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Sample records for 2nd european rectal

  1. Conference Proceedings: 2nd European Conference of Rehabilitation International; Disability in the Family. (Brighton, England, September 18-21, 1978)

    ERIC Educational Resources Information Center

    Royal Association for Disability and Rehabilitation, London (England).

    The conference proceedings of the 2nd European Conference of Rehabilitation International (1978) on the theme disability in the family contains the agenda and approximately 80 papers. National presentations consider the theme in papers by representatives of Finland, Hungary, Belgium, The Netherlands, Portugal, Hong Kong, India, The German…

  2. European Software Engineering Process Group Conference (2nd Annual), EUROPEAN SEPG󈨥. Delegate Material, Tutorials

    DTIC Science & Technology

    1997-06-17

    improvements European SEPG 1997 - Measurement Symposium [-chumer ier i Schtumberger Retail Petroleum Systems e Capture definitions, assumptions and 0 models ...Yellow Technology 񓃅 systems , 13,000 modules, I5MLOC "Analysis took 10 people 3 months "*The total estimate is 150 to 200 programmer years c • S...fml7 e Mt~ e .. , ~ Th. Ye A ’• P Some Examples - 2 A Cap Gemini study of 3 organizations *financial services -40 systems -6.5 MLOC -89,535 dates to

  3. [In search of the ideal surgical treatment for lymphedema. Report of 2nd European Conference on supermicrosurgery (Barcelona - March 2012)].

    PubMed

    Rausky, J; Robert, N; Binder, J-P; Revol, M

    2012-12-01

    Since more than 50 years, many surgeons all around the world try to find the perfect surgical technique to treat limb lymphedemas. Decongestive physiotherapy associated with the use of a compressive garment has been the primary choice for lymphedema treatment. Many different surgical techniques have been developed, however, to date, there is no consensus on surgical procedure. Most surgical experts of lymphedema met in the second European Conference on supermicrosurgery, organized on March 1st and 2nd 2012, in San Pau Hospital, Barcelona. Together they tried to clarify these different options and ideally a strategy for using these techniques.

  4. Report on the 2nd European conference on computer-aided design (CAD) in small- and medium-size industries (MICAD 82)

    SciTech Connect

    Magnuson, W.G. Jr.

    1982-10-01

    A summary is presented of the 2nd European conference on computer aided design (CAD) in small- and medium-size industries (MICAD82) held in Paris, France, September 21-23, 1982. The conference emphasized applications of CAD in industries with limited investment resources and which are forced to innovate in order to sustain competition.

  5. [JAN JĘDRZEJEWICZ AND EUROPEAN ASTRONOMY OF THE 2ND HALF OF THE 19TH CENTURY].

    PubMed

    Siuda-Bochenek, Magda

    2015-01-01

    Jan Jędrzejewicz was an amateur astronomer who in the 2nd half of the 19th century created an observation centre, which considering the level of research was comparable to the European ones. Jędrzejewicz settled down in Plonsk in 1862 and worked as a doctor ever since but his greatest passion was astronomy, to which he dedicated all his free time. In 1875 Jędrzejewicz finished the construction of his observatory. He equipped it with basic astronomical and meteorological instruments, then began his observations and with time he became quite skilled in it. Jędrzejewicz focused mainly on binary stars but he also pointed his telescopes at the planets of the solar system, the comets, the Sun, as well as all the phenomena appearing in the sky at that time. Thanks to the variety of the objects observed and the number of observations he stood out from other observers in Poland and took a very good position in the mainstream of the 19th-century astronomy in Europe. Micrometer observations of binary stars made in Płońsk gained recognition in the West and were included in the catalogues of binary stars. Interest in Jędrzejewicz and his observatory was confirmed by numerous references in the English "Nature" magazine.

  6. EDITORIAL: Selected Papers from OMS'07, the 2nd Topical Meeting of the European Optical Society on Optical Microsystems (OMS)

    NASA Astrophysics Data System (ADS)

    Rendina, Ivo; Fazio, Eugenio; Ferraro, Pietro

    2008-06-01

    OMS'07 was the 2nd Topical Meeting of the European Optical Society (EOS) on Optical Microsystems (OMS). It was organized by the EOS in the frame of its international topical meeting activity, and after the success of the inaugural meeting was once again held in Italy, 30 September to 3 October 2007, amidst the wonderful scenery of the Island of Capri. The local organizing committee was composed of researchers from `La Sapienza' University in Rome and the National Council of Research (CNR) in Naples, Italy. A selected group of leading scientists in the field formed the international scientific committee. The conference was fully dedicated to the most recent advancements carried out in the field of optical microsystems. More then 150 scientists coming from five continents attended the conference and more than 100 papers were presented, organized into the following sessions: Photonic cystals and metamaterials Optofluidic microsystems and devices Optical microsystems and devices New characterization methods for materials and devices Application of optical systems Optical sources and photodetectors Optical resonators Nonlinear optic devices Micro-optical devices. Four keynote lecturers were invited for the Plenary sessions: Federico Capasso, Harvard University, USA; Bahram Javidi, University of Connecticut, USA (Distinguished Lecturer, Emeritus of LEOS--IEEE Society); Demetri Psaltis, EPFL, Lausanne, Switzerland; Ammon Yariv, California Institute of Technology, USA. Furthermore, 21 invited speakers opened each session of the conference with their talks. In addition a special session was organized to celebrate eighty years of the Isituto Nazionale di Ottica Applicata (INOA) of CNR. The special invited speaker for this session was Professor Theodor W Hänsch (Nobel Prize in Physics, 2005), who gave a lecture entitled `What can we do with optical frequency combs?' In this special issue of Journal of Optics A: Pure and Applied Optics, a selection of the most interesting

  7. Proceedings of the European Seminar on Industrial Software Engineering (2nd) Held in Freiburg (Germany, F.R.) on 9-10 May 1985,

    DTIC Science & Technology

    1985-05-10

    ACCESS TO INDIVIDUALLY AUTHORED SECTIONS OF PROCEEDING, ANNALS, SYMPOSIA, ETC. HOWEVER, THE COMPONENT SHOULD BE CONSIDERED WITHIN THE CONTEXT OF THE...REPORT SECURITY CLASSIFICATIONl b. RESTRICTIVE MARKINGS.. J/-, Unclassified WI4" . J/ IS’r 2a. SECURITY CLASSIFICATION AUTHORITY 3. DISTRIBUTION...Classification) (U) Proceedings of the Second European Seminar on Industrial Software Engineering 12. PERSONAL AUTHOR (S)IA. Ba zert .M . Jackson, P

  8. 2nd Generation ELT Performance Specification Development

    NASA Technical Reports Server (NTRS)

    Stimson, Chad M.

    2015-01-01

    NASA Search And Rescue is supporting RTCA SC-229 with research and recommendations for performance specifications for the 2nd generation of emergency locator transmitters. Areas for improvement and methods for collecting data will be presented.

  9. Education and Modernization: the European Experience. The "Intensive Course," Erasmus Strand III in Theory and History of Education and Comparative Education (2nd, Gazzada, Italy, March 15-27, 1993).

    ERIC Educational Resources Information Center

    Kruithof, Bernard, Ed.; Sting, Stephan, Ed.

    The articles presented in this document provide a framework for examining concepts of educational modernization in Europe. The document is organized into three parts. Part 1 "European Perspectives" includes: (1) What Is Implied by a "European curriculum"? Issues of Eurocentrism, Rationality, and Education (Sven Erik Nordenbo);…

  10. Education and Modernization: the European Experience. The "Intensive Course," Erasmus Strand III in Theory and History of Education and Comparative Education (2nd, Gazzada, Italy, March 15-27, 1993).

    ERIC Educational Resources Information Center

    Kruithof, Bernard, Ed.; Sting, Stephan, Ed.

    The articles presented in this document provide a framework for examining concepts of educational modernization in Europe. The document is organized into three parts. Part 1 "European Perspectives" includes: (1) What Is Implied by a "European curriculum"? Issues of Eurocentrism, Rationality, and Education (Sven Erik Nordenbo);…

  11. PIRLS 2016 Assessment Framework. 2nd Edition

    ERIC Educational Resources Information Center

    Mullis, Ina V. S., Ed.; Martin, Michael O., Ed.

    2015-01-01

    The "PIRLS 2016 Assessment Framework, 2nd Edition" provides the foundation for the three international assessments planned as part of the International Association for the Evaluation of Educational Achievement's Progress in International Reading Literacy Study (PIRLS) 2016: PIRLS, PIRLS Literacy, and ePIRLS. PIRLS represents the…

  12. Subtypes of fruit and vegetables, variety in consumption and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition.

    PubMed

    Leenders, Max; Siersema, Peter D; Overvad, Kim; Tjønneland, Anne; Olsen, Anja; Boutron-Ruault, Marie-Christine; Bastide, Nadia; Fagherazzi, Guy; Katzke, Verena; Kühn, Tilman; Boeing, Heiner; Aleksandrova, Krasimira; Trichopoulou, Antonia; Lagiou, Pagona; Klinaki, Eleni; Masala, Giovanna; Grioni, Sara; Santucci De Magistris, Maria; Tumino, Rosario; Ricceri, Fulvio; Peeters, Petra H M; Lund, Eiliv; Skeie, Guri; Weiderpass, Elisabete; Quirós, J Ramón; Agudo, Antonio; Sánchez, María-José; Dorronsoro, Miren; Navarro, Carmen; Ardanaz, Eva; Ohlsson, Bodil; Jirström, Karin; Van Guelpen, Bethany; Wennberg, Maria; Khaw, Kay-Tee; Wareham, Nick; Key, Timothy J; Romieu, Isabelle; Huybrechts, Inge; Cross, Amanda J; Murphy, Neil; Riboli, Elio; Bueno-de-Mesquita, H Bas

    2015-12-01

    Previously, a lower risk of colorectal cancer was observed with fruit and vegetable consumption in the European Prospective Investigation into Cancer and Nutrition within a follow-up period of 9 years which was not fully supported by a recent meta-analysis. Therefore, we were interested in the relation with extended follow-up, also focusing on single subtypes and a variety of intake of fruit and vegetables. Fruit and vegetable consumption was assessed at baseline. After an average of 13 years of follow-up, 3,370 participants were diagnosed with colon or rectal cancer. Diet diversity scores were constructed to quantify variety in fruit and vegetable consumption. A lower risk of colon cancer was observed with higher self-reported consumption of fruit and vegetable combined (HR Q4 vs. Q1 0.87, 95% CI 0.75-1.01, p for trend 0.02), but no consistent association was observed for separate consumption of fruits and vegetables. No associations with risk of rectal cancer were observed. The few observed associations for some fruit and vegetable subtypes with colon cancer risk may have been due to chance. Variety in consumption of fruits and vegetables was not associated with a lower risk of colon or rectal cancer. Although a lower risk of colon cancer is suggested with high consumption of fruit and vegetables, this study does not support a clear inverse association between fruit and vegetable consumption and colon or rectal cancer beyond a follow-up of more than 10 years. Attenuation of the risk estimates from dietary changes over time cannot be excluded, but appears unlikely. © 2015 UICC.

  13. Medical museum, 2nd surgical hospital.

    PubMed

    Hawk, Alan J

    2013-12-01

    When his unit, the 2nd Surgical Hospital (MA), was established at An Khe in January 1966, MAJ Rich began collecting retrieved foreign bodies along with documentation of the wound. A museum displaying these objects was established at one end of the operating room Quonset hut. During Rich's tour of duty, there were 324 cases where the patient was wounded by a punji stick, representing 38% wounds because of hostile action.

  14. 2nd & 3rd Generation Vehicle Subsystems

    NASA Technical Reports Server (NTRS)

    2000-01-01

    This paper contains viewgraph presentation on the "2nd & 3rd Generation Vehicle Subsystems" project. The objective behind this project is to design, develop and test advanced avionics, power systems, power control and distribution components and subsystems for insertion into a highly reliable and low-cost system for a Reusable Launch Vehicles (RLV). The project is divided into two sections: 3rd Generation Vehicle Subsystems and 2nd Generation Vehicle Subsystems. The following topics are discussed under the first section, 3rd Generation Vehicle Subsystems: supporting the NASA RLV program; high-performance guidance & control adaptation for future RLVs; Evolvable Hardware (EHW) for 3rd generation avionics description; Scaleable, Fault-tolerant Intelligent Network or X(trans)ducers (SFINIX); advance electric actuation devices and subsystem technology; hybrid power sources and regeneration technology for electric actuators; and intelligent internal thermal control. Topics discussed in the 2nd Generation Vehicle Subsystems program include: design, development and test of a robust, low-maintenance avionics with no active cooling requirements and autonomous rendezvous and docking systems; design and development of a low maintenance, high reliability, intelligent power systems (fuel cells and battery); and design of a low cost, low maintenance high horsepower actuation systems (actuators).

  15. 2nd Generation RLV Risk Definition Program

    NASA Technical Reports Server (NTRS)

    Davis, Robert M.; Stucker, Mark (Technical Monitor)

    2000-01-01

    The 2nd Generation RLV Risk Reduction Mid-Term Report summarizes the status of Kelly Space & Technology's activities during the first two and one half months of the program. This report was presented to the cognoscente Contracting Officer's Technical Representative (COTR) and selected Marshall Space Flight Center staff members on 26 September 2000. The report has been approved and is distributed on CD-ROM (as a PowerPoint file) in accordance with the terms of the subject contract, and contains information and data addressing the following: (1) Launch services demand and requirements; (2) Architecture, alternatives, and requirements; (3) Costs, pricing, and business cases analysis; (4) Commercial financing requirements, plans, and strategy; (5) System engineering processes and derived requirements; and (6) RLV system trade studies and design analysis.

  16. 2nd International Planetary Probe Workshop

    NASA Technical Reports Server (NTRS)

    Venkatapathy, Ethiraj; Martinez, Ed; Arcadi, Marla

    2005-01-01

    Included are presentations from the 2nd International Planetary Probe Workshop. The purpose of the second workshop was to continue to unite the community of planetary scientists, spacecraft engineers and mission designers and planners; whose expertise, experience and interests are in the areas of entry probe trajectory and attitude determination, and the aerodynamics/aerothermodynamics of planetary entry vehicles. Mars lander missions and the first probe mission to Titan made 2004 an exciting year for planetary exploration. The Workshop addressed entry probe science, engineering challenges, mission design and instruments, along with the challenges of reconstruction of the entry, descent and landing or the aerocapture phases. Topics addressed included methods, technologies, and algorithms currently employed; techniques and results from the rich history of entry probe science such as PAET, Venera/Vega, Pioneer Venus, Viking, Galileo, Mars Pathfinder and Mars MER; upcoming missions such as the imminent entry of Huygens and future Mars entry probes; and new and novel instrumentation and methodologies.

  17. Diazepam Rectal

    MedlinePlus

    Diazepam rectal gel is used in emergency situations to stop cluster seizures (episodes of increased seizure activity) in people who are ... Diazepam comes as a gel to instill rectally using a prefilled syringe with a special plastic tip. Follow the directions on your prescription label carefully, ...

  18. The effects of dietary sodium loading on the activity and expression of Na, K-ATPase in the rectal gland of the European dogfish (Scyliorhinus canicula).

    PubMed

    MacKenzie, S; Cutler, C P; Hazon, N; Cramb, G

    2002-02-01

    cDNA fragments of both the alpha- and beta-subunits of the Na, K-ATPase and a cDNA fragment of the secretory form of Na-K-Cl cotransporter from the European dogfish (Scyliorhinus canicula) were amplified and cloned using degenerate primers in RT-PCR. These clones were used along with a sCFTR cDNA from the related dogfish shark, Squalus acanthias to characterise the expression of mRNAs for these ion transporters in the dogfish rectal gland subsequent to an acute feeding episode. Following a single feeding event where starved dogfish were fed squid portions (20 g squid/kg fish), there was a delayed and transient 40-fold increase in the activity of Na, K-ATPase in crude rectal gland homogenates. Increases in enzyme activity were apparent 3 h after the feeding event and peaked at 9 h before returning to control values within 24 h. These increases in activity were accompanied by small and transient decreases in plasma sodium and chloride concentrations lasting up to 3 days. Significant increases in the expression of mRNAs for alpha- and beta-subunits of the Na, K-ATPase, the Na-K-Cl cotransporter and CFTR chloride channel were detected but not until 1-2 days after the feeding event. It is concluded that the transient increase in Na, K-ATPase activity is not attributable to increases in the abundance of alpha- and beta-subunit mRNAs but must be associated with some, as yet unknown, post-transcriptional activation mechanism.

  19. Plasma and dietary carotenoids and vitamins A, C and E and risk of colon and rectal cancer in the European Prospective Investigation into Cancer and Nutrition.

    PubMed

    Leenders, Max; Leufkens, Anke M; Siersema, Peter D; van Duijnhoven, Fränzel J B; Vrieling, Alina; Hulshof, Paul J M; van Gils, Carla H; Overvad, Kim; Roswall, Nina; Kyrø, Cecilie; Boutron-Ruault, Marie-Christine; Fagerhazzi, Guy; Cadeau, Claire; Kühn, Tilman; Johnson, Theron; Boeing, Heiner; Aleksandrova, Krasimira; Trichopoulou, Antonia; Klinaki, Eleni; Androulidaki, Anna; Palli, Domenico; Grioni, Sara; Sacerdote, Carlotta; Tumino, Rosario; Panico, Salvatore; Bakker, Marije F; Skeie, Guri; Weiderpass, Elisabete; Jakszyn, Paula; Barricarte, Aurelio; María Huerta, José; Molina-Montes, Esther; Argüelles, Marcial; Johansson, Ingegerd; Ljuslinder, Ingrid; Key, Timothy J; Bradbury, Kathryn E; Khaw, Kay-Tee; Wareham, Nicholas J; Ferrari, Pietro; Duarte-Salles, Talita; Jenab, Mazda; Gunter, Marc J; Vergnaud, Anne-Claire; Wark, Petra A; Bueno-de-Mesquita, H B

    2014-12-15

    Carotenoids and vitamins A, C and E are possibly associated with a reduced colorectal cancer (CRC) risk through antioxidative properties. The association of prediagnostic plasma concentrations and dietary consumption of carotenoids and vitamins A, C and E with the risk of colon and rectal cancer was examined in this case-control study, nested within the European Prospective Investigation into Cancer and Nutrition study. Plasma concentrations of carotenoids (α- and β-carotene, canthaxanthin, β-cryptoxanthin, lutein, lycopene, zeaxanthin) and vitamins A (retinol), C and E (α-, β- and γ- and δ-tocopherol) and dietary consumption of β-carotene and vitamins A, C and E were determined in 898 colon cancer cases, 501 rectal cancer cases and 1,399 matched controls. Multivariable conditional logistic regression models were performed to estimate incidence rate ratios (IRR) and corresponding 95% confidence intervals (CIs). An association was observed between higher prediagnostic plasma retinol concentration and a lower risk of colon cancer (IRR for highest quartile = 0.63, 95% CI: 0.46, 0.87, p for trend = 0.01), most notably proximal colon cancer (IRR for highest quartile = 0.46, 95% CI: 0.27, 0.77, p for trend = 0.01). Additionally, inverse associations for dietary β-carotene and dietary vitamins C and E with (distal) colon cancer were observed. Although other associations were suggested, there seems little evidence for a role of these selected compounds in preventing CRC through their antioxidative properties.

  20. Exogenous attention enhances 2nd-order contrast sensitivity

    PubMed Central

    Barbot, Antoine; Landy, Michael S.; Carrasco, Marisa

    2011-01-01

    Natural scenes contain a rich variety of contours that the visual system extracts to segregrate the retinal image into perceptually coherent regions. Covert spatial attention helps extract contours by enhancing contrast sensitivity for 1st-order, luminance-defined patterns at attended locations, while reducing sensitivity at unattended locations, relative to neutral attention allocation. However, humans are also sensitive to 2nd-order patterns such as spatial variations of texture, which are predominant in natural scenes and cannot be detected by linear mechanisms. We assess whether and how exogenous attention—the involuntary and transient capture of spatial attention—affects the contrast sensitivity of channels sensitive to 2nd-order, texture-defined patterns. Using 2nd-order, texture-defined stimuli, we demonstrate that exogenous attention increases 2nd-order contrast sensitivity at the attended location, while decreasing it at unattended locations, relative to a neutral condition. By manipulating both 1st- and 2nd-order spatial frequency, we find that the effects of attention depend both on 2nd-order spatial frequency of the stimulus and the observer’s 2nd-order spatial resolution at the target location. At parafoveal locations, attention enhances 2nd-order contrast sensitivity to high, but not to low 2nd-order spatial frequencies; at peripheral locations attention also enhances sensitivity to low 2nd-order spatial frequencies. Control experiments rule out the possibility that these effects might be due to an increase in contrast sensitivity at the 1st-order stage of visual processing. Thus, exogenous attention affects 2nd-order contrast sensitivity at both attended and unattended locations. PMID:21356228

  1. Exogenous attention enhances 2nd-order contrast sensitivity.

    PubMed

    Barbot, Antoine; Landy, Michael S; Carrasco, Marisa

    2011-05-11

    Natural scenes contain a rich variety of contours that the visual system extracts to segregate the retinal image into perceptually coherent regions. Covert spatial attention helps extract contours by enhancing contrast sensitivity for 1st-order, luminance-defined patterns at attended locations, while reducing sensitivity at unattended locations, relative to neutral attention allocation. However, humans are also sensitive to 2nd-order patterns such as spatial variations of texture, which are predominant in natural scenes and cannot be detected by linear mechanisms. We assess whether and how exogenous attention--the involuntary and transient capture of spatial attention--affects the contrast sensitivity of channels sensitive to 2nd-order, texture-defined patterns. Using 2nd-order, texture-defined stimuli, we demonstrate that exogenous attention increases 2nd-order contrast sensitivity at the attended location, while decreasing it at unattended locations, relative to a neutral condition. By manipulating both 1st- and 2nd-order spatial frequency, we find that the effects of attention depend both on 2nd-order spatial frequency of the stimulus and the observer's 2nd-order spatial resolution at the target location. At parafoveal locations, attention enhances 2nd-order contrast sensitivity to high, but not to low 2nd-order spatial frequencies; at peripheral locations attention also enhances sensitivity to low 2nd-order spatial frequencies. Control experiments rule out the possibility that these effects might be due to an increase in contrast sensitivity at the 1st-order stage of visual processing. Thus, exogenous attention affects 2nd-order contrast sensitivity at both attended and unattended locations. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. [About Cryptophthalmos (2nd Czech Study)].

    PubMed

    Krásný, J; Čakrtová, M; Kletenský, J; Novák, V; Šach, J

    To get acquainted with the 2nd Czech study about cryptophthamos and with self-surgical methods. The boy with unilateral complete cryptophthalmos of left eye was treated from 2 to 20 years. The girls was treated from 4 month to 5 year yet for right abortive cryptophthalmos with microblepharon and left complete type still waiting for solutions.Surgical methods and results: Authors present a surgical procedures for correction of the upper and lower eyelids and ocular anomalies both patients studied. Successful reconstruction of palpebral fissure took place in several stages at the boy. The surgical procedure gradually contained: the insertion of gradually increased convex concave circular-shaped implant (silicone ruber) due a modeling of palpebral fissure, an enucleation of rudimentary eye, a reconstruction of bottom palpebral fissure by retro-auricular skin graf and a releasing of the lower transitory fold by the cul-de-sac method. An adequate depth of palpebral fissure to allow perfect position of an aesthetic protesis. Enucleated eye was atypically shaped, remiding partly sand-glass clock. The cornea was replaced by thick fibrous membrane, the iris and the lens were not revealed. Gliomatic retina was detached nearly totaly and the optic nerv was rudimental. The repairing the upper lid coloboma of girl by a lid rotation flap reconstruction using the inferior eyelid was performed at the age 17 month. Corneal dermoid simultaneously removed (histologically verified). Upper conjunctival fornix was formed using the spherical covering foil (silicone rubber) before and after the reconstruction of the lid. Plastic reconstructions required the need for patient access without trying immediate effect. An important role played silicone rubber implants (elastomer medical grade) which used temporarily. cryptophthalmos, microblepharon, relief surgery, silicon ruber implants.

  3. 2nd Generation Reusable Launch Vehicle NASA Led Propulsion Tasks

    NASA Technical Reports Server (NTRS)

    Richards, Steve

    2000-01-01

    Design, development and test of a 2nd generation Reusable Launch Vehicle (RLV) is presented. This current paper discusses the following: 2nd Generation RLV Propulsion Project, Overview of NASA Led Tasks in Propulsion, Gen2 Turbo Machinery Technology Demonstrator, and Combustion Devices Test Bed, GRCop-84 Sheet For Combustion Chambers, Nozzles and Large Actively Cooled Structures

  4. Lifelong Learning: Thematic Bibliography. 2nd Edition.

    ERIC Educational Resources Information Center

    EURYDICE European Unit, Brussels (Belgium).

    This seventh publication in the Eurydice European Unit series of thematic bibliographies draws attention to a selection of publications on the topic of lifelong learning. This annotated bibliography lists 268 books, articles, publications, and reports that have appeared since 1994. Some earlier items of published literature of special historical…

  5. Emissions trading: principles and practice. 2nd

    SciTech Connect

    Tietenberg, T.H.

    2006-02-15

    The author demonstrates how emissions trading became an attractive alternative to command-and-control policies that would have required the EPA to disallow the opening of new plants in the middle of the recession-burdened 1970s. His examination of the evolution of this system includes, among other applications, the largest multinational trading system ever conceived, the European Union's Greenhouse Gas Emission Trading Scheme (EUETG), and the use of emissions trading in the Kyoto Protocol.

  6. Immunoscore in Rectal Cancer

    ClinicalTrials.gov

    2017-06-13

    Cancer of the Rectum; Neoplasms, Rectal; Rectal Cancer; Rectal Tumors; Rectal Adenocarcinoma; Melanoma; Breast Cancer; Renal Cell Cancer; Lung Cancer; Bladder Cancer; Head and Neck Cancer; Ovarian Cancer; Thyroid Cancer

  7. International Conference on Hyperbolic Problems (2nd). Theory, Numerical Methods and Applications, 14-18 March 1988

    DTIC Science & Technology

    1988-01-01

    SOlution of’ th icai Ele quations. Proceedings of (lie 2nd European Conference on Multigrid 3. - --- AND B. KoRSN (1997). A Non-linear Afiultq,’rid...of Aerospace Engineering Indian Institute of Science Bangalore, India A new upwind scheme called Kinetic Flux Vector Splitting (KFVS) method has been

  8. 2ND FLOOR HALLWAY LOOKING EAST, NOTE PRESSED TIN CEILING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2ND FLOOR HALLWAY LOOKING EAST, NOTE PRESSED TIN CEILING - New York State Soldiers & Sailors Home, Building No. 29, Department of Veterans Affairs Medical Center, 76 Veterans Avenue, Bath, Steuben County, NY

  9. Molecular motors and the 2nd law of thermodynamics

    NASA Astrophysics Data System (ADS)

    Wang, Zhisong

    2014-03-01

    Molecular motors from biology and nanotechnology often operate on chemical energy of fuel molecules in an isothermal environment, unlike macroscopic heat engines that draw energy from a heat flow between two temperatures. Nevertheless, isothermal molecular motors are still subject to the 2nd law of thermodynamics in a fundamental way: their directional motion must cost a finite amount of energy other than the environmental heat even though no work is done; otherwise the 2nd law would be violated. Hence the 2nd law requires a finite energy price for pure direction of molecular motors. But what is the lowest price of direction allowed by the 2nd law? And how does the 2nd law-decreed price of direction limit performance of molecular motors? In the talk, I shall present our theoretical study of the 2nd law-molecular motor link on basis of the accumulated biomotor phenomenology, and also introduce our experimental effort to develop biomimetic DNA bipedal nanomotors following the mechanistic guidelines out of the theoretical study. [Main contents of this talk are from references:] This work is partially supported by FRC grants R-144-000-259-112, R-144-000-290-112 and R-144-000-320-112.

