.; Caldani, C.; Vallicioni, J.; Chauvel, P.; Demard, F.

    1986-01-01

    One hundred and eight patients with squamous cell carcinoma of the upper aerodigestive tract (UADT) (T3, T4, NO-N3; 17% stage II, 54% stage III, 27% stage IV) were given three courses of chemotherapy before any local treatment. The regimen consisted of cis-platinum 100 mg m-2 on day 1 and 5-fluorouracil 1000 mg m-2 on days 2-6; drugs were administered by continuous infusion. The toxicity of this protocol was acceptable, as 82% of the patients were able to receive the initially scheduled drug dose. The overall response rate of 86.5% included a 35% rate of complete lesion regression. The effect of this regimen on primary tumours was especially remarkable--87.5% responses, including 47.5% complete responses. Results for lymph node metastases were not as good--66% responses, including 33% complete responses. The best results were obtained for tumours of the oropharynx and hypopharynx; oral cavity lesions were the most refractory. For those patients who were subsequently operated on, histological examination of the surgical specimen either confirmed sterilization or demonstrated the persistence of small disease foci. After local treatment, which consisted of radiotherapy alone for 69% of patients, the lesion control rate was 80%. At 18 months follow-up, the survival rate for patients who achieved a complete response with chemotherapy was significantly better than that for patients with a response of less than 50%. PMID:3801272

  11. Long-term survival after liver transplantation for alcoholic liver disease

    PubMed Central

    Iruzubieta, Paula; Crespo, Javier; Fábrega, Emilio

    2013-01-01

    Currently, alcoholic cirrhosis is the second leading indication for liver transplantation in the United States and Europe. The quality of life and survival after a liver transplantation (LT) in patients with alcoholic liver disease (ALD) are similar to those in patients with other cirrhosis etiologies. The alcoholic relapse rate after a LT varies from 10%-50%, and these relapse patients are the ones who present a reduced long-term survival, mainly due to cardiovascular diseases and the onset of de novo neoplasms, including lung and upper aerodigestive tract. Nearly 40% of ALD recipients resume smoking and resume it early post-LT. Therefore, our pre-and post-LT follow-up efforts regarding ALD should be focused not only on alcoholic relapse but also on treating and avoiding other modifiable risk factors such as tobacco. The psychiatric and psychosocial pre-LT evaluation and the post-LT follow-up with physicians, psychiatrists and addiction specialists are important for reversing these problems because these professionals help to identify patients at risk for relapse as well as those patients who have relapsed, thus enabling responsive actions. PMID:24409048

  12. Radiotherapy Alone With Curative Intent in Patients With Stage I Extranodal Nasal-Type NK/T-Cell Lymphoma

    SciTech Connect

    Li Yexiong; Wang Hua; Jin Jing; Wang Weihu; Liu Qingfeng; Song Yongwen; Wang Zhaoyang; Qi Shunan; Wang Shulian; Liu Yueping; Liu Xinfan; Yu Zihao

    2012-04-01

    Purpose: This study aims to evaluate the outcome and pattern of failure in a large cohort of patients with Stage I NK/T-cell lymphoma of the upper aerodigestive tract treated with radiotherapy alone. Methods and Materials: The pathological diagnosis was confirmed using standard criteria. All patients were treated with high-dose extended-field radiotherapy alone. The median dose was 50 Gy. The primary tumor was located in the nasal cavity (n = 80), Waldeyer ring (n = 5), or oral cavity (n = 2). Results: The overall response to radiotherapy was achieved in 85 of 87 (97.7%) patients, with a complete response rate of 95.4% and a partial response rate of 2.3%. The 5-year overall survival, progression-free survival, and local control rates for all patients were 80%, 69%, and 93%, respectively. Twenty patients (23%) had disease progression or relapse. Of these, 15 patients (17%) developed systemic extranodal disseminations, whereas only 4 (5%) patients had local relapse and 4 (5%) patients had lymph node relapse. Conclusions: Our study suggests that high-dose extended-field radiotherapy alone is a curative therapy and shows favorable clinical outcome in patients with Stage I disease. With the high possibility of local control and primary failure of systemic dissemination, the integration of optimal radiotherapy with more effective systematic therapy is warranted to bring additional improvement to the outcome for these patients.

  13. Educational differences in cancer mortality among women and men: a gender pattern that differs across Europe

    PubMed Central

    Menvielle, G; Kunst, A E; Stirbu, I; Strand, B H; Borrell, C; Regidor, E; Leclerc, A; Esnaola, S; Bopp, M; Lundberg, O; Artnik, B; Costa, G; Deboosere, P; Martikainen, P; Mackenbach, J P

    2008-01-01

    We used longitudinal mortality data sets for the 1990s to compare socioeconomic inequalities in total cancer mortality between women and men aged 30–74 in 12 different European populations (Madrid, Basque region, Barcelona, Slovenia, Turin, Switzerland, France, Belgium, Denmark, Norway, Sweden, Finland) and to investigate which cancer sites explain the differences found. We measured socioeconomic status using educational level and computed relative indices of inequality (RII). We observed large variations within Europe for educational differences in total cancer mortality among men and women. Three patterns were observed: Denmark, Norway and Sweden (significant RII around 1.3–1.4 among both men and women); France, Switzerland, Belgium and Finland (significant RII around 1.7–1.8 among men and around 1.2 among women); Spanish populations, Slovenia and Turin (significant RII from 1.29 to 1.88 among men; no differences among women except in the Basque region, where RII is significantly lower than 1). Lung, upper aerodigestive tract and breast cancers explained most of the variations between gender and populations in the magnitude of inequalities in total cancer mortality. Given time trends in cancer mortality, the gap in the magnitude of socioeconomic inequalities in cancer mortality between gender and between European populations will probably decrease in the future. PMID:18283307

  14. High Resolution Multi-Detector CT Aided Tissue Analysis and Quantification of Lung Fibrosis

    PubMed Central

    Zavaletta, Vanessa A.; Bartholmai, Brian J.; Robb, Richard A

    2009-01-01

    Rational and Objectives Volumetric high-resolution scans can be acquired of the lungs with multi-detector CT (MDCT). Such scans have potential to facilitate useful visualization, characterization, and quantification of the extent of diffuse lung diseases, such as Usual Interstitial Pneumonitis or Idiopathic Pulmonary Fibrosis (UIP/IPF). There is a need to objectify, standardize and improve the accuracy and repeatability of pulmonary disease characterization and quantification from such scans. This paper presents a novel texture analysis approach toward classification and quantification of various pathologies present in lungs with UIP/IPF. The approach integrates a texture matching method with histogram feature analysis. Materials and Methods Patients with moderate UIP/IPF were scanned on a Lightspeed 8-detector GE CT scanner (140kVp, 250mAs). Images were reconstructed with 1.25mm slice thickness in a high-frequency sparing algorithm (BONE) with 50% overlap and a 512 × 512 axial matrix, (0.625 mm3 voxels). Eighteen scans were used in this study. Each dataset is pre-processed which includes segmentation of the lungs and the broncho-vascular trees. Two types of analysis were performed, first an analysis of independent volume of interests (VOIs) and second an analysis of whole lung datasets. 1.) Fourteen of the eighteen scans were used to create a database of independent 15×15×15 cubic voxel VOIs. The VOIs were selected by experts as having greater than 70% of the defined class. The database was composed of the following: Honeycombing (# of VOIs 337), Reticular (130), Ground glass (148), Normal (240), and Emphysema (54). This database was used to develop our algorithm. Three progressively challenging classification experiments were designed to test our algorithm. All three experiments were performed using a 10-fold cross validation method for error estimation. Experiment 1 consisted of a two class discrimination: Normal and Abnormal. Experiment 2 consisted of a four class discrimination: Normal, Reticular, Honeycombing, and Emphysema. Experiment 3 consisted of a five class discrimination: Normal, Ground glass, Reticular, Honeycombing, and Emphysema. 2.) The remaining four scans were used to further test the algorithm on new data in the context of a whole lung analysis. Each of the four datasets was manually segmented by three experts. These datasets included Normal, Reticular and Honeycombing regions and did not include Ground glass or Emphysema. The accuracy of the classification algorithm was then compared with results from experts. Results Independent VOIs: 1.) Two class discrimination problem (sensitivity, specificity): Normal versus Abnormal (92.96%,93.78%). 2.) Four class discrimination problem: Normal (92%,95%), Reticular (86%,87%), Honeycombing (74%,98%), and Emphysema (93%,98%). 3.) Five class discrimination problem: Normal(92%,95%), Ground glass (75%,89%), Reticular (22%,92%), Honeycombing (74%,91%), and Emphysema (94%,98%). Whole lung datasets: 1.) William's Index shows that algorithm classification of lungs agrees with the experts as well as the experts agree with themselves. 2.) Student-T test between overlap measures of algorithm and expert (AE) and expert and expert (EE) : Normal (t=-1.20, p = 0.230), Reticular (t=-1.44, p = 0.155), Honeycombing (t=-3.15, p = 0.003). 3.) Lung Volumes Intra-class correlation: Dataset 1 (ICC = 0.9984, F = 0.0007); Dataset 2 (ICC = 0.9559, F = 0); Dataset 3 (ICC = 0.8623, F= 0.0015); Dataset 4 (ICC = 0.7807, F = 0.0136). Conclusions We have demonstrated that our novel method is computationally efficient and produces results comparable to expert radiologic judgment. It is effective in the classification of normal versus abnormal tissue and performs as well as the experts in distinguishing among typical pathologies present in lungs with UIP/IPF. The continuing development of quantitative metrics will improve quantification of disease and provide objective measures of disease progression. PMID:17574128

  15. A decision tree model to estimate the value of information provided by a groundwater quality monitoring network

    NASA Astrophysics Data System (ADS)

    Khader, A. I.; Rosenberg, D. E.; McKee, M.

    2013-05-01

    Groundwater contaminated with nitrate poses a serious health risk to infants when this contaminated water is used for culinary purposes. To avoid this health risk, people need to know whether their culinary water is contaminated or not. Therefore, there is a need to design an effective groundwater monitoring network, acquire information on groundwater conditions, and use acquired information to inform management options. These actions require time, money, and effort. This paper presents a method to estimate the value of information (VOI) provided by a groundwater quality monitoring network located in an aquifer whose water poses a spatially heterogeneous and uncertain health risk. A decision tree model describes the structure of the decision alternatives facing the decision-maker and the expected outcomes from these alternatives. The alternatives include (i) ignore the health risk of nitrate-contaminated water, (ii) switch to alternative water sources such as bottled water, or (iii) implement a previously designed groundwater quality monitoring network that takes into account uncertainties in aquifer properties, contaminant transport processes, and climate (Khader, 2012). The VOI is estimated as the difference between the expected costs of implementing the monitoring network and the lowest-cost uninformed alternative. We illustrate the method for the Eocene Aquifer, West Bank, Palestine, where methemoglobinemia (blue baby syndrome) is the main health problem associated with the principal contaminant nitrate. The expected cost of each alternative is estimated as the weighted sum of the costs and probabilities (likelihoods) associated with the uncertain outcomes resulting from the alternative. Uncertain outcomes include actual nitrate concentrations in the aquifer, concentrations reported by the monitoring system, whether people abide by manager recommendations to use/not use aquifer water, and whether people get sick from drinking contaminated water. Outcome costs include healthcare for methemoglobinemia, purchase of bottled water, and installation and maintenance of the groundwater monitoring system. At current methemoglobinemia and bottled water costs of 150/person and 0.6/baby/day, the decision tree results show that the expected cost of establishing the proposed groundwater quality monitoring network exceeds the expected costs of the uninformed alternatives and there is no value to the information the monitoring system provides. However, the monitoring system will be preferred to ignoring the health risk or using alternative sources if the methemoglobinemia cost rises to 300/person or the bottled water cost increases to 2.3/baby/day. Similarly, the monitoring system has value if the system can more accurately report actual aquifer concentrations and the public more fully abides by manager recommendations to use/not use the aquifer. The system also has value if it will serve a larger population or if its installation costs can be reduced, for example using a smaller number of monitoring wells. The VOI analysis shows how monitoring system design, accuracy, installation and operating costs, public awareness of health risks, costs of alternatives, and demographics together affect the value of implementing a system to monitor groundwater quality.

  16. Economic Value of an Advanced Climate Observing System

    NASA Astrophysics Data System (ADS)

    Wielicki, B. A.; Cooke, R.; Young, D. F.; Mlynczak, M. G.