  10. PREFACE: 2nd National Conference on Nanotechnology 'NANO 2008'

    NASA Astrophysics Data System (ADS)

    Czuba, P.; Kolodziej, J. J.; Konior, J.; Szymonski, M.

    2009-03-01

    This issue of Journal of Physics: Conference Series contains selected papers presented at the 2nd National Conference on Nanotechnology 'NANO2008', that was held in Kraków, Poland, 25-28 June 2008. It was organized jointly by the Polish Chemical Society, Polish Physical Society, Polish Vacuum Society, and the Centre for Nanometer-scale Science and Advanced Materials (NANOSAM) of the Jagiellonian University. The meeting presentations were categorized into the following topics: 1. Nanomechanics and nanotribology 2. Characterization and manipulation in nanoscale 3. Quantum effects in nanostructures 4. Nanostructures on surfaces 5. Applications of nanotechnology in biology and medicine 6. Nanotechnology in education 7. Industrial applications of nanotechnology, presentations of the companies 8. Nanoengineering and nanomaterials (international sessions shared with the fellows of Maria-Curie Host Fellowships within the 6th FP of the European Community Project 'Nano-Engineering for Expertise and Development, NEED') 9. Nanopowders 10. Carbon nanostructures and nanosystems 11. Nanoelectronics and nanophotonics 12. Nanomaterials in catalysis 13. Nanospintronics 14. Ethical, social, and environmental aspects of nanotechnology The Conference was attended by 334 participants. The presentations were delivered as 7 invited plenary lectures, 25 invited topical lectures, 78 oral and 108 poster contributions. Only 1/6 of the contributions presented during the Conference were submitted for publication in this Proceedings volume. From the submitted material, this volume of Journal of Physics: Conference Series contains 37 articles that were positively evaluated by independent referees. The Organizing Committee gratefully acknowledges all these contributions. We also thank all the referees of the papers submitted for the Proceedings for their timely and thorough work. We would like to thank all members of the National Program Committee for their work in the selection process of

  11. Involving patients in a multidisciplinary European consensus process and in the development of a 'patient summary of the consensus document for colon and rectal cancer care'.

    PubMed

    Boelens, Petra G; Taylor, Claire; Henning, Geoffrey; Marang-van de Mheen, Perla J; Espin, Eloy; Wiggers, Theo; Gore-Booth, Jola; Moss, Barbara; Valentini, Vincenzo; van de Velde, Cornelis J H

    2014-01-01

    High-quality cancer care should be accessible for patients and healthcare professionals. Involvement of patients as partners in guideline formation and consensus processes is still rarely found. EURECCA, short for European Registration of Cancer Care, is the platform to improve outcomes of cancer care by reducing variation in the diagnostic and treatment process. EURECCA acknowledges the important role of patients in implementation of consensus information in clinical practice. The aim of this article is to describe the process of involving patients in the consensus process and in developing the patient summary of the consensus for colon and rectal cancer care. The Delphi method for achieving consensus was used. Three online voting rounds and one tele-voting round were offered to an expert panel of oncology professionals and patient representatives. At four different stages, patients and/or patient representatives were involved in the process: (1) during the consensus process, (2) lecturing about the role of the patient, (3) development of the patient summary, and (4) testing the patient summary. Representatives were invited to the voting and commenting rounds of this process and given an equal vote. Although patients were not consulted during the planning stages of this process, patient involvement increased following the panel's discussion of the implementation of the consensus among the patient population. After the consensus meeting, the patient summary was written by patient representatives, oncologists and nurses. A selection of proactive patients reviewed the draft patient summary; responses were positive and several patient-reported outcomes were added. Questionnaires to evaluate the use and implementation of the patient summary in daily practice are currently being developed and tested. Patient consultation will be needed in future planning for selection of topics. The present study may function as a model for future consensus processes to involve patients

  12. [Health and environment: the 2nd public health revolution.].

    PubMed

    Cicolella, André

    2010-01-01

    As of the mid-19th century, most infectious disease epidemics have been fought and slowed down by taking action on the environment (water, housing, waste) and education. This constitutes the 1st public health revolution paradigm. As we face the current epidemic of chronic diseases and the failure of the dominant biomedical model to stop them, a 2nd public health revolution is needed. The vision for this 2nd public health revolution requires a new paradigm built upon an eco-systemic definition of health and the recognition of the legitimacy for citizen participation based on the precautionary principle.

  13. A Handbook for Classroom Instruction That Works, 2nd Edition

    ERIC Educational Resources Information Center

    Association for Supervision and Curriculum Development, 2012

    2012-01-01

    Perfect for self-help and professional learning communities, this handbook makes it much easier to apply the teaching practices from the ASCD-McREL best-seller "Classroom Instruction That Works: Research-Based Strategies for Increasing Student Achievement, 2nd Edition." The authors take you through the refined Instructional Planning Guide, so you…

  14. A Handbook for Classroom Instruction That Works, 2nd Edition

    ERIC Educational Resources Information Center

    Association for Supervision and Curriculum Development, 2012

    2012-01-01

    Perfect for self-help and professional learning communities, this handbook makes it much easier to apply the teaching practices from the ASCD-McREL best-seller "Classroom Instruction That Works: Research-Based Strategies for Increasing Student Achievement, 2nd Edition." The authors take you through the refined Instructional Planning Guide, so you…

  15. Book Review: Bioassays with Arthropods: 2nd Edition

    USDA-ARS?s Scientific Manuscript database

    The technical book "Bioassays with Arthropods: 2nd Edition" (2007. Jacqueline L. Robertson, Robert M. Russell, Haiganoush K, Preisler and N. E. Nevin, Eds. CRC Press, Boca Raton, FL, 224 pp.) was reviewed for the scientific readership of the peer-reviewed publication Journal of Economic Entomology. ...

  16. Test Review: The Profile of Mood States 2nd Edition

    ERIC Educational Resources Information Center

    Lin, Shuqiong; Hsiao, Yu-Yu; Wang, Miao

    2014-01-01

    The "Profile of Mood States 2nd Edition" (POMS 2) was published in 2012 by Multi-Health Systems (MHS) to assess transient feelings and mood among individuals aged 13 years and above. Evolving from the original POMS (McNair, Lorr, & Droppleman, 1971, 1992), the POMS 2 was designed for youth (13-17 years old) and adults (18 years old…

  17. Test Review: The Profile of Mood States 2nd Edition

    ERIC Educational Resources Information Center

    Lin, Shuqiong; Hsiao, Yu-Yu; Wang, Miao

    2014-01-01

    The "Profile of Mood States 2nd Edition" (POMS 2) was published in 2012 by Multi-Health Systems (MHS) to assess transient feelings and mood among individuals aged 13 years and above. Evolving from the original POMS (McNair, Lorr, & Droppleman, 1971, 1992), the POMS 2 was designed for youth (13-17 years old) and adults (18 years old…

  18. SrF2:Nd3+ laser fluoride ceramics.

    PubMed

    Basiev, T T; Doroshenko, M E; Konyushkin, V A; Osiko, V V

    2010-12-01

    SrF(2):Nd(3+) fluoride ceramics of high optical quality was prepared and its spectroscopic and laser properties investigated. Oscillations of different optical centers depending on the excitation wavelength were obtained with a slope efficiency of up to 19%.

  19. European Software Engineering Process Group Conference (2nd Annual), EUROPEAN SEPG󈨥. Delegate Material, Conference

    DTIC Science & Technology

    1997-06-19

    developing sound: Software Initiative skills - innovations at reasonable cost social environment SCo eSot Eng g - $..,,w So. l ý PP -3?- ZTSW A’v. ON W TW...Consulting Problems of use CFCs Tobacco Credit reporting Lotus ’Households’ Social change Problems of abuse Diamorphine Nuclear fission Internet SABRE...m o STEP 2 * ESTABLISH SENIOR MANAGEME f * COMMITMENT: - INTERNAL COMMUNICATIONS SOCIAL EVENTS TRAINING COURSE DINNERS PUBLICISE SPI AT EVERY

  20. Monolithic Microwave Integrated Circuit (MMIC) Frequency Doublers - 2nd Pass Correction

    DTIC Science & Technology

    2013-09-01

    Monolithic Microwave Integrated Circuit (MMIC) Frequency Doublers—2nd Pass Correction by John E. Penn ARL-TN-0580 September 2013...September 2013 Monolithic Microwave Integrated Circuit (MMIC) Frequency Doublers—2nd Pass Correction John E. Penn Sensors and Electron...COVERED (From - To) 4. TITLE AND SUBTITLE Monolithic Microwave Integrated Circuit (MMIC) Frequency Doublers–2nd Pass Correction 5a. CONTRACT NUMBER

  1. Digital rectal exam

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007069.htm Digital rectal exam To use the sharing features on this page, please enable JavaScript. A digital rectal exam is an examination of the lower ...

  2. 2nd Generation RLV: Program Goals and Acquisition Strategy

    NASA Technical Reports Server (NTRS)

    Graham, J. Bart; Dumbacher, D. L. (Technical Monitor)

    2001-01-01

    The risk to loss of life for Space Shuttle crewmembers is approximately one in 245 missions. U.S. launch service providers captured nearly 100%, of the commercial launch market revenues in the mid 1980s. Today, the U.S. captures less than 50% of that market. A launch system architecture is needed that will dramatically increase the safety of space flight while significantly reducing the cost. NASA's Space Launch Initiative, which is implemented by the 2nd Generation RLV Program Office at Marshall Space Flight Center, seeks to develop technology and reusable launch vehicle concepts which satisfy the commercial launch market needs and the unique needs of NASA. Presented in this paper are the five primary elements of NASA's Integrated Space Transportation Plan along with the highest level goals and the acquisition strategy of the 2nd Generation RLV Program. Approval of the Space Launch Initiative FY01 budget of $290M is seen as a major commitment by the Agency and the Nation to realize the commercial potential that space offers and to move forward in the exploration of space.

  3. A Meta-Analysis of Quality of Life, Estimated by Questionnaires of the European Organization for Research and Treatment of Cancer (EORTC) after Rectal Cancer Surgery.

    PubMed

    Maslyankov, S; Penchev, D; Todorov, G; Vladov, N

    2015-01-01

    Rectal carcinoma is one of the most common cancers on a global scale. Although there were major improvements in its treatment during the last two decades, surgery is still the only curative method. However, is often complicated and can cause disorder of different aspects of the patients self-perception of health. The aim of this study is performing ofa meta-analysis for evaluation and comparison of the quality of liferesults after rectal cancer treatment. Search of relevant articles, which were published between 2000 and 2015, was performed. The outcomes of abdominoperineal resection and anterior resection were analyzed with the EORTC's quality of life measuring instruments - quality-of-life questionnaire C30 (QLQ-C30)and quality-of-life questionnaire CR38 (QLQ-CR38). The assessment score, appropriate for the survey, was established at least one year after radical surgery. The Statistical Package for Social Sciences (SPSS) package of IBM Statistics, version 19 was used for the statistical analyses. 13 studies, published between 2001 and 2015, have been presented in this meta-analysis. Data from 1805 patients,with a mean age of 64.7 years, have been included. When comparing Miles extirpation and sphincter-sparing operations,statistical significance was detected for the following variables:social functioning (74.6 ± 8.5 vs. 83.4 ± 8.6, P = 0.045),constipation (11 ± 8.4 vs. 22.6 ± 8.3, P = 0.032), and body image (67.9 ± 14 vs. 82.5 ± 9.1, P= 0.01). Preservation of the sphincter is a better treatment option that should be carefully considered. Dependently registered differences, our conviction for the rectal cancer care concern needs individualization of the approach in this surgery.It is essential that the policy of avoidance of abdominoperineal resection (APR) cannot currently be justified on the grounds of quality-of-life (QoL) results alone. Celsius.

  4. Philips' 2nd generation Novallure LED candle lamp

    NASA Astrophysics Data System (ADS)

    Li, Yun; Pei, Zhigang; Yuan, Chuan; Jiang, Tan; Lu, Zhengsong; Wang, Yuqian; Duan, Xiaoqing; Xiong, Yan; Zhong, Hong; Liu, Ye

    2010-08-01

    Finding an energy efficient replacement of incandescent candle lamp has been a technical challenge. Compact fluorescent lamps, for example, can be miniaturized to fit the form factor of a candle lamp but they fail to reproduce its "sparkle" effect. Empowered by solid state lighting technology along with original optical design, Philips has successfully developed LED-powered candle lamps "Novallure" with great energy savings (2W power consumption with lumen output of 55 lumen) and the "butterfly" radiation pattern that mimics the sparkle effect from an incandescent candle lamp. With new high performance LED packages, novel under-cut prismatic optics and state-of-the-art electronic driver solution and thermal solution, we have developed a 2nd generation Novallure with breakthrough performance: a dimmable 2700K 136 lumen LED candle lamp with CRI 90.

  5. The 2nd generation VLTI path to performance

    NASA Astrophysics Data System (ADS)

    Woillez, Julien; Alonso, Jaime; Berger, Jean-Philippe; Bonnet, Henri; de Wit, Willem-Jan; Egner, Sebastian; Eisenhauer, Frank; Gonté, Frédéric; Guieu, Sylvain; Haguenauer, Pierre; Mérand, Antoine; Pettazzi, Lorenzo; Poupar, Sébastien; Schöller, Markus; Schuhler, Nicolas

    2016-08-01

    The upgrade of the VLTI infrastructure for the 2nd generation instruments is now complete with the transformation of the laboratory, and installation of star separators on both the 1.8-m Auxiliary Telescopes (ATs) and the 8-m Unit Telescopes (UTs). The Gravity fringe tracker has had a full semester of commissioning on the ATs, and a first look at the UTs. The CIAO infrared wavefront sensor is about to demonstrate its performance relative to the visible wavefront sensor MACAO. First astrometric measurements on the ATs and astrometric qualification of the UTs are on-going. Now is a good time to revisit the performance roadmap for VLTI that was initiated in 2014, which aimed at coherently driving the developments of the interferometer, and especially its performance, in support to the new generation of instruments: Gravity and MATISSE.

  6. Refraction data survey: 2nd generation correlation of myopia.

    PubMed

    Greene, Peter R; Medina, Antonio

    2016-10-01

    The objective herein is to provide refraction data, myopia progression rate, prevalence, and 1st and 2nd generation correlations, relevant to whether myopia is random or inherited. First- and second-generation ocular refraction data are assembled from N = 34 families, average of 2.8 children per family. From this group, data are available from N = 165 subjects. Inter-generation regressions are performed on all the data sets, including correlation coefficient r, and myopia prevalence [%]. Prevalence of myopia is [M] = 38.5 %. Prevalence of high myopes with |R| >6 D is [M-] = 20.5 %. Average refraction is  = -1.84 D ± 3.22 (N = 165). For the high myopes, |R| >6 D, prevalence for the parents is [M-] = 25 %, for the 2nd generation [M-] = 16.5 %. Average myopia level for the high myopes, both generations, is  = -7.52 D ± 1.31 D (N = 33). Regression parameters are calculated for all the data sets, yielding correlation coefficients in the range r = 0.48-0.72 for some groups of myopes and high myopes, fathers to daughters, and mothers to sons. Also of interest, some categories show essentially no correlation, -0.20 < r < 0.20, indicating that the refractive errors occur randomly. Time series results show myopia diopter rates = -0.50 D/year.

  7. Super Boiler 2nd Generation Technology for Watertube Boilers

    SciTech Connect

    Mr. David Cygan; Dr. Joseph Rabovitser

    2012-03-31

    This report describes Phase I of a proposed two phase project to develop and demonstrate an advanced industrial watertube boiler system with the capability of reaching 94% (HHV) fuel-to-steam efficiency and emissions below 2 ppmv NOx, 2 ppmv CO, and 1 ppmv VOC on natural gas fuel. The boiler design would have the capability to produce >1500 F, >1500 psig superheated steam, burn multiple fuels, and will be 50% smaller/lighter than currently available watertube boilers of similar capacity. This project is built upon the successful Super Boiler project at GTI. In that project that employed a unique two-staged intercooled combustion system and an innovative heat recovery system to reduce NOx to below 5 ppmv and demonstrated fuel-to-steam efficiency of 94% (HHV). This project was carried out under the leadership of GTI with project partners Cleaver-Brooks, Inc., Nebraska Boiler, a Division of Cleaver-Brooks, and Media and Process Technology Inc., and project advisors Georgia Institute of Technology, Alstom Power Inc., Pacific Northwest National Laboratory and Oak Ridge National Laboratory. Phase I of efforts focused on developing 2nd generation boiler concepts and performance modeling; incorporating multi-fuel (natural gas and oil) capabilities; assessing heat recovery, heat transfer and steam superheating approaches; and developing the overall conceptual engineering boiler design. Based on our analysis, the 2nd generation Industrial Watertube Boiler when developed and commercialized, could potentially save 265 trillion Btu and $1.6 billion in fuel costs across U.S. industry through increased efficiency. Its ultra-clean combustion could eliminate 57,000 tons of NOx, 460,000 tons of CO, and 8.8 million tons of CO2 annually from the atmosphere. Reduction in boiler size will bring cost-effective package boilers into a size range previously dominated by more expensive field-erected boilers, benefiting manufacturers and end users through lower capital costs.

  8. Preoperative high-resolution magnetic resonance imaging can identify good prognosis stage I, II, and III rectal cancer best managed by surgery alone: a prospective, multicenter, European study.

    PubMed

    Taylor, Fiona G M; Quirke, Philip; Heald, Richard J; Moran, Brendan; Blomqvist, Lennart; Swift, Ian; Sebag-Montefiore, David J; Tekkis, Paris; Brown, Gina

    2011-04-01

    To assess local recurrence, disease-free survival, and overall survival in magnetic resonance imaging (MRI)-predicted good prognosis tumors treated by surgery alone. The MERCURY study reported that high-resolution MRI can accurately stage rectal cancer. The routine policy in most centers involved in the MERCURY study was primary surgery alone in MRI-predicted stage II or less and in MRI "good prognosis" stage III with selective avoidance of neoadjuvant therapy. Data were collected prospectively on all patients included in the MERCURY study who were staged as MRI-defined "good" prognosis tumors. "Good" prognosis included MRI-predicted safe circumferential resection margins, with MRI-predicted T2/T3a/T3b (less than 5 mm spread from muscularis propria), regardless of MRI N stage. None received preoperative or postoperative radiotherapy. Overall survival, disease-free survival, and local recurrence were calculated. Of 374 patients followed up in the MERCURY study, 122 (33%) were defined as "good prognosis" stage III or less on MRI. Overall and disease-free survival for all patients with MRI "good prognosis" stage I, II and III disease at 5 years was 68% and 85%, respectively. The local recurrence rate for this series of patients predicted to have a good prognosis tumor on MRI was 3%. The preoperative identification of good prognosis tumors using MRI will allow stratification of patients and better targeting of preoperative therapy. This study confirms the ability of MRI to select patients who are likely to have a good outcome with primary surgery alone.

  9. [Microsurgical 2nd toe transfer for catastrophic hand reconstruction].

    PubMed

    Placer, A; Lozano, Ja

    2007-01-01

    The correct reconstruction of the catastrophic hand requires complex surgical techniques. The microsurgical transference of a toe is indicated when all other reconstructive options are shown to be useless for the reconstruction of the required clamp function. In this clinical note we set out the case of a 32 year old man, who came to our accident and emergency department after suffering a traffic accident. After exploration the diagnosis was that of catastrophic left hand, among other policontusions. Urgent surgery was carried out, saving the maximum possible viable structures. The immediate result of this surgery was a hand with 1st, 4th and 5th functional fingers. As the essential clamp function between the 1st and 4th or 5th fingers was not totally satisfactory, we decided to reconstruct the 3rd finger of his hand with his ipsilateral 2nd toe. All pertinent studies to determine vascularisation of the flap were carried out in planning the surgery, and the microsurgical transfer was then realized, which was successful. Today, after a suitable rehabilitation, the patient has recovered a satisfactory function of heavy and fine clamp in the operated hand. Toe to hand transfer is a good option for finger reconstruction and its function. Rehabilitation is the key to functional recovery.

  10. Aging Studies of 2nd Generation BaBar RPCs

    SciTech Connect

    Band, H.R.; /SLAC

    2007-09-25

    The BaBar detector, operating at the PEPII B factory of the Stanford Linear Accelerator Center (SLAC), installed over 200 2nd generation Resistive Plate Chambers (RPCs) in 2002. The streamer rates produced by backgrounds and signals from normal BaBar running vary considerably (0.1- >20 Hz/cm2) depending on the layer and position of the chambers, thus providing a broad spectrum test of RPC performance and aging. The lowest rate chambers have performed very well with stable efficiencies averaging 95%. Other chambers had rate-dependant inefficiencies due to Bakelite drying which were reversed by the introduction of humidified gases. RPC inefficiencies in the highest rate regions of the higher rate chambers have been observed and also found to be rate dependant. The inefficient regions grow with time and have not yet been reduced by operation with humidified input gas. Three of these chambers were converted to avalanche mode operation and display significantly improved efficiencies. The rate of production of HF in the RPC exhaust gases was measured in avalanche and streamer mode RPCs and found to be comparable despite the lower current of the avalanche mode RPCs.

  11. PREFACE: 2nd International Symposium "Optics and its Applications"

    NASA Astrophysics Data System (ADS)

    Calvo, Maria L.; Dolganova, Irina N.; Gevorgyan, Narine; Guzman, Angela; Papoyan, Aram; Sarkisyan, Hayk; Yurchenko, Stanislav

    2016-01-01

    The ICTP smr2633: 2nd International Symposium "Optics and its Applications" (OPTICS-2014) http://indico.ictp.it/event/a13253/ was held in Yerevan and Ashtarak, Armenia, on 1-5 September 2014. The Symposium was organized by the Abdus Salam International Center for Theoretical Physics (ICTP) with the collaboration of the SPIE Armenian Student Chapter, the Armenian TC of ICO, the Russian-Armenian University (RAU), the Institute for Physical Research of the National Academy of Sciences of Armenia (IPR of NAS), the Greek-Armenian industrial company LT-Pyrkal, and the Yerevan State University (YSU). The Symposium was co-organized by the BMSTU SPIE & OSA student chapters. The International Symposium OPTICS-2014 was dedicated to the 50th anniversary of the Abdus Salam International Center for Theoretical Physics. This symposium "Optics and its Applications" was the First Official ICTP Scientific Event in Armenia. The presentations at OPTICS-2014 were centered on these topics: optical properties of nanostructures; quantum optics & information; singular optics and its applications; laser spectroscopy; strong field optics; nonlinear & ultrafast optics; photonics & fiber optics; optics of liquid crystals; and mathematical methods in optics.

  12. What's Up With Mercury's 2nd-Degree Shape?

    NASA Astrophysics Data System (ADS)

    Chen, E.; Phillips, R. J.; Zhong, S.

    2015-12-01

    The long-wavelength topography and geoid of a planet are basic observations fundamental to understanding the planet's thermal and dynamical history. Observations by the MESSENGER spacecraft have significantly reduced the uncertainty in the spherical harmonic 2nd-degree (l2) topography and gravity coefficients. Similar to those of the Moon, the long wavelength shape and geoid of Mercury are significantly out of hydrostatic equilibrium [Perry et al., 2015]. The diversion from equilibrium of the Moon has been attributed to orbital evolution and the "freezing-in" of a fossil bulge. With respect to Mercury, the disequilibrium of the l2 shape and geoid is unlikely to be due to its orbital history [Matsuyama and Nimmo, 2009]. Non-hydrostatic models can explain the gravity and shape of Mercury. Buoyancy from thermal anomalies isostatically supporting the surface falls short of reproducing the observed l2 admittance and topography. We explore three scenarios that can generate high admittances at degree-2: flexural/membrane loading on the surface, buoyant structures within the mantle, or topography on the core-mantle boundary. We discuss both isostatic and dynamic models of compensation, and include variations of viscosity structure and elastic properties. However, typical sources of these mechanisms (e.g. large volcanic provinces that collectively have symmetry about the equator or mantle convection with a strong l2 component) are not obviously present on Mercury.

  13. Current concepts in rectal cancer.

    PubMed

    Fleshman, James W; Smallwood, Nathan

    2015-03-01

    The history of rectal cancer management informs current therapy and points us in the direction of future improvements. Multidisciplinary team management of rectal cancer will move us to personalized treatment for individuals with rectal cancer in all stages.

  14. The 2nd Generation Real Time Mission Monitor (RTMM) Development

    NASA Technical Reports Server (NTRS)

    Blakeslee, Richard; Goodman, Michael; Meyer, Paul; Hardin, Danny; Hall, John; He, Yubin; Regner, Kathryn; Conover, Helen; Smith, Tammy; Lu, Jessica; Garrett, Michelle

    2009-01-01

    The NASA Real Time Mission Monitor (RTMM) is a visualization and information system that fuses multiple Earth science data sources, to enable real time decisionmaking for airborne and ground validation experiments. Developed at the National Aeronautics and Space Administration (NASA) Marshall Space Flight Center, RTMM is a situational awareness, decision-support system that integrates satellite imagery and orbit data, radar and other surface observations (e.g., lightning location network data), airborne navigation and instrument data sets, model output parameters, and other applicable Earth science data sets. The integration and delivery of this information is made possible using data acquisition systems, network communication links, network server resources, and visualizations through the Google Earth virtual globe application. In order to improve the usefulness and efficiency of the RTMM system, capabilities are being developed to allow the end-user to easily configure RTMM applications based on their mission-specific requirements and objectives. This second generation RTMM is being redesigned to take advantage of the Google plug-in capabilities to run multiple applications in a web browser rather than the original single application Google Earth approach. Currently RTMM employs a limited Service Oriented Architecture approach to enable discovery of mission specific resources. We are expanding the RTMM architecture such that it will more effectively utilize the Open Geospatial Consortium Sensor Web Enablement services and other new technology software tools and components. These modifications and extensions will result in a robust, versatile RTMM system that will greatly increase flexibility of the user to choose which science data sets and support applications to view and/or use. The improvements brought about by RTMM 2nd generation system will provide mission planners and airborne scientists with enhanced decision-making tools and capabilities to more

  15. The 2nd Generation Real Time Mission Monitor (RTMM) Development

    NASA Technical Reports Server (NTRS)

    Blakeslee, Richard; Goodman, Michael; Meyer, Paul; Hardin, Danny; Hall, John; He, Yubin; Regner, Kathryn; Conover, Helen; Smith, Tammy; Lu, Jessica; hide

    2009-01-01

    The NASA Real Time Mission Monitor (RTMM) is a visualization and information system that fuses multiple Earth science data sources, to enable real time decisionmaking for airborne and ground validation experiments. Developed at the National Aeronautics and Space Administration (NASA) Marshall Space Flight Center, RTMM is a situational awareness, decision-support system that integrates satellite imagery and orbit data, radar and other surface observations (e.g., lightning location network data), airborne navigation and instrument data sets, model output parameters, and other applicable Earth science data sets. The integration and delivery of this information is made possible using data acquisition systems, network communication links, network server resources, and visualizations through the Google Earth virtual globe application. In order to improve the usefulness and efficiency of the RTMM system, capabilities are being developed to allow the end-user to easily configure RTMM applications based on their mission-specific requirements and objectives. This second generation RTMM is being redesigned to take advantage of the Google plug-in capabilities to run multiple applications in a web browser rather than the original single application Google Earth approach. Currently RTMM employs a limited Service Oriented Architecture approach to enable discovery of mission specific resources. We are expanding the RTMM architecture such that it will more effectively utilize the Open Geospatial Consortium Sensor Web Enablement services and other new technology software tools and components. These modifications and extensions will result in a robust, versatile RTMM system that will greatly increase flexibility of the user to choose which science data sets and support applications to view and/or use. The improvements brought about by RTMM 2nd generation system will provide mission planners and airborne scientists with enhanced decision-making tools and capabilities to more

  16. Development of a Hydrologic Characterization Technology for Fault Zones Phase II 2nd Report

    SciTech Connect

    Karasaki, Kenzi; Doughty, Christine; Gasperikova, Erika; Peterson, John; Conrad, Mark; Cook, Paul; Tiemi, Onishi

    2011-03-31

    This is the 2nd report on the three-year program of the 2nd phase of the NUMO-LBNL collaborative project: Development of Hydrologic Characterization Technology for Fault Zones under NUMO-DOE/LBNL collaboration agreement. As such, this report is a compendium of the results by Kiho et al. (2011) and those by LBNL.