    2013-12-01

    Scientific missions increasingly need to show the monetary value of knowledge advances in budget-constrained environments. For example, suppose a climate science mission promises to yield decisive information on the rate of human caused global warming within a shortened time frame. How much should society be willing to pay for this knowledge today? The US interagency memo on the social cost of carbon (SCC) creates a standard yardstick for valuing damages from carbon emissions. We illustrate how value of information (VOI) calculations can be used to monetize the relative value of different climate observations. We follow the SCC, setting uncertainty in climate sensitivity to a truncated Roe and Baker (2007) distribution, setting discount rates of 2.5%, 3% and 5%, and using one of the Integrated Assessment Models sanctioned in SCC (DICE, Nordhaus 2008). We consider three mitigation scenarios: Business as Usual (BAU), a moderate mitigation response DICE Optimal, and a strong response scenario (Stern). To illustrate results, suppose that we are on the BAU emissions scenario, and that we would switch to the Stern emissions path if we learn with 90% confidence that the decadal rate of temperature change reaches or exceeds 0.2 C/decade. Under the SCC assumptions, the year in which this happens, if it happens, depends on the uncertain climate sensitivity and on the emissions path. The year in which we become 90% certain that it happens depends, in addition, on our Earth observations, their accuracy, and their completeness. The basic concept is that more accurate observations can shorten the time for societal decisions. The economic value of the resulting averted damages depends on the discount rate, and the years in which the damages occur. A new climate observation would be economically justified if the net present value (NPV) of the difference in averted damages, relative to the existing systems, exceeds the NPV of the system costs. Our results (Cooke et al. 2013) compared the proposed CLARREO advance in satellite absolute calibration for climate change records to an existing system for detecting decadal temperature change using infrared spectra from weather satellites. New results extend this to observational detection of cloud feedback which is the largest uncertainty in determining climate sensitivity and therefore the uncertainty in economic impacts. New results also include the use of multiple societal decision triggers. While CLARREO is used as an example, the value should be considered as relevant to a complete high accuracy climate observing system, as societal decisions are unlikely to be based on one or a few observations. The VOI is found to depend on the required confidence level, the trigger value at which we would abandon the BAU emissions path, the path to which we switch, and the date at which the new system is launched. The VOI of advanced climate observations in this decision context is the surfeit of NPV of averted damages, relative to the existing system. Over all it is in the order of tens of trillions of US dollars in Net Present Value. The results conclude that the economic value of advanced climate observing systems is dramatically larger than their cost, and argues for the continual enhancement of the SCC assessment process.

  17. A decision tree model to estimate the value of information provided by a groundwater quality monitoring network

    NASA Astrophysics Data System (ADS)

    Khader, A.; Rosenberg, D.; McKee, M.

    2012-12-01

    Nitrate pollution poses a health risk for infants whose freshwater drinking source is groundwater. This risk creates a need to design an effective groundwater monitoring network, acquire information on groundwater conditions, and use acquired information to inform management. These actions require time, money, and effort. This paper presents a method to estimate the value of information (VOI) provided by a groundwater quality monitoring network located in an aquifer whose water poses a spatially heterogeneous and uncertain health risk. A decision tree model describes the structure of the decision alternatives facing the decision maker and the expected outcomes from these alternatives. The alternatives include: (i) ignore the health risk of nitrate contaminated water, (ii) switch to alternative water sources such as bottled water, or (iii) implement a previously designed groundwater quality monitoring network that takes into account uncertainties in aquifer properties, pollution transport processes, and climate (Khader and McKee, 2012). The VOI is estimated as the difference between the expected costs of implementing the monitoring network and the lowest-cost uninformed alternative. We illustrate the method for the Eocene Aquifer, West Bank, Palestine where methemoglobinemia is the main health problem associated with the principal pollutant nitrate. The expected cost of each alternative is estimated as the weighted sum of the costs and probabilities (likelihoods) associated with the uncertain outcomes resulting from the alternative. Uncertain outcomes include actual nitrate concentrations in the aquifer, concentrations reported by the monitoring system, whether people abide by manager recommendations to use/not-use aquifer water, and whether people get sick from drinking contaminated water. Outcome costs include healthcare for methemoglobinemia, purchase of bottled water, and installation and maintenance of the groundwater monitoring system. At current methemoglobinemia and bottled water costs of 150 $/person and 0.6 $/baby/day, the decision tree results show that the expected cost of establishing the proposed groundwater quality monitoring network exceeds the expected costs of the uninformed alternatives and there is not value to the information the monitoring system provides. However, the monitoring system will be preferred to ignoring the health risk or using alternative sources if the methemoglobinemia cost rises to 300 $/person or the bottled water cost increases to 2.3 $/baby/day. Similarly, the monitoring system has value if the system can more accurately report actual aquifer concentrations and the public more fully abides by managers' recommendations to use/not use the aquifer. The system also has value if it will serve a larger population or if its installation costs can be reduced, for example using a smaller number of monitoring wells. The VOI analysis shows how monitoring system design, accuracy, installation and operating costs, public awareness of health risks, costs of alternatives, and demographics together affect the value of implementing a system to monitor groundwater quality.

  18. The Value of Information: Assessing the Ability of Electrical Resistivity to Detect CO2 Leakage in a Shallow Aquifer

    NASA Astrophysics Data System (ADS)

    Trainor Guitton, W. J.; Yang, X.; Mansoor, K.; Ramirez, A. L.; Sun, Y.; Carroll, S.

    2012-12-01

    This study demonstrates a methodology for evaluating the value of electrical resistivity data to detect CO2 leakage in a shallow groundwater aquifer. This methodology adopts the value of information (VOI) metric from the field of decision analysis. We consider a stakeholder's decision of whether or not to remediate the aquifer, given that they are uncertain whether or not a CO2 leak has occurred from a deep storage source through a well-bore into the shallow aquifer and what the impact of that leak would be. Two themes of uncertainty are needed for VOI studies. The first is related to the uncertain state of the subsurface, which is directly related to the outcome of the decision. In our example, it is uncertain whether or not the shallow groundwater has been impacted by CO2 leakage. The impact may be determined by the existence of depressed pH or elevated TDS (total dissolved solids) plume. We utilize results from a previous work that investigated uncertainty quantification of spatial heterogeneity and leakage rates (Mansoor et al, 2011). Therefore, we have a comprehensive suite of 713 simulations that represent our uncertainty regarding the existence and extent of a CO2 plume. Given certain TDS and pH thresholds, the simulations are categorized into two groups: impacted (a plume exists) or not impacted (no plume) at time=50 years. The second theme is related to the information's accuracy to inform us about the existence of a plume (e.g. the state of the subsurface directly relevant to the decision). The uncertainty of the information is measured by the data likelihood and is used to determine the value of imperfect information. For this demonstration, we consider how electrical resistivity data can detect the existence of pH plumes (due to the dissolution of CO2) and TDS (due to the accompanying brine leakage). The pH and TDS output from the 713 simulations are used to determine the electrical resistivity at time = 0 and time=50 years. An empirical method is used to compare the time=0 and time=50 resistivities: the geometric log mean ratio (GLMR) of the 2 data sets is calculated (Daily et al, 2004). This requires only the forward response be calculated at the 2 different times. The GLMR is used as a sensitivity measure, representing how much the electrical resistivity would change given the conditions of the aquifer. The likelihood of electrical resistivity to detect the presence of a plume is estimated by comparing the GLMR and the category (plume or no plume) for all the 713 simulations. Electrical resistivity forward models were calculated for two acquisition configurations: surface electrodes only and surface-to-borehole. For the surface acquisition, a GLMR >0.05 exclusively identifies impacted simulations. Whereas GLMR <0.05 give a more ambiguous message: both simulations that are impacted and not have GMLR<0.05. The degree of this ambiguity changes with different definitions of the plume (i.e. pH and TDS thresholds). Surface-to-borehole forward models were performed for a borehole located 200m from the leaky well. Results show that surface-to-borehole resistivity data is more reliable at distinguishing between impacted and non-impacted simulations, and therefore the VOI is higher than for surface electrodes alone. Prepared by LLNL under Contract No. DE-AC52-07NA27344.

  19. The economic value of remote sensing information: a case study of agricultural production and groundwater vulnerability using applied environmental science and hydrogeospatial methods

    NASA Astrophysics Data System (ADS)

    Forney, W.; Bernknopf, R. L.; Mishra, S.; Raunikar, R. P.

    2011-12-01

    William M. Forney1*, Richard L. Bernknopf1, Shruti K. Mishra2, Ronald P. Raunikar1. 1=Western Geographic Science Center, US Geological Survey, Menlo Park, California. 2=Contractor, Western Geographic Science Center, US Geological Survey, Menlo Park, California *=Contact author, wforney@usgs.gov, 650-329-4237. Does remote sensing information provide economic benefits to society and can those benefits be valued? Can resource management and policy be better informed by coupling past and present earth observations with groundwater nitrate measurements? Using an integrated assessment approach, the USGS's research applies an established conceptual framework to answer these questions as well as estimate the value of information (VOI) for remote sensing imagery. The approach uses moderate resolution land imagery (MRLI) data from the Landsat and Advanced Wide Field Sensor satellites that has been classified by the National Agricultural Statistics Service into the Cropland Data Layer (CDL). Within the constraint of the US Environmental Protection Agency's public health threshold for potable groundwater resources, we model the relationship between a population of the CDL's land uses and the evolution of nitrate (NO3-) contamination of aquifers in a case study region in northeastern Iowa. Using source data from the Iowa Department of Natural Resources and the USGS's National Water Quality Assessment Program, the approach uses multi-scaled, environmental science models to address dynamic, biophysical process models of nitrogen fate and transport at specific sites (wells) and at landscape scale (35 counties) in order to assess groundwater vulnerability. In addition to the ecosystem service of potable groundwater, this effort focuses on particular agricultural goods and land uses: corn, soybeans and livestock manure management. Results of this four-year study will be presented, including: 1) the integrated models of the assessment approach, 2) mapping the range of vulnerabilities across the region, and 3) considerations of improved nitrogen and crop management. Finally, utilizing both a situation where society does not have access to MRLI, and an enhanced land use scenario based on plausible, future regulatory and policy frameworks and continued availability of MRLI, estimates of the incremental increase in the MRLI's VOI are presented.

  20. Pulmonary vessel segmentation utilizing curved planar reformation and optimal path finding (CROP) in computed tomographic pulmonary angiography (CTPA) for CAD applications

    NASA Astrophysics Data System (ADS)

    Zhou, Chuan; Chan, Heang-Ping; Kuriakose, Jean W.; Chughtai, Aamer; Wei, Jun; Hadjiiski, Lubomir M.; Guo, Yanhui; Patel, Smita; Kazerooni, Ella A.

    2012-03-01

    Vessel segmentation is a fundamental step in an automated pulmonary embolism (PE) detection system. The purpose of this study is to improve the segmentation scheme for pulmonary vessels affected by PE and other lung diseases. We have developed a multiscale hierarchical vessel enhancement and segmentation (MHES) method for pulmonary vessel tree extraction based on the analysis of eigenvalues of Hessian matrices. However, it is difficult to segment the pulmonary vessels accurately under suboptimal conditions, such as vessels occluded by PEs, surrounded by lymphoid tissues or lung diseases, and crossing with other vessels. In this study, we developed a new vessel refinement method utilizing curved planar reformation (CPR) technique combined with optimal path finding method (MHES-CROP). The MHES segmented vessels straightened in the CPR volume was refined using adaptive gray level thresholding where the local threshold was obtained from least-square estimation of a spline curve fitted to the gray levels of the vessel along the straightened volume. An optimal path finding method based on Dijkstra's algorithm was finally used to trace the correct path for the vessel of interest. Two and eight CTPA scans were randomly selected as training and test data sets, respectively. Forty volumes of interest (VOIs) containing "representative" vessels were manually segmented by a radiologist experienced in CTPA interpretation and used as reference standard. The results show that, for the 32 test VOIs, the average percentage volume error relative to the reference standard was improved from 32.9+/-10.2% using the MHES method to 9.9+/-7.9% using the MHES-CROP method. The accuracy of vessel segmentation was improved significantly (p<0.05). The intraclass correlation coefficient (ICC) of the segmented vessel volume between the automated segmentation and the reference standard was improved from 0.919 to 0.988. Quantitative comparison of the MHES method and the MHES-CROP method with the reference standard was also evaluated by the Bland-Altman plot. This preliminary study indicates that the MHES-CROP method has the potential to improve PE detection.

  1. Voxel-based evidence of perfusion normalization in glioblastoma patients included in a phase I-II trial of radiotherapy/tipifarnib combination.

    PubMed

    Ken, Soléakhéna; Deviers, Alexandra; Filleron, Thomas; Catalaa, Isabelle; Lotterie, Jean-Albert; Khalifa, Jonathan; Lubrano, Vincent; Berry, Isabelle; Péran, Patrice; Celsis, Pierre; Moyal, Elizabeth Cohen-Jonathan; Laprie, Anne

    2015-09-01

    We previously showed that the farnesyl transferase inihibitor, Tipifarnib induced vascularization normalization, oxygenation and radiosensitization in a pre-clinical glioblastoma (GBM) model. The aim of this study was to assess by dynamic-susceptibility-contrast MRI (DSC-MRI) the effect of radiotherapy (RT) and Tipifarnib combination on tumor perfusion in GBM patients. Eighteen patients with newly diagnosed GBM, enrolled in a phase I-II clinical trial associating RT with Tipifarnib, underwent anatomical MR imaging and DSC-MRI before (M0) and two months after treatment (M2). Anatomic volumes of interest (VOIs) were delineated according to contrast-enhanced and hyper-intense signal areas on T1-Gd and T2 images, respectively. Perfusion variations between M0 and M2 were assessed with median relative cerebral blood volume (rCBV) inside these VOIs. Another voxel by voxel analysis of CBV values classified 405,117 tumor voxels into High_, Normal_ and Low_CBVTUMOR according to the distribution of CBV in the contralateral normal tissue. These three categories of CBVTUMOR voxels were color-coded over anatomical MRI. Variations of median rCBV were significantly different for two groups of patients (P < 0.013): rCBV decreased when initial rCBV was ≥ 1.0 (Group_rCBV_M0 > 1) and rCBV increased when initial rCBV was < 1.0 (Group_rCBV_M0 < 1). Mapping of color-coded voxels provided additional spatial and quantitative information about tumor perfusion: Group_rCBV_M0 > 1 presented a significant decrease of High_CBVTUMOR volume (P = 0.015) simultaneously with a significant increase of Normal_CBVTUMOR volume (P = 0.009) after treatment. Group_rCBV_M0 < 1 presented a decrease of Low_CBVTUMOR volume with an increase of Normal_ and High_CBV TUMOR volume after treatment. Pre and post-treatment CBV measurements with DSC-MRI characterized tumor perfusion evolution in GBM patients treated with RT combined to Tipifarnib; showing variations in favour of tumor perfusion normalization in agreement with our pre-clinical results of vascular normalization. PMID:26189058

  2. In vivo MRS and MRSI: Performance analysis, measurement considerations and evaluation of metabolite concentration images

    NASA Astrophysics Data System (ADS)

    Vikhoff-Baaz, Barbro

    2000-10-01

    The doctoral thesis concerns development, evaluation and performance of quality assessment methods for volume- selection methods in 31P and 1H MR spectroscopy (MRS). It also contains different aspects of the measurement procedure for 1H MR spectroscopic imaging (MRSI) with application on the human brain, image reconstruction of the MRSI images and evaluation methods for lateralization of temporal lobe epilepsy (TLE). Two complementary two-compartment phantoms and evaluation methods for quality assessment of 31P MRS in small-bore MR systems were presented. The first phantom consisted of an inner cube inside a sphere phantom where measurements with and without volume selection where compared for various VOI sizes. The multi-centre showed that the evaluated parameters provide useful information of the performance of volume-selective MRS at the MR system. The second phantom consisted of two compartments divided by a very thin wall and was found useful for measurements of the appearance and position of the VOI profile in specific gradient directions. The second part concerned 1H MRS and MRSI of whole-body MR systems. Different factors that may degrade or complicate the measurement procedure like for MRSI were evaluated, e.g. the volume selection performance, contamination, susceptibility and motion. Two interpolation methods for reconstruction of MRSI images were compared. Measurements and computer simulations showed that Fourier interpolation correctly visualizes the information inherent in the data set, while the results were dependent on the position of the object relative the original matrix using Cubic spline interpolation. Application of spatial filtering may improve the image representation of the data. Finally, 1H MRSI was performed on healthy volunteers and patients with temporal lobe epilepsy (TLE). Metabolite concentration images were used for lateralization of TLE, where the signal intensity in the two hemispheres were compared. Visual analysis of the metabolite concentration images can, with high accuracy, be used for lateralization in routine examinations. Analysis from measurements with region-of-interests (ROI) in different locations gives quantitative information about the degree of signal loss and the spatial distribution.

  3. PET/CT imaging evidence of FUS-mediated (18)F-FDG uptake changes in rat brain

    PubMed Central

    Kim, Hyungmin; Park, Mi-Ae; Wang, Shuyan; Chiu, Alan; Fischer, Krisztina; Yoo, Seung-Schik

    2013-01-01

    Purpose: Transcranial focused ultrasound (FUS) delivers highly focused acoustic energy to a small region of the brain in a noninvasive manner. Recent studies have revealed that FUS, which is administered either in pulsed or continuous waves, can elicit or suppress neural tissue excitability. This neuromodulatory property of FUS has been demonstrated via direct motion detection, electrophysiological recordings, functional magnetic resonance imaging (fMRI), confocal imaging, and microdialysis sampling of neurotransmitters. This study presents new evidence of local increase in glucose metabolism induced by FUS to the rat brain using FDG (18-fludeoxyglucose) positron emission tomography (PET). Methods: Sprague–Dawley rats underwent sonication to a unilateral hemispheric area of the brain prior to PET scan. The pulsed sonication (350 kHz, tone burst duration of 0.5 ms, pulse repetition frequency of 1 kHz, and duration of 300 ms) was applied in 2 s intervals for 40 min immediately after the FDG injection via tail vein. Subsequently, the PET was acquired in dynamic list-mode to image FDG activity for an hour, and reconstructed into a single volume representing standardized uptake value (SUV). The raw SUV as well as its asymmetry index (AI) were measured from five different volume-of-interests (VOIs) of the brain for both hemispheres, and compared between sonicated and unsonicated groups. Results: Statistically significant hemispheric changes in SUV were observed only at the center of sonication focus within the FUS group [paired t-test; t(7) = 3.57, p < 0.05]. There were no significant hemispheric differences in SUV within the control group in any of the VOIs. A statistically significant elevation in AI (t-test; t(7) = 3.40, p < 0.05) was observed at the center of sonication focus (7.9 ± 2.5%, the deviations are in standard error) among the FUS group when compared to the control group (−0.8 ± 1.2%). Conclusions: Spatially distinct increases in the glucose metabolic activity in the rat brain is present only at the center of sonication focus, suggesting localized functional neuromodulation mediated by the sonication. PMID:23464343

  4. Error analysis of tumor blood flow measurement using dynamic contrast-enhanced data and model-independent deconvolution analysis.

    PubMed

    Murase, Kenya; Miyazaki, Shohei

    2007-05-21

    We performed error analysis of tumor blood flow (TBF) measurement using dynamic contrast-enhanced data and model-independent deconvolution analysis, based on computer simulations. For analysis, we generated a time-dependent concentration of the contrast agent in the volume of interest (VOI) from the arterial input function (AIF) consisting of gamma-variate functions using an adiabatic approximation to the tissue homogeneity model under various plasma flow (F(p)), mean capillary transit time (T(c)), permeability-surface area product (PS) and signal-to-noise ratio (SNR) values. Deconvolution analyses based on truncated singular value decomposition with a fixed threshold value (TSVD-F), with an adaptive threshold value (TSVD-A) and with the threshold value determined by generalized cross validation (TSVD-G) were used to estimate F(p) values from the simulated concentration-time curves in the VOI and AIF. First, we investigated the relationship between the optimal threshold value and SNR in TSVD-F, and then derived the equation describing the relationship between the threshold value and SNR for TSVD-A. Second, we investigated the dependences of the estimated F(p) values on T(c), PS, the total duration for data acquisition and the shape of AIF. Although TSVD-F with a threshold value of 0.025, TSVD-A with the threshold value determined by the equation derived in this study and TSVD-G could estimate the F(p) values in a similar manner, the standard deviation of the estimates was the smallest and largest for TSVD-A and TSVD-G, respectively. PS did not largely affect the estimates, while T(c) did in all methods. Increasing the total duration significantly improved the variations in the estimates in all methods. TSVD-G was most sensitive to the shape of AIF, especially when the total duration was short. In conclusion, this study will be useful for understanding the reliability and limitation of model-independent deconvolution analysis when applied to TBF measurement using an extravascular contrast agent. PMID:17473352

  5. Error analysis of tumor blood flow measurement using dynamic contrast-enhanced data and model-independent deconvolution analysis

    NASA Astrophysics Data System (ADS)

    Murase, Kenya; Miyazaki, Shohei

    2007-05-01

    We performed error analysis of tumor blood flow (TBF) measurement using dynamic contrast-enhanced data and model-independent deconvolution analysis, based on computer simulations. For analysis, we generated a time-dependent concentration of the contrast agent in the volume of interest (VOI) from the arterial input function (AIF) consisting of gamma-variate functions using an adiabatic approximation to the tissue homogeneity model under various plasma flow (Fp), mean capillary transit time (Tc), permeability-surface area product (PS) and signal-to-noise ratio (SNR) values. Deconvolution analyses based on truncated singular value decomposition with a fixed threshold value (TSVD-F), with an adaptive threshold value (TSVD-A) and with the threshold value determined by generalized cross validation (TSVD-G) were used to estimate Fp values from the simulated concentration-time curves in the VOI and AIF. First, we investigated the relationship between the optimal threshold value and SNR in TSVD-F, and then derived the equation describing the relationship between the threshold value and SNR for TSVD-A. Second, we investigated the dependences of the estimated Fp values on Tc, PS, the total duration for data acquisition and the shape of AIF. Although TSVD-F with a threshold value of 0.025, TSVD-A with the threshold value determined by the equation derived in this study and TSVD-G could estimate the Fp values in a similar manner, the standard deviation of the estimates was the smallest and largest for TSVD-A and TSVD-G, respectively. PS did not largely affect the estimates, while Tc did in all methods. Increasing the total duration significantly improved the variations in the estimates in all methods. TSVD-G was most sensitive to the shape of AIF, especially when the total duration was short. In conclusion, this study will be useful for understanding the reliability and limitation of model-independent deconvolution analysis when applied to TBF measurement using an extravascular contrast agent.

  6. Cerebellar neurochemical alterations in spinocerebellar ataxia type 14 appear to include glutathione deficiency.

    PubMed

    Doss, Sarah; Rinnenthal, Jan Leo; Schmitz-Hübsch, Tanja; Brandt, Alexander U; Papazoglou, Sebastian; Lux, Silke; Maul, Stephan; Würfel, Jens; Endres, Matthias; Klockgether, Thomas; Minnerop, Martina; Paul, Friedemann

    2015-08-01

    Autosomal dominant ataxia type 14 (SCA14) is a rare usually adult-onset progressive disorder with cerebellar neurodegeneration caused by mutations in protein kinase C gamma. We set out to examine cerebellar and extracerebellar neurochemical changes in SCA14 by MR spectroscopy. In 13 SCA14 patients and 13 healthy sex- and age-matched controls, 3-T single-voxel brain proton MR spectroscopy was performed in a cerebellar voxel of interest (VOI) at TE = 30 ms to obtain a neurochemical profile of metabolites with short relaxation times. In the cerebellum and in additional VOIs in the prefrontal cortex, motor cortex, and somatosensory cortex, a second measurement was performed at TE = 144 ms to mainly extract the total N-acetyl-aspartate (tNAA) signal besides the signals for total creatine (tCr) and total choline (tCho). The cerebellar neurochemical profile revealed a decrease in glutathione (6.12E-06 ± 2.50E-06 versus 8.91E-06 ± 3.03E-06; p = 0028) and tNAA (3.78E-05 ± 5.67E-06 versus 4.25E-05 ± 5.15E-06; p = 0023) and a trend for reduced glutamate (2.63E-05 ± 6.48E-06 versus 3.15E-05 ± 7.61E-06; p = 0062) in SCA14 compared to controls. In the tNAA-focused measurement, cerebellar tNAA (296.6 ± 42.6 versus 351.7 ± 16.5; p = 0004) and tCr (272.1 ± 25.2 versus 303.2 ± 31.4; p = 0004) were reduced, while the prefrontal, somatosensory and motor cortex remained unaffected compared to controls. Neuronal pathology in SCA14 detected by MR spectroscopy was restricted to the cerebellum and did not comprise cortical regions. In the cerebellum, we found in addition to signs of neurodegeneration a glutathione reduction, which has been associated with cellular damage by oxidative stress in other neurodegenerative diseases such as Parkinson's disease and Friedreich's ataxia. PMID:26041613

  7. Intranasal delivery of Norwalk virus-like particles formulated in an in-situ gelling, dry powder vaccine

    PubMed Central

    Velasquez, Lissette S.; Shira, Samantha; Berta, Alice N.; Kilbourne, Jacquelyn; Medi, Babu M.; Tizard, Ian; Ni, Yawei; Arntzen, Charles J.; Herbst-Kralovetz, Melissa M.