  17. Psychiatric Diagnosis and Concomitant Medical Treatment for 1st and 2nd Grade Children

    ERIC Educational Resources Information Center

    Cornell-Swanson, La Vonne; Frankenberger, William; Ley, Katie; Bowman, Krista

    2007-01-01

    This study examined the proportion of children in 1st and 2nd grade classes who were currently prescribed medication for psychotropic disorders. The study also examined the attitudes of 1st and 2nd grade teachers toward diagnosis of psychiatric disorders and use of psychiatric medication to treat children. Results of the current study indicate…

  18. Highlights of the 2 nd Bioinformatics Student Symposium by ISCB RSG-UK

    PubMed Central

    White, Benjamen; Fatima, Vayani; Fatima, Nazeefa; Das, Sayoni; Rahman, Farzana; Hassan, Mehedi

    2016-01-01

    Following the success of the 1 st Student Symposium by ISCB RSG-UK, a 2 nd Student Symposium took place on 7 th October 2015 at The Genome Analysis Centre, Norwich, UK. This short report summarizes the main highlights from the 2 nd Bioinformatics Student Symposium. PMID:27239284

  19. Rectal diverticulitis mimicking rectal carcinoma with intestinal obstruction: case report.

    PubMed

    Özçelik, Ümit; Bircan, Hüseyin Yüce; Eren, Eryiğit; Demiralay, Ebru; Işıklar, İclal; Demirağ, Alp; Moray, Gökhan

    2015-01-01

    Although diverticular disease of the colon is common, the occurrence of rectal diverticula is extremely rare with only sporadic reports in the literature since 1911. Symptomatic rectal diverticula are seen even less frequently, and surgical intervention is needed for only complicated cases. Here we report the case of a 63-year-old woman presenting with rectal diverticulitis mimicking rectal carcinoma with intestinal obstruction.

  20. The 2nd Generation Real Time Mission Monitor (RTMM) Development

    NASA Astrophysics Data System (ADS)

    Blakeslee, R. J.; Goodman, M.; Hardin, D. M.; Hall, J.; Yubin He, M.; Regner, K.; Conover, H.; Smith, T.; Meyer, P.; Lu, J.; Garrett, M.

    2009-12-01

    The NASA Real Time Mission Monitor (RTMM) is a visualization and information system that fuses multiple Earth science data sources, to enable real time decision-making for airborne and ground validation experiments. Developed at the National Aeronautics and Space Administration (NASA) Marshall Space Flight Center, RTMM is a situational awareness, decision-support system that integrates satellite imagery and orbit data, radar and other surface observations (e.g., lightning location network data), airborne navigation and instrument data sets, model output parameters, and other applicable Earth science data sets. The integration and delivery of this information is made possible using data acquisition systems, network communication links, network server resources, and visualizations through the Google Earth virtual globe application. In order to improve the usefulness and efficiency of the RTMM system, capabilities are being developed to allow the end-user to easily configure RTMM applications based on their mission-specific requirements and objectives. This second generation RTMM is being redesigned to take advantage of the Google plug-in capabilities to run multiple applications in a web browser rather than the original single application Google Earth approach. Currently RTMM employs a limited Service Oriented Architecture approach to enable discovery of mission specific resources. We are expanding the RTMM architecture such that it will more effectively utilize the Open Geospatial Consortium Sensor Web Enablement services and other new technology software tools and components. These modifications and extensions will result in a robust, versatile RTMM system that will greatly increase flexibility of the user to choose which science data sets and support applications to view and/or use. The improvements brought about by RTMM 2nd generation system will provide mission planners and airborne scientists with enhanced decision-making tools and capabilities to more

  1. 2nd interface between ecology and land development in California

    USGS Publications Warehouse

    Keeley, Jon E.; Baer-Keeley, Melanie; Fortheringham, C.J.

    2000-01-01

    The 2nd Interface Between Ecology and Land Development Conference was held in association with Earth Day 1997, five years after the first Interface Conference. Rapid population growth in California has intensified the inevitable conflict between land development and preservation of natural ecosystems. Sustainable development requires wise use of diminishing natural resources and, where possible, restoration of damaged landscapes. These Earth Week Celebrations brought together resource managers, scientists, politicians, environmental consultants, and concerned citizens in an effort to improve the communication necessary to maintain our natural biodiversity, ecosystem processes and general quality of life. As discussed by our keynote speaker, Michael Soule, the best predictor of habitat loss is population growth and nowhere is this better illustrated than in California. As urban perimeters expand, the interface between wildlands and urban areas increases. Few problems are more vexing than how to manage the fire prone ecosystems indigenous to California at this urban interface. Today resource managers face increasing challenges of dealing with this problem and the lead-off section of the proceedings considers both the theoretical basis for making decisions related to prescribed burning and the practical application. Habitat fragmentation is an inevitable consequence of development patterns with significant impacts on animal and plant populations. Managers must be increasingly resourceful in dealing with problems of fragmentation and the often inevitable consequences, including susceptibility to invasive oganisms. One approach to dealing with fragmentation problems is through careful landplanning. California is the national leader in the integration of conservation and economics. On Earth Day 1991, Governor Pete Wilson presented an environmental agenda that promised to create between land owners and environmentalists, agreements that would guarantee the protection of

  2. 1st- and 2nd-order motion and texture resolution in central and peripheral vision

    NASA Technical Reports Server (NTRS)

    Solomon, J. A.; Sperling, G.

    1995-01-01

    STIMULI. The 1st-order stimuli are moving sine gratings. The 2nd-order stimuli are fields of static visual texture, whose contrasts are modulated by moving sine gratings. Neither the spatial slant (orientation) nor the direction of motion of these 2nd-order (microbalanced) stimuli can be detected by a Fourier analysis; they are invisible to Reichardt and motion-energy detectors. METHOD. For these dynamic stimuli, when presented both centrally and in an annular window extending from 8 to 10 deg in eccentricity, we measured the highest spatial frequency for which discrimination between +/- 45 deg texture slants and discrimination between opposite directions of motion were each possible. RESULTS. For sufficiently low spatial frequencies, slant and direction can be discriminated in both central and peripheral vision, for both 1st- and for 2nd-order stimuli. For both 1st- and 2nd-order stimuli, at both retinal locations, slant discrimination is possible at higher spatial frequencies than direction discrimination. For both 1st- and 2nd-order stimuli, motion resolution decreases 2-3 times more rapidly with eccentricity than does texture resolution. CONCLUSIONS. (1) 1st- and 2nd-order motion scale similarly with eccentricity. (2) 1st- and 2nd-order texture scale similarly with eccentricity. (3) The central/peripheral resolution fall-off is 2-3 times greater for motion than for texture.

  3. PREFACE: 2nd Workshop on Germanium Detectors and Technologies

    NASA Astrophysics Data System (ADS)

    Abt, I.; Majorovits, B.; Keller, C.; Mei, D.; Wang, G.; Wei, W.

    2015-05-01

    The 2nd workshop on Germanium (Ge) detectors and technology was held at the University of South Dakota on September 14-17th 2014, with more than 113 participants from 8 countries, 22 institutions, 15 national laboratories, and 8 companies. The participants represented the following big projects: (1) GERDA and Majorana for the search of neutrinoless double-beta decay (0νββ) (2) SuperCDMS, EDELWEISS, CDEX, and CoGeNT for search of dark matter; (3) TEXONO for sub-keV neutrino physics; (4) AGATA and GRETINA for gamma tracking; (5) AARM and others for low background radiation counting; (5) as well as PNNL and LBNL for applications of Ge detectors in homeland security. All participants have expressed a strong desire on having better understanding of Ge detector performance and advancing Ge technology for large-scale applications. The purpose of this workshop was to leverage the unique aspects of the underground laboratories in the world and the germanium (Ge) crystal growing infrastructure at the University of South Dakota (USD) by brining researchers from several institutions taking part in the Experimental Program to Stimulate Competitive Research (EPSCoR) together with key leaders from international laboratories and prestigious universities, working on the forefront of the intensity to advance underground physics focusing on the searches for dark matter, neutrinoless double-beta decay (0νββ), and neutrino properties. The goal of the workshop was to develop opportunities for EPSCoR institutions to play key roles in the planned world-class research experiments. The workshop was to integrate individual talents and existing research capabilities, from multiple disciplines and multiple institutions, to develop research collaborations, which includes EPSCor institutions from South Dakota, North Dakota, Alabama, Iowa, and South Carolina to support multi-ton scale experiments for future. The topic areas covered in the workshop were: 1) science related to Ge

  4. Rectal cancer: a review

    PubMed Central

    Fazeli, Mohammad Sadegh; Keramati, Mohammad Reza

    2015-01-01

    Rectal cancer is the second most common cancer in large intestine. The prevalence and the number of young patients diagnosed with rectal cancer have made it as one of the major health problems in the world. With regard to the improved access to and use of modern screening tools, a number of new cases are diagnosed each year. Considering the location of the rectum and its adjacent organs, management and treatment of rectal tumor is different from tumors located in other parts of the gastrointestinal tract or even the colon. In this article, we will review the current updates on rectal cancer including epidemiology, risk factors, clinical presentations, screening, and staging. Diagnostic methods and latest treatment modalities and approaches will also be discussed in detail. PMID:26034724

  5. A rectal neuroendocrine neoplasm.

    PubMed

    Varas Lorenzo, Modesto J; Muñoz Agel, Fernando

    2017-08-01

    The incidence of gastric and rectal carcinoids is increasing. This is probably due to endoscopic screening. The prognosis is primarily dependent upon tumor size, aggressiveness (pathology, Ki-67), metastatic disease and stage. However, neuroendocrine carcinoma usually behaves as an adenocarcinoma.

  6. Rectal imaging and cancer.

    PubMed

    Vining, D J

    1998-09-01

    Rectal imaging has evolved substantially during the past 25 years and now offers surgeons exquisite anatomic detail and physiologic information. Dynamic cystoproctography, helical computed tomography, endoscopic ultrasonography, endorectal magnetic resonance imaging, and immunoscintigraphy have become standards for the diagnosis of rectal disease, staging of neoplasia, and survey of therapeutic results. The indications, limitations, and relative costs of current imaging methods are reviewed, and advances in imaging technology that promise future benefits to colorectal surgeons are introduced.

  7. Consensus Report: 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals.

    PubMed

    Ramseier, Christoph A; Warnakulasuriya, Saman; Needleman, Ian G; Gallagher, Jennifer E; Lahtinen, Aira; Ainamo, Anja; Alajbeg, Ivan; Albert, David; Al-Hazmi, Nadia; Antohé, Magda Ecaterina; Beck-Mannagetta, Johann; Benzian, Habib; Bergström, Jan; Binnie, Viv; Bornstein, Michael; Büchler, Silvia; Carr, Alan; Carrassi, Antonio; Casals Peidró, Elias; Chapple, Ian; Compton, Sharon; Crail, Jon; Crews, Karen; Davis, Joan Mary; Dietrich, Thomas; Enmark, Birgitta; Fine, Jared; Gallagher, Jennifer; Jenner, Tony; Forna, Doriana; Fundak, Angela; Gyenes, Monika; Hovius, Marjolijn; Jacobs, Annelies; Kinnunen, Taru; Knevel, Ron; Koerber, Anne; Labella, Roberto; Lulic, Martina; Mattheos, Nikos; McEwen, Andy; Ohrn, Kerstin; Polychronopoulou, Argy; Preshaw, Philip; Radley, Nicki; Rosseel, Josine; Schoonheim-Klein, Meta; Suvan, Jean; Ulbricht, Sabina; Verstappen, Petra; Walter, Clemens; Warnakulasuriya, Saman; Wennström, Jan; Wickholm, Seppo; Zoitopoulos, Liana

    2010-02-01

    Tobacco use has been identified as a major risk factor for oral disorders such as cancer and periodontal disease. Tobacco use cessation (TUC) is associated with the potential for reversal of precancer, enhanced outcomes following periodontal treatment, and better periodontal status compared to patients who continue to smoke. Consequently, helping tobacco users to quit has become a part of both the responsibility of oral health professionals and the general practice of dentistry. TUC should consist of behavioural support, and if accompanied by pharmacotherapy, is more likely to be successful. It is widely accepted that appropriate compensation of TUC counselling would give oral health professionals greater incentives to provide these measures. Therefore, TUC-related compensation should be made accessible to all dental professionals and be in appropriate relation to other therapeutic interventions. International and national associations for oral health professionals are urged to act as advocates to promote population, community and individual initiatives in support of tobacco use prevention and cessation (TUPAC) counselling, including integration in undergraduate and graduate dental curricula. In order to facilitate the adoption of TUPAC strategies by oral health professionals, we propose a level of care model which includes 1) basic care: brief interventions for all patients in the dental practice to identify tobacco users, assess readiness to quit, and request permission to re-address at a subsequent visit, 2) intermediate care: interventions consisting of (brief) motivational interviewing sessions to build on readiness to quit, enlist resources to support change, and to include cessation medications, and 3) advanced care: intensive interventions to develop a detailed quit plan including the use of suitable pharmacotherapy. To ensure that the delivery of effective TUC becomes part of standard care, continuing education courses and updates should be implemented and offered to all oral health professionals on a regular basis.

  8. 22. MILL NO. 1, 2nd FLOOR, LIGHT TABLES AND KNITTING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    22. MILL NO. 1, 2nd FLOOR, LIGHT TABLES AND KNITTING MACHINE. LIGHT TABLE USED TO CHECK FOR CLOTH DEFECTS. - Prattville Manufacturing Company, Number One, 242 South Court Street, Prattville, Autauga County, AL

  9. Front elevation of Rostrum with 2nd Division American Expeditionary Force ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Front elevation of Rostrum with 2nd Division American Expeditionary Force Monument in foreground, view to northwest - Cypress Hills National Cemetery, Jamaica Avenue Unit, 625 Jamaica Avenue, Brooklyn, Kings County, NY

  10. 21. VIEW FROM INTERIOR OF 2ND FLOOR ARCHED WINDOW WITH ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    21. VIEW FROM INTERIOR OF 2ND FLOOR ARCHED WINDOW WITH HOLLOW STEEL SASH AND POLISHED PLATE WIRE GLASS. THIS WINDOW IS AT THE FRONT OF THE BUILDING. - Pacific Telephone & Telegraph Company Building, 1519 Franklin Street, Oakland, Alameda County, CA

  11. 2nd International Gliomatosis Cerebri Working Group Conference | Center for Cancer Research

    Cancer.gov

    On June 22-23, the NIH hosted the 2nd Gliomatosis Cerebri International Conference that brought together leading neuro-oncologists, neuroscientists and families who have lost a child to the disease. Learn more...

  12. 85. BUILDING NO. 561, CANNON POWDER BLENDER, MIXING CORE, 2ND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    85. BUILDING NO. 561, CANNON POWDER BLENDER, MIXING CORE, 2ND LEVEL; TOP (3RD) BIN ABOVE, SECOND BIN BELOW. - Picatinny Arsenal, 500 Area, Powder Factory & Power House, State Route 15 near I-80, Dover, Morris County, NJ

  13. VIEW SOUTH/SOUTHEAST LOOKING DOWN ON 2ND AQUEDUCT AND 1ST AQUEDUCT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    VIEW SOUTH/SOUTHEAST LOOKING DOWN ON 2ND AQUEDUCT AND 1ST AQUEDUCT CASCADES TOWARDS FILTRATION PLANT AND LOS ANGELES RESERVOIR - Los Angeles Aqueduct, Cascades Structures, Los Angeles, Los Angeles County, CA

  14. 42. OVERALL OF 2nd FLOOR PICKER ROOM OFF MILL NO. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    42. OVERALL OF 2nd FLOOR PICKER ROOM OFF MILL NO. 2. NOTE TRUSSWORK. SPACE TO RIGHT OF COLUMNS IS PART OF 1915 CLOTH ROOM ADDITION. - Prattville Manufacturing Company, Number One, 242 South Court Street, Prattville, Autauga County, AL

  15. 12. Bldg #13, 2nd floor, interior stone walls w/windows and ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. Bldg #13, 2nd floor, interior stone walls w/windows and bent pipe thru wall L and light bulbs in ceiling, to NE - Lawrence Machine Shop, Building No. 13, Union & Canal Streets, Lawrence, Essex County, MA

  16. 24. INTERIOR, ADMINISTRATION BUILDING, 2ND FLOOR OFFICES, LOOKING NORTH; NOTE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    24. INTERIOR, ADMINISTRATION BUILDING, 2ND FLOOR OFFICES, LOOKING NORTH; NOTE GLASS (BROKEN) TRANSOM, WHICH OPENS, BETWEEN CORRIDOR AND OFFICE - Ford Motor Company Plant, 700 South Union Street, Alexandria, Independent City, VA

  17. 27. INTERIOR, ADMINISTRATION BUILDING, 2ND FLOOR, SOUTHEAST CORNER SPACE, LOOKING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    27. INTERIOR, ADMINISTRATION BUILDING, 2ND FLOOR, SOUTHEAST CORNER SPACE, LOOKING UP AT CIRCULAR MOTIF AND BANDS IN THE CEILING ABOVE THE ACOUSTICAL TILES - Ford Motor Company Plant, 700 South Union Street, Alexandria, Independent City, VA

  18. 37. MILL NO. 2, 2nd FLOOR, CLOSE SHOT OF 2 ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    37. MILL NO. 2, 2nd FLOOR, CLOSE SHOT OF 2 CREEL MACHINES, WHICH FEED YARN INTO KNITTING MACHINES. - Prattville Manufacturing Company, Number One, 242 South Court Street, Prattville, Autauga County, AL

  19. MAGAZINE E30. VIEW FROM BETWEEN 1ST AND 2ND BLAST WALL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    MAGAZINE E-30. VIEW FROM BETWEEN 1ST AND 2ND BLAST WALL LOOKING TO THE REAR OF THE MAGAZINE. - Naval Magazine Lualualei, Waikele Branch, Tunnel Magazine Type, Waikakalaua & Kipapa Gulches, Pearl City, Honolulu County, HI

  20. 4. VIEW WEST, WEST SIDE, SHOWING CHANNELS 1ST AND 2ND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. VIEW WEST, WEST SIDE, SHOWING CHANNELS 1ST AND 2ND VERTICAL BRACED DOUBLE ANGLES, DIAGONAL BRACING AND CROSS BRACED RAILING - Thirty-Sixth Street Bridge, Spanning Rabbit River, Hamilton, Allegan County, MI

  1. Morgenröthe or business as usual: a personal account of the 2nd Annual EULAR Congress, Prague

    PubMed Central

    Wollheim, Frank A

    2001-01-01

    The 2nd Annual European League Against Rheumatism (EULAR) Congress, held in Prague, 13–16 June 2001, was an impressive event with a record turnout of 8300 delegates. It offered a large variety of first-class state of the art lectures by some 180 invited worldwide speakers. Several new and ongoing therapeutic developments were discussed. The aim to attract the young scientific community was only partly achieved, and the dependence on industry posed some problems. The organization, however, was a big improvement compared with the previous congress in this series. The number of submitted abstracts was relatively low (1200) compared with the number of delegates. Accommodation of satellite symposia and organization of poster sessions remain problem areas of this meeting. The Annual EULAR Congress emerges as one of the two most important annual congresses of rheumatology, the other being the American College of Rheumatology meeting.

  2. Production and verification of a 2nd generation clonal group of Japanese flounder, Paralichthys olivaceus

    PubMed Central

    Hou, Jilun; Zhang, Xiaoyan; Wang, Yufen; Sun, Zhaohui; Si, Fei; Jiang, Xiufeng; Liu, Haijin

    2016-01-01

    Clonal fishes are useful tools in biology and aquaculture studies due to their isogenicity. In Japanese flounder (Paralichthys olivaceus), a group of homozygous clones was created by inducing meiogynogenesis in eggs from a mitogynogenetic homozygous diploid. As the clones reached sexual maturity, meiogynogenesis was again induced in order to produce a 2nd generation clonal group of Japanese flounder. After 3 months, there were 611 healthy, surviving individuals. Twenty-four microsatellite markers, that covered all the linkage groups of Japanese flounder, were used to identify the homozygosity of the 2nd generation clones; no heterozygous locus was detected. This indicates that the production of a 2nd generation clonal group of Japanese flounder was successful. Restriction-site DNA associated sequencing at the genomic level also confirmed the homozygosity and clonality of the 2nd generation clonal group. Furthermore, these 2nd generation clones had a small coefficient of variation for body shape indices at 210 days of age and showed a high degree of similarity in body characteristics among individuals. The successful production of 2nd generation clones has laid the foundation for the large-scale production of clonal Japanese flounder. PMID:27767055

  3. 2nd Iberian Nuclear Astrophysics Meeting on Compact Stars

    NASA Astrophysics Data System (ADS)

    Perez-Garcia, M. Angeles; Pons, Jose; Albertus, C.

    2012-02-01

    ORGANIZING COMMITTEE Dr M Ángeles Pérez-García (Área Física Teórica-Universidad de Salamanca & IUFFYM) Dr J A Miralles (Universidad de Alicante) Dr J Pons (Universidad de Alicante) Dr C Albertus (Área Física Nuclear-Universidad de Salamanca & IUFFYM) Dr F Atrio (Área Física Teórica-Universidad de Salamanca & IUFFYM) PREFACE The second Iberian Nuclear Astrophysics meeting was held at the University of Salamanca, Spain on 22-23 September 2011. This volume contains most of the presentations delivered at this international workshop. This meeting was the second in the series following the previous I Encuentro Ibérico de Compstar, held at the University of Coimbra, Portugal in 2010. The main purpose of this meeting was to strengthen the scientific collaboration between the participants of the Iberian and the rest of the southern European branches of the European Nuclear Astrophysics network, formerly, COMPSTAR. This ESF (European Science Foundation) supported network has been crucial in helping to make a broader audience for the the most interesting and relevant research lines being developed currently in Nuclear Astrophysics, especially related to the physics of neutron stars. It is indeed important to emphasize the need for a collaborative approach to the rest of the scientific communities so that we can reach possible new members in this interdisciplinary area and as outreach for the general public. The program of the meeting was tailored to theoretical descriptions of the physics of neutron stars although some input from experimental observers and other condensed matter and optics areas of interest was also included. The main scientific topics included: Magnetic fields in compact stars Nuclear structure and in-medium effects in nuclear interaction Equation of state: from nuclear matter to quarks Importance of crust in the evolution of neutron stars Computational simulations of collapsing dense objects Observational phenomenology In particular, leading

  4. Evaluation of the robotic approach concerning pitfalls in rectal surgery.

    PubMed

    Baukloh, J K; Reeh, M; Spinoglio, G; Corratti, A; Bartolini, I; Mirasolo, V M; Priora, F; Izbicki, J R; Gomez Fleitas, M; Gomez Ruiz, M; Perez, D R

    2017-07-01

    The feasibility and advantages of robotic rectal surgery (RRS) in comparison to conventional open or laparoscopic rectal resections have been postulated in several reports. But well-known challenges and pitfalls of minimal invasive rectal surgery have not been evaluated by a prospective, multicenter setting so far. Aim of this study was to analyze the perioperative outcome of patients following RRS especially in regard to the pitfalls such as obesity, male patients and low tumors by a European multicenter setting. This prospective study included 348 patients undergoing robotic surgery due to rectal cancer in six major European centers. Clinicopathological parameters, morbidity, perioperative recovery and short-term outcome were analyzed. A total of 283 restorative surgeries and 65 abdominoperineal resections were carried out. The conversion rate was 4.3%, mean blood loss was 191 ml, and mean operative time was 315 min. Postoperative complications with a Clavien-Dindo score >2 were observed in 13.5%. Obesity and low rectal tumors showed no significant higher rates of major complications or impaired oncological parameters. Male patients had significant higher rates of major complications and anastomotic leakage (p = 0.048 and p = 0.007, respectively). RRS is a promising tool for improvement of rectal resections. The well-known pitfalls of minimal-invasive rectal surgery like obesity and low tumors were sufficiently managed by RRS. However, RRS showed significantly higher rates of major complications and anastomotic leakage in male patients, which has to be evaluated by future randomized trials. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  5. Rectal absorption of propylthiouracil.

    PubMed

    Bartle, W R; Walker, S E; Silverberg, J D

    1988-06-01

    The rectal absorption of propylthiouracil (PTU) was studied and compared to oral absorption in normal volunteers. Plasma levels of PTU after administration of suppositories of PTU base and PTU diethanolamine were significantly lower compared to the oral route. Elevated plasma reverse T3 levels were demonstrated after each treatment, however, suggesting a desirable therapeutic effect at this dosage level for all preparations.

  6. Exploring the potentials of nurture: 2(nd) and 3(rd) generation explant human skin equivalents.

    PubMed

    Danso, Mogbekeloluwa O; van Drongelen, Vincent; Mulder, Aat; Gooris, Gert; van Smeden, Jeroen; El Ghalbzouri, Abdoelwaheb; Bouwstra, Joke A

    2015-02-01

    Explant human skin equivalents (Ex-HSEs) can be generated by placing a 4mm skin biopsy onto a dermal equivalent. The keratinocytes migrate from the biopsy onto the dermal equivalent, differentiate and form the epidermis of 1(st) generation Ex-HSEs. This is especially suitable for the expansion of skin material from which only small fragments of skin can be harvested e.g. diseased skin. We evaluated whether 2(nd) and 3(rd) generation Ex-HSEs can also be generated from a single skin biopsy whilst maintaining the epidermal properties of 1(st) generation Ex-HSEs and native human skin. 2(nd) generation Ex-HSEs were produced by placing a biopsy from the 1(st) generation Ex-HSE onto a new dermal equivalent. Likewise, the 3(rd) generation Ex-HSEs were generated from a 2(nd) generation Ex-HSE biopsy. We show for the first time that Ex-HSEs can be passaged to the 2(nd) and 3(rd) generation and display similar epidermal morphology and expression of differentiation markers as in native human skin and 1(st) generation Ex-HSEs except for involucrin. The 2(nd) and 3(rd) generation Ex-HSEs also show many similarities with 1(st) generation Ex-HSEs in lipid properties e.g. presence of all lipid classes, similar fatty acid chain length distribution and lamellar lipid organization. However, some differences arise in increased level of hexagonal lateral packing and a change in ceramide profiling. The changes in specific lipid classes were also accompanied by changes in the expression of the enzymes responsible for their synthesis. The expansion of skin biopsies to the 2(nd) and 3(rd) generation Ex-HSEs could be a promising method to expand valuable epidermal tissue to analyze morphological and differentiation parameters in the native epidermis. Copyright © 2015 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Rectal contrast increases rectal dose during vaginal cuff brachytherapy.