    2011-01-01

    The development of a vaccine to prevent norovirus infections has been focused on immunization at a mucosal surface, but has been limited by the low immunogenicity of self-assembling Norwalk virus-like particles (NV VLPs) delivered enterically or at nasal surfaces. Nasal immunization, which offers the advantage of ease of immunization, faces obstacles imposed by the normal process of mucociliary clearance, which limits residence time of applied antigens. Herein, we describe the use of a dry powder formulation (GelVac) of an inert in-situ gelling polysaccharide (GelSite) extracted from Aloe vera for nasal delivery of NV VLP antigen. Powder formulations, with or without NV VLP antigen, were similar in structure in dry form or when rehydrated in simulated nasal fluids. Immunogenicity of the dry powder VLP formulation was compared to equivalent antigen/adjuvant liquid formulations in animals. For the GelVac powder, we observed superior NV-specific serum and mucosal (aerodigestive and reproductive tracts) antibody responses relative to liquid formulations. Incorporation of TLR7 agonist gardiquimod in dry powder formulations did not enhance antibody responses, although its inclusion in liquid formulations did enhance VLP immunogenicity irrespective of the presence or absence of GelSite. We interpret these data as showing that GelSite-based dry powder formulations 1.) stabilize the immunogenic structural properties of VLPs and 2.) induce systemic and mucosal antibody titers which are equal or greater than those achieved by VLPs plus adjuvant in a liquid formulation. We conclude that in-situ gelation of the GelVac dry powder formulation at nasal mucosal surfaces delays mucociliary clearance and thereby prolongs VLP antigen exposure to immune effector sites. PMID:21640778

  8. The buccal mucosa as a route for TiO2 nanoparticle uptake.

    PubMed

    Teubl, Birgit Johanna; Leitinger, Gerd; Schneider, Marc; Lehr, Claus-Michael; Fröhlich, Eleonore; Zimmer, Andreas; Roblegg, Eva

    2015-03-01

    The oral cavity, although part of the aero-digestive tract, is still neglected in terms of risk assessment with respect to nanoparticle uptake. If nanoparticles enter the oral cavity, either via oral products or inhaled materials, it is not clear whether they rapidly interact with the mucosae or are swallowed. In this study, interactions of three distinct titanium dioxide (TiO2) particles (i.e. NM 100, NM 101 and NM 105) with oral tissues are presented. Physicochemical properties were addressed in relevant media, and particle penetration was investigated with an ex vivo model using porcine mucosa. To avoid modification of the particle surfaces via labeling, multiphoton microscopy was introduced as an accurate method to detect TiO2 particles within the tissue. The spatiotemporal aspects of nanoparticle uptake, as well as the intracellular localization in human epithelial cells, were studied and potential toxic effects were evaluated. Although TiO2 particles formed large aggregates once dispersed in media, 10-50% remained in the nanoscale range, rapidly interacting with the mucus layer and infecting the epithelium. However, differences in the penetration depth were observed depending on the particle characteristics. NM 100 and NM 105 were found in both the upper part and the lower part of the buccal mucosa, while NM 101 (smallest particle sizes) only penetrated the upper parts. Transport studies revealed that TiO2 nanoparticles were found in vesicles, as well as freely distributed in the cytoplasm. Cell viability/integrity was not affected negatively; however, NM 105 triggered the production of reactive oxygen species. These data clearly suggest that the oral cavity should be considered in further risk assessment studies. PMID:24873758

  9. Prophylactic cervical lymph node irradiation provides no benefit for patients of stage IE extranodal natural killer/T cell lymphoma, nasal type.

    PubMed

    Wang, Liang; Xia, Zhong-Jun; Lu, Yue; Zhang, Yu-Jing

    2015-01-01

    Radiation therapy (RT) may cure many patients with stage IE extranodal natural killer/T cell lymphoma (ENKTL), but the real benefit of prophylactic cervical node irradiation (PCNI) for this patient population has not been defined yet. We retrospectively reviewed 126 patients who were diagnosed as stage IE ENKTL and treated with chemoradiotherapy in Sun Yat-sen University Cancer Center. The RT dose was 36-72 Gy (median 54 Gy), with 1.8-2.0 Gy a day and 5 fractions each week. 35 patients (27.8 %) in this cohort received PCNI. At a median follow-up time of 94.59 months (range 14.59-182.08 months), the systemic failure rate and locoregional failure rate in patients with PCNI were 76.5 and 23.5 %, respectively, compared with 62.9 and 37.1 % in those without PCNI, and there was no significant difference between those two groups (P = 0.505). Whether patients received PCNI or not did not affect the survival outcome (P > 0.05). Also, PCNI did not improve the survival outcome for neither patients with primary tumor site localized to nasal cavity nor those localized to upper aerodigestive tract beyond nasal cavity (P > 0.05), and PCNI did not provide survival benefit for neither patients with local tumor invasion nor those without (P > 0.05). In conclusion, in a large cohort of 126 patients with stage IE ENKTL, we found that PCNI provided no benefit for PFS and OS, regardless of the primary tumor site or local tumor invasiveness. PMID:25429828

  10. Dietary flavonoid intake and risk of cancer in postmenopausal women: The Iowa Women's Health Study

    PubMed Central

    Cutler, Gretchen J.; Nettleton, Jennifer A.; Ross, Julie A.; Harnack, Lisa J.; Jacobs, David R.; Scrafford, Carolyn G.; Barraj, Leila M.; Mink, Pamela J.; Robien, Kim

    2008-01-01

    Flavonoids, which are found in certain plant foods, are thought to lower cancer risk through their antioxidant, antiestrogenic and antiproliferative properties. We examined the association of intake of total flavonoids and 7 flavonoid subclasses with risk of lung, colorectal, breast, pancreatic and upper aerodigestive cancer among women in a large prospective cohort study. Study participants were 34,708 postmenopausal women in the Iowa Women's Health Study who completed a food frequency questionnaire and were followed for cancer occurrence from 1986 through 2004. Flavonoid intake was estimated from 3 databases developed by the USDA Nutrient Data Laboratory (NDL). Hazard ratios (HR) for cancer risk were calculated across total flavonoid and flavonoid subclass intake categories. Interactions between smoking history and flavonoid intake were also examined. After multivariable adjustment, lung cancer incidence was inversely associated with intakes of flavanones (HR = 0.68; 95% CI: 0.53?0.86, all results highest vs. lowest quintile) and proanthocyanidins (HR = 0.75; 95% CI: 0.57?0.97). Among current and past smokers, those with intakes in the highest quintile for flavanones (HR = 0.66; 95% CI: 0.50?0.86), and proanthocyanidins (HR = 0.66; 95% CI; 0.49?0.89) had significantly lower lung cancer incidence than those in the lowest quintile. Similar associations were not seen in never smokers. Isoflavone intake was inversely associated with overall cancer incidence (HR = 0.93, 95% CI: 0.86?1.00). This study provides further support for a beneficial effect of flavonoid intake on lung cancer risk, especially among current and past smokers. PMID:18491403

  11. A retrospective study of correlation of morphologic patterns, MIB1 proliferation index, and survival analysis in 134 cases of plasmacytoma.

    PubMed

    Ghodke, Kiran; Shet, Tanuja; Epari, Sridhar; Sengar, Manju; Menon, Hari; Gujral, Sumeet

    2015-06-01

    Plasmacytoma classified into solitary plasmacytoma of bone (SPB) and extramedullary plasmacytoma (EMP) is characterized by infiltrate of plasma cells of diverse maturity and by their monoclonal immunoglobulin products. Both SPB and EMP represent different groups of neoplasm in terms of location, tumor progression, and overall survival rate. There is a need for features that indicate likelihood of myeloma in patients with plasmacytoma without other manifestations. This study was an attempt to study the morphologic patterns of plasmacytoma (SPB and EMP), MIB1 proliferation index, and correlation of these with clinicopathologic features and survival of the patients. The study group comprised of 134 cases of plasmacytoma (88 SPB and 46 EMP) over duration of 8 years and were graded as per Bartl's histologic grading system. Commonest site was vertebral body in SPB (36%) and upper aerodigestive tract in EMP (48%). On serum electrophoresis, overall M band was detected in 41% cases. Both SPB and EMP on histology revealed similar morphologic features. MIB1 proliferation index ranged from less than 1% to 80%. It was slightly higher in EMP in comparison with SPB (P value = .002). Seventy percent of cases, which progressed to multiple myeloma (MM) showed MIB1 labeling index more than 10%; however, it was not statistically significant in predicting the disease progression. With the median follow-up of 19 months (range, 1-99 months), 10 SPB had disease progression of which 7 converted to MM, and 3 developed EMP, with a median interval of 21 months (range, 8-75 months) for the development of MM and 3 months (range, 3-9 months) for the progression to EMP. Five-year survival for EMP varied by site, with poorest survival in brain/central nervous system EMP as compared with EMP at other sites. To conclude, grade and MIB1 proliferation index help in predicting aggressive course in plasmacytoma. PMID:25842207

  12. Penetrating neck injuries: analysis of experience from a Canadian trauma centre

    PubMed Central

    Nason, Richard W.; Assuras, George N.; Gray, Perry R.; Lipschitz, Jeremy; Burns, Charles M.

    2001-01-01

    Objective To study the demographics and treatment outcome of penetrating neck injuries presenting to a major trauma centre in order to develop a treatment protocol. Design A case review. Setting A trauma centre at a tertiary care institution. Patients One hundred and thirty consecutive patients who had 134 neck wounds penetrating the platysma and presented to the trauma service between 1979 and 1997. Intervention Surgical exploration or observation alone. Main outcome measures The location of injury, patient management, number of significant injuries, duration of hospital stay and outcome. Results Injuries were caused by stab wounds in 124 patients (95%) and gunshot wounds in 6 (5%). The location of injury was zone I (lower neck) in 20 cases (15%), zone II (midportion of the neck) in 108 (81%) and zone III (upper neck) in 5 (4%). The location was not recorded in 1 case. Fifty patients were managed by observation alone and 80 were managed surgically. Neck exploration in 48 asymptomatic patients was negative in 32 (67%). Significant injuries, including major vascular (12), nerve (13) and aerodigestive tract (19) injuries, were identified in 34 patients. Two of the 130 patients (1.5%) died of major vascular injuries. Seventy-six percent of significant injuries, including all zone II major vascular injuries, were symptomatic on presentation. The mean (and standard deviation) hospital stay for asymptomatic patients treated with observation alone and surgical exploration was similar (3.5 [6.02] versus 4.3 [5.46] days respectively, p = 0.575). Long-term disability, all neurologic in nature, was documented in 3 patients managed by observation alone and 6 patients managed by surgical exploration. Conclusions Penetrating neck trauma, in particular stab wounds to zone II in asymptomatic patients, is associated with low morbidity and mortality. A selective management protocol with investigations directed by symptoms is the most appropriate approach for the patient population and resource base in this setting. PMID:11308235

  13. Survey of otorhinolaryngologists on their clinical examinations performed in patients with suspected sleep-disordered breathing.

    PubMed

    Plößl, Sebastian; Herzog, Beatrice; Glien, Alexander; Plontke, Stefan; Herzog, Michael

    2016-04-01

    There is currently no standardized ear, nose, and throat (ENT) clinical examination for patients with sleep-disordered breathing (SDB). As a result, there are large inter-individual differences in the examinations due to an inadequate estimation of the relevance of certain anatomic sites. We aimed to identify which examinations/dynamic tests are considered most relevant by German ENT physicians. A questionnaire was designed, evaluating 23 anatomic sites/dynamic tests of the upper aero-digestive tract. The questionnaire was sent to all German ENT departments (n = 153), including universities and other tertiary or secondary referral centers, by postal mail. In addition, almost all private ENT specialists registered with the German professional association (n = 2496) were contacted via e-mail. Participants assessed how often they examined the sites/dynamic tests, subjective importance, and the impact on the therapeutic procedure. A mean score of relevance (mSOR) was generated (minimum score 1; maximum score 75) from these three items. The response rate for hospitals was 58.8 %; while, it was 4.1 % for ENT specialists in private practice. Therefore, the total response rate was 7.3 %. Of the 23 assessed items, some showed a high overall relevance, such as the tonsils (mSOR 64.75), webbing (mSOR 58.14), uvula (mSOR 55.12), or tongue base (mSOR 53.99). Other examinations, such as simulated snoring (mSOR 19.34) or the Mueller maneuver (mSOR 18.98), were estimated as less relevant. Our data reflect the assessment of German otorhinolaryngologists on the clinical examination of SDB patients. The results should be considered as a basis for compiling a standardized procedure. PMID:26298704

  14. Cancer incidence among alcoholic liver disease patients in Finland: A retrospective registry study during years 1996-2013.

    PubMed

    Sahlman, Perttu; Nissinen, Markku; Pukkala, Eero; Färkkilä, Martti

    2016-06-01

    Both alcohol abuse and liver cirrhosis are known risk factors for various cancers. This article was aimed to assess the long-term risk of malignancies among patients with severe alcoholic liver disease (ALD), i.e., alcoholic liver cirrhosis and alcoholic hepatitis. A cohort of 8,796 male and 3,077 female ALD patients from 1996 to 2012 was identified from the Finnish National Hospital Discharge Register. This nationwide cohort was combined with the data from the Finnish Cancer Registry for incidence of malignancies during the years 1996-2013. The cancer cases diagnosed were compared with the number of cancers in the general population. The number of malignancies in our cohort was 1,052 vs. 368 expected. There was statistically significant excess of cancers of the liver, (standardized incidence ratio [SIR] 59.20; 95% CI 53.11-65.61), pancreas (SIR 3.71; 95% CI 2.72-4.94), pharynx (SIR 9.25; 95% CI 6.05-13.56), mouth (SIR 8.31; 95% CI 4.84-13,29), oesophagus (SIR 7.92; 95% CI 5.49-11.07), tongue (SIR 7,21; 95% CI 3.60-12.89), larynx (SIR 5.20; 95% CI 2.77-8.89), lung (SIR 2.77; 95% CI 2.27-3.32), stomach (SIR 2.76; 95% CI 1.79-4.07), kidney (SIR 2.69; 95% CI 1.84-3.79) and colon (SIR 2.33; 95% CI 1.70-3.11). There was no decreased risk of any cancer among ALD patients. Severe ALD is associated with markedly increased risk of malignancies. The risk is especially high for hepatocellular carcinoma, but also significantly increased for cancers of the upper aerodigestive tract, pancreas and kidneys, and warrants cancer surveillance in selected cases. PMID:26756434

  15. Impact of multiple Alcohol Dehydrogenase gene polymorphisms on risk of laryngeal, esophageal, gastric and colorectal cancers in Chinese Han population

    PubMed Central

    An, Jiaze; Zhao, Junsheng; Zhang, Xiyang; Ding, Rui; Geng, Tingting; Feng, Tian; Jin, Tianbo

    2015-01-01

    Alcohol intake is positively associated with the risk of upper aerodigestive tract (UADT) cancers; but its effect on gastric or colorectal cancer is controversial. Previous study had identified several single nucleotide polymorphisms (SNPs) of Alcohol Dehydrogenase (ADH) genes associated with UADT cancers in European and Japanese populations. We sought to determine if these SNPs associated with laryngeal, esophageal, gastric or colorectal cancer in Chinese population. We conducted a case-control study among 1577 cases and 1013 healthy controls from northwest China. Five SNPs associated with UADT cancers risk were selected from previous genome-wide association studies and genotyped using Sequenom Mass-ARRAY technology. Odds ratios and 95% confidence intervals (CIs) were calculated by unconditional logistic regression adjusting for age and gender. We identified that the minor alleles of rs1789924 and rs971074 were associated with decreased risk of laryngeal cancer (OR = 0.311; 95% CI = 0.161-0.602; P < 0.001) and esophagus cancer (OR = 0.711; 95% CI = 0.526-0.962; P = 0.027) in allelic model analysis, respectively. In the genetic model analysis, we found the “C/T” genotype of rs1789924 was associated with decreased laryngeal cancer risk in codominant model (P = 0.046) and overdominant model (P = 0.013); the “C/T-T/T” genotype of rs1789924 was associated with reduced risk of laryngeal cancer under dominant model (P = 0.013). Additionally, none of the SNPs was associated with gastric or colorectal cancer in our study. Our data shed new light on the association between ADH SNPs and respiratory and digestive tract cancers susceptibility in the Han Chinese population. PMID:26396927

  16. Analysis of the Upper Respiratory Tract Microbiotas as the Source of the Lung and Gastric Microbiotas in Healthy Individuals

    PubMed Central

    Bassis, Christine M.; Erb-Downward, John R.; Dickson, Robert P.; Freeman, Christine M.; Schmidt, Thomas M.; Young, Vincent B.; Beck, James M.; Curtis, Jeffrey L.

    2015-01-01

    ABSTRACT No studies have examined the relationships between bacterial communities along sites of the upper aerodigestive tract of an individual subject. Our objective was to perform an intrasubject and intersite analysis to determine the contributions of two upper mucosal sites (mouth and nose) as source communities for the bacterial microbiome of lower sites (lungs and stomach). Oral wash, bronchoalveolar lavage (BAL) fluid, nasal swab, and gastric aspirate samples were collected from 28 healthy subjects. Extensive analysis of controls and serial intrasubject BAL fluid samples demonstrated that sampling of the lungs by bronchoscopy was not confounded by oral microbiome contamination. By quantitative PCR, the oral cavity and stomach contained the highest bacterial signal levels and the nasal cavity and lungs contained much lower levels. Pyrosequencing of 16S rRNA gene amplicon libraries generated from these samples showed that the oral and gastric compartments had the greatest species richness, which was significantly greater in both than the richness measured in the lungs and nasal cavity. The bacterial communities of the lungs were significantly different from those of the mouth, nose, and stomach, while the greatest similarity was between the oral and gastric communities. However, the bacterial communities of healthy lungs shared significant membership with the mouth, but not the nose, and marked subject-subject variation was noted. In summary, microbial immigration from the oral cavity appears to be the significant source of the lung microbiome during health, but unlike the stomach, the lungs exhibit evidence of selective elimination of Prevotella bacteria derived from the upper airways. PMID:25736890

  17. Helical tomotherapy with simultaneous integrated boost dose painting for the treatment of synchronous primary cancers involving the head and neck

    PubMed Central

    Daly, M E; Cui, J; Wooten, H O; Farwell, D G; Purdy, J A

    2014-01-01

    Objective: To demonstrate the feasibility of helical tomotherapy (HT)-based intensity-modulated radiotherapy (IMRT) for the treatment of synchronous primary cancers arising from the head and neck. Methods: 14 consecutive patients with histologically proven squamous cell carcinoma of the head and neck were determined to have a second primary cancer in the upper aerodigestive tract on further evaluation and were treated with HT using simultaneous integrated boost IMRT. Megavoltage CT scans were acquired daily as part of an image-guided registration protocol. Concurrent platinum-based systemic therapy was given to nine patients (64%). Results: HT resulted in durable local control in 21 of the 28 primary disease sites irradiated, including a complete clinical and radiographic response initially observed at 17 of the 20 sites with gross tumour. The mean displacements to account for interfraction motion were 2.44 ± 1.25, 2.92 ± 1.09 and 2.31 ± 1.70 mm for the medial–lateral (ML), superior–inferior (SI) and anteroposterior (AP) directions, respectively. Table shifts of >3 mm occurred in 19%, 20% and 22% of the ML, SI and AP directions, respectively. The 2-year estimates of overall survival, local-regional control and progression-free survival were 58%, 73% and 60%, respectively. Conclusion: The effectiveness of HT for the treatment of synchronous primary cancers of the head and neck was demonstrated. Advances in knowledge: HT is a feasible option for synchronous primary cancers of the head and neck and can result in long-term disease control with acceptable toxicity in appropriately selected patients. PMID:24884726

  18. Association between Socioeconomic Factors and Cancer Risk: A Population Cohort Study in Scotland (1991-2006)

    PubMed Central

    Sharpe, Katharine H.; McMahon, Alex D.; Raab, Gillian M.; Brewster, David H.; Conway, David I.

    2014-01-01

    Background Lung and upper aero-digestive tract (UADT) cancer risk are associated with low socioeconomic circumstances and routinely measured using area socioeconomic indices. We investigated effect of country of birth, marital status, one area deprivation measure and individual socioeconomic variables (economic activity, education, occupational social class, car ownership, household tenure) on risk associated with lung, UADT and all cancer combined (excluding non melanoma skin cancer). Methods We linked Scottish Longitudinal Study and Scottish Cancer Registry to follow 203,658 cohort members aged 15+ years from 1991–2006. Relative risks (RR) were calculated using Poisson regression models by sex offset for person-years of follow-up. Results 21,832 first primary tumours (including 3,505 lung, 1,206 UADT) were diagnosed. Regardless of cancer, economically inactivity (versus activity) was associated with increased risk (male: RR 1.14, 95% CI 1.10–1.18; female: RR 1.06, 95% CI 1.02–1.11). For lung cancer, area deprivation remained significant after full adjustment suggesting the area deprivation cannot be fully explained by individual variables. No or non degree qualification (versus degree) was associated with increased lung risk; likewise for UADT risk (females only). Occupational social class associations were most pronounced and elevated for UADT risk. No car access (versus ownership) was associated with increased risk (excluding all cancer risk, males). Renting (versus home ownership) was associated with increased lung cancer risk, UADT cancer risk (males only) and all cancer risk (females only). Regardless of cancer group, elevated risk was associated with no education and living in deprived areas. Conclusions Different and independent socioeconomic variables are inversely associated with different cancer risks in both sexes; no one socioeconomic variable captures all aspects of socioeconomic circumstances or life course. Association of multiple socioeconomic variables is likely to reflect the complexity and multifaceted nature of deprivation as well as the various roles of these dimensions over the life course. PMID:24586838

  19. Effects of ALDH2 Genotype, PPI Treatment and L-Cysteine on Carcinogenic Acetaldehyde in Gastric Juice and Saliva after Intragastric Alcohol Administration

    PubMed Central

    Maejima, Ryuhei; Iijima, Katsunori; Kaihovaara, Pertti; Hatta, Waku; Koike, Tomoyuki; Imatani, Akira; Shimosegawa, Tooru; Salaspuro, Mikko

    2015-01-01

    Acetaldehyde (ACH) associated with alcoholic beverages is Group 1 carcinogen to humans (IARC/WHO). Aldehyde dehydrogenase (ALDH2), a major ACH eliminating enzyme, is genetically deficient in 30–50% of Eastern Asians. In alcohol drinkers, ALDH2-deficiency is a well-known risk factor for upper aerodigestive tract cancers, i.e., head and neck cancer and esophageal cancer. However, there is only a limited evidence for stomach cancer. In this study we demonstrated for the first time that ALDH2 deficiency results in markedly increased exposure of the gastric mucosa to acetaldehyde after intragastric administration of alcohol. Our finding provides concrete evidence for a causal relationship between acetaldehyde and gastric carcinogenesis. A plausible explanation is the gastric first pass metabolism of ethanol. The gastric mucosa expresses alcohol dehydrogenase (ADH) enzymes catalyzing the oxidation of ethanol to acetaldehyde, especially at the high ethanol concentrations prevailing in the stomach after the consumption of alcoholic beverages. The gastric mucosa also possesses the acetaldehyde-eliminating ALDH2 enzyme. Due to decreased mucosal ALDH2 activity, the elimination of ethanol-derived acetaldehyde is decreased, which results in its accumulation in the gastric juice. We also demonstrate that ALDH2 deficiency, proton pump inhibitor (PPI) treatment, and L-cysteine cause independent changes in gastric juice and salivary acetaldehyde levels, indicating that intragastric acetaldehyde is locally regulated by gastric mucosal ADH and ALDH2 enzymes, and by oral microbes colonizing an achlorhydric stomach. Markedly elevated acetaldehyde levels were also found at low intragastric ethanol concentrations corresponding to the ethanol levels of many foodstuffs, beverages, and dairy products produced by fermentation. A capsule that slowly releases L-cysteine effectively eliminated acetaldehyde from the gastric juice of PPI-treated ALDH2-active and ALDH2-deficient subjects. These results provide entirely novel perspectives for the prevention of gastric cancer, especially in established risk groups. PMID:25831092

  20. Direct and indirect costs of smoking in Vietnam

    PubMed Central

    Hoang Anh, Pham Thi; Thu, Le Thi; Ross, Hana; Quynh Anh, Nguyen; Linh, Bui Ngoc; Minh, Nguyen Thac