    PubMed

    Sabater, Sebastia; Andres, Ignacio; Jimenez-Jimenez, Esther; Berenguer, Roberto; Sevillano, Marimar; Lopez-Honrubia, Veronica; Rovirosa, Angeles; Sanchez-Prieto, Ricardo; Arenas, Meritxell

    2016-01-01

    To evaluate the impact of rectal dose on rectal contrast use during vaginal cuff brachytherapy (VCB). A retrospective review of gynecology patients who received some brachytherapy fractions with and without rectal contrast was carried out. Rectal contrast was instilled at the clinician's discretion to increase rectal visibility. Thirty-six pairs of CT scans in preparation for brachytherapy were analyzed. Pairs of CTs were segmented and planned using the same parameters. The rectum was always defined from 1 cm above the cylinder tip up to 1.5 cm below the last activated dwell source position. An individual plan was computed at every VCB fraction. A set of values (Dmax, D(0.1cc), D(1cc), and D(2cc)) derived from dose-volume histograms were extracted and compared according to the rectal status. Rectal volume was 26.7% larger in the fractions with rectal contrast. Such an increase in volume represented a significant increase from 7.7% to 10.4% in all parameters analyzed except Dmax dose-volume histogram. Avoiding rectal contrast is a simple way of decreasing the rectal dose parameters of VCB, which would mean a better therapeutic ratio. Results also suggest that action directed at maintaining the rectum empty might have the same effect. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  8. The Effect of Using Computer Edutainment on Developing 2nd Primary Graders' Writing Skills

    ERIC Educational Resources Information Center

    Mohammed Abdel Raheem, Azza Ashraf

    2011-01-01

    The present study attempted to examine the effect of using computer edutainment on developing 2nd graders' writing skills. The study comprised thirty-second year primary stage enrolled in Bani Hamad primary governmental school, Minia governorate. The study adopted the quasi-experimental design. Thirty participants were randomly assigned to one…

  9. Proceedings of the 2nd symposium on valves for coal conversion and utilization

    SciTech Connect

    Maxfield, D.A.

    1981-01-01

    The 2nd symposium on valves for coal conversion and utilization was held October 15 to 17, 1980. It was sponsored by the US Department of Energy, Morgantown Energy Technology Center, in cooperation with the Valve Manufacturers Association. Seventeen papers have been entered individually into EDB and ERA. (LTN)

  10. Introduction-2nd Fire Behavior and Fuels Conference: The fire environment-innovations, management, and policy

    Treesearch

    Wayne Cook; Bret W. Butler

    2007-01-01

    The 2nd Fire Behavior and Fuels Conference: Fire Environment -- Innovations, Management and Policy was held in Destin, FL, March 26-30, 2007. Following on the success of the 1st Fire Behavior and Fuels Conference, this conference was initiated in response to the needs of the National Wildfire Coordinating Group -- Fire Environment Working Team.

  11. SINGLEFAMILY MANAGERS' HOUSES ON EAST SIDE OF 2ND STREET, LOOKING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    SINGLE-FAMILY MANAGERS' HOUSES ON EAST SIDE OF 2ND STREET, LOOKING NORTH; THE MINE SUPERINTENDENT, ASSISTANT SUPERINTENDENT AND OTHER HIGH-RANKING MANAGERS LIVED IN THESE HOUSES WHICH ARE ALSO CONSTRUCTED OF CONCRETE - Town of Cairnbrook, Cairnbrook, Somerset County, PA

  12. Technical Adequacy of the Disruptive Behavior Rating Scale-2nd Edition--Self-Report

    ERIC Educational Resources Information Center

    Erford, Bradley T.; Miller, Emily M.; Isbister, Katherine

    2015-01-01

    This study provides preliminary analysis of the Disruptive Behavior Rating Scale-2nd Edition--Self-Report, which was designed to screen individuals aged 10 years and older for anxiety and behavior symptoms. Score reliability and internal and external facets of validity were good for a screening-level test.

  13. 2nd International Forum for Surveillance and Control of Mosquitoes and Mosquito-borne Diseases

    USDA-ARS?s Scientific Manuscript database

    The Entomological Society of China (ESC) and Beijing Institute of Microbiology and Epidemiology (BIME) hosted the 2nd International Forum for Surveillance and Control of Mosquitoes and Mosquito-borne Diseases in Beijing, China, May 23-27, 2011. The theme of the Forum was “Impact of global climate ch...

  14. Stem cells and cancer immunotherapy: Arrowhead’s 2nd annual cancer immunotherapy conference

    PubMed Central

    2014-01-01

    Investigators from academia and industry gathered on April 4 and 5, 2013, in Washington DC at the Arrowhead’s 2nd Annual Cancer Immunotherapy Conference. Two complementary concepts were discussed: cancer “stem cells” as targets and therapeutic platforms based on stem cells.

  15. Methods for the Determination of Chemical Substances in Marine and Estuarine Environmental Matrices - 2nd Edition

    EPA Science Inventory

    This NERL-Cincinnati publication, “Methods for the Determination of Chemical Substances in Marine and Estuarine Environmental Matrices - 2nd Edition” was prepared as the continuation of an initiative to gather together under a single cover a compendium of standardized laborato...

  16. Methods for the Determination of Chemical Substances in Marine and Estuarine Environmental Matrices - 2nd Edition

    EPA Science Inventory

    This NERL-Cincinnati publication, “Methods for the Determination of Chemical Substances in Marine and Estuarine Environmental Matrices - 2nd Edition” was prepared as the continuation of an initiative to gather together under a single cover a compendium of standardized laborato...

  17. Technical Adequacy of the Disruptive Behavior Rating Scale-2nd Edition--Self-Report

    ERIC Educational Resources Information Center

    Erford, Bradley T.; Miller, Emily M.; Isbister, Katherine

    2015-01-01

    This study provides preliminary analysis of the Disruptive Behavior Rating Scale-2nd Edition--Self-Report, which was designed to screen individuals aged 10 years and older for anxiety and behavior symptoms. Score reliability and internal and external facets of validity were good for a screening-level test.

  18. Evaluation of a Hand Washing Program for 2nd-Graders

    ERIC Educational Resources Information Center

    Tousman, Stuart; Arnold, Dani; Helland, Wealtha; Roth, Ruth; Heshelman, Nannatte; Castaneda, Oralia; Fischer, Emily; O'Neil, Kristen; Bileto, Stephanie

    2007-01-01

    The purpose of this project was to determine if a multiple-week learner-centered hand washing program could improve hand hygiene behaviors of 2nd-graders in a northern Illinois public school system. Volunteers from the Rockford Hand Washing Coalition went into 19 different classrooms for 4 consecutive weeks and taught a learner-centered program.…

  19. Evaluation of a Hand Washing Program for 2nd-Graders

    ERIC Educational Resources Information Center

    Tousman, Stuart; Arnold, Dani; Helland, Wealtha; Roth, Ruth; Heshelman, Nannatte; Castaneda, Oralia; Fischer, Emily; O'Neil, Kristen; Bileto, Stephanie

    2007-01-01

    The purpose of this project was to determine if a multiple-week learner-centered hand washing program could improve hand hygiene behaviors of 2nd-graders in a northern Illinois public school system. Volunteers from the Rockford Hand Washing Coalition went into 19 different classrooms for 4 consecutive weeks and taught a learner-centered program.…

  20. Phase I Study of Neoadjuvant Radiotherapy With 5-Fluorouracil for Rectal Cancer

    ClinicalTrials.gov

    2017-09-14

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

  1. Rectal Dose and Source Strength of the High-Dose-Rate Iridium-192 Both Affect Late Rectal Bleeding After Intracavitary Radiation Therapy for Uterine Cervical Carcinoma

    SciTech Connect

    Isohashi, Fumiaki; Yoshioka, Yasuo; Koizumi, Masahiko

    2010-07-01

    Purpose: The purpose of this study was to reconfirm our previous findings that the rectal dose and source strength both affect late rectal bleeding after high-dose-rate intracavitary brachytherapy (HDR-ICBT), by using a rectal dose calculated in accordance with the definitions of the International Commission on Radiation Units and Measurements Report 38 (ICRU{sub RP}) or of dose-volume histogram (DVH) parameters by the Groupe Europeen de Curietherapie of the European Society for Therapeutic Radiology and Oncology. Methods and Materials: Sixty-two patients who underwent HDR-ICBT and were followed up for 1 year or more were studied. The rectal dose for ICBT was calculated by using the ICRP{sub RP} based on orthogonal radiographs or the DVH parameters based on computed tomography (CT). The total dose was calculated as the biologically equivalent dose expressed in 2-Gy fractions (EQD{sub 2}). The relationship between averaged source strength or the EQD{sub 2} and late rectal bleeding was then analyzed. Results: When patients were divided into four groups according to rectal EQD{sub 2} ({>=} or =} or <2.4 cGy.m{sup 2}.h{sup -1}), the group with both a high EQD{sub 2} and a high source strength showed a significantly greater probability of rectal bleeding for ICRU{sub RP}, D{sub 2cc}, and D{sub 1cc}. The patients with a median rectal dose above the threshold level did not show a greater frequency of rectal bleeding unless the source strength exceeded 2.4 cGy.m{sup 2}.h{sup -1}. Conclusions: Our results obtained with data based on ICRU{sub RP} and CT-based DVH parameters indicate that rectal dose and source strength both affect rectal bleeding after HDR-ICBT.

  2. Rectal dose and source strength of the high-dose-rate iridium-192 both affect late rectal bleeding after intracavitary radiation therapy for uterine cervical carcinoma.

    PubMed

    Isohashi, Fumiaki; Yoshioka, Yasuo; Koizumi, Masahiko; Suzuki, Osamu; Konishi, Koji; Sumida, Iori; Takahashi, Yutaka; Ogata, Toshiyuki; Kotsuma, Tadayuki; Inoue, Takehiro

    2010-07-01

    The purpose of this study was to reconfirm our previous findings that the rectal dose and source strength both affect late rectal bleeding after high-dose-rate intracavitary brachytherapy (HDR-ICBT), by using a rectal dose calculated in accordance with the definitions of the International Commission on Radiation Units and Measurements Report 38 (ICRU(RP)) or of dose-volume histogram (DVH) parameters by the Groupe Européen de Curietherapie of the European Society for Therapeutic Radiology and Oncology. Sixty-two patients who underwent HDR-ICBT and were followed up for 1 year or more were studied. The rectal dose for ICBT was calculated by using the ICRP(RP) based on orthogonal radiographs or the DVH parameters based on computed tomography (CT). The total dose was calculated as the biologically equivalent dose expressed in 2-Gy fractions (EQD(2)). The relationship between averaged source strength or the EQD(2) and late rectal bleeding was then analyzed. When patients were divided into four groups according to rectal EQD(2) (>or= or or= or <2.4 cGy.m(2).h(-1)), the group with both a high EQD(2) and a high source strength showed a significantly greater probability of rectal bleeding for ICRU(RP), D(2cc), and D(1cc). The patients with a median rectal dose above the threshold level did not show a greater frequency of rectal bleeding unless the source strength exceeded 2.4 cGy.m(2).h(-1). Our results obtained with data based on ICRU(RP) and CT-based DVH parameters indicate that rectal dose and source strength both affect rectal bleeding after HDR-ICBT. (c) 2010 Elsevier Inc. All rights reserved.

  3. 2nd-Order CESE Results For C1.4: Vortex Transport by Uniform Flow

    NASA Technical Reports Server (NTRS)

    Friedlander, David J.

    2015-01-01

    The Conservation Element and Solution Element (CESE) method was used as implemented in the NASA research code ez4d. The CESE method is a time accurate formulation with flux-conservation in both space and time. The method treats the discretized derivatives of space and time identically and while the 2nd-order accurate version was used, high-order versions exist, the 2nd-order accurate version was used. In regards to the ez4d code, it is an unstructured Navier-Stokes solver coded in C++ with serial and parallel versions available. As part of its architecture, ez4d has the capability to utilize multi-thread and Messaging Passage Interface (MPI) for parallel runs.

  4. Graphical shapes of the 2nd type singularities of a 3-RR̠R planar mechanism

    NASA Astrophysics Data System (ADS)

    Buium, F.; Duca, C.; Doroftei, I.; Leohchi, D.

    2016-08-01

    This paper intends to discuss about singularity curves of 2nd type inside the workspace of a 3R̠RR planar parallel mechanism used as robot structure. In order to attain this goal we will use certain variation of the links dimensional parameters. This characterization of the mechanism singularities located inside mechanism workspace depends on the dimensional parameters and can be useful in mechanism designing accorded to some functional particularities in the sense that it can help in avoiding singular configurations.

  5. Idaho National Laboratory Quarterly Performance Analysis for the 2nd Quarter FY 2015

    SciTech Connect

    Mitchell, Lisbeth A.

    2015-04-01

    This report is published quarterly by the Idaho National Laboratory (INL) Quality and Performance Management Organization. The Department of Energy (DOE) Occurrence Reporting and Processing System (ORPS), as prescribed in DOE Order 232.2, “Occurrence Reporting and Processing of Operations Information,” requires a quarterly analysis of events, both reportable and not reportable, for the previous 12 months. This report is the analysis of events for the 2nd Qtr FY-15.

  6. [Termination of pregnancy in the 2nd trimester: mifepriston/misoprostol preferable to sulprostone].

    PubMed

    Ebbers, Sabine; Creemers, Johan W T; Lotgering, Fred K

    2009-01-01

    To compare the efficacy of sulprostone and mifepristone/misoprostol when used for termination of pregnancy (TOP) in the 2nd trimester. Comparative retrospective cohort study. Data were collected on all women whose pregnancies were terminated in the 2nd trimester, in the presence of severe fetal defects, between 1996 and 2007 at the Radboud University Nijmegen Medical Centre, the Netherlands. From the start of 1996 until the end of 2001 TOPs were performed using sulprostone. In 2001 the treatment was switched to the combination mifepristone/misoprostol. The primary outcome measure was the time interval between the initiation of prostaglandin medication and the birth of the infant. 158 patients met the inclusion criteria: 51 women were treated with sulprostone, 107 women with mifepriston/misoprostol. The duration of treatment in the mifepristone/misoprostol group (median 8.7 hours, range: 1.1-72.0 hours) was significantly shorter than in the sulprostone group (median 21.3 hours, range: 7.8-265.0 hours). In the mifepristone/misoprostol group significantly more women (94%) delivered within 24 hours than in the sulprostone group (55%). In the mifepristone/misoprostol group anti-emetics and pain relief were given significantly less often than in the sulprostone group 5 versus 12% and 54 versus 90%, respectively). There was no statistically significant difference in the number of women with post partum blood loss (6 versus 6%), (suspected) placental remnants (33 versus 43%) or fever (12 versus 4%). In termination of pregnancy in the 2nd trimester mifepristone/misoprostol was more effective than sulprostone. Given the disadvantages of sulprostone in comparison with mifepristone/misoprostol, sulprostone no longer deserves a place in termination of pregnancy in the 2nd trimester.

  7. Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004

    PubMed Central

    McCrory, P; Johnston, K; Meeuwisse, W; Aubry, M; Cantu, R; Dvorak, J; Graf-Baumann, T; Kelly, J; Lovell, M; Schamasch, P

    2005-01-01

    In November 2001, the 1st International Symposium on Concussion in Sport was held in Vienna, Austria to provide recommendations for the improvement of safety and health of athletes who suffer concussive injuries in ice hockey, football (soccer), and other sports. The 2nd International Symposium on Concussion in Sport was organised by the same group and held in Prague, Czech Republic in November 2004. It resulted in a revision and update of the Vienna consensus recommendations, which are presented here.

  8. Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004

    PubMed Central

    McCrory, P; Johnston, K; Meeuwisse, W; Aubry, M; Cantu, R; Dvorak, J; Graf-Baumann, T; Kelly, J; Lovell, M; Schamasch, P

    2005-01-01

    In November 2001, the 1st International Symposium on Concussion in Sport was held in Vienna, Austria to provide recommendations for the improvement of safety and health of athletes who suffer concussive injuries in ice hockey, football (soccer), and other sports. The 2nd International Symposium on Concussion in Sport was organised by the same group and held in Prague, Czech Republic in November 2004. It resulted in a revision and update of the Vienna consensus recommendations, which are presented here. PMID:15793085

  9. [Complications of multiple pregnancy in the 2nd and 3rd trimesters].

    PubMed

    Poniedziałek-Czajkowska, E; Leszczyńska-Gorzelak, B; Oleszczuk, J

    2000-11-01

    Multiple pregnancy contributes to higher maternal and fetal risks than a single one. Complications typical only for multiple pregnancy such as PROM with preterm delivery, intrauterine death or IUGR of one of twins can occur during 2nd and 3rd trimester. Treatment in such situations is usually difficult and often controversial because of simultaneous presence of an alive and/or healthy fetus and possible risk for mother. The paper presents such situations and possible ways of treatment.

  10. A Communications Guide for Sustainable Development: How Interested Parties Become Partners, 2nd Edition

    SciTech Connect

    Fowler, Kimberly M.; Hund, Gretchen; Engel-Cox, Jill A.

    2016-03-06

    The 2nd edition is an updated version plus an e-book. This book was developed to assist organizations in designing and managing their communication and stakeholder involvement programs. The guidebook describes a step-by-step approach, provides case studies, and presents tools to consider. The book uses a scenario approach to outline changes an organization may confront, and provides a menu of communication and engagement activities that support organizational decision making.

  11. The accuracy of endorectal ultrasonography in rectal cancer staging

    PubMed Central

    COTE, ADRIAN; GRAUR, FLORIN; LEBOVICI, ANDREI; MOIS, EMIL; AL HAJJAR, NADIM; MARE, CODRUTA; BADEA, RADU; IANCU, CORNEL

    2015-01-01

    Background and aims The incidence of rectal cancer in the European Union is about 35% of the total colorectal cancer incidence. Staging rectal cancer is important for planning treatment. It is essential for the management of rectal cancer to have adequate preoperative imaging, because accurate staging can influence the therapeutic strategy, type of resection, and candidacy for neoadjuvant therapy. The aim of this work is to evaluate the accuracy of endorectal ultrasound (ERUS) in rectal cancer staging. Methods A retrospective study was performed to assess the accuracy of ERUS by analyzing patients discharged from Regional Institute of Gastroenterology and Hepatology (IRGH) Cluj-Napoca, Romania, diagnosed with rectal cancer between 01 January 2011 and 31 December 2013. Patients who were preoperatively staged by other imaging methods and those who had ERUS performed in another service were excluded from the analysis. As inclusion criteria remained ERUS performed for patients with rectal cancer in IRGH Cluj-Napoca where they were also operated. We analyzed preoperative T stage obtained by ERUS and it was compared with the histopathology findings. Results The number of patients discharged with a diagnosis of rectal cancer were 200 (operated – 157) in 2011, 193 (operated – 151) in 2012, and 198 (operated – 142) in 2013. We analyzed a total of 51 cases diagnosed with rectal cancer who performed ERUS in IRGH Cluj-Napoca. The results according to the T stage obtained by ERUS and histopathology test were: Under-stage T2= 25.0%, T3=7.9% of cases; Over-stage T2=25.0%, T3=31.6% and T4=60.0% of cases. Less than 20% of patients underwent preoperative radio-chemotherapy. Conclusions ERUS is a method of staging rectal cancer which is human dependent. ERUS is less accurate for T staging of stenotic tumours, but the accuracy may still be within acceptable limits. Surgeons use ERUS to adopt a treatment protocol, knowing the risk of under-staging and over-staging of this method

  12. Application research on enhancing near-infrared micro-imaging quality by 2nd derivative

    NASA Astrophysics Data System (ADS)

    Wang, Dong; Ma, Zhi-hong; Zhao, Liu; Wang, Bei-hong; Han, Ping; Pan, Li-gang; Wang, Ji-hua

    2013-08-01

    Near-infrared micro-imaging will not only provide the sample's spatial distribution information, but also the spectroscopic information of each pixel. In this thesis, it took the artificial sample of wheat flour and formaldehyde sodium sulfoxylate distribution given for example to research the data processing method for enhancing the quality of near-infrared micro-imaging. Near-infrared spectroscopic feature of wheat flour and formaldehyde sodium sulfoxylate being studied on, compare correlation imaging and 2nd derivative imaging were applied in the imaging processing of the near-infrared micro-image of the artificial sample. Furthermore, the two methods were combined, i.e. 2nd derivative compare correlation imaging was acquired. The result indicated that the difference of the correlation coefficients between the two substances, i.e. wheat flour and formaldehyde sodium sulfoxylate, and the reference spectrum has been increased from 0.001 in compare correlation image to 0.796 in 2nd derivative compare correlation image respectively, which enhances the imaging quality efficiently. This study will, to some extent, be of important reference significance to near-infrared micro-imaging method research of agricultural products and foods.

  13. NASA 2nd Generation RLV Program Introduction, Status and Future Plans

    NASA Technical Reports Server (NTRS)

    Dumbacher, Dan L.; Smith, Dennis E. (Technical Monitor)

    2002-01-01

    The Space Launch Initiative (SLI), managed by the Second Generation Reusable Launch Vehicle (2ndGen RLV) Program, was established to examine the possibility of revolutionizing space launch capabilities, define conceptual architectures, and concurrently identify the advanced technologies required to support a next-generation system. Initial Program funds have been allocated to design, evaluate, and formulate realistic plans leading to a 2nd Gen RLV full-scale development (FSD) decision by 2006. Program goals are to reduce both risk and cost for accessing the limitless opportunities afforded outside Earth's atmosphere fo civil, defense, and commercial enterprises. A 2nd Gen RLV architecture includes a reusable Earth-to-orbit launch vehicle, an on-orbit transport and return vehicle, ground and flight operations, mission planning, and both on-orbit and on-the-ground support infrastructures All segments of the architecture must advance in step with development of the RLV if a next-generation system is to be fully operational early next decade. However, experience shows that propulsion is the single largest contributor to unreliability during ascent, requires the largest expenditure of time for maintenance, and takes a long time to develop; therefore, propulsion is the key to meeting safety, reliability, and cost goals. For these reasons, propulsion is SLI's top technology investment area.

  14. Spelling performance of 2nd to 5th grade students from public school.

    PubMed

    Capellini, Simone Aparecida; Amaral, Amanda Corrêa do; Oliveira, Andrea Batista; Sampaio, Maria Nobre; Fusco, Natália; Cervera-Mérida, José Francisco; Ygual-Fernández, Amparo

    2011-09-01

    To characterize, compare and classify the performance of 2nd to 5th grade students from public schools according to the semiology of spelling errors. Participants were 120 students from 2nd to 5th grades of a public school in Marília (SP), Brazil, 30 students from each grade, who were divided into four groups: GI (2nd grade), GII (3rd grade), GIII (4th grade), and GIV (5th grade). The tasks of the Pro-Ortografia test were applied: collective version (writing of alphabet letters, randomized dictation of letters, words dictation, nonwords dictation, dictation with pictures, thematic writing induced by picture) and individual version (dictation of sentences, purposeful error, spelled dictation, orthographic lexical memory). Significant difference was found in the between-group comparison indicating better performance of students in every subsequent grade in most of the individual and collective version tasks. With the increase of grade level, the groups decreased the average of writing errors. The profile of spelling acquisition of the Portuguese writing system found in these public school students indicates normal writing development in this population.

  15. Development of fetal intestinal length during 2nd-trimester in normal and pathologic pregnancies.

    PubMed

    Marnerides, Andreas; Ghazi, Sam; Sundberg, Anders; Papadogiannakis, Nikos

    2012-01-01

    Linear growth of the human fetal gastrointestinal tract is not often discussed in the literature, and little is known about the effects of chromosomal abnormalities and intrauterine growth restriction (IUGR) on intestinal length, especially during the 2nd trimester. Accurate evaluation of intestinal length and knowledge of normal and reference values are of clinical importance. For example, intestinal resection may be necessary in preterm infants with necrotizing enterocolitis or mid-gut volvulus, and the surgeon should use data to be judicious in the amount removed. Linear measurements are essential in evaluating fetal development ultrasonographically and are an integral part of the postmortem examination. The intestinal lengths of 203 2nd-trimester fetuses and premature infants were measured. Small intestine length (SIL), colon length (CL), total bowel length (TBL; TBL  =  SIL + CL), and the length of the appendix (AL) increased with gestational age. No differences between the genders were observed. Colon length increased secondary to maceration, but no such effects were shown on SIL, TBL, or AL. No differences were shown in relation to IUGR. Small intestine length, CL, and TBL, but not AL, were shorter in fetuses with trisomy 21. Appendix length was not affected by any of the studied factors. We propose that the measurement of the length of the appendix may be used as an additional parameter for the postmortem evaluation of gestational age. Furthermore, its assessment may have potential as an ultrasonographic indicator of gestational age, particularly for the 2nd trimester.

  16. Healing of rat mouth mucosa after irradiation with CO2, Nd:YAG, and CO2-Nd:YAG combination lasers.

    PubMed

    Luomanen, M; Rauhamaa-Mäkinen, R; Meurman, J H; Kosloff, T; Tiitta, O

    1994-08-01

    The healing process of wounds made by a combination laser was studied in 90 rats. The laser system enabled both separate and combined use of CO2 and Nd:YAG laser irradiations. The laser wounds and the control excision wounds made by alligator forceps appeared on both sides of the tongue. Specimens from the wound sites were taken immediately, 6 h, and 1, 2, 4, 7, 11, 21, 28, and 42 days after surgery. The wound-healing process was studied by macroscopic evaluation before preparing the specimens for light microscopy. Some differences were noted in the wound-healing process among the three groups into which the experimental animals were divided. Tissue coagulation damage was most extensive in the Nd:YAG laser sites, where it was observed in its full extent 4 days after surgery. Epithelial cells were seen to begin to proliferate in all the wounds 6 h after surgery. Re-epithelialization was completed by between 7 (CO2) and 21 days (Nd:YAG) at all the wound sites. The inflammatory cell infiltration was more prominent in the Nd:YAG and the CO2-Nd:YAG combination laser wounds than in the CO2 and excision wounds during healing. Tissue regeneration occurred faster with less contraction in the combination CO2-Nd:YAG wounds than in Nd:YAG wounds. The best macroscopic healing result was seen in the CO2 wound sites. The combination laser was effective both at cutting and at coagulating tissue. Combining the CO2 and Nd:YAG laser irradiation into one beam resulted in a greater incision depth than what could have been expected from using the two lasers separately.

  17. [Prevalence and causes of pain after cataract surgery: Comparison of 1st and 2nd eyes].