    2016-01-01

    Objective To estimate the direct and indirect costs of active smoking in Vietnam. Method A prevalence-based disease-specific cost of illness approach was utilised to calculate the costs related to five smoking-related diseases: lung cancer, cancers of the upper aerodigestive tract, chronic obstructive pulmonary disease, ischaemic heart disease and stroke. Data on healthcare came from an original survey, hospital records and official government statistics. Morbidity and mortality due to smoking combined with the average per capita income were used to calculate the indirect costs of smoking by applying the human capital approach. The smoking-attributable fraction was calculated using the adjusted relative risk values from phase II of the American Cancer Society Cancer Prevention Study (CPS-II). Costs were classified as personal, governmental and health insurance costs. Results The total economic cost of smoking in 2011 was estimated at 24?679.9 billion Vietnamese dong (VND), equivalent to US$1173.2 million or approximately 0.97% of the 2011 gross domestic product. The direct costs of inpatient and outpatient care reached 9896.2 billion VND (US$470.4 million) and 2567.2 billion VND (US$122.0 million), respectively. The government’s contribution to these costs was 4534.3 billion VND (US$215.5 million), which was equivalent to 5.76% of its 2011 healthcare budget. The indirect costs (productivity loss) due to morbidity and mortality were 2652.9 billion VND (US$126.1 million) and 9563.5 billion VND (US$454.6 million), respectively. These indirect costs represent about 49.5% of the total costs of smoking. Conclusions Tobacco consumption has large negative consequences on the Vietnamese economy. PMID:25512430

  1. Lifestyle and cancer: effect of parental divorce.

    PubMed

    Hemminki, Kari; Chen, Bowang

    2006-12-01

    According to previous studies, divorced individuals have increased risks of cancers related to alcohol and tobacco consumption and sexual habits, but the increases are balanced with decreased risks of many common cancers. In the present study, cancer risks were analyzed for 0-70-year-old offspring of divorced parents, on the basis the Swedish Family-Cancer Database with cancer data from the years 1958 to 2002. We calculated standardized incidence ratios for cancer among offspring of divorced parents (19,000 cancer patients) and compared them with offspring of stably married parents (121,000 cancer patients). Standardized incidence ratios were adjusted for many factors, including socio-economic status. Offspring of divorced parents were divided into groups depending on whether their mothers, fathers or both had had children with different partners. Offspring of divorced parents had an increased risk of upper aerodigestive tract, esophageal, anal, pancreatic, lung and cervical cancers. Decreased risks were noted for Hodgkin's disease and bone cancer. For Hodgkin's disease, the data suggest protective effects through early exposure to childhood pathogens but for bone cancer mechanisms remain to be established. The overall cancer risk for offspring of divorced parents was at or above unity. The results show that offspring of divorced parents have increased cancer risks at tobacco-related, alcohol-related and sex-related sites, in analogy to their parent, but they lack decreased risks at common sites, experienced by their parents. Divorce is becoming increasingly common in many countries and any deviant cancer patterns among offspring of divorced parents will have an impact on the population risk. PMID:17106333

  2. Laser resistant stainless steel endotracheal tube: experimental and clinical evaluation.

    PubMed

    Fried, M P; Mallampati, S R; Liu, F C; Kaplan, S; Caminear, D S; Samonte, B R

    1991-01-01

    A fire due to endotracheal tube (ET) ignition is a catastrophic event that may occur during laser surgery of the upper airway, regardless of the wavelength utilized. Although methods exist that permit laser surgery without an ET, this is frequently not feasible. The current investigation was undertaken to evaluate the efficacy of a double-cuffed stainless steel ET, first in the laboratory and subsequently in a clinical setting. Bench testing was performed using CO2 (both standard and milliwatt) and KTP/532 lasers. Only the distal polyvinyl chloride cuffed end of the tube was potentially ignitable, however, the appropriate use of saline to fill the cuffs allowed only for cuff perforation without ignition. Canine testing was performed in 10 animals: 4 dogs were intubated from 3 to 4.5 hours with the laser resistant stainless steel endotracheal tube (LRSS-ET) (Laser-Flex Tracheal Tube; Mallinckrodt Anesthesia Products, St. Louis, MO) and 2 with an aluminum tape wrapped red rubber ET. Visual and histological examination were performed in both groups at 3 and 7 days. Four dogs underwent CO2 laser laryngeal surgery with visual and histological examination performed at 7 days postoperatively. No untoward effects could be demonstrated due to the LRSS-ET. A clinical study was then performed in 24 patients who underwent laser surgery of the upper aerodigestive tract with either a CO2 or KTP/532 laser. In all cases ventilation was adequate, the shaft of the LRSS-ET proved impervious to the laser, and the distal end of the tube protected the tracheobronchial tree safely.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1861569

  3. Effects of the holmium:YAG and erbium:YAG lasers on endotracheal tubes.

    PubMed

    Kautzky, M; Fitzgerald, R; Dechtyar, I; Schenk, P

    1993-01-01

    Endotracheal tube (ET) fire is the most frequent complication arising with laser surgery in the upper aerodigestive tract. No data are available about the safety of commonly used ETs when used with recently developed high-energy pulsed lasers, working with only a minimal thermal component but mainly photoablative. A comparative in vitro study was performed with three types of endotracheal tubes to assess their resistance to wall and cuff damage by the laser beams of two pulsed infrared solid-state lasers. ET perforation was attempted with the erbium:YAG (lambda = 2,930 nm) and holmium:YAG (lambda = 2,120 nm) lasers. For all experiments, a repetition rate of 5 Hz was used. The 2.5-microseconds holmium:YAG pulses were coupled into a nylon fibre of 400 microns diameter. The 2.0-microseconds erbium:YAG laser pulses were applied to ETs through a lens system providing a spot size diameter of 200 microns. Polyvinyl chloride and silicon ET segments were exposed to laser pulse energies from 97 to 500 mJ in the presence of different anaesthetic gas mixtures. The time from the onset of exposure to tube perforation was recorded. Thermal gradients following laser application were measured. Laser exposure was continued for up to 90 s, unless tube ignition occurred. At all energy levels tested, the photo-ablative mechanism of laser-tube interaction, with few thermal components, led to laser-induced tube ignition if an FiO2 > 21% for the holmium:YAG and 34% for the erbium:YAG laser was established. With increasing pulse energies, ET segments ignited sooner. MLT tubes performed best in the present safety test. PMID:8446385

  4. Sexual behaviours and head and neck cancer: A systematic review and meta-analysis.

    PubMed

    Farsi, N J; El-Zein, M; Gaied, H; Lee, Y C A; Hashibe, M; Nicolau, B; Rousseau, M-C

    2015-12-01

    Human papillomaviruses (HPV) are associated with head and neck cancers (H&NC). Transmission of HPV to the upper aerodigestive tract occurs plausibly through sexual contact, although epidemiologic evidence on the role of sexual behaviours in H&NC aetiology is inconsistent. We conducted a meta-analysis of studies examining the association between four indicators of sexual behaviours (number of sexual partners and oral sex partners, oral sex practice, and age at first intercourse) and H&NC. Summary odds ratios (OR) and 95% confidence intervals (CI) were estimated using fixed and random effects models for each indicator, contrasting 'highest' to 'lowest', 'ever' to 'never', or 'youngest' to 'oldest' categories. Twenty case-control studies were included out of 3838 identified publications. Using random effects models, summary ORs suggested an increased risk of H&NC for number of sexual partners [OR=1.29, 95% CI: 1.02-1.63] (19 studies) and number of oral sex partners [OR=1.69, 95% CI: 1.00-2.84] (5 studies), whereas no effect was observed with oral sex practice [OR=1.09, 95% CI: 0.88-1.35] (17 studies) and age at first intercourse [OR=1.40, 95% CI: 0.71-2.79] (6 studies). For number of sexual partners and oral sex practice, which were assessed in more studies, we further excluded studies contributing to heterogeneity and those not adjusted for age, sex, smoking, and alcohol consumption. The summary ORs were 0.95 (95% CI: 0.75-1.20) for number of sexual partners and 1.03 (95% CI: 0.84-1.26) for oral sex practice. Our findings highlight that observed associations might be partly attributed to confounding effects of sociodemographic and behavioural factors. PMID:26372414

  5. Incidence, risk factors and outcome of de novo tumors in liver transplant recipients focusing on alcoholic cirrhosis

    PubMed Central

    Jiménez-Romero, Carlos; Justo-Alonso, Iago; Cambra-Molero, Félix; Calvo-Pulido, Jorge; García-Sesma, Álvaro; Abradelo-Usera, Manuel; Caso-Maestro, Oscar; Manrique-Municio, Alejandro

    2015-01-01

    Orthotopic liver transplantation (OLT) is an established life-saving procedure for alcoholic cirrhotic (AC) patients, but the incidence of de novo tumors ranges between 2.6% and 15.7% and is significantly increased in comparison with patients who undergo OLT for other etiologies. Tobacco, a known carcinogen, has been reported to be between 52% and 83.3% in AC patients before OLT. Other risk factors that contribute to the development of malignancies are dose-dependent immunosuppression, advanced age, viral infections, sun exposure, and premalignant lesions (inflammatory bowel disease, Barrett’s esophagus). A significantly more frequent incidence of upper aerodigestive (UAD) tract, lung, skin, and kidney-bladder tumors has been found in OLT recipients for AC in comparison with other etiologies. Liver transplant recipients who develop de novo non-skin tumors have a decreased long-term survival rate compared with controls. This significantly lower survival rate is more evident in AC recipients who develop UAD tract or lung tumors after OLT mainly because the diagnosis is usually performed at an advanced stage. All transplant candidates, especially AC patients, should be encouraged to cease smoking and alcohol consumption in the pre- and post-OLT periods, use skin protection, avoid sun exposure and over-immunosuppression, and have a yearly otopharyngolaryngeal exploration and chest computed tomography scan in order to prevent or reduce the incidence of de novo malignancies. Although still under investigation, substitution of calcineurin inhibitors for sirolimus or everolimus may reduce the incidence of de novo tumors after OLT. PMID:25954477

  6. Carnosol, a constituent of Zyflamend, inhibits aryl hydrocarbon receptor-mediated activation of CYP1A1 and CYP1B1 transcription and mutagenesis.

    PubMed

    Mohebati, Arash; Guttenplan, Joseph B; Kochhar, Amit; Zhao, Zhong-Lin; Kosinska, Wieslawa; Subbaramaiah, Kotha; Dannenberg, Andrew J

    2012-04-01

    The aryl hydrocarbon receptor (AhR), a ligand-activated member of the basic helix-loop-helix family of transcription factors, plays a significant role in polycyclic aromatic hydrocarbon (PAH)-induced carcinogenesis. In the upper aerodigestive tract of humans, tobacco smoke, a source of PAHs, activates the AhR leading to increased expression of CYP1A1 and CYP1B1, which encode proteins that convert PAHs to genotoxic metabolites. Inhibitors of Hsp90 ATPase cause a rapid decrease in levels of AhR, an Hsp90 client protein, and thereby block PAH-mediated induction of CYP1A1 and CYP1B1. The main objective of this study was to determine whether Zyflamend, a polyherbal preparation, suppressed PAH-mediated induction of CYP1A1 and CYP1B1 and inhibited DNA adduct formation and mutagenesis. We also investigated whether carnosol, one of multiple phenolic antioxidants in Zyflamend, had similar inhibitory effects. Treatment of cell lines derived from oral leukoplakia (MSK-Leuk1) and skin (HaCaT) with benzo[a]pyrene (B[a]P), a prototypic PAH, induced CYP1A1 and CYP1B1 transcription, resulting in enhanced levels of message and protein. Both Zyflamend and carnosol suppressed these effects of B[a]P. Notably, both Zyflamend and carnosol inhibited Hsp90 ATPase activity and caused a rapid reduction in AhR levels. The formation of B[a]P-induced DNA adducts and mutagenesis was also inhibited by Zyflamend and carnosol. Collectively, these results show that Zyflamend and carnosol inhibit Hsp90 ATPase leading to reduced levels of AhR, suppression of B[a]P-mediated induction of CYP1A1 and CYP1B1, and inhibition of mutagenesis. Carnosol-mediated inhibition of Hsp90 ATPase activity can help explain the chemopreventive activity of herbs such as Rosemary, which contain this phenolic antioxidant. PMID:22374940

  7. Suppression of Proinflammatory and Prosurvival Biomarkers in Oral Cancer Patients Consuming a Black Raspberry Phytochemical-Rich Troche.

    PubMed

    Knobloch, Thomas J; Uhrig, Lana K; Pearl, Dennis K; Casto, Bruce C; Warner, Blake M; Clinton, Steven K; Sardo-Molmenti, Christine L; Ferguson, Jeanette M; Daly, Brett T; Riedl, Kenneth; Schwartz, Steven J; Vodovotz, Yael; Buchta, Anthony J; Schuller, David E; Ozer, Enver; Agrawal, Amit; Weghorst, Christopher M

    2016-02-01

    Black raspberries (BRB) demonstrate potent inhibition of aerodigestive tract carcinogenesis in animal models. However, translational clinical trials evaluating the ability of BRB phytochemicals to impact molecular biomarkers in the oral mucosa remain limited. The present phase 0 study addresses a fundamental question for oral cancer food-based prevention: Do BRB phytochemicals successfully reach the targeted oral tissues and reduce proinflammatory and antiapoptotic gene expression profiles? Patients with biopsy-confirmed oral squamous cell carcinomas (OSCC) administered oral troches containing freeze-dried BRB powder from the time of enrollment to the date of curative intent surgery (13.9 ± 1.27 days). Transcriptional biomarkers were evaluated in patient-matched OSCCs and noninvolved high at-risk mucosa (HARM) for BRB-associated changes. Significant expression differences between baseline OSCC and HARM tissues were confirmed using a panel of genes commonly deregulated during oral carcinogenesis. Following BRB troche administration, the expression of prosurvival genes (AURKA, BIRC5, EGFR) and proinflammatory genes (NFKB1, PTGS2) were significantly reduced. There were no BRB-associated grade 3-4 toxicities or adverse events, and 79.2% (N = 30) of patients successfully completed the study with high levels of compliance (97.2%). The BRB phytochemicals cyanidin-3-rutinoside and cyanidin-3-xylosylrutinoside were detected in all OSCC tissues analyzed, demonstrating that bioactive components were successfully reaching targeted OSCC tissues. We confirmed that hallmark antiapoptotic and proinflammatory molecular biomarkers were overexpressed in OSCCs and that their gene expression was significantly reduced following BRB troche administration. As these molecular biomarkers are fundamental to oral carcinogenesis and are modifiable, they may represent emerging biomarkers of molecular efficacy for BRB-mediated oral cancer chemoprevention. Cancer Prev Res; 9(2); 159-71. ©2015 AACR. PMID:26701664

  8. The Case for Requiring Graphic Warning Labels on Smokeless Tobacco Product Packages.

    PubMed

    Pakhale, Smita; Samet, Jonathan; Folan, Patricia; Leone, Frank; White, Alexander

    2016-03-01

    On November 10, 2015, the U.S. Food and Drug Administration approved, for the first time, the sale of smokeless tobacco products authorized under the new premarket tobacco application pathway. This Food and Drug Administration regulatory decision draws attention to the growing worldwide use of smokeless tobacco products in general. Use of these tobacco products is particularly popular in low- and middle-income countries of Asia. Due to aggressive and strategic marketing to children, young adults, and current smokers, rates of smokeless tobacco use in men of all ages are on the rise in United States and elsewhere. The tobacco industry also continues to market these products to current cigarette smokers for use in the growing number of "smoke-free environments." Smokeless tobacco products are associated with cancers of the upper aerodigestive tract, particularly the oral cavity, esophagus, and pancreas; cardiovascular diseases; small-for-gestational-age infants; premature births; increased risk of apnea; and stillbirth. There is no convincing evidence regarding the efficacy of smokeless tobacco, including snus, to promote smoking cessation. Rather, studies from Europe and the United States demonstrate that smokeless tobacco use may facilitate regular cigarette smoking by acting as a gateway drug, especially for children. Caution is warranted before proposing smokeless tobacco as a harm-reduction strategy, in part because of the potential for further promoting smokeless tobacco in low- and middle-income countries where use is already widespread. Continued vigilance through comprehensive surveillance is warranted. We strongly recommend the use of graphic warning labels as a "no regrets" strategy for all smokeless tobacco products marketed globally. PMID:26784741

  9. The association between gastrostomy tube placement, poor post-operative outcomes, and hospital re-admissions in head and neck cancer patients?

    PubMed Central

    Mays, Ashley C.; Worley, Mitchell; Ackall, Feras; D'Agostino, Ralph; Waltonen, Joshua D.

    2015-01-01

    Objectives Investigate the relationship of G-tube placement timing on post-operative outcomes. Participants 908 patients underwent resection of head and neck upper aerodigestive tract tumors between 2007 and 2013. Patient charts were retrospectively screened for patient demographics, pre-operative nutrition variables, co-morbid conditions, Tumor-Node-Metastasis staging, surgical treatment type, and timing of G-tube placement. Exclusionary criteria included death within the first three months of the resection and resections performed solely for nodal disease. Main Outcomes Post-surgical outcomes, including wound and medical complications, hospital re-admissions, length of inpatient hospital stay (LOS), intensive care unit (ICU) time. Results 793 surgeries were included: 8% of patients had G-tubes pre-operatively and 25% had G-tubes placed post-operatively. Patients with G-tubes (pre-operative or post-operative) were more likely to have complications and prolonged hospital care as compared to those without G-tubes (p < 0.001). Patients with pre-operative G-tubes had shortened length of stay (p = 0.007), less weight loss (p = 0.03), and fewer wound care needs (p < 0.0001), when compared to those that received G-tubes post-operatively. Those with G-tubes placed post-operatively had worse outcomes in all categories, except pre-operative BMI. Conclusions Though having enteral access in the form of a G-tube at any point suggests a more high risk patient, having a G-tube placed in the pre-operative period may protect against poor post-operative outcomes. Post-operative outcomes can be predicted based on patient characteristics available to the physician in the pre-operative period. PMID:26321115

  10. Physiology of esophageal sensorimotor malfunctions in neonatal neurological illness

    PubMed Central

    Chan, Chin Yee; Moore, Rebecca; Fernandez, Soledad; Shaker, Reza

    2013-01-01

    We aimed to define the sensorimotor characteristics of aero-digestive reflexes evoked upon midesophageal provocations in neuropathology infants. Provocative esophageal motility testing was performed in 20 neuropathology infants and 10 controls at 42.3 ± 0.6 and 38.9 ± 0.9 wk postmenstrual age. Data from 1,073 infusions were examined for the sensory thresholds, response frequencies, response magnitude of upper esophageal sphincter (UES) contractile reflexes, lower esophageal sphincter (LES) relaxation reflexes, and peristaltic reflexes using mixed statistical models. Threshold volumes for air and liquid in neuropathology and control infants were similar for all reflexes. Graded air- and liquid volume-dependent UES contractile reflex, LES relaxation reflex, and peristaltic reflex frequency recruitment were present in neuropathology and control subjects for the media (P < 0.0001) and the reflexes (P < 0.0001). In neuropathology infants (vs. controls), UES contractile magnitude is higher (P < 0.0001); LES relaxation reflex occurred earlier (P = 0.008); LES nadir duration lasted longer (P = 0.006); secondary peristalsis is the chief method of esophageal clearance (P < 0.0001); pharyngeal swallows and deglutition apneas are less frequent (P = 0.001); proximal, midesophageal waveform magnitudes and duration are exaggerated (P < 0.008). UES contractile reflex was longer with liquid than air in both groups (P = 0.03). We concluded that 1) perception to midesophageal provocation remains preserved in neuropathology neonates; 2) sustained and exaggerated myogenic response from afferent activation is evident by increased excitatory efferent outputs to the UES and esophageal body and increased inhibitory efferent outputs to the LES; 3) dysfunctional regulation of pharyngeal swallowing and infrequent deglutition responses indicate the possibility of impaired descending modulation and central malfunctions of brainstem and vagal nuclei. PMID:23328206

  11. Delineating Metabolic Signatures of Head and Neck Squamous Cell Carcinoma: Phospholipase A2, a Potential Therapeutic Target

    PubMed Central

    Tripathi, Pratima; Kamarajan, Pachiyappan; Somashekar, Bagganahalli S.; MacKinnon, Neil; Chinnaiyan, Arul M.; Kapila, Yvonne L.; Rajendiran, Thekkelnaycke M.; Ramamoorthy, Ayyalusamy

    2012-01-01

    A better understanding of molecular pathways involved in malignant transformation of head and neck squamous cell carcinoma (HNSCC) is essential for the development of novel and efficient anti-cancer drugs. To delineate the global metabolism of HNSCC, we report 1H NMR-based metabolic profiling of HNSCC cells from five different patients that were derived from various sites of the upper aerodigestive tract, including the floor of mouth, tongue and larynx. Primary cultures of normal human oral keratinocytes (NHOK) from three different donors were used for comparison. 1H NMR spectra of polar and non-polar extracts of cells were used to identify more than thirty-five metabolites. Principal component analysis performed on the NMR data revealed a clear classification of NHOK and HNSCC cells. HNSCC cells exhibited significantly altered levels of various metabolites that clearly revealed dysregulation in multiple metabolic events, including Warburg effect, oxidative phosphorylation, energy metabolism, TCA cycle anaplerotic flux, glutaminolysis, hexosamine pathway, osmo-regulatory and anti-oxidant mechanism. In addition, significant alterations in the ratios of phosphatidylcholine/lysophosphatidylcholine and phosphocholine/glycerophosphocholine, and elevated arachidonic acid observed in HNSCC cells reveal an altered membrane choline phospholipid metabolism (MCPM). Furthermore, significantly increased activity of phospholipase A2 (PLA2), particularly cytosolic PLA2 (cPLA2) observed in all the HNSCC cells confirm an altered MCPM. In summary, the metabolomic findings presented here can be useful to further elucidate the biological aspects that lead to HNSCC, and also provide a rational basis for monitoring molecular mechanisms in response to chemotherapy. Moreover, cPLA2 may serve as a potential therapeutic target for anti-cancer therapy of HNSCC. PMID:22743333

  12. Combination of Anti-IGF-1R Antibody A12 and Ionizing Radiation in Upper Respiratory Tract Cancers

    SciTech Connect

    Riesterer, Oliver; Yang Qiuan; Raju, Uma; Torres, Mylin; Molkentine, David; Patel, Nalini; Valdecanas, David; Milas, Luka; Ang, K. Kian

    2011-03-15

    Purpose: The IGF1/IGF-1R signaling pathway has emerged as a potential determinant of radiation resistance in human cancer cell lines. Therefore we investigated the potency of monoclonal anti-IGF-1R antibody, A12, to enhance radiation response in upper respiratory tract cancers. Methods and Materials: Cell lines were assessed for IGF-1R expression and IGF1-dependent response to A12 or radiation using viability and clonogenic cancer cell survival assays. In vivo response of tumor xenografts to 10 or 20 Gy and A12 (0.25-2 mg x 3) was assessed using growth delay assays. Combined treatment effects were also analyzed by immunohistochemical assays for tumor cell proliferation, apoptosis, necrosis, and vascular endothelial growth factor expression at Days 1 and 6 after start of treatment. Results: A12 enhanced the radiosensitivity of HN5 and FaDu head-and-neck carcinomas in vitro (p < 0.05) and amplified the radioresponse of FaDu xenografts in a dose-dependent manner, with enhancement factors ranging from 1.2 to 1.8 (p < 0.01). Immunohistochemical analysis of FaDu xenografts demonstrated that A12 inhibited tumor cell proliferation (p < 0.05) and vascular endothelial growth factor expression. When A12 was combined with radiation, this resulted in apoptosis induction that persisted until 6 days from the start of treatment and in increased necrosis at Day 1 (p < 0.01, respectively). Combined treatment with A12 and radiation resulted in additive or subadditive growth delay in H460 or A549 xenografts, respectively. Conclusions: The results of this study strengthen the evidence for investigating how anti-IGF-1R strategies can be integrated into radiation and radiation-cetuximab regimen in the treatment of cancer of the upper aerodigestive tract cancers.

  13. Curcumin inhibits carcinogen and nicotine-induced Mammalian target of rapamycin pathway activation in head and neck squamous cell carcinoma.