    PubMed

    Gayadine-Harricham, Y; Amzallag, T

    2017-06-01

    In our practice, patients undergoing bilateral cataract surgery complain of more significant pain after the 2nd eye surgery. The goal of this study was to compare postoperative pain between the 1st and 2nd eyes with cataract surgery under topical anesthesia and to identify the causes of this pain. We conducted a prospective observational study between May and September 2015. We included 69 consecutive adults scheduled for bilateral cataract surgery under topical anesthesia within 2 months by the same surgeon. A self-assessment questionnaire of anxiety (the Amsterdam Preoperative Anxiety and Information Scale [APAIS]) was completed before each procedure. Postoperative pain was assessed by the visual analogue scale (VAS) in the recovery room. Among the 69 included patients (mean age: 70±1.3 years), 13 (19%) experienced more pain after the 2nd eye procedure. The median VAS was 0 (EI: 0-1) after the first eye versus 0 (EI: 0-2) after the second eye (P=0.836). The patients with the most pain after the second eye surgery had a median anxiety score of 5 (EI: 4 to 9.5), which was comparable to those without pain (P=0.589). On bivariate analysis, women had more pain after second eye surgery (27%) than men (4%) (P=0.026). However, this association lost its significance when the analysis was adjusted for the level of anxiety (adjusted OR 7.7, 95% CI [0.91; 64.6]). In fact, women were more anxious [median anxiety score of 6 (EI: 4 to 8.5)] before 2nd eye surgery than men [median score: 4 (EI: 4-6); P=0.013]. Pain levels appeared to be very moderate on both sides when measured postoperatively, as opposed to statements often made in the immediate postoperative period. There is a discrepancy with the literature data. However, each study had small sample sizes. We did not find any significant difference in pain between 1st and 2nd eye cataract surgery under topical local anesthesia. While postoperative pain appeared greater among women, we have noted the possible influence of

  18. A systematic approach to the interpretation of preoperative staging MRI for rectal cancer.

    PubMed

    Taylor, Fiona G M; Swift, Robert I; Blomqvist, Lennart; Brown, Gina

    2008-12-01

    The purpose of this article is to provide an aid to the systematic evaluation of MRI in staging rectal cancer. MRI has been shown to be an effective tool for the accurate preoperative staging of rectal cancer. In the Magnetic Resonance Imaging and Rectal Cancer European Equivalence Study (MERCURY), imaging workshops were held for participating radiologists to ensure standardization of scan acquisition techniques and interpretation of the images. In this article, we report how the information was obtained and give examples of the images and how they are interpreted, with the aim of providing a systematic approach to the reporting process.

  19. Life Cycle Systems Engineering Approach to NASA's 2nd Generation Reusable Launch Vehicle

    NASA Technical Reports Server (NTRS)

    Thomas, Dale; Smith, Charles; Safie, Fayssal; Kittredge, Sheryl

    2002-01-01

    The overall goal of the 2nd Generation RLV Program is to substantially reduce technical and business risks associated with developing a new class of reusable launch vehicles. NASA's specific goals are to improve the safety of a 2nd- generation system by 2 orders of magnitude - equivalent to a crew risk of 1 -in- 10,000 missions - and decrease the cost tenfold, to approximately $1,000 per pound of payload launched. Architecture definition is being conducted in parallel with the maturating of key technologies specifically identified to improve safety and reliability, while reducing operational costs. An architecture broadly includes an Earth-to-orbit reusable launch vehicle, on-orbit transfer vehicles and upper stages, mission planning, ground and flight operations, and support infrastructure, both on the ground and in orbit. The systems engineering approach ensures that the technologies developed - such as lightweight structures, long-life rocket engines, reliable crew escape, and robust thermal protection systems - will synergistically integrate into the optimum vehicle. Given a candidate architecture that possesses credible physical processes and realistic technology assumptions, the next set of analyses address the system's functionality across the spread of operational scenarios characterized by the design reference missions. The safety/reliability and cost/economics associated with operating the system will also be modeled and analyzed to answer the questions "How safe is it?" and "How much will it cost to acquire and operate?" The systems engineering review process factors in comprehensive budget estimates, detailed project schedules, and business and performance plans, against the goals of safety, reliability, and cost, in addition to overall technical feasibility. This approach forms the basis for investment decisions in the 2nd Generation RLV Program's risk-reduction activities. Through this process, NASA will continually refine its specialized needs and

  20. Structure Relations and Darboux Contractions for 2D 2nd Order Superintegrable Systems

    NASA Astrophysics Data System (ADS)

    Heinonen, Robin; Kalnins, Ernest G.; Miller, Willard, Jr.; Subag, Eyal

    2015-06-01

    Two-dimensional quadratic algebras are generalizations of Lie algebras that include the symmetry algebras of 2nd order superintegrable systems in 2 dimensions as special cases. The superintegrable systems are exactly solvable physical systems in classical and quantum mechanics. Distinct superintegrable systems and their quadratic algebras can be related by geometric contractions, induced by Inönü-Wigner type Lie algebra contractions. These geometric contractions have important physical and geometric meanings, such as obtaining classical phenomena as limits of quantum phenomena as hbar to 0 and nonrelativistic phenomena from special relativistic as cto ∞, and the derivation of the Askey scheme for obtaining all hypergeometric orthogonal polynomials as limits of Racah/Wilson polynomials. In this paper we show how to simplify the structure relations for abstract nondegenerate and degenerate quadratic algebras and their contractions. In earlier papers we have classified contractions of 2nd order superintegrable systems on constant curvature spaces and have shown that all results are derivable from free quadratic algebras contained in the enveloping algebras of the Lie algebras e(2,C) in flat space and o(3,C) on nonzero constant curvature spaces. The quadratic algebra contractions are induced by generalizations of Inönü-Wigner contractions of these Lie algebras. As a special case we obtained the Askey scheme for hypergeometric orthogonal polynomials. After constant curvature spaces, the 4 Darboux spaces are the 2D manifolds admitting the most 2nd order Killing tensors. Here we complete this theoretical development for 2D superintegrable systems by showing that the Darboux superintegrable systems are also characterized by free quadratic algebras contained in the symmetry algebras of these spaces and that their contractions are also induced by Inönü-Wigner contractions. We present tables of the contraction results.

  1. Systems Engineering Approach to Technology Integration for NASA's 2nd Generation Reusable Launch Vehicle

    NASA Technical Reports Server (NTRS)

    Thomas, Dale; Smith, Charles; Thomas, Leann; Kittredge, Sheryl

    2002-01-01

    The overall goal of the 2nd Generation RLV Program is to substantially reduce technical and business risks associated with developing a new class of reusable launch vehicles. NASA's specific goals are to improve the safety of a 2nd-generation system by 2 orders of magnitude - equivalent to a crew risk of 1-in-10,000 missions - and decrease the cost tenfold, to approximately $1,000 per pound of payload launched. Architecture definition is being conducted in parallel with the maturating of key technologies specifically identified to improve safety and reliability, while reducing operational costs. An architecture broadly includes an Earth-to-orbit reusable launch vehicle, on-orbit transfer vehicles and upper stages, mission planning, ground and flight operations, and support infrastructure, both on the ground and in orbit. The systems engineering approach ensures that the technologies developed - such as lightweight structures, long-life rocket engines, reliable crew escape, and robust thermal protection systems - will synergistically integrate into the optimum vehicle. To best direct technology development decisions, analytical models are employed to accurately predict the benefits of each technology toward potential space transportation architectures as well as the risks associated with each technology. Rigorous systems analysis provides the foundation for assessing progress toward safety and cost goals. The systems engineering review process factors in comprehensive budget estimates, detailed project schedules, and business and performance plans, against the goals of safety, reliability, and cost, in addition to overall technical feasibility. This approach forms the basis for investment decisions in the 2nd Generation RLV Program's risk-reduction activities. Through this process, NASA will continually refine its specialized needs and identify where Defense and commercial requirements overlap those of civil missions.

  2. Systems Engineering Approach to Technology Integration for NASA's 2nd Generation Reusable Launch Vehicle

    NASA Technical Reports Server (NTRS)

    Thomas, Dale; Smith, Charles; Thomas, Leann; Kittredge, Sheryl

    2002-01-01

    The overall goal of the 2nd Generation RLV Program is to substantially reduce technical and business risks associated with developing a new class of reusable launch vehicles. NASA's specific goals are to improve the safety of a 2nd generation system by 2 orders of magnitude - equivalent to a crew risk of 1-in-10,000 missions - and decrease the cost tenfold, to approximately $1,000 per pound of payload launched. Architecture definition is being conducted in parallel with the maturating of key technologies specifically identified to improve safety and reliability, while reducing operational costs. An architecture broadly includes an Earth-to-orbit reusable launch vehicle, on-orbit transfer vehicles and upper stages, mission planning, ground and flight operations, and support infrastructure, both on the ground and in orbit. The systems engineering approach ensures that the technologies developed - such as lightweight structures, long-life rocket engines, reliable crew escape, and robust thermal protection systems - will synergistically integrate into the optimum vehicle. To best direct technology development decisions, analytical models are employed to accurately predict the benefits of each technology toward potential space transportation architectures as well as the risks associated with each technology. Rigorous systems analysis provides the foundation for assessing progress toward safety and cost goals. The systems engineering review process factors in comprehensive budget estimates, detailed project schedules, and business and performance plans, against the goals of safety, reliability, and cost, in addition to overall technical feasibility. This approach forms the basis for investment decisions in the 2nd Generation RLV Program's risk-reduction activities. Through this process, NASA will continually refine its specialized needs and identify where Defense and commercial requirements overlap those of civil missions.

  3. PREFACE: 2nd International Conference on Innovative Materials, Structures and Technologies

    NASA Astrophysics Data System (ADS)

    Ručevskis, Sandris

    2015-11-01

    The 2nd International Conference on Innovative Materials, Structures and Technologies (IMST 2015) took place in Riga, Latvia from 30th September - 2nd October, 2015. The first event of the conference series, dedicated to the 150th anniversary of the Faculty of Civil Engineering of Riga Technical University, was held in 2013. Following the established tradition, the aim of the conference was to promote and discuss the latest results of industrial and academic research carried out in the following engineering fields: analysis and design of advanced structures and buildings; innovative, ecological and energy efficient building materials; maintenance, inspection and monitoring methods; construction technologies; structural management; sustainable and safe transport infrastructure; and geomatics and geotechnics. The conference provided an excellent opportunity for leading researchers, representatives of the industrial community, engineers, managers and students to share the latest achievements, discuss recent advances and highlight the current challenges. IMST 2015 attracted over 120 scientists from 24 countries. After rigorous reviewing, over 80 technical papers were accepted for publication in the conference proceedings. On behalf of the organizing committee I would like to thank all the speakers, authors, session chairs and reviewers for their efficient and timely effort. The 2nd International Conference on Innovative Materials, Structures and Technologies was organized by the Faculty of Civil Engineering of Riga Technical University with the support of the Latvia State Research Programme under the grant agreement "INNOVATIVE MATERIALS AND SMART TECHNOLOGIES FOR ENVIRONMENTAL SAFETY, IMATEH". I would like to express sincere gratitude to Juris Smirnovs, Dean of the Faculty of Civil Engineering, and Andris Chate, manager of the Latvia State Research Programme. Finally, I would like to thank all those who helped to make this event happen. Special thanks go to Diana

  4. Mars Curriculum for K-12 Science Education, 2nd Edition, Making Tracks on Mars Teacher Resource and Activity Guide

    NASA Astrophysics Data System (ADS)

    Aubele, J. C.; Stanley, J.; Grochowski, A.; Jones, K.; Aragon, J.

    2012-03-01

    A Mars K-12 curriculum, created by the New Mexico Museum of Natural History & Science, is now in 2nd edition DVD, approved by NASA educational review, 508 compliant to ensure accessibility for people with disabilities, and applicable to MSL.

  5. Secular Motion in a 2nd Degree and Order-Gravity Field with no Rotation

    NASA Astrophysics Data System (ADS)

    Scheeres, D. J.; Hu, W.

    2001-03-01

    The motion of a particle about a non-rotating 2nd degree and order-gravity field is investigated. Averaging conditions are applied to the particle motion and a qualitative analysis which reveals the general character of motion in this system is given. It is shown that the orbit plane will either be stationary or precess about the body's axis of minimum or maximum moment of inertia. It is also shown that the secular equations for this system can be integrated in terms of trigonometric, hyperbolic or elliptic functions. The explicit solutions are derived in all cases of interest.

  6. Dynamic Recrystallization Behavior of a Coarse-Grained Mg-2Zn-2Nd Magnesium Alloy

    NASA Astrophysics Data System (ADS)

    Wang, Tong; Jonas, John J.; Yue, Stephen

    2017-02-01

    Compression tests were performed on samples of Mg-2Zn-2Nd at 673 K (400 °C) and at three different strain rates. At 0.1/s, three mechanisms of dynamic recrystallization (DRX) were observed to operate: discontinuous DRX (DDRX), twinning DRX (TDRX), and continuous DRX (CDRX). At 0.01/s, DDRX took place as a result of grain boundary bulging, followed by CDRX on further straining. At 0.001/s, only CDRX was observed. At a strain of 0.3, the activation of multiple DRX mechanisms in the 0.1/s samples produced the weakest deformation textures.

  7. Development of self-recognition, personal pronoun use, and pretend play during the 2nd year.

    PubMed

    Lewis, Michael; Ramsay, Douglas

    2004-01-01

    This study examined the relation of visual self-recognition to personal pronoun use and pretend play. For a longitudinal sample (N=66) at the ages when self-recognition was emerging (15, 18, and 21 months), self-recognition was related to personal pronoun use and pretend play such that children showing self-recognition used more personal pronouns and demonstrated more advanced pretend play than did children not showing self-recognition. The finding of a relation among these measures provides additional evidence that in the middle of the 2nd year of life a metarepresentation of self emerges in the human child.

  8. Overview of the 2nd State of the Carbon Cycle Report Process, results and next steps

    NASA Astrophysics Data System (ADS)

    Cavallaro, N.; Shrestha, G.; Najjar, R.; Romero-Lankao, P.; Mayes, M. A.; Reed, S.; Birdsey, R.; Zhu, Z.; Shrestha, G.; Cavallaro, N.; Zhu, Z.; Cavallaro, N.; Zhu, Z.; Shrestha, G.

    2016-12-01

    With official kick-off in public engagement and writing in the early Spring of 2016, the 2nd State of the Carbon Cycle Report (SOCCR-2) is now set to be completed and published by the U.S. Government as a Highly Influential Scientific (Interagency) Assessment, a product of the Sustained National Climate Assessment, in late 2017. This presentation will highlight the planning process, the achievements so far, public engagement needs and the scientific community's contribution in the production of SOCCR-2.

  9. [Model and enlightenment from rescue of August 2nd Kunshan explosion casualty].

    PubMed

    Tan, Q; Qiu, H B; Sun, B W; Shen, Y M; Nie, L J; Zhang, H W

    2016-01-01

    On August 2nd, 2014, a massive dust explosion occurred in a factory of Kunshan, resulting in a mass casualty involving 185 burn patients. They were transported to 20 medical institutions in Jiangsu province and Shanghai. More than one thousand of medical personnel of our country participated in this emergency rescue, and satisfactory results were achieved. In this paper, the characteristics of this accident were analyzed, the positive effects of interdisciplinary cooperation were affirmed, and the contingency plan, rescue process and pattern, and reserve, organization and management of talents during this rescue process were reviewed retrospectively.

  10. VLT interferometer upgrade for the 2nd generation of interferometric instruments

    NASA Astrophysics Data System (ADS)

    Gonté, Frederic; Woillez, Julien; Schuhler, Nicolas; Egner, Sebastian; Merand, Antoine; Abad, José Antonio; Abadie, Sergio; Abuter, Roberto; Acuña, Margarita; Allouche, Fatmé; Alonso, Jaime; Andolfalto, Luigi; Antonelli, Pierre; Avila, Gerardo; Barriga, Pablo José; Beltran, Juan; Berger, Jean-Philippe; Bolados, Carlos; Bonnet, Henri; Bourget, Pierre; Brast, Roland; Bristow, Paul; Caniguante, Luis; Castillo, Roberto; Conzelmann, Ralf; Cortes, Angela; Delplancke, Françoise; Del Valle, Diego; Derie, Frederic; Diaz, Alvaro; Donoso, Reinaldo; Dorn, Reinhold; Duhoux, Philippe; Dupuy, Christophe; Eisenhauer, Frank; Elao, Christian; Fuenteseca, Eloy; Fernandez, Ruben; Gaytan, Daniel; Glindemann, Andreas; Gonzales, Jaime; Guieu, Sylvain; Guisard, Stephane; Haguenauer, Pierre; Haimerl, Andreas; Heinz, Volker; Henriquez, Juan Pablo; van der Heyden, P.; Hubin, Norbert; Huerta, Rodrigo; Jochum, Lieselotte; Leiva, Alfredo; Lévêque, Samuel; Lizon, Jean-Louis; Luco, Fernando; Mardones, Pedro; Mellado, Angel; Osorio, Juan; Ott, Jürgen; Pallanca, Laurent; Pavez, Marcus; Pasquini, Luca; Percheron, Isabelle; Pirard, Jean-Francois; Than Phan, Duc; Pineda, Juan Carlos; Pino, Andres; Poupar, Sebastien; Ramírez, Andres; Reinero, Claudio; Riquelme, Miguel; Romero, Juan; Rivinius, Thomas; Rojas, Chester; Rozas, Felix; Salgado, Fernando; Scheithauer, Silvia; Schmid, Christian; Schöller, Markus; Siclari, Waldo; Stephan, Christian; Tamblay, Richard; Tapia, Mario; Tristram, Konrad; Valdes, Guillermo; de Wit, Willem-Jan; Wright, Andrew; Zins, Gerard

    2016-08-01

    ESO is undertaking a large upgrade of the infrastructure on Cerro Paranal in order to integrate the 2nd generation of interferometric instruments Gravity and MATISSE, and increase its performance. This upgrade started mid 2014 with the construction of a service station for the Auxiliary Telescopes and will end with the implementation of the adaptive optics system for the Auxiliary telescope (NAOMI) in 2018. This upgrade has an impact on the infrastructure of the VLTI, as well as its sub-systems and scientific instruments.

  11. Effects of Thermal Cycling on Control and Irradiated EPC 2nd Generation GaN FETs

    NASA Technical Reports Server (NTRS)

    Patterson, Richard L.; Scheick, Leif; Lauenstein, Jean-Marie; Casey, Megan; Hammoud, Ahmad

    2013-01-01

    The power systems for use in NASA space missions must work reliably under harsh conditions including radiation, thermal cycling, and exposure to extreme temperatures. Gallium nitride semiconductors show great promise, but information pertaining to their performance is scarce. Gallium nitride N-channel enhancement-mode field effect transistors made by EPC Corporation in a 2nd generation of manufacturing were exposed to radiation followed by long-term thermal cycling in order to address their reliability for use in space missions. Results of the experimental work are presented and discussed.

  12. PREFACE: 2nd International Meeting for Researchers in Materials and Plasma Technology

    NASA Astrophysics Data System (ADS)

    Niño, Ely Dannier V.

    2013-11-01

    These proceedings present the written contributions of the participants of the 2nd International Meeting for Researchers in Materials and Plasma Technology, 2nd IMRMPT, which was held from February 27 to March 2, 2013 at the Pontificia Bolivariana Bucaramanga-UPB and Santander and Industrial - UIS Universities, Bucaramanga, Colombia, organized by research groups from GINTEP-UPB, FITEK-UIS. The IMRMPT, was the second version of biennial meetings that began in 2011. The three-day scientific program of the 2nd IMRMPT consisted in 14 Magisterial Conferences, 42 Oral Presentations and 48 Poster Presentations, with the participation of undergraduate and graduate students, professors, researchers and entrepreneurs from Colombia, Russia, France, Venezuela, Brazil, Uruguay, Argentina, Peru, Mexico, United States, among others. Moreover, the objective of IMRMPT was to bring together national and international researchers in order to establish scientific cooperation in the field of materials science and plasma technology; introduce new techniques of surface treatment of materials to improve properties of metals in terms of the deterioration due to corrosion, hydrogen embrittlement, abrasion, hardness, among others; and establish cooperation agreements between universities and industry. The topics covered in the 2nd IMRMPT include New Materials, Surface Physics, Laser and Hybrid Processes, Characterization of Materials, Thin Films and Nanomaterials, Surface Hardening Processes, Wear and Corrosion / Oxidation, Modeling, Simulation and Diagnostics, Plasma Applications and Technologies, Biomedical Coatings and Surface Treatments, Non Destructive Evaluation and Online Process Control, Surface Modification (Ion Implantation, Ion Nitriding, PVD, CVD). The editors hope that those interested in the are of materials science and plasma technology, enjoy the reading that reflect a wide range of topics. It is a pleasure to thank the sponsors and all the participants and contributors for

  13. Acute effect of electrical stimulation of the dorsal genital nerve on rectal capacity in patients with spinal cord injury.

    PubMed

    Worsøe, J; Fynne, L; Laurberg, S; Krogh, K; Rijkhoff, N J M

    2012-06-01

    Constipation and fecal incontinence are considerable problems for most individuals with spinal cord injury (SCI). Neurogenic bowel symptoms are caused by several factors including abnormal rectal wall properties. Stimulation of the dorsal genital nerve (DGN) can inhibit bladder contractions and because of common innervation inhibitory effects are anticipated in the rectum too. Therefore, DNG could have a future role in the treatment of neurogenic fecal incontinence. To study the effect of acute DGN stimulation on the rectal cross sectional area (CSA) in SCI patients. Seven patients with complete supraconal SCI (median age 50 years) were included. Stimulation was applied via plaster-electrodes using an amplitude of twice the genito-anal reflex threshold (pulse width: 200 μs; pulse rate: 20 Hz). A pressure controlled phasic (10, 20 and 30 cmH(2)O) rectal distension protocol was repeated four times with subjects randomized to stimulation during 1st and 3rd distension series or 2nd and 4th distension series. The rectal CSA and pressure were measured using impedance planimetry and manometry. All patients completed the investigation. Median stimulation amplitude was 51 mA (range 30-64). CSA was smaller during stimulation and differences reached statistical significance at distension pressures of 20 cmH(2)O (average decrease 9%; P = 0.02) and 30 cmH(2)O (average decrease 4%; P = 0.03) above resting rectal pressure. Accordingly, rectal pressure-CSA relation was significantly reduced during stimulation at 20 (P=0.03) and 30 cmH(2)O distension (P=0.02). DGN Stimulation in patients with supraconal SCI results in an acute decrease of rectal CSA and the rectal pressure-CSA relation.

  14. A novel 2nd-order bandpass MFSS filter with miniaturized structure

    NASA Astrophysics Data System (ADS)

    Fang, C. Y.; Gao, J. S.; Feng, X. G.

    2015-08-01

    In order to effectively obtain a miniaturized structure and good filtering properties, we propose a novel 2nd-order bandpass metamaterial frequency selective surface (MFSS) filter which contains two capacitive layers and one inductive layer, where there are multi-loop metallic patches as shunt capacitor C and planar wire grids as series inductor L respectively. Unlike the traditional operation way—the tuned elements used in resonant surface approximately equal to one wavelength in circumference and the structure thickness with a spacing of a quarter wavelength apart, by changing the value of L and C and matching multilayer dielectric to adjust the LC coupling resonance and the resonance impedance respectively, the proposed MFSS filter can achieves a miniatured structure with ideal bandpass properties. Measurement results of the fabricated prototype of the bandpass filter (BPF) indicate that the dimension of the tuned element on resonant surface is approximately 0.025 wavelength, i.e., 0.025λ. At the same time, the filter has the stable center frequency of f0 = 1.53GHz and the transmittance of T ⩾ 96.3% and high Q-value for the TE/TM wave polarization at various incidence angles. The novel 2nd-order bandpass MFSS filter with miniaturized structure not only can decrease structure dimension, but also has a wide range of applications to microwave and infrared band.

  15. [How to read and understand Registries for Evaluating Patient Outcomes: A User's Guide (2nd Edition)].

    PubMed

    Yang, Wei; Xie, Yan-Ming

    2013-09-01

    Registry studies (RS) get more and more attention in recent years because it can reflect the health care situations of the real world. There are a number of large scale RS for traditional Chinese medicine (TCM). RS are observational studies that can complement randomized controlled trials (RCT). RS have an irreplaceable position in real word study (RWS), especially for small probability events. There are some different characters and qualities in RS. Registries for Evaluating Patient Outcomes: A User's Guide (2nd Edition) was published by the agency for healthcare research and quality (AHRQ) in 2010. It described the details of how to establish, maintain, and evaluate RS, and using 38 RS samples to illustrate the possible problems in undertaking such research. The User's Guide (2nd Edition) provides a reliable reference document for RS. TCM injections post-marketing safety surveillance RS is a national program involving multiple centers in China. This program can further improve RS quality their application in China and is a good illustration of how to follow this guide accurately.

  16. The relation between 1st grade grey matter volume and 2nd grade math competence.

    PubMed

    Price, Gavin R; Wilkey, Eric D; Yeo, Darren J; Cutting, Laurie E

    2016-01-01

    Mathematical and numerical competence is a critical foundation for individual success in modern society yet the neurobiological sources of individual differences in math competence are poorly understood. Neuroimaging research over the last decade suggests that neural mechanisms in the parietal lobe, particularly the intraparietal sulcus (IPS) are structurally aberrant in individuals with mathematical learning disabilities. However, whether those same brain regions underlie individual differences in math performance across the full range of math abilities is unknown. Furthermore, previous studies have been exclusively cross-sectional, making it unclear whether variations in the structure of the IPS are caused by or consequences of the development of math skills. The present study investigates the relation between grey matter volume across the whole brain and math competence longitudinally in a representative sample of 50 elementary school children. Results show that grey matter volume in the left IPS at the end of 1st grade relates to math competence a year later at the end of 2nd grade. Grey matter volume in this region did not change over that year, and was still correlated with math competence at the end of 2nd grade. These findings support the hypothesis that the IPS and its associated functions represent a critical foundation for the acquisition of mathematical competence.

  17. 2nd to 4th digit ratios, fetal testosterone and estradiol.

    PubMed

    Lutchmaya, S; Baron-Cohen, S; Raggatt, P; Knickmeyer, R; Manning, J T

    2004-04-01

    The ratio of 2nd to 4th digit length (2D:4D) is sexually dimorphic (mean 2D:4D is lower in males than females) and is thought to be fixed early in development. 2D:4D has been reported to be related to fetal growth, hand preference, autism, Asperger's syndrome, sperm counts, family size, age at myocardial infarction in men and breast cancer in women. There is indirect evidence that 2D:4D is established in utero and is negatively related to prenatal testosterone and positively with prenatal estradiol. However, there are no studies which show direct relationships between fetal testosterone (FT), fetal estradiol (FE) and 2D:4D. To investigate the relationships between 2D:4D ratios and FT and FE from amniotic fluid. Cohort study. 33 children. Radioimmunoassays of FT and FE obtained from routine amniocentesis; 2D:4D ratios calculated from 2nd and 4th digit length of the right and left hands at age 2 years. A significant negative association between right 2D:4D ratio and FT/FE ratio, which was independent of sex. These preliminary findings lend support to an association between low 2D:4D and high levels of FT relative to FE, and high 2D:4D with low FT relative to FE.

  18. Editorial: 2nd Special Issue on behavior change, health, and health disparities

    PubMed Central

    Higgins, Stephen T.