    PubMed

    Clark, Cheryl A; McEachern, Matthew D; Shah, Shivang H; Rong, Youhua; Rong, Xiaohua; Smelley, Christopher L; Caldito, Gloria C; Abreo, Fleurette W; Nathan, C O

    2010-12-01

    Curcumin appears to be a safe, bioactive food compound that is a potential chemopreventive for patients at a high risk for head and neck squamous cell carcinoma (HNSCC). Identification and validation of intermediate endpoints is an important step in evaluating chemopreventive agents. AKT/MTOR pathway biomarkers are intrinsic to the carcinogenic process as well as the mechanism of intervention with curcumin. Antiproliferative effects of curcumin were assayed in 9 HNSCC and a keratinocyte cell line. Nicotine, a genotoxic alkaloid involved in tobacco addiction, forms DNA adducts and has been implicated in upper aerodigestive tract cancer promotion. The antiproliferative effects of curcumin were associated with inhibition of the AKT/MTOR pathway in presence and absence of nicotine, which also induced this pathway. Curcumin was highly effective at suppressing growth of SCC40 xenografts and its activity is associated with modulation of MTOR's downstream target pS6. Curcumin at 15 mg significantly increased survival (286 ± 37 vs. 350 days) in the 4NQO carcinogenic model survival study. A major cause of lethal progression of HNSCC is local regional migration and invasion of malignant cells, and curcumin significantly inhibited cancer cell migration and invasion in vitro and in vivo where downregulation of pS6 was associated with a significant decrease in MMP-9. This is the first study to demonstrate that curcumin inhibits the adverse effects of nicotine by blocking nicotine-induced activation of the AKT/MTOR pathway in HNSCC, which retards cell migration. These studies indicate that inhibiting the AKT/MTOR pathway with curcumin may be useful as an oral chemopreventive agent. PMID:20851953

  14. Cannabinoids and cancer: causation, remediation, and palliation.

    PubMed

    Hall, Wayne; Christie, MacDonald; Currow, David

    2005-01-01

    This review discusses three different associations between cannabinoids and cancer. First, it assesses evidence that smoking of cannabis preparations may cause cancers of the aerodigestive and respiratory system. There have been case reports of upper-respiratory-tract cancers in young adults who smoke cannabis, but evidence from a few epidemiological cohort studies and case-control studies is inconsistent. Second, there is mixed evidence on the effects of THC and other cannabinoids on cancers: in some in vitro and in vivo studies THC and some synthetic cannabinoids have had antineoplastic effects, but in other studies THC seems to impair the immune response to cancer. As yet there is no evidence that THC or other cannabinoids have anticancer effects in humans. Third, Delta(9)-tetrahydrocannabinol (THC) may treat the symptoms and side-effects of cancer, and there is evidence that it and other cannabinoids may be useful adjuvant treatments that improve appetite, reduce nausea and vomiting, and alleviate moderate neuropathic pain in patients with cancer. The main challenge for the medical use of cannabinoids is the development of safe and effective methods of use that lead to therapeutic effects but that avoid adverse psychoactive effects. Furthermore, medical, legal, and regulatory obstacles hinder the smoking of cannabis for medical purposes. These very different uses of cannabinoids are in danger of being confused in public debate, especially in the USA where some advocates for the medical use of cannabinoids have argued for smoked cannabis rather than pharmaceutical cannabinoids. We review the available evidence on these three issues and consider their implications for policy. PMID:15629274

  15. Follow up study of moderate alcohol intake and mortality among middle aged men in Shanghai, China.

    PubMed Central

    Yuan, J. M.; Ross, R. K.; Gao, Y. T.; Henderson, B. E.; Yu, M. C.

    1997-01-01

    OBJECTIVE: To assess the risk of death associated with various patterns of alcohol intake. DESIGN: Prospective study of mortality in relation to alcohol consumption at recruitment, with active annual follow up. SETTING: Four small, geographically defined communities in Shanghai, China. SUBJECTS: 18,244 men aged 45-64 years enrolled in a prospective study of diet and cancer during January 1986 to September 1989. MAIN OUTCOME MEASURE: All cause mortality. RESULTS: By 28 February 1995, 1198 deaths (including 498 from cancer, 269 from stroke, and 104 from ischaemic heart disease) had been identified. Compared with lifelong non-drinkers, those who consumed 1-14 drinks a week had a 19% reduction in overall mortality (relative risk 0.81; 95% confidence interval 0.70 to 0.94) after age, level of education, and cigarette smoking were adjusted for. This protective effect was not restricted to any specific type of alcoholic drink. Although light to moderate drinking (28 or fewer drinks per week) was associated with a 36% reduction in death from ischaemic heart disease (0.64; 0.41 to 0.998), it had no effect on death from stroke, which is the leading cause of death in this population. As expected, heavy drinking (29 or more drinks per week) was significantly associated with increased risks of death from cancer of the upper aerodigestive tract, hepatic cirrhosis, and stroke. CONCLUSIONS: Regular consumption of small amounts of alcohol is associated with lower overall mortality including death from ischaemic heart disease in middle aged Chinese men. The type of alcoholic drink does not affect this association. PMID:9001474

  16. Human papillomavirus type 16 E6 activates NF-kappaB, induces cIAP-2 expression, and protects against apoptosis in a PDZ binding motif-dependent manner.

    PubMed

    James, Michael A; Lee, John H; Klingelhutz, Aloysius J

    2006-06-01

    Infection with human papillomavirus (HPV) is a critical factor in the pathogenesis of most cervical cancers and some aerodigestive cancers. The HPV E6 oncoprotein from high-risk HPV types contributes to the immortalization and transformation of cells by multiple mechanisms, including degradation of p53, transcriptional activation of human telomerase reverse transcriptase (hTERT), and degradation of several proteins containing PDZ domains. The ability of E6 to bind PDZ domain-containing proteins is independent of p53 degradation or hTERT activation but does correlate with oncogenic potential (R. A. Watson, M. Thomas, L. Banks, and S. Roberts, J. Cell Sci. 116:4925-4934, 2003) and is essential for induction of epithelial hyperplasia in vivo (M. L. Nguyen, M. M. Nguyen, D. Lee, A. E. Griep, and P. F. Lambert, J. Virol. 77:6957-6964, 2003). In this study, we found that HPV type 16 E6 was able to activate NF-kappaB in airway epithelial cells through the induction of nuclear binding activity of p52-containing NF-kappaB complexes in a PDZ binding motif-dependent manner. Transcript accumulation for the NF-kappaB-responsive antiapoptotic gene encoding cIAP-2 and binding of nuclear factors to the proximal NF-kappaB binding site of the cIAP-2 gene promoter are induced by E6 expression. Furthermore, E6 is able to protect cells from TNF-induced apoptosis. All of these E6-dependent phenotypes are dependent on the presence of the PDZ binding motif of E6. Our results imply a role for targeting of PDZ proteins by E6 in NF-kappaB activation and protection from apoptosis in airway epithelial cells. PMID:16699010

  17. Scintigraphy in laryngopharyngeal and gastroesophageal reflux disease: A definitive diagnostic test?

    PubMed Central

    Falk, Gregory L; Beattie, John; Ing, Alvin; Falk, SE; Magee, Michael; Burton, Leticia; Van der Wall, Hans

    2015-01-01

    AIM: To investigate the utility of scintigraphic studies in predicting response to laparoscopic fundoplication (LF) for chronic laryngopharyngeal reflux symptoms. METHODS: Patients with upper aero-digestive symptoms that remained undiagnosed after a period of 2 mo were studied with conventional pH and manometric studies. Patients mainly complained of cough, sore throat, dysphonia and globus. These patients were imaged after ingestion of 99m-technetium diethylene triamine pentaacetic acid. Studies were quantified with time activity curves over the pharynx, upper and lower oesophagus and background. Late studies of the lungs were obtained for aspiration. Patients underwent LF with post-operative review at 3 mo after surgery. RESULTS: Thirty four patients (20 F, 14 M) with an average age of 57 years and average duration of symptoms of 4.8 years were studied. Twenty four hour pH and manometry studies were abnormal in all patients. On scintigraphy, 27/34 patients demonstrated pharyngeal contamination and a rising or flat pharyngeal curve. Lung aspiration was evident in 50% of patients. There was evidence of pulmonary aspiration in 17 of 34 patients in the delayed study (50%). Pharyngeal contamination was found in 27 patients. All patients with aspiration showed pharyngeal contamination. In the 17 patients with aspiration, graphical time activity curve showed rising activity in the pharynx in 9 patients and a flat curve in 8 patients. In those 17 patients without pulmonary aspiration, 29% (5 patients) had either a rising or flat pharyngeal graph. A rising or flat curve predicted aspiration with a positive predictive value of 77% and a negative predictive value of 100%. Over 90% of patients reported a satisfactory symptomatic response to LF with an acceptable side-effect profile. CONCLUSION: Scintigraphic reflux studies offer a good screening tool for pharyngeal contamination and aspiration in patients with gastroesophageal reflux disease. PMID:25834329

  18. Nasopharyngeal alveolar rhabdomyosarcoma expressing CD56: a mimicker of extranodal natural killer/T-cell lymphoma.

    PubMed

    Win, Khin Than; Lee, Ming-Yuan; Tan, Tran-Der; Tsai, Mung-pei; Bahrami, Armita; Raimondi, Susana C; Chuang, Shih-Sung

    2014-01-01

    Alveolar rhabdomyosarcoma (ARMS) is remarkably rare in adults older than 45 years. Histologically, the tumor is composed of blue round cells with frequent expression of CD56 in addition to myogenic markers. Recent studies of ARMS have shown two specific recurrent translocations: PAX3-FKHR [t(2;13)(q35;q14)] or PAX7-FKHR [t(1;13)(p36;q14)]. Extranodal natural killer (NK)/T-cell lymphoma (ENKTL) occurs most frequently in the upper aerodigestive tract with a male preference in East Asia and Central and South Americas with neoplastic cells frequently expressing CD56. We report a 53-year-old Taiwanese man presenting with a nasopharyngeal mass, cervical lymphadenopathy, and multiple bone metastases. Histologically, the nasopharyngeal biopsy revealed diffuse sheets of small blue round tumor cells without obvious alveolar pattern, angioinvasion or tumor necrosis. An initial erroneous diagnosis of ENKTL was made due to CD56 expression using fresh tumor tissue with flow cytometric analysis and the patient was treated accordingly. Retrospective study showed that the tumor cells expressed CD56, desmin, and myogenin. Fluorescence in situ hybridization revealed that the tumor cells were positive for FKHR gene rearrangement, confirming the diagnosis of ARMS. Our case illustrates that a diagnosis of ENKTL based solely on CD56 expression can be misleading for a nasopharyngeal small blue round cell tumor. ARMS should be included as a differential diagnosis, and a correct diagnosis can be reached only after a high index of suspicion and a thorough histological examination with the aid of ancillary studies. PMID:24427371

  19. Age-related differences in human palatine tonsillar B cell subsets and immunoglobulin isotypes.

    PubMed

    Lee, Jino; Chang, Dong-Yeop; Kim, Sang-Wook; Choi, Yoon Seok; Jeon, Sea-Yuong; Racanelli, Vito; Kim, Dae Woo; Shin, Eui-Cheol

    2016-02-01

    The tonsils provide defense of the upper aerodigestive tract against pathogens. Although long known to undergo functional changes with age, the precise changes occurring within tonsillar B cell populations remain undefined. In the present study, we investigated age-related changes in palatine tonsillar B cell subsets and immunoglobulin (Ig) isotypes. Palatine tonsils were obtained from forty-two tonsillectomy patients without tonsillitis who were divided into three groups: young children (4-9 years), adolescents (10-19 years), and adults (20-60 years). Tonsillar B cells were then analyzed by flow cytometry. Using expression of CD38 and IgD to define B cell subsets, we found that the frequency of germinal center (GC) B cells in the tonsils was significantly higher, and the frequency of memory B cells lower, in young children as compared to adolescents and adults. Within the GC B cell subsets, adults had a higher frequency of IgA(+) cells and a lower frequency of IgM(+) cells as compared to individuals in the younger age groups. Moreover, young children had a higher frequency of IgG(+) cells in the GC B cell subsets than did individuals in the older age groups. We also observed an abundance of IgM(+) cells among memory B cells and plasmablasts in young children and IgA(+) cells in adults. In summary, the proportion of GC B cells in palatine tonsillar B cells decreases with age, while the proportion of memory B cells increases with age. In addition, Ig isotypes in tonsils preferentially switch from IgM to IgA as individuals age. PMID:25618165

  20. Socioeconomic inequalities in alcohol related cancer mortality among men: to what extent do they differ between Western European populations?

    PubMed Central

    Menvielle, Gwenn; Kunst, Anton E.; Stirbu, Irina; Borrell, Carme; Bopp, Matthias; Regidor, Enrique; Heine Strand, Bjørn; Deboosere, Patrick; Lundberg, Olle; Leclerc, Annette; Costa, Giuseppe; Chastang, Jean-Francois; Esnaola, Santiago;