    2016-01-01

    This Special Issue of Preventive Medicine (PM) is the 2nd that we have organized on behavior change, health, and health disparities. This is a topic of fundamental importance to improving population health in the U.S. and other industrialized countries that are trying to more effectively manage chronic health conditions. There is broad scientific consensus that personal behavior patterns such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. As such behavior change needs to be a key component of improving population health. There is also broad agreement that while these problems extend across socioeconomic strata, they are overrepresented among more economically disadvantaged populations and contribute directly to the growing problem of health disparities. Hence, behavior change represents an essential step in curtailing that unsettling problem as well. In this 2nd Special Issue, we devote considerable space to the current U.S. prescription opioid addiction epidemic, a crisis that was not addressed in the prior Special Issue. We also continue to devote attention to the two largest contributors to preventable disease and premature death, cigarette smoking and physical inactivity/obesity as well as risks of co-occurrence of these unhealthy behavior patterns. Across each of these topics we included contributions from highly accomplished policymakers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges to effectively managing these important chronic health problems. PMID:26257372

  19. Editorial: 2nd Special Issue on behavior change, health, and health disparities.

    PubMed

    Higgins, Stephen T

    2015-11-01

    This Special Issue of Preventive Medicine (PM) is the 2nd that we have organized on behavior change, health, and health disparities. This is a topic of fundamental importance to improving population health in the U.S. and other industrialized countries that are trying to more effectively manage chronic health conditions. There is broad scientific consensus that personal behavior patterns such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. As such behavior change needs to be a key component of improving population health. There is also broad agreement that while these problems extend across socioeconomic strata, they are overrepresented among more economically disadvantaged populations and contribute directly to the growing problem of health disparities. Hence, behavior change represents an essential step in curtailing that unsettling problem as well. In this 2nd Special Issue, we devote considerable space to the current U.S. prescription opioid addiction epidemic, a crisis that was not addressed in the prior Special Issue. We also continue to devote attention to the two largest contributors to preventable disease and premature death, cigarette smoking and physical inactivity/obesity as well as risks of co-occurrence of these unhealthy behavior patterns. Across each of these topics we included contributions from highly accomplished policy makers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges to effectively managing these important chronic health problems.

  20. Scoping analysis of the Advanced Test Reactor using SN2ND

    SciTech Connect

    Wolters, E.; Smith, M.

    2012-07-26

    A detailed set of calculations was carried out for the Advanced Test Reactor (ATR) using the SN2ND solver of the UNIC code which is part of the SHARP multi-physics code being developed under the Nuclear Energy Advanced Modeling and Simulation (NEAMS) program in DOE-NE. The primary motivation of this work is to assess whether high fidelity deterministic transport codes can tackle coupled dynamics simulations of the ATR. The successful use of such codes in a coupled dynamics simulation can impact what experiments are performed and what power levels are permitted during those experiments at the ATR. The advantages of the SN2ND solver over comparable neutronics tools are its superior parallel performance and demonstrated accuracy on large scale homogeneous and heterogeneous reactor geometries. However, it should be noted that virtually no effort from this project was spent constructing a proper cross section generation methodology for the ATR usable in the SN2ND solver. While attempts were made to use cross section data derived from SCALE, the minimal number of compositional cross section sets were generated to be consistent with the reference Monte Carlo input specification. The accuracy of any deterministic transport solver is impacted by such an approach and clearly it causes substantial errors in this work. The reasoning behind this decision is justified given the overall funding dedicated to the task (two months) and the real focus of the work: can modern deterministic tools actually treat complex facilities like the ATR with heterogeneous geometry modeling. SN2ND has been demonstrated to solve problems with upwards of one trillion degrees of freedom which translates to tens of millions of finite elements, hundreds of angles, and hundreds of energy groups, resulting in a very high-fidelity model of the system unachievable by most deterministic transport codes today. A space-angle convergence study was conducted to determine the meshing and angular cubature

  1. Chemoradiation of rectal cancer.

    PubMed

    Arrazubi, V; Suárez, J; Novas, P; Pérez-Hoyos, M T; Vera, R; Martínez Del Prado, P

    2013-02-01

    The treatment of locally advanced rectal cancer is a challenge. Surgery, chemotherapy and radiotherapy comprise the multimodal therapy that is administered in most cases. Therefore, a multidisciplinary approach is required. Because this cancer has a high rate of local recurrence, efforts have been made to improve clinical outcomes while minimizing toxicity and maintaining quality of life. Thus, total mesorectal excision technique was developed as the standard surgery, and chemotherapy and radiotherapy have been established as neoadjuvant treatment. Both approaches reduce locoregional relapse. Two neoadjuvant treatments have emerged as standards of care: short-course radiotherapy and long-course chemoradiotherapy with fluoropyrimidines; however, long-course chemoradiotherapy might be more appropriate for low-lying neoplasias, bulky tumours or tumours with near-circumferential margins. If neoadjuvant treatment is not administered and locally advanced stage is demonstrated in surgical specimens, adjuvant chemoradiotherapy is recommended. The addition of chemotherapy to the treatment regimen confers a significant benefit. Adjuvant chemotherapy is widely accepted despite scarce evidence of its benefit. The optimal time for surgery after neoadjuvant therapy, the treatment of low-risk T3N0 neoplasms, the convenience of avoiding radiotherapy in some cases and tailoring treatment to pathological response have been recurrent subjects of debate that warrant more extensive research. Adding new drugs, changing the treatment sequence and selecting the treatment based on prognostic or predictive factors other than stage remain experimental.

  2. Establishment of the World Health Organization 2(nd) International Standard for Factor XI, Plasma, Human.

    PubMed

    Wilmot, Helen; Hockley, Jason; Rigsby, Peter; Gray, Elaine

    2017-01-01

    The 1(st) International Standard (IS) for blood coagulation factor XI (FXI), plasma, has been successfully used for potency labeling of FXI therapeutics and for diagnosis of FXI deficiency in patients. With stocks of the 1(st) IS near depletion, a replacement is required. In addition to the functional activity value, assignment of an antigen value to the 2(nd) IS would allow harmonization of antigen assay methods and differentiation of patients who have low functional activity but normal antigen FXI levels from patients who have both low functional and antigen FXI levels. The aims of this study were, therefore, to assign FXI functional activity to the 2(nd) IS for FXI, plasma, and to additionally assign a new analyte, FXI antigen, to the same International Standard. The candidate material was prepared from double-spun, virology negative, normal plasma, which was pooled and filled into siliconized glass ampoules and subsequently freeze-dried. Assignment of the functional activity (FXI:C) value in International Units (IUs) was performed by one-stage clotting assay by 29 laboratories, relative to the 1(st) IS. The overall geometric mean (GM) was 0.71 IU/amp with extremely low inter-laboratory variability (expressed as geometric coefficient of variation) of 1.8%. The antigen value assignment was performed by 11 laboratories and was calculated relative to normal plasma pools, as is customary with new coagulation factor analytes. The amount of antigen present in 1 ml of normal plasma was taken to be 1 U. The overall GM for the antigen assays was 0.78 IU/amp with an inter-laboratory variation of 10%. The candidate (National Institute for Biological Standards and Control code, 15/180) was established by the World Health Organization (WHO) Expert Committee on Biological Standardization in 2016 as the WHO 2(nd) IS for blood coagulation FXI, plasma, with a functional activity value (FXI:C) of 0.71 IU/amp and an antigen value (FXI:Ag) of 0.78 IU/amp.

  3. Establishment of the World Health Organization 2nd International Standard for Factor XI, Plasma, Human

    PubMed Central

    Wilmot, Helen; Hockley, Jason; Rigsby, Peter; Gray, Elaine

    2017-01-01

    The 1st International Standard (IS) for blood coagulation factor XI (FXI), plasma, has been successfully used for potency labeling of FXI therapeutics and for diagnosis of FXI deficiency in patients. With stocks of the 1st IS near depletion, a replacement is required. In addition to the functional activity value, assignment of an antigen value to the 2nd IS would allow harmonization of antigen assay methods and differentiation of patients who have low functional activity but normal antigen FXI levels from patients who have both low functional and antigen FXI levels. The aims of this study were, therefore, to assign FXI functional activity to the 2nd IS for FXI, plasma, and to additionally assign a new analyte, FXI antigen, to the same International Standard. The candidate material was prepared from double-spun, virology negative, normal plasma, which was pooled and filled into siliconized glass ampoules and subsequently freeze-dried. Assignment of the functional activity (FXI:C) value in International Units (IUs) was performed by one-stage clotting assay by 29 laboratories, relative to the 1st IS. The overall geometric mean (GM) was 0.71 IU/amp with extremely low inter-laboratory variability (expressed as geometric coefficient of variation) of 1.8%. The antigen value assignment was performed by 11 laboratories and was calculated relative to normal plasma pools, as is customary with new coagulation factor analytes. The amount of antigen present in 1 ml of normal plasma was taken to be 1 U. The overall GM for the antigen assays was 0.78 IU/amp with an inter-laboratory variation of 10%. The candidate (National Institute for Biological Standards and Control code, 15/180) was established by the World Health Organization (WHO) Expert Committee on Biological Standardization in 2016 as the WHO 2nd IS for blood coagulation FXI, plasma, with a functional activity value (FXI:C) of 0.71 IU/amp and an antigen value (FXI:Ag) of 0.78 IU/amp. PMID:28373973

  4. American Society of Colon and Rectal Surgeons

    MedlinePlus

    ... Educational Resources ASCRS Textbook, 3rd Edition CARSEP® CREST® Case Study Listserv International Colon and Rectal Societies and Organizations ... Board of Colon and Rectal Surgery CARSEP® Members Case Study Listserv CREST® Young Surgeons Listserv Quality Assessment and ...

  5. ACR Appropriateness Criteria on Resectable Rectal Cancer

    SciTech Connect

    Suh, W. Warren; Konski, Andre A.; Mohiuddin, Mohammed; Poggi, Matthew M.; Regine, William F.; Cosman, Bard C.; Saltz, Leonard; Johnstone, Peter A.S.

    2008-04-01

    The American College of Radiology (ACR) Appropriateness Criteria on Resectable Rectal Cancer was updated by the Expert Panel on Radiation Oncology-Rectal/Anal Cancer, based on a literature review completed in 2007.

  6. A Perpendicular Biased 2nd Harmonic Cavity for the Fermilab Booster

    SciTech Connect

    Tan, C. Y.; Dey, J.; Madrak, R. L.; Pellico, W.; Romanov, G.; Sun, D.; Terechkine, I.

    2015-07-13

    A perpendicular biased 2nd harmonic cavity is currently being designed for the Fermilab Booster. Its purpose cavity is to flatten the bucket at injection and thus change the longitudinal beam distribution so that space charge effects are decreased. It can also with transition crossing. The reason for the choice of perpendicular biasing over parallel biasing is that the Q of the cavity is much higher and thus allows the accelerating voltage to be a factor of two higher than a similar parallel biased cavity. This cavity will also provide a higher accelerating voltage per meter than the present folded transmission line cavity. However, this type of cavity presents technical challenges that need to be addressed. The two major issues are cooling of the garnet material from the effects of the RF and the cavity itself from eddy current heating because of the 15 Hz bias field ramp. This paper will address the technical challenge of preventing the garnet from overheating.

  7. Simultaneous Vibrant Soundbridge Implantation and 2nd Stage Auricular Reconstruction for Microtia with Aural Atresia

    PubMed Central

    Lim, Lynne Hsueh Yee; Xiang, Ling; del Prado, Jocelynne; Ee Chin, Ling; Beltrame, Millo Achille

    2011-01-01

    Aural atresia and severe microtia are associated malformations that result in problems with hearing and cosmesis, associated speech and language difficulties and diminished self-esteem. In cases where middle ear ossiculoplasty and aural atresia canalplasty are expected to give poor hearing outcomes that would eventually require the use of hearing aids, bone anchored hearing aids or active middle ear implants may be better options. This case report describes a simultaneous Vibrant Soundbridge implantation and 2nd stage auricular reconstruction with rib graft cartilage for an 11-year-old boy with grade III microtia and aural atresia 8 months after the 1st stage reconstruction. Audiometric results of the Vibrant Soundbridge aided ear were comparable to that of the contralateral hearing aid aided ear. PMID:26557321

  8. Computation of equivalent poles placement for class of 2nd order discrete bilinear systems

    NASA Astrophysics Data System (ADS)

    Gadek, Lukasz; Koszalka, Leszek; Burnham, Keith

    2015-11-01

    This paper introduces an adaptation of the classical linear control theory representation of zeros, poles and gain into a bilinear approach. The placement of poles at the complex plane is a complete description of plants dynamics; hence it is a convenient form from which calculation of various properties, e.g. rise time, settling time, is plausible. Such technique can be adjusted into the bilinear structure if poles of a quasi-linear representation (linear with respect to input) are concerned. The research outcomes with conclusion on the equivalent poles displacement and generalized rules for a 2nd order bilinear system equivalent poles input dependent loci. The proposed approach seems to be promising, as simplification of design and identification of a bilinear system increases transparency during modelling and control in practical applications and hence it may be followed by applicability of such structure in common industrial problems.

  9. We also CanFly! The 2nd MexFly drosophila research conference.

    PubMed

    Missirlis, Fanis; Nahmad, Marcos

    2017-04-03

    The 2nd Mexican Drosophila Research Conference (MexFly) took place on June 30th and July 1st, 2016 in Mexico City, at the Center for Research and Advanced Studies of the National Polytechnic Institute (Cinvestav). Principal investigators, postdocs, students, and technicians from Drosophila labs across Mexico attended. The guest speaker was Chris Rushlow from New York University, who presented work on Zelda, a key transcriptional activator of the early zygotic genome. Here we provide a brief report of the meeting, which sketches the present landscape of Drosophila research in Mexico. We also provide a brief historical note on one of the pioneers of the field in this country, Victor Salceda, personally trained by Theodosius Dobzhansky. Salceda presented at the meeting an update of his collaborative project with Dobzhansky on the distribution of Drosophila pseudoobscura chromosomal inversions, initiated over forty years ago.

  10. Automated CFD Database Generation for a 2nd Generation Glide-Back-Booster

    NASA Technical Reports Server (NTRS)

    Chaderjian, Neal M.; Rogers, Stuart E.; Aftosmis, Michael J.; Pandya, Shishir A.; Ahmad, Jasim U.; Tejmil, Edward

    2003-01-01

    A new software tool, AeroDB, is used to compute thousands of Euler and Navier-Stokes solutions for a 2nd generation glide-back booster in one week. The solution process exploits a common job-submission grid environment using 13 computers located at 4 different geographical sites. Process automation and web-based access to the database greatly reduces the user workload, removing much of the tedium and tendency for user input errors. The database consists of forces, moments, and solution files obtained by varying the Mach number, angle of attack, and sideslip angle. The forces and moments compare well with experimental data. Stability derivatives are also computed using a monotone cubic spline procedure. Flow visualization and three-dimensional surface plots are used to interpret and characterize the nature of computed flow fields.

  11. Improvement of a plasma uniformity of the 2nd ion source of KSTAR neutral beam injector

    SciTech Connect

    Jeong, S. H. Kim, T. S.; Lee, K. W.; Chang, D. H.; In, S. R.; Bae, Y. S.

    2014-02-15

    The 2nd ion source of KSTAR (Korea Superconducting Tokamak Advanced Research) NBI (Neutral Beam Injector) had been developed and operated since last year. A calorimetric analysis revealed that the heat load of the back plate of the ion source is relatively higher than that of the 1st ion source of KSTAR NBI. The spatial plasma uniformity of the ion source is not good. Therefore, we intended to identify factors affecting the uniformity of a plasma density and improve it. We estimated the effects of a direction of filament current and a magnetic field configuration of the plasma generator on the plasma uniformity. We also verified that the operation conditions of an ion source could change a uniformity of the plasma density of an ion source.

  12. Language and pragmatic profile in children with ADHD measured by Children's Communication Checklist 2nd edition.

    PubMed

    Väisänen, Raija; Loukusa, Soile; Moilanen, Irma; Yliherva, Anneli

    2014-12-01

    The aim of this study was to explore whether children with attention deficit hyperactivity disorder (ADHD) have language and/or pragmatic difficulties compared to typically developing children. Nineteen children with ADHD (age 5-12 years) and nineteen typically developing children (age 5-8 years) were evaluated using the Finnish version of Children's Communication Checklist 2nd edition (CCC-2). The CCC-2 questionnaire was filled in by their parents. According to the CCC-2 questionnaire, differences between the groups were found in linguistic abilities, pragmatics skills, and social interaction. According to the CCC-2 profiles, many children with ADHD may have various kinds of communication difficulties, even if they do not have a diagnosed language disorder.

  13. Production of artificial ionospheric layers by frequency sweeping near the 2nd gyroharmonic

    NASA Astrophysics Data System (ADS)

    Pedersen, T.; McCarrick, M.; Reinisch, B.; Watkins, B.; Hamel, R.; Paznukhov, V.

    2011-01-01

    Artificial ionospheric plasmas descending from the background F-region have been observed on multiple occasions at the High Frequency Active Auroral Research Program (HAARP) facility since it reached full 3.6 MW power. Proximity of the transmitter frequency to the 2nd harmonic of the electron gyrofrequency (2fce) has been noted as a requirement for their occurrence, and their disappearance after only a few minutes has been attributed to the increasing frequency mismatch at lower altitudes. We report new experiments employing frequency sweeps to match 2fce in the artificial plasmas as they descend. In addition to revealing the dependence on the 2fce resonance, this technique reliably produces descending plasmas in multiple transmitter beam positions and appears to increase their stability and lifetime. High-speed ionosonde measurements are used to monitor the altitude and density of the artificial plasmas during both the formation and decay stages.

  14. Preliminary GPS orbit combination results of the IGS 2nd reprocessing campaign

    NASA Astrophysics Data System (ADS)

    Choi, Kevin

    2015-04-01

    International GNSS Service (IGS) has contributed to the International Terrestrial Reference Frame by reprocessing historic GPS network data and submitting Terrestrial Reference Frame solutions and Earth Rotation Parameters. For the 2nd reprocessing campaign, Analysis Centers (ACs) used up to 21 years of GPS observation data with daily integrations. IERS2010 conventions are applied to model the physical effects of the Earth. Total eight ACs have participated (7 Global solutions, and 2 Tide Gauge solutions) by reprocessing entire time series in a consistent way using the latest models and methodology. IGS combined daily SINEX TRF and EOP combinations have already been submitted to the IERS for ITRF2013. This presentation mainly focuses on the preliminary quality assessment of the reprocessed AC orbits. Quality of the orbit products are examined by examining the repeatability between daily AC satellite ephemeris. Power spectral analysis shows the background noise characteristics of each AC products, and its periodic behaviors.

  15. Simultaneous Vibrant Soundbridge Implantation and 2nd Stage Auricular Reconstruction for Microtia with Aural Atresia.

    PubMed

    Lim, Lynne Hsueh Yee; Xiang, Ling; Del Prado, Jocelynne; Ee Chin, Ling; Beltrame, Millo Achille

    2011-07-01

    Aural atresia and severe microtia are associated malformations that result in problems with hearing and cosmesis, associated speech and language difficulties and diminished self-esteem. In cases where middle ear ossiculoplasty and aural atresia canalplasty are expected to give poor hearing outcomes that would eventually require the use of hearing aids, bone anchored hearing aids or active middle ear implants may be better options. This case report describes a simultaneous Vibrant Soundbridge implantation and 2(nd) stage auricular reconstruction with rib graft cartilage for an 11-year-old boy with grade III microtia and aural atresia 8 months after the 1(st) stage reconstruction. Audiometric results of the Vibrant Soundbridge aided ear were comparable to that of the contralateral hearing aid aided ear.

  16. Danish translation and adaptation of Loewenstein Occupational Therapy Cognitive Assessment 2nd Edition (LOTCA-II).

    PubMed

    Lund, Karina; Oestergaard, Lisa Gregersen; Maribo, Thomas

    2013-07-01

    To translate and adapt the English version of the Loewenstein Occupational Therapy Cognitive Assessment 2nd Edition (LOTCA-II) to Danish. The translation process followed the overall guidelines of the World Health Organization (WHO) with forward translation, expert panel discussion, pre-tests and interviews with patients and laymen, and back-translation. The translation was successful and minor corrections and adaptations were made. In total three versions were produced before the final Danish version LOTCA-II/D was drafted. The Danish version of LOTCA-II was successfully translated and adapted based on the WHO guidelines. Before implementation in clinical practice further research of the reliability and validity of the LOTCA-II/D are needed.

  17. Increased ratio of 2nd to 4th digit (2D:4D) in schizophrenia.

    PubMed

    Collinson, Simon Lowes; Lim, Matthew; Chaw, Jia Hui; Verma, Swapna; Sim, Kang; Rapisarda, Attilio; Chong, Siow Ann

    2010-03-30

    Sex differences in the onset, epidemiology, clinical presentation and neuropathology of schizophrenia suggest that sexual dimorphism in brain development may be relevant to pathogenesis. Sex hormones, in particular testosterone, are considered to be crucial in brain development, but few investigations have examined the potential role of prenatal testosterone in schizophrenia. In this study, we examined a retrospective marker of prenatal testosterone release - 2D:4D finger length ratio (2D:4D), the relative length of 2nd to 4th digit, in 64 Asian patients with schizophrenia and 64 sex-matched controls. No significant difference in mean finger lengths was present, however 2D:4D ratio was significantly different between patients and controls. The effect was primarily seen in males consistent with a 'less masculinised' pattern and hypotheses suggesting that schizophrenia may be associated with an abnormality in prenatal circulating testosterone. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  18. The New 2nd-Generation SRF R&D Facility at Jefferson Lab: TEDF

    SciTech Connect

    Reece, Charles E.; Reilly, Anthony V.

    2012-09-01

    The US Department of Energy has funded a near-complete renovation of the SRF-based accelerator research and development facilities at Jefferson Lab. The project to accomplish this, the Technical and Engineering Development Facility (TEDF) Project has completed the first of two phases. An entirely new 3,100 m{sup 2} purpose-built SRF technical work facility has been constructed and was occupied in summer of 2012. All SRF work processes with the exception of cryogenic testing have been relocated into the new building. All cavity fabrication, processing, thermal treatment, chemistry, cleaning, and assembly work is collected conveniently into a new LEED-certified building. An innovatively designed 800 m2 cleanroom/chemroom suite provides long-term flexibility for support of multiple R&D and construction projects as well as continued process evolution. The characteristics of this first 2nd-generation SRF facility are described.

  19. [Quality radiotherapy in rectal cancer].

    PubMed

    Capirci, C; Amichetti, M; De Renzis, C

    2001-01-01

    The quality of radiotherapy significantly impacts on the results of treatment, in patients with rectal carcinoma, especially in terms of acute and late toxicity. Based on this assumption, the Italian Association of Radiation Oncology (AIRO) formulated a document aimed to define the standards of radiation treatment for rectal carcinomas. Two different levels of standard were described: a first level, considered as "minimal requirement", and a second level, considered as "optimal treatment". A retrospective evaluation, based on a questionnaire, revealed that in 1996, in most Italian Centers, patients affected by rectal carcinoma received radiation treatment within the first level of proposed standards. A subsequent analysis concerned the evaluation of the level of treatments applied in 2000. In this paper the radiotherapy standards proposed by the AIRO are described in the different phases of the radiation treatment.

  20. An European inter-laboratory validation of alternative endpoints of the murine local lymph node assay: 2nd round.

    PubMed

    Ehling, G; Hecht, M; Heusener, A; Huesler, J; Gamer, A O; van Loveren, H; Maurer, Th; Riecke, K; Ullmann, L; Ulrich, P; Vandebriel, R; Vohr, H-W

    2005-08-15

    The original local lymph node assay (LLNA) is based on the use of radioactive labelling to measure cell proliferation. Other endpoints for the assessment of proliferation are also authorized by the OECD Guideline 429 provided there is appropriate scientific support, including full citations and description of the methodology (OECD, 2002. OECD Guideline for the Testing of Chemicals; Skin Sensitization: Local Lymph Node Assay, Guideline 429. Paris, adopted 24th April 2002.). Here, we describe the outcome of the second round of an inter-laboratory validation of alternative endpoints in the LLNA conducted in nine laboratories in Europe. The validation study was managed and supervised by the Swiss Agency for Therapeutic Products (Swissmedic) in Bern. Ear-draining lymph node (LN) weight and cell counts were used to assess LN cell proliferation instead of [3H]TdR incorporation. In addition, the acute inflammatory skin reaction was measured by ear weight determination of circular biopsies of the ears to identify skin irritation properties of the test items. The statistical analysis was performed in the department of statistics at the university of Bern. Similar to the EC(3) values defined for the radioactive method, threshold values were calculated for the endpoints measured in this modification of the LLNA. It was concluded that all parameters measured have to be taken into consideration for the categorisation of compounds due to their sensitising potencies. Therefore, an assessment scheme has been developed which turned out to be of great importance to consistently assess sensitisation versus irritancy based on the data of the different parameters. In contrast to the radioactive method, irritants have been picked up by all the laboratories applying this assessment scheme.

  1. Enabling the 2nd Generation in Space: Building Blocks for Large Scale Space Endeavours

    NASA Astrophysics Data System (ADS)

    Barnhardt, D.; Garretson, P.; Will, P.

    Today the world operates within a "first generation" space industrial enterprise, i.e. all industry is on Earth, all value from space is from bits (data essentially), and the focus is Earth-centric, with very limited parts of our population and industry participating in space. We are limited in access, manoeuvring, on-orbit servicing, in-space power, in-space manufacturing and assembly. The transition to a "Starship culture" requires the Earth to progress to a "second generation" space industrial base, which implies the need to expand the economic sphere of activity of mankind outside of an Earth-centric zone and into CIS-lunar space and beyond, with an equal ability to tap the indigenous resources in space (energy, location, materials) that will contribute to an expanding space economy. Right now, there is no comfortable place for space applications that are not discovery science, exploration, military, or established earth bound services. For the most part, space applications leave out -- or at least leave nebulous, unconsolidated, and without a critical mass -- programs and development efforts for infrastructure, industrialization, space resources (survey and process maturation), non-traditional and persistent security situational awareness, and global utilities -- all of which, to a far greater extent than a discovery and exploration program, may help determine the elements of a 2nd generation space capability. We propose a focus to seed the pre-competitive research that will enable global industry to develop the necessary competencies that we currently lack to build large scale space structures on-orbit, that in turn would lay the foundation for long duration spacecraft travel (i.e. key technologies in access, manoeuvrability, etc.). This paper will posit a vision-to-reality for a step wise approach to the types of activities the US and global space providers could embark upon to lay the foundation for the 2nd generation of Earth in space.

  2. 2nd Gen FeCrAl ODS Alloy Development For Accident-Tolerant Fuel Cladding

    SciTech Connect

    Dryepondt, Sebastien N.; Massey, Caleb P.; Edmondson, Philip D.

    2016-08-01

    Extensive research at ORNL aims at developing advanced low-Cr high strength FeCrAl alloys for accident tolerant fuel cladding. One task focuses on the fabrication of new low Cr oxide dispersion strengthened (ODS) FeCrAl alloys. The first Fe-12Cr-5Al+Y2O3 (+ ZrO2 or TiO2) ODS alloys exhibited excellent tensile strength up to 800 C and good oxidation resistance in steam up to 1400 C, but very limited plastic deformation at temperature ranging from room to 800 C. To improve alloy ductility, several fabrication parameters were considered. New Fe-10-12Cr-6Al gas-atomized powders containing 0.15 to 0.5wt% Zr were procured and ball milled for 10h, 20h or 40h with Y2O3. The resulting powder was then extruded at temperature ranging from 900 to 1050 C. Decreasing the ball milling time or increasing the extrusion temperature changed the alloy grain size leading to lower strength but enhanced ductility. Small variations of the Cr, Zr, O and N content did not seem to significantly impact the alloy tensile properties, and, overall, the 2nd gen ODS FeCrAl alloys showed significantly better ductility than the 1st gen alloys. Tube fabrication needed for fuel cladding will require cold or warm working associated with softening heat treatments, work was therefore initiated to assess the effect of these fabrications steps on the alloy microstructure and properties. This report has been submitted as fulfillment of milestone M3FT 16OR020202091 titled, Report on 2nd Gen FeCrAl ODS Alloy Development for the Department of Energy Office of Nuclear Energy, Advanced Fuel Campaign of the Fuel Cycle R&D program.

  3. Local management of rectal neoplasia.

    PubMed

    Touzios, John; Ludwig, Kirk A

    2008-11-01

    The treatment of rectal neoplasia, whether benign or malignant, challenges the surgeon. The challenge in treating rectal cancer is selecting the proper approach for the appropriate patient. In a small number of rectal cancer patients local excision may be the best approach. In an attempt to achieve two goals-cure of disease with a low rate of local failure and maintenance of function and quality of life-multiple approaches can be utilized. The key to obtaining a good outcome for any one patient is balancing the competing factors that impact on these goals. Any effective treatment aimed at controlling rectal cancer in the pelvis must take into account the disease in the bowel wall itself and the disease, or potential disease, in the mesorectum. The major downside of local excision techniques is the potential of leaving untreated disease in the mesorectum. Local management techniques avoid the potential morbidity, mortality, and functional consequences of a major abdominal radical resection and are thus quite effective in achieving the maintenance of function and quality of life goal. The issue for the transanal techniques is how they fare in achieving the first goal-cure of the cancer while keeping local recurrence rates to an absolute minimum. Without removing both the rectum and the mesorectum there is no completely accurate way to determine whether a rectal cancer has moved outside the bowel wall, so any decision on local management of a rectal neoplasm is a calculated risk. For benign neoplasia, the challenge is removing the lesion without having to resort to a major abdominal procedure.

  4. 21 CFR 876.5450 - Rectal dilator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Rectal dilator. 876.5450 Section 876.5450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5450 Rectal dilator. (a) Identification. A rectal...

  5. 21 CFR 876.5450 - Rectal dilator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Rectal dilator. 876.5450 Section 876.5450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5450 Rectal dilator. (a) Identification. A rectal...

  6. Chemotherapy, Radiation Therapy, and Surgery in Treating Patients With Locally Advanced Rectal Cancer

    ClinicalTrials.gov

    2013-01-09

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

  7. Can endobronchial or endotracheal metastases appear from rectal adenocarcinoma?

    PubMed Central

    Serbanescu, GL; Anghel, RM

    2017-01-01

    Background: Endobronchial and endotracheal metastases from extra-pulmonary solid tumors are rare. Patients and methods: We reported the case of a patient diagnosed with endobronchial and endotracheal metastases from rectal adenocarcinoma. Case report: Patient P.G., 62 years old, was diagnosed with a rectal tumor in 2011, for which, a surgical intervention was performed (pT3 pN2a M0, stage IIIB). Afterwards, she underwent adjuvant chemotherapy and concomitant radiochemotherapy. In September 2013, the chest CT showed 2 nodules for which, an incomplete surgical resection was done and which were histopathologically diagnosed as metastases from rectal cancer. The patient continued the treatment with chemotherapy associated with Bevacizumab and after 6 months only Bevacizumab for maintenance. In June 2015, the chest CT pointed out a nodule in the right upper lobe and the bronchoscopy highlighted a 4-5 mm lesion at the level of the right primary bronchus, whose biopsy proved the rectal origin. Afterwards, another surgical intervention was performed. Unfortunately, the postoperative chest CT revealed an intratracheal tissue mass (11/ 7mm) and multiple metastases in the right lung. The bronchoscopy showed 2 endotracheal lesions, out of which one was biopsied (histopathological result of metastasis from rectal cancer). Despite the fact that chemotherapy was continued, other endobronchial lesions appeared. All of them were removed and the patient started radiotherapy on the tracheal area. Afterwards, she refused to continue chemotherapy. The last bronchoscopy highlighted one endobronchial and two endotracheal secondary malignant lesions. Conclusion: Endobronchial and endotracheal metastases must be taken into consideration in all the patients with a history of extra-pulmonary cancer. Abbreviations: CT = computed tomography, MRI = magnetic resonance imaging, IMRT = intensity-modulated radiotherapy, ESMO = European Society for Medical Oncology, NCCN = National Comprehensive

  8. Magnetic resonance imaging of rectal cancer.

    PubMed

    Dewhurst, Catherine E; Mortele, Koenraad J

    2013-01-01

    This article aims to discuss the anatomy of the anorectum, the MRI protocol parameters required to optimize diagnosis of rectal cancer, and the diagnostic MRI criteria essential to stage rectal cancer accurately, using the TNM staging classification. A brief review of more emerging important aspects of rectal cancer staging, such as the circumferential resection margin, extramural vascular invasion, and the staging of low rectal cancers, will also be provided. Finally, the authors will touch upon the evaluation of tumor response to neoadjuvant chemoradiation therapy in the setting of locally advanced rectal cancer. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. [Rectosacropexy in rectal prolapse management].

    PubMed

    Titov, A Iu; Biriukov, O M; Fomenko, O Iu; Zarodniuk, I V; Voĭnov, M A

    2016-01-01

    To compare results of rectosacropexy and posterior-loop rectopexy in rectal prolapse management. Study included 122 patients operated for rectal prolapse for the period January 2007 to August 2014. Patients' age ranged from 19 to 85 years (mean 47.3±16.1). Main group consisted of 60 (49.2%) patients who underwent rectosacropexy (D'Hoore's procedure). Control group included 62 (50.8%) patients in whom posterior-loop rectopexy was applied (Wells's procedure). Long-term results were followed-up in 94 (77.0%) patients including 48 and 46 from main and control group respectively. Recurrent prolaple incidence after rectosacropexy and posterior-loop rectopexy was 2% and 8.7% respectively. Multivariant analysis statistically confirmed that postoperative impaired colon motility was independent risk factor of recurrence. Recurrent disease is observed 5.7 times more often in this case. Rectosacropexy does not significantly impair colon motility because of ileus occurs in 8.3% of operated patients. Impovement of anal continence does not depend on rectopexy method and occurs in all patients with degree 1-2 of anal sphincter failure. Rectosacropexy may be preferred in rectal prolapse. However, further highly significant studies are necessary to optimize rectal prolapse management.

  10. Incidence and risk factors for rectal pain after laparoscopic rectal cancer surgery

    PubMed Central

    Lee, Jin Young; Kim, Hee Cheol; Huh, Jung Wook; Lim, Hyun Young; Lee, Eun Kyung; Park, Hui Gyeong; Bang, Yu Jeong

    2017-01-01

    Objective This study was performed to investigate the incidence of and potential risk factors for rectal pain after laparoscopic rectal cancer surgery. Methods We retrospectively analyzed data from 300 patients who underwent laparoscopic rectal cancer surgery. We assessed the presence of rectal pain and categorized patients into Group N (no rectal pain) or Group P (rectal pain). Results In total, 288 patients were included. Of these patients, 39 (13.5%) reported rectal pain and 14 (4.9%) had rectal pain that persisted for >3 months. Univariate analysis revealed that patients in Group P had more preoperative chemoradiotherapy, more ileostomies, longer operation times, more anastomotic margins of <2 cm from the anal verge, more anastomotic leakage, and longer hospital stays. Multivariate analysis identified an anastomotic margin of <2 cm from the anal verge and a long operation time as risk factors. The presence of diabetes mellitus was a negative predictor of rectal pain. Conclusions In this study, the incidence of rectal pain after laparoscopic rectal cancer surgery was 13.5%. An anastomotic margin of <2 cm from the anal verge and a long operation time were risk factors for rectal pain. The presence of diabetes mellitus was a negative predictor of rectal pain. Thus, the possibility of postoperative rectal pain should be discussed preoperatively with patients with these risk factors. PMID:28415928

  11. Give It a Shot! Toolkit for Nurses and Other Immunization Champions Working with Secondary Schools. 2nd Edition

    ERIC Educational Resources Information Center

    Boyer-Chu, Lynda; Wooley, Susan F.

    2008-01-01

    Adolescent immunization saves lives--but promoting immunization takes time and thought, and today's nurses and other health advocates are faced with a host of ever-expanding responsibilities in a time of reduced budgets and staff. This toolkit is thus structured as an easy and reliable resource. This 2nd edition contains: (1) a 64-page manual;…

  12. Perspectives on Art Therapy: The Proceedings of the Pittsburgh Conference on Art Therapy (2nd, Pittsburgh, Pennsylvania, May 20, 1977).

    ERIC Educational Resources Information Center

    Roth, Ellen A., Ed.; Rubin, Judith A., Ed.

    The proceedings of the 2nd annual Pittsburgh Conference on Art Therapy (with handicapped persons) consists of 44 items including full length papers, summaries of previously published papers, descriptions of workshops, and a limited number of abstracts (submitted by those who chose not to present a paper or workshop description). The papers are…

  13. Comparative analysis of 1st, 2nd, and 4th year MD students' attitudes toward Complementary Alternative Medicine (CAM)

    PubMed Central

    Riccard, Christopher P; Skelton, Michele

    2008-01-01

    Background To identify and report the attitudes and beliefs of 1st, 2nd, and 4th year medical students toward complementary alternative medicine (CAM). Methods The previously validated and reliability tested CHBQ was administered to medical students attending the University of South Florida School of Medicine. Results Significant changes were found between both 1st (46.0 ± 7.7) and 4th (37.8 ± 15.7) year students and 2nd (48.3 ± 7.8) and 4th (37.8 ± 15.7) year students. No significant difference was found between 1st (46.0 ± 7.7) and 2nd (48.3 ± 7.8) year students. When comparing scores based on gender, a significant difference was present between males (41.2 ± 12.2) and females (46.1 ± 11.0). Conclusion CHBQ scores were significantly more positive in both 1st and 2nd year medical students in comparison with 4th year student's scores. These findings suggest that as student exposure to allopathic techniques and procedures increases during the last year of medical school, their attitudes toward CAM decrease. Females were also significantly more likely to have stronger positive attitudes toward CAM than males, though both genders represented an overall positive attitude toward CAM. PMID:18799010

  14. The Hyphen as a Syllabification Cue in Reading Bisyllabic and Multisyllabic Words among Finnish 1st and 2nd Graders

    ERIC Educational Resources Information Center

    Häikiö, Tuomo; Bertram, Raymond; Hyönä, Jukka

    2016-01-01

    Finnish ABC books present words with hyphens inserted at syllable boundaries. Syllabification by hyphens is abandoned in the 2nd grade for bisyllabic words, but continues for words with three or more syllables. The current eye movement study investigated how and to what extent syllable hyphens in bisyllabic ("kah-vi" "cof-fee")…

  15. Observation in a School without Walls: Peer Observation of Teaching in a 2nd-12th Grade Independent School

    ERIC Educational Resources Information Center

    Salvador, Josephine

    2012-01-01

    What happens when teachers start to observe each other's classes? How do teachers make meaning of observing and being observed? What effects, if any, does requiring peer observation have on the teaching community? This research explores these questions in a qualitative study of peer observation of teaching (POT) in the 2nd-12th grades of an…

  16. Curriculum on the Edge of Survival: How Schools Fail to Prepare Students for Membership in a Democracy. 2nd Edition

    ERIC Educational Resources Information Center

    Heller, Daniel

    2012-01-01

    Typically, school curriculum has been viewed through the lens of preparation for the workplace or higher education, both worthy objectives. However, this is not the only lens, and perhaps not even the most powerful one to use, if the goal is to optimize the educational system. "Curriculum on the Edge of Survival, 2nd Edition," attempts to define…

  17. Optical DC overlay measurement in the 2nd level process of 65 nm alternating phase shift mask

    NASA Astrophysics Data System (ADS)

    Ma, Jian; Han, Ke; Lee, Kyung; Korobko, Yulia; Silva, Mary; Chavez, Joas; Irvine, Brian; Henrichs, Sven; Chakravorty, Kishore; Olshausen, Robert; Chandramouli, Mahesh; Mammen, Bobby; Padmanaban, Ramaswamy

    2005-11-01

    Alternating phase shift mask (APSM) techniques help bridge the significant gap between the lithography wavelength and the patterning of minimum features, specifically, the poly line of 35 nm gate length (1x) in Intel's 65 nm technology. One of key steps in making APSM mask is to pattern to within the design tolerances the 2nd level resist so that the zero-phase apertures will be protected by the resist and the pi-phase apertures will be wide open for quartz etch. The ability to align the 2nd level to the 1st level binary pattern, i.e. the 2nd level overlay capability is very important, so is the capability of measuring the overlay accurately. Poor overlay could cause so-called the encroachment after quartz etch, producing undesired quartz bumps in the pi-apertures or quartz pits in the zero-apertures. In this paper, a simple, low-cost optical setup for the 2nd level DC (develop check) overlay measurements in the high volume manufacturing (HVM) of APSM masks is presented. By removing systematic errors in overlay associated with TIS and MIS (tool-induced shift and Mask-process induced shift), it is shown that this setup is capable of supporting the measurement of DC overlay with a tolerance as small as +/- 25 nm. The outstanding issues, such as DC overlay error component analysis, DC - FC (final check) overlay correlation and the overlay linearity (periphery vs. indie), are discussed.

  18. Curriculum on the Edge of Survival: How Schools Fail to Prepare Students for Membership in a Democracy. 2nd Edition

    ERIC Educational Resources Information Center

    Heller, Daniel

    2012-01-01

    Typically, school curriculum has been viewed through the lens of preparation for the workplace or higher education, both worthy objectives. However, this is not the only lens, and perhaps not even the most powerful one to use, if the goal is to optimize the educational system. "Curriculum on the Edge of Survival, 2nd Edition," attempts to define…

  19. The Hyphen as a Syllabification Cue in Reading Bisyllabic and Multisyllabic Words among Finnish 1st and 2nd Graders

    ERIC Educational Resources Information Center

    Häikiö, Tuomo; Bertram, Raymond; Hyönä, Jukka

    2016-01-01

    Finnish ABC books present words with hyphens inserted at syllable boundaries. Syllabification by hyphens is abandoned in the 2nd grade for bisyllabic words, but continues for words with three or more syllables. The current eye movement study investigated how and to what extent syllable hyphens in bisyllabic ("kah-vi" "cof-fee")…

  20. Observation in a School without Walls: Peer Observation of Teaching in a 2nd-12th Grade Independent School

    ERIC Educational Resources Information Center

    Salvador, Josephine

    2012-01-01

    What happens when teachers start to observe each other's classes? How do teachers make meaning of observing and being observed? What effects, if any, does requiring peer observation have on the teaching community? This research explores these questions in a qualitative study of peer observation of teaching (POT) in the 2nd-12th grades of an…

  1. Perspectives on Art Therapy: The Proceedings of the Pittsburgh Conference on Art Therapy (2nd, Pittsburgh, Pennsylvania, May 20, 1977).

    ERIC Educational Resources Information Center

    Roth, Ellen A., Ed.; Rubin, Judith A., Ed.

    The proceedings of the 2nd annual Pittsburgh Conference on Art Therapy (with handicapped persons) consists of 44 items including full length papers, summaries of previously published papers, descriptions of workshops, and a limited number of abstracts (submitted by those who chose not to present a paper or workshop description). The papers are…

  2. Efficient Simulation of Wing Modal Response: Application of 2nd Order Shape Sensitivities and Neural Networks

    NASA Technical Reports Server (NTRS)

    Kapania, Rakesh K.; Liu, Youhua

    2000-01-01

    At the preliminary design stage of a wing structure, an efficient simulation, one needing little computation but yielding adequately accurate results for various response quantities, is essential in the search of optimal design in a vast design space. In the present paper, methods of using sensitivities up to 2nd order, and direct application of neural networks are explored. The example problem is how to decide the natural frequencies of a wing given the shape variables of the structure. It is shown that when sensitivities cannot be obtained analytically, the finite difference approach is usually more reliable than a semi-analytical approach provided an appropriate step size is used. The use of second order sensitivities is proved of being able to yield much better results than the case where only the first order sensitivities are used. When neural networks are trained to relate the wing natural frequencies to the shape variables, a negligible computation effort is needed to accurately determine the natural frequencies of a new design.

  3. The validity and reliability of developmental test of visual perception-2nd edition (DTVP-2).

    PubMed

    Brown, Ted; Hockey, Sarah Caitlin

    2013-11-01

    The Developmental Test of Visual Perception-2nd edition (DTVP-2) is frequently used by occupational therapists to evaluate school-age children. It is important that therapists use assessments with established validity and reliability. This study investigated the convergent validity and internal consistency of the DTVP-2. Forty-five healthy participants from Australia, aged 6-12 years, completed the DTVP-2, the Beery-Buktenica Developmental Test of Visual-Motor Integration-6th edition (VMI), and the Test of Visual Perceptual Skills-3rd edition (TVPS-3). A Spearman rho correlation coefficient was used to investigate the DTVP-2's convergent validity and Cronbach alpha coefficients were used to determine the DTVP-2's internal consistency. Statistically significant correlations between the DTVP-2, VMI, and TVPS-3 total scale scores and subscale scores were found. Internal consistency of items for the DTVP-2, VMI, and TVPS-3 total scores was >0.80 and internal consistency of items for subscale scores was >0.70. The DTVP-2 exhibited evidence of convergent validity with the VMI and TVPS-3, and moderate to high levels of internal consistency.

  4. Introduction of the 2nd Phase of the Integrated Hydrologic Model Intercomparison Project

    NASA Astrophysics Data System (ADS)

    Kollet, Stefan; Maxwell, Reed; Dages, Cecile; Mouche, Emmanuel; Mugler, Claude; Paniconi, Claudio; Park, Young-Jin; Putti, Mario; Shen, Chaopeng; Stisen, Simon; Sudicky, Edward; Sulis, Mauro; Ji, Xinye

    2015-04-01

    The 2nd Phase of the Integrated Hydrologic Model Intercomparison Project commenced in June 2013 with a workshop at Bonn University funded by the German Science Foundation and US National Science Foundation. Three test cases were defined and compared that are available online at www.hpsc-terrsys.de including a tilted v-catchment case; a case called superslab based on multiple slab-heterogeneities in the hydraulic conductivity along a hillslope; and the Borden site case, based on a published field experiment. The goal of this phase is to further interrogate the coupling of surface-subsurface flow implemented in various integrated hydrologic models; and to understand and quantify the impact of differences in the conceptual and technical implementations on the simulation results, which may constitute an additional source of uncertainty. The focus has been broadened considerably including e.g. saturated and unsaturated subsurface storages, saturated surface area, ponded surface storage in addition to discharge, and pressure/saturation profiles and cross-sections. Here, first results are presented and discussed demonstrating the conceptual and technical challenges in implementing essentially the same governing equations describing highly non-linear moisture redistribution processes and surface-groundwater interactions.

  5. Suppressing transthyretin production in mice, monkeys and humans using 2nd-Generation antisense oligonucleotides.

    PubMed

    Ackermann, Elizabeth J; Guo, Shuling; Benson, Merrill D; Booten, Sheri; Freier, Sue; Hughes, Steven G; Kim, Tae-Won; Jesse Kwoh, T; Matson, John; Norris, Dan; Yu, Rosie; Watt, Andy; Monia, Brett P

    2016-09-01

    Transthyretin amyloidosis (ATTR amyloidosis) is a rare disease that results from the deposition of misfolded transthyretin (TTR) protein from the plasma into tissues as amyloid fibrils, leading to polyneuropathy and cardiomyopathy. IONIS-TTRRx (ISIS 420915) is a 2nd-Generation 2'-O-(2-methoxyethyl) modified "2'-MOE" antisense oligonucleotide (ASO) that targets the TTR RNA transcript and reduces the levels of the TTR transcript through an RNaseH1 mechanism of action, leading to reductions in both mutant and wild-type TTR protein. The activity of IONIS-TTRRx to decrease TTR protein levels was studied in transgenic mice bearing the Ile84Ser human TTR mutant, in cynomolgus monkeys and in healthy human volunteers. Robust (>80%) reductions of plasma TTR protein were obtained in all three species treated with IONIS-TTRRx, which in mice and monkeys was associated with substantial reductions in hepatic TTR RNA levels. These effects were dose-dependent and lasted for weeks post-dosing. In a Phase 1 healthy volunteer study, treatment with IONIS-TTRRx for four weeks was well tolerated without any remarkable safety issues. TTR protein reductions up to 96% in plasma were observed. These nonclinical and clinical results support the ongoing Phase 3 development of IONIS-TTRRx in patients with ATTR amyloidosis.

  6. Minimal Clinically Important Difference on Parkinson's Disease Sleep Scale 2nd Version

    PubMed Central

    Horváth, Krisztina; Aschermann, Zsuzsanna; Ács, Péter; Deli, Gabriella; Janszky, József; Komoly, Sámuel; Karádi, Kázmér; Kovács, Márton; Makkos, Attila; Faludi, Béla; Kovács, Norbert

    2015-01-01

    Background and Aims. The aim of the present study was to determine the estimates of minimal clinically important difference for Parkinson's Disease Sleep Scale 2nd version (PDSS-2) total score and dimensions. Methods. The subject population consisted of 413 PD patients. At baseline, MDS-UPDRS, Hoehn-Yahr Scale, Mattis Dementia Rating Scale, and PDSS-2 were assessed. Nine months later the PDSS-2 was reevaluated with the Patient-Reported Global Impression Improvement Scale. Both anchor-based techniques (within patients' score change method and sensitivity- and specificity-based method by receiver operating characteristic analysis) and distribution-based approaches (effect size calculations) were utilized to determine the magnitude of minimal clinically important difference. Results. According to our results, any improvements larger than −3.44 points or worsening larger than 2.07 points can represent clinically important changes for the patients. These thresholds have the effect size of 0.21 and −0.21, respectively. Conclusions. Minimal clinically important differences are the smallest change of scores that are subjectively meaningful to patients. Studies using the PDSS-2 as outcome measure should utilize the threshold of −3.44 points for detecting improvement or the threshold of 2.07 points for observing worsening. PMID:26539303

  7. Evaluation of a hand washing program for 2nd-graders.

    PubMed

    Tousman, Stuart; Arnold, Dani; Helland, Wealtha; Roth, Ruth; Heshelman, Nannatte; Castaneda, Oralia; Fischer, Emily; O'Neil, Kristen; Bileto, Stephanie

    2007-12-01

    The purpose of this project was to determine if a multiple-week learner-centered hand washing program could improve hand hygiene behaviors of 2nd-graders in a northern Illinois public school system. Volunteers from the Rockford Hand Washing Coalition went into 19 different classrooms for 4 consecutive weeks and taught a learner-centered program. The program consisted of interactive class discussions and activities using GlitterBug training devices and agar plate materials. A one-factor repeated measure analysis of variance indicated a statistically significant 34% decrease in the absenteeism rate for students in the intervention group. Chi-square analyses on agar plate data indicated that students had cleaner hands after washing. Qualitative data from parents and teachers indicated that a majority of the students were engaging in hand-washing behavior. These results indicate that integrating a learner-centered interactive program in a multiple-week structure can lead to improvement in hand hygiene behavior.

  8. Proceedings: 2nd IEA international workshop on beryllium technology for fusion

    SciTech Connect

    Longhurst, G.R.

    1995-09-01

    The 2nd IEA International Workshop on Beryllium Technology for Fusion was held September 6--8, 1995 at Jackson Lake Lodge, Wyoming. Forty-four participants took part in the workshop representing Europe, Japan, the Russian Federation, and the United States including representatives from both government laboratories and private industry. The workshop was divided into six technical sessions and a ``town meeting`` panel discussion. Technical sessions addressed the general topics of: Thermomechanical Properties; Manufacturing Technologies; Radiation Effects; Plasma/Tritium Interactions; Safety, Applications, and Design; and Joining and Testing. This volume contains the majority of the papers presented at the workshop. In some instances, the authors of the papers could not be present at the workshop, and the papers were given by others, sometimes in summary form and in some instances combined with others. The full papers are included here in the sequence in which they would have been given. In other instances, presentations were made but no papers were submitted for publication. Those papers do not appear here. In summary, the workshop was very successful. The main objectives of bringing key members of the fusion beryllium community together was certainly met. Forty-four participants registered, and 35 papers were presented. Individual papers are indexed separately on the energy data bases.

  9. Wind-US Results for the AIAA 2nd Propulsion Aerodynamics Workshop

    NASA Technical Reports Server (NTRS)

    Dippold, Vance III; Foster, Lancert; Mankbadi, Mina

    2014-01-01

    This presentation contains Wind-US results presented at the 2nd Propulsion Aerodynamics Workshop. The workshop was organized by the American Institute of Aeronautics and Astronautics, Air Breathing Propulsion Systems Integration Technical Committee with the purpose of assessing the accuracy of computational fluid dynamics for air breathing propulsion applications. Attendees included representatives from government, industry, academia, and commercial software companies. Participants were encouraged to explore and discuss all aspects of the simulation process including the effects of mesh type and refinement, solver numerical schemes, and turbulence modeling. The first set of challenge cases involved computing the thrust and discharge coefficients for a 25deg conical nozzle for a range of nozzle pressure ratios between 1.4 and 7.0. Participants were also asked to simulate two cases in which the 25deg conical nozzle was bifurcated by a solid plate, resulting in vortex shedding (NPR=1.6) and shifted plume shock (NPR=4.0). A second set of nozzle cases involved computing the discharge and thrust coefficients for a convergent dual stream nozzle for a range of subsonic nozzle pressure ratios. The workshop committee also compared the plume mixing of these cases across various codes and models. The final test case was a serpentine inlet diffuser with an outlet to inlet area ratio of 1.52 and an offset of 1.34 times the inlet diameter. Boundary layer profiles, wall static pressure, and total pressure at downstream rake locations were examined.

  10. Bôcher and Abstract Contractions of 2nd Order Quadratic Algebras

    NASA Astrophysics Data System (ADS)

    Escobar-Ruiz, Mauricio A.; Kalnins, Ernest G.; Miller, Willar, Jr.; Subag, Eyal

    2017-03-01

    Quadratic algebras are generalizations of Lie algebras which include the symmetry algebras of 2nd order superintegrable systems in 2 dimensions as special cases. The superintegrable systems are exactly solvable physical systems in classical and quantum mechanics. Distinct superintegrable systems and their quadratic algebras can be related by geometric contractions, induced by Bôcher contractions of the conformal Lie algebra {so}(4,C) to itself. In this paper we give a precise definition of Bôcher contractions and show how they can be classified. They subsume well known contractions of {e}(2,C) and {so}(3,C) and have important physical and geometric meanings, such as the derivation of the Askey scheme for obtaining all hypergeometric orthogonal polynomials as limits of Racah/Wilson polynomials. We also classify abstract nondegenerate quadratic algebras in terms of an invariant that we call a canonical form. We describe an algorithm for finding the canonical form of such algebras. We calculate explicitly all canonical forms arising from quadratic algebras of 2D nondegenerate superintegrable systems on constant curvature spaces and Darboux spaces. We further discuss contraction of quadratic algebras, focusing on those coming from superintegrable systems.

  11. Severe weather phenomena: SQUALL LINES The case of July 2nd 2009

    NASA Astrophysics Data System (ADS)

    Paraschivescu, Mihnea; Tanase, Adrian

    2010-05-01

    The wind intensity plays an important role, among the dangerous meteorological phenomena, to produce negative effects on the economy and the social activities, particularly when the wind is about to turn into a storm. During the past years one can notice an increase of wind frequency and intensity due to climate changes and, consequently, as a result of the extreme meteorological phenomena not only on a planetary level but also on a regional one. Although dangerous meteorological phenomena cannot be avoided, since they are natural, nevertheless they can be anticipated and decision making institutions and mass media can be informed. This is the reason why, in this paper, we set out to identify the synoptic conditions that led to the occurrence of the severe storm case in Bucharest on July 2nd, 2009, as well as the matrices that generate such cases. At the same time we sought to identify some indications evidence especially from radar data so as to lead to the improvement of the time interval between the nowcasting warning and the actual occurrence of the phenomenon.

  12. Plasmodium falciparum malaria in 1(st)-2(nd) century CE southern Italy.

    PubMed

    Marciniak, Stephanie; Prowse, Tracy L; Herring, D Ann; Klunk, Jennifer; Kuch, Melanie; Duggan, Ana T; Bondioli, Luca; Holmes, Edward C; Poinar, Hendrik N

    2016-12-05

    The historical record attests to the devastation malaria exacted on ancient civilizations, particularly the Roman Empire [1]. However, evidence for the presence of malaria during the Imperial period in Italy (1st-5th century CE) is based on indirect sources, such as historical, epigraphic, or skeletal evidence. Although these sources are crucial for revealing the context of this disease, they cannot establish the causative species of Plasmodium. Importantly, definitive evidence for the presence of malaria is now possible through the implementation of ancient DNA technology. As malaria is presumed to have been at its zenith during the Imperial period [1], we selected first or second molars from 58 adults from three cemeteries from this time: Isola Sacra (associated with Portus Romae, 1st-3rd century CE), Velia (1st-2nd century CE), and Vagnari (1st-4th century CE). We performed hybridization capture using baits designed from the mitochondrial (mtDNA) genomes of Plasmodium spp. on a prioritized subset of 11 adults (informed by metagenomic sequencing). The mtDNA sequences generated provided compelling phylogenetic evidence for the presence of P. falciparum in two individuals. This is the first genomic data directly implicating P. falciparum in Imperial period southern Italy in adults.

  13. Hypertrophic osteoarthropathy in a young adult male from Berber, Sudan (2nd-3rd century CE).

    PubMed

    Binder, M; Saad, M

    2017-09-01

    Hypertrophic osteoarthropathy (HOA) is a pathological condition characterised by extensive periosteal new bone formation (NBF) on the diaphyses of the long bones, metacarpal and metatarsal bones. In modern clinical contexts, the secondary form of the disease is common and most often occurs secondary to intra-thoracic cancer and other forms of chronic pulmonary disease. Paleopathological evidence for HOA on the other hand has only occasionally been reported. Here we report a young adult male from the Meriotic cemetery at Berber in Sudan (2nd-3rd century CE) displaying widespread NBF on the diaphyses of the upper and lower limb bones, metacarpal and metatarsal bones, as well as the pelvis and scapulae. While several pathological conditions have to be considered as differential diagnostic options for NBF in the post-cranial skeleton, HOA is the most likely diagnosis, based on the distribution of the changes observed in this individual, as well as their macroscopic and radiographic characteristics. A chronic pulmonary condition as indicated by NBF on the visceral side of the ribs may represent the underlying cause for the HOA. This individual represents the first paleopathological case of HOA reported from an archaeological site in Africa. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Studies with Ferrous Sulfamate and Alternate Reductants for 2nd Uranium Cycle

    SciTech Connect

    Crowder, M.L.

    2003-01-15

    A wide range of miniature mixer-settler tests were conducted to determine the source of iron and sulfur contamination in the uranium product stream (''1EU'') of H Canyon's 2nd Uranium Cycle. The problem was reproduced on the laboratory scale mixer-settlers by changing the feed location of ferrous sulfamate from stage D4 to stage D1. Other process variables effected no change. It was later determined that ferrous sulfamate (FS) solids had plugged the FS line to stage D4, causing FS to backup a ventline and enter the Canyon process at stage D1. Pluggage was almost certainly due to precipitation of FS solids during extended process downtime. During the search for the root cause, tests showed that FS solids were quite small (1-10 mm), and a portion of them could bypass the current Canyon prefilter (3-mm). Also, additional tests were done to find an alternate means of reducing and thereby removing plutonium and neptunium from the uranium product. These tests showed that FS was a more effective reductant than either ascorbic acid or a hydroxylamine nitrate (HAN) / dilute FS combination.

  15. Early Proctoscopy is a Surrogate Endpoint of Late Rectal Toxicity in Prostate Cancer Treated With Radiotherapy

    SciTech Connect

    Ippolito, Edy; Massaccesi, Mariangela; Digesu, Cinzia; Deodato, Francesco; Macchia, Gabriella; Pirozzi, Giuseppe Antonio; Cilla, Savino; Cuscuna, Daniele; Di Lallo, Alessandra; Mattiucci, Gian Carlo; Mantini, Giovanna; Pacelli, Fabio; Valentini, Vincenzo; Cellini, Numa; Ingrosso, Marcello; Morganti, Alessio Giuseppe

    2012-06-01

    Purpose: To predict the grade and incidence of late clinical rectal toxicity through short-term (1 year) mucosal alterations. Methods and Materials: Patients with prostate adenocarcinoma treated with curative or adjuvant radiotherapy underwent proctoscopy a year after the course of radiotherapy. Mucosal changes were classified by the Vienna Rectoscopy Score (VRS). Late toxicity data were analyzed according to the Kaplan-Meier method. Comparison between prognosis groups was performed by log-rank analysis. Results: After a median follow-up time of 45 months (range, 18-99), the 3-year incidence of grade {>=}2 rectal late toxicity according to the criteria of the European Organization for Research and Treatment of Cancer and the Radiation Therapy Oncology Group was 24%, with all patients (24/24; 100%) experiencing rectal bleeding. The occurrence of grade {>=}2 clinical rectal late toxicity was higher in patients with grade {>=}2 (32% vs. 15 %, p = 0.02) or grade {>=}3 VRS telangiectasia (47% vs. 17%, p {<=} 0.01) and an overall VRS score of {>=}2 (31% vs. 16 %, p = 0.04) or {>=}3 (48% vs. 17%, p = 0.01) at the 1-year proctoscopy. Conclusions: Early proctoscopy (1 year) predicts late rectal bleeding and therefore can be used as a surrogate endpoint for late rectal toxicity in studies aimed at reducing this frequent complication.

  16. Rectal dose to prostate cancer patients treated with proton therapy with or without rectal spacer.

    PubMed

    Chung, Heeteak; Polf, Jerimy; Badiyan, Shahed; Biagioli, Matthew; Fernandez, Daniel; Latifi, Kujtim; Wilder, Richard; Mehta, Minesh; Chuong, Michael

    2017-01-01

    The purpose of this study was to evaluate whether a spacer inserted in the prerectal space could reduce modeled rectal dose and toxicity rates for patients with prostate cancer treated in silico with pencil beam scanning (PBS) proton therapy. A total of 20 patients were included in this study who received photon therapy (12 with rectal spacer (DuraSeal™ gel) and 8 without). Two PBS treatment plans were retrospectively created for each patient using the following beam arrangements: (1) lateral-opposed (LAT) fields and (2) left and right anterior oblique (LAO/RAO) fields. Dose volume histograms (DVH) were generated for the prostate, rectum, bladder, and right and left femoral heads. The normal tissue complication probability (NTCP) for ≥grade 2 rectal toxicity was calculated using the Lyman-Kutcher-Burman model and compared between patients with and without the rectal spacer. A significantly lower mean rectal DVH was achieved in patients with rectal spacer compared to those without. For LAT plans, the mean rectal V70 with and without rectal spacer was 4.19 and 13.5%, respectively. For LAO/RAO plans, the mean rectal V70 with and without rectal spacer was 5.07 and 13.5%, respectively. No significant differences were found in any rectal dosimetric parameters between the LAT and the LAO/RAO plans generated with the rectal spacers. We found that ≥ 9 mm space resulted in a significant decrease in NTCP modeled for ≥grade 2 rectal toxicity. Rectal spacers can significantly decrease modeled rectal dose and predicted ≥grade 2 rectal toxicity in prostate cancer patients treated in silico with PBS. A minimum of 9 mm separation between the prostate and anterior rectal wall yields the largest benefit.

  17. Correlation between tumor regression grade and rectal volume in neoadjuvant concurrent chemoradiotherapy for rectal cancer

    PubMed Central

    Lee, Hong Seok; Choi, Doo Ho; Park, Hee Chul; Park, Won; Yu, Jeong Il; Chung, Kwangzoo

    2016-01-01

    Purpose To determine whether large rectal volume on planning computed tomography (CT) results in lower tumor regression grade (TRG) after neoadjuvant concurrent chemoradiotherapy (CCRT) in rectal cancer patients. Materials and Methods We reviewed medical records of 113 patients treated with surgery following neoadjuvant CCRT for rectal cancer between January and December 2012. Rectal volume was contoured on axial images in which gross tumor volume was included. Average axial rectal area (ARA) was defined as rectal volume divided by longitudinal tumor length. The impact of rectal volume and ARA on TRG was assessed. Results Average rectal volume and ARA were 11.3 mL and 2.9 cm². After completion of neoadjuvant CCRT in 113 patients, pathologic results revealed total regression (TRG 4) in 28 patients (25%), good regression (TRG 3) in 25 patients (22%), moderate regression (TRG 2) in 34 patients (30%), minor regression (TRG 1) in 24 patients (21%), and no regression (TRG0) in 2 patients (2%). No difference of rectal volume and ARA was found between each TRG groups. Linear correlation existed between rectal volume and TRG (p = 0.036) but not between ARA and TRG (p = 0.058). Conclusion Rectal volume on planning CT has no significance on TRG in patients receiving neoadjuvant CCRT for rectal cancer. These results indicate that maintaining minimal rectal volume before each treatment may not be necessary. PMID:27592514

  18. [Surgical treatment of rectal cancer].

    PubMed

    Vergara-Fernández, O; Salinas-Aragón, L E; Camacho-Mauries, D; Medina-Franco, H

    2010-01-01

    Rectal affection accounts for 30% of colorectal cancer. The standard of treatment is surgical resection, which often is curative. For superior and middle-rectal involvement, low anterior resection (LAR) is the preferred procedure. For tumors involving the lower portion of the rectum, abdominoperineal resection (APR) or LAR are the options of treatment, depending on sphincter involvement. The main surgical objective is to achieve a R0 resection with an appropriated total mesorrectal excision, greater number of lymph nodes and negative distal and radial margins. These surgical parameters have been used as quality indicators and have prognostic implications in terms of overall and disease-free survival. Total mesorectal excision with preservation of hypogastric nerves has shown a reduction in rates of sexual and bladder dysfunction as well as lower local recurrence. At specialized centers such procedures are performed by minimal invasive surgery; however the number of meta-analysis is scarce.

  19. The adenovirus type 2-simian virus 40 hybrid virus Ad2+ND4 requires deletion variants to grow in monkey cells.

    PubMed Central

    Lewis, A M; Westphal, H

    1983-01-01

    The Ad2+ND4 virus is an adenovirus type 2 (Ad2)-simian virus 40 (SV40) recombination. The Ad2 genome of this recombinant has a rearrangement within early region 3; Ad2 DNA sequences between map positions 81.3 and 85.5 have been deleted, and the SV40 DNA sequences between map positions 0.11 and 0.626 have been inserted into the deletion in an 81.3-0.626 orientation. Nonhybrid Ad2 is defective in monkey cells; however, the Ad2+ND4 virus can replicate in monkey cells due to the expression of the SV40-enhancing function encoded by the DNA insert. Stocks of the Ad2+ND4 hybrid were produced in primary monkey cells by using the progeny of a three-step plaque purification procedure and were considered to be homogeneous populations of Ad2+ND4 virions because they induced plaques in primary monkey cells by first-order kinetics. By studying the kinetics of plaque induction in continuous lines (BSC-1 and CV-1) of monkey cells, we have found that stocks (prepared with virions before and after plaque purification) of Ad2+ND4 are actually heterogeneous populations of Ad2+ND4 virions and Ad2+ND4 deletion variants that lack SV40 and frequently Ad2 DNA sequences at the left Ad2-SV40 junction. Due to the defectiveness of the Ad2+ND4 virus, the production of progeny in BSC-1 and CV-1 cells requires complementation between the Ad2+ND4 genome and the genome of an Ad2+ND4 deletion variant. Since the deletion variants that have been obtained from Ad2+ND4 stocks do not express the SV40-enhancing function in that they cannot produce progeny in monkey cells, we conclude that they are providing an Ad2 component that is essential for the production of Ad2+ND4 progeny. These data imply that the Ad2+ND4 virus is incapable of replicating in singly infected primary monkey cells without generating deletion variants that are missing various amounts of DNA around the left Ad2-SV40 junction in the hybrid genome. As the deletion variants that arise from the Ad2+ND4 virus are created by nonhomologous

  20. Robotic surgery for rectal cancer.

    PubMed

    Nozawa, Hiroaki; Watanabe, Toshiaki

    2017-09-26

    Laparoscopic surgery has gained acceptance as a less invasive approach in the treatment of colon cancer. However, laparoscopic surgery for rectal cancer, particularly cancer of the lower rectum, is still challenging because of limited accessibility. Robotic surgery overcomes the limitations of laparoscopy associated with anatomy and offers certain advantages, including 3-D imaging, dexterity and ambidextrous capability, lack of tremors, motion scaling, and a short learning curve. Robotic rectal surgery has been reported to reduce conversion rates, particularly in low anterior resection, but it is associated with longer operative times than the conventional laparoscopic approach. Postoperative morbidities are similar between the robotic and conventional laparoscopic approaches, and oncological outcomes such as the quality of the mesorectum and the status of resection margins are also equivalent. The possible superiority of robotic surgery in terms of the preservation of autonomic function has yet to be established in research based on larger numbers of patients. Although robotic rectal surgery is safe, feasible, and appears to overcome some of the technical limitations associated with conventional laparoscopic surgery, the advantages provided by this technical innovation are currently limited. To justify its expensive cost, robotic surgery is more suitable for select patients, such as obese patients, men, those with cancer of the lower rectum, and those receiving preoperative chemoradiotherapy. © 2017 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

  1. Stubborn rectal prolapse in systemic sclerosis.

    PubMed

    Petersen, Sven; Tobisch, Alexander; Puhl, Gero; Kötter, Ina; Wollina, Uwe

    2017-01-01

    Systemic sclerosis (SSc) is an autoimmune connective tissue disorder. Anorectal involvement might typically cause fecal incontinence and rarely rectal prolapse. Here we report three female patients, who were admitted with a mean history of 10 years suffering from SSc. All patients presented with the initial symptom of anal incontinence, in all cases this was associated with rectal intussusception or rectal prolapse. The three women faced prolapse recurrence, independent of the initial procedure. After surgical removal of the prolapse, the incontinence remained. In SSc rectal prolapse syndrome might occur at an earlier age, and a primary prolapse of the ventral aspect of the rectal wall seems to be typical for this disease. If patients with prior diagnosis of SSc appear with third degree of fecal incontinence, it is suspected to be associated with rectal prolapse. The prolapse recurrence rate after surgery in SSc patients is high.

  2. Overview of the 2nd Gen 3.7m HIAD Static Load Test

    NASA Technical Reports Server (NTRS)

    Swanson, G. T.; Kazemba, C. D.; Johnson, R. K.; Hughes, S. J.; Calomino, A. M.; Cheatwood, F. M.; Cassell, A. M.; Anderson, P.; Lowery, A.

    2015-01-01

    To support NASAs long term goal of landing humans on Mars, technologies which enable the landing of heavy payloads are being developed. Current entry, decent, and landing technologies are not practical for human class payloads due to geometric constraints dictated by current launch vehicle fairing limitations. Therefore, past and present technologies are now being explored to provide a mass and volume efficient solution to atmospheric entry, including Hypersonic Inflatable Aerodynamic Decelerators (HIADs). In October of 2014, a 3.7m HIAD inflatable structure with an integrated flexible thermal protection sys-tem (F-TPS) was subjected to a static load test series to verify the designs structural performance. The 3.7m HIAD structure was constructed in a 70 deg sphere-cone stacked-toroid configuration using eight inflatable tori, which were joined together using adhesives and high strength textile webbing to help distribute the loads throughout the inflatable structure. The inflatable structure was fabricated using 2nd generation structural materials that permit an increase in use temperature to 400 C+ as compared to the 250 C limitation of the 1st generation materials. In addition to the temperature benefit, these materials also offer a 40 reduction in structure mass. The 3.7m F-TPS was fabricated using high performance materials to protect the inflatable structure from heat loads that would be seen during atmospheric entry. The F-TPS was constructed of 2nd generation TPS materials increasing its heating capability from 35W sq cm to over 100W sq cm. This test article is the first stacked-torus HIAD to be fabricated and tested with a 70 deg sphere-cone. All previous stacked-torus HIADs have employed a 60o sphere-cone. To perform the static load test series, a custom test fixture was constructed. The fixture consisted of a structural tub rim with enough height to allow for dis-placement of the inflatable structure as loads were applied. The tub rim was attached to the

  3. Madeira Extreme Floods: 2009/2010 Winter. Case study - 2nd and 20th of February

    NASA Astrophysics Data System (ADS)

    Pires, V.; Marques, J.; Silva, A.

    2010-09-01

    Floods are at world scale the natural disaster that affects a larger fraction of the population. It is a phenomenon that extends it's effects to the surrounding areas of the hydrographic network (basins, rivers, dams) and the coast line. Accordingly to USA FEMA (Federal Emergency Management Agency) flood can be defined as:"A general and temporary condition of partial or complete inundation of two or more acres of normally dry land area or of two or more properties from: Overflow of inland or tidal waters; Unusual and rapid accumulation or runoff of surface waters from any source; Mudflow; Collapse or subsidence of land along the shore of a lake or similar body of water as a result of erosion or undermining caused by waves or currents of water exceeding anticipated cyclical levels that result in a flood as defined above." A flash flood is the result of intense and long duration of continuous precipitation and can result in dead casualties (i.e. floods in mainland Portugal in 1967, 1983 and 1997). The speed and strength of the floods either localized or over large areas, results in enormous social impacts either by the loss of human lives and or the devastating damage to the landscape and human infrastructures. The winter of 2009/2010 in Madeira Island was characterized by several episodes of very intense precipitation (specially in December 2009 and February 2010) adding to a new record of accumulated precipitation since there are records in the island. In February two days are especially rainy with absolute records for the month of February (daily records since 1949): 111mm and 97mm on the 2nd and 20th respectively. The accumulated precipitation ended up with the terrible floods on the 20th of February causing the lost of dozens of human lives and hundreds of millions of Euros of losses The large precipitation occurrences either more intense precipitation in a short period or less intense precipitation during a larger period are sometimes the precursor of

  4. A convective divertor utilizing a 2nd-order magnetic field null

    NASA Astrophysics Data System (ADS)

    Rognlien, Thomas

    2014-10-01

    New results motivate a detailed study of a magnetic divertor concept characterized by strong plasma convection near a poloidal magnetic field (Bp) null region. The configuration is that of a near-2nd-order Bp null (Bp ~ Δ r2) , as in a snowflake divertor. The concept has 2 key features: (A) Convection spreads the heat flux between multiple divertor legs and further broadens the heat-flux profile within each leg, thereby greatly reducing target-plate heat loads. (B) The heat flux is further reduced by line radiation in each leg in detachment-like ionization zones. Theory indicates that convective turbulence arises when the poloidal plasma beta, βp = 2μ0nT/B p 2 >> 1 . Measurements in TCV now more fully quantify earlier NSTX and TCV observations of plasma mixing, and related modeling of TCV indicates that strongly enhanced null-region transport is present. Convective mixing provides a stabilizing mechanism to prevent the ionization fronts (hydrogenic and impurity) from collapsing to a highly radiating core MARFE. Also, the radiating zone maps to a very small region at the midplane owing to the very weak Bp in the convective region, thus minimizing its impact on the core plasma. Detailed calculations are reported that combine features A and B noted above. The plasma mixing mechanisms are described together with the corresponding transport model implemented in the 2D UEDGE edge transport code. UEDGE calculations are presented that quantify the roles of mixing, impurity radiation, and detachment stability for a realistic snowflake configuration. Work in collaboration with D.D. Ryutov, S.I. Krasheninnikov, and M.V. Umansky. Performed for the U.S. DoE by LLNS, LLC, LLNL, under Contract DE-AC52-07NA27344.

  5. PREFACE: 2nd International Conference on Competitive Materials and Technological Processes (IC-CMTP2)

    NASA Astrophysics Data System (ADS)

    László, Gömze A.

    2013-12-01

    Competitiveness is one of the most important factors in our life and it plays a key role in the efficiency both of organizations and societies. The more scientifically supported and prepared organizations develop more competitive materials with better physical, chemical and biological properties and the leading companies apply more competitive equipment and technology processes. The aims of the 2nd International Conference on Competitive Materials and Technology Processes (ic-cmtp2) are the following: Promote new methods and results of scientific research in the fields of material, biological, environmental and technology sciences; Change information between the theoretical and applied sciences as well as technical and technological implantations. Promote the communication between the scientist of different nations, countries and continents. Among the major fields of interest are materials with extreme physical, chemical, biological, medical, thermal, mechanical properties and dynamic strength; including their crystalline and nano-structures, phase transformations as well as methods of their technological processes, tests and measurements. Multidisciplinary applications of materials science and technological problems encountered in sectors like ceramics, glasses, thin films, aerospace, automotive and marine industry, electronics, energy, construction materials, medicine, biosciences and environmental sciences are of particular interest. In accordance to the program of the conference ic-cmtp2, more than 250 inquiries and registrations from different organizations were received. Researchers from 36 countries in Asia, Europe, Africa, North and South America arrived at the venue of conference. Including co-authors, the research work of more than 500 scientists are presented in this volume. Professor Dr Gömze A László Chair, ic-cmtp2 The PDF also contains lists of the boards, session chairs and sponsors.

  6. Conference Report on the 2nd International Symposium on Lithium Applications for Fusion Devices

    NASA Astrophysics Data System (ADS)

    Ono, M.; Bell, M. G.; Hirooka, Y.; Kaita, R.; Kugel, H. W.; Mazzitelli, G.; Menard, J. E.; Mirnov, S. V.; Shimada, M.; Skinner, C. H.; Tabares, F. L.

    2012-03-01

    The 2nd International Symposium on Lithium Applications for Fusion Devices (ISLA-2011) was held on 27-29 April 2011 at the Princeton Plasma Physics Laboratory (PPPL) with broad participation from the community working on aspects of lithium research for fusion energy development. This community is expanding rapidly in many areas including experiments in magnetic confinement devices and a variety of lithium test stands, theory and modeling and developing innovative approaches. Overall, 53 presentations were given representing 26 institutions from 10 countries. The latest experimental results from nine magnetic fusion devices were given in 24 presentations, from NSTX (PPPL, USA), LTX (PPPL, USA), FT-U (ENEA, Italy), T-11M (TRINITY, RF), T-10 (Kurchatov Institute, RF), TJ-II (CIEMAT, Spain), EAST (ASIPP, China), HT-7 (ASIPP, China), and RFX (Padova, Italy). Sessions were devoted to: I. Lithium in magnetic confinement experiments (facility overviews), II. Lithium in magnetic confinement experiments (topical issues), III. Special session on liquid lithium technology, IV. Lithium laboratory test stands, V. Lithium theory/modeling/comments, VI. Innovative lithium applications and VII. Panel discussion on lithium PFC viability in magnetic fusion reactors. There was notable participation from the fusion technology communities, including the IFE, IFMIF and TBM communities providing productive exchanges with the physics oriented magnetic confinement lithium research groups. It was agreed to continue future exchanges of ideas and data to help develop attractive liquid lithium solutions for very challenging magnetic fusion issues, such as development of a high heat flux steady-state divertor concept and acceptable plasma disruption mitigation techniques while improving plasma performance with lithium. The next workshop will be held at ENEA, Frascati, Italy in 2013.

  7. Feasibility of a 2(nd) generation MR-compatible manipulator for transrectal prostate biopsy guidance.

    PubMed

    Bomers, J G R; Bosboom, D G H; Tigelaar, G H; Sabisch, J; Fütterer, J J; Yakar, D

    2017-04-01

    To assess the feasibility of a 2(nd) generation MR-compatible, remote-controlled manipulator (RCM) as an aid to perform MR-guided transrectal prostate biopsy in males with suspicion of prostate cancer (PCa). This prospective phase I study was approved by the local ethical committee and written informed consent was obtained from each patient. Twenty patients with ≥1 cancer suspicious region (CSR) with a PI-RADS score of ≥3 detected on the diagnostic multi-parametric MRI and no prior prostate treatment underwent MR-guided biopsy with the aid of the RCM. Complications were classified according to the modified Clavien system for reporting surgical complications. For evaluation of the workflow, procedure- and manipulation times were recorded. All CSR's (n=20) were reachable with the MR-compatible RCM and the cancer detection rate was 70 %. The median procedure time was 36:44 minutes (range, 23 - 61 minutes) and the median manipulation time for needle guide movement was 5:48 minutes (range, 1:15 - 18:35 minutes). Two Clavien grade 1 complications were reported. It is feasible and safe to perform transrectal MR-guided prostate biopsy using a MR-compatible RCM as an aid. It is a fast and efficient way to biopsy suspicious prostate lesions with a minimum number of biopsies per patient. • It is feasible to perform transrectal prostate biopsy using a MR-compatible RCM. • Using a RCM for MR-guided biopsy is safe, fast, and efficient. • All cancer suspicious regions were reachable with the RCM.

  8. The Ratio of 2nd to 4th Digit Length in Korean Alcohol-dependent Patients

    PubMed Central

    Han, Changwoo; Bae, Hwallip; Lee, Yu-Sang; Won, Sung-Doo; Kim, Dai Jin

    2016-01-01

    Objective The ratio of 2nd to 4th digit length (2D:4D) is a sexually dimorphic trait. Men have a relatively shorter second digit than fourth digit. This ratio is thought to be influenced by higher prenatal testosterone level or greater sensitivity to androgen. The purpose of this study is to investigate the relationship between alcohol dependence and 2D:4D in a Korean sample and whether 2D:4D can be a biologic marker in alcohol dependence. Methods In this study, we recruited 87 male patients with alcohol dependence from the alcohol center of one psychiatric hospital and 52 healthy male volunteers who were all employees in the same hospital as controls. We captured images of the right and left hands of patients and controls using a scanner and extracted data with a graphics program. We measured the 2D:4D of each hand and compared the alcohol dependence group with the control group. We analyzed these ratios using an independent-samples t-test. Results The mean 2D:4D of patients was 0.934 (right hand) and 0.942 (left hand), while the mean 2D:4D of controls was 0.956 (right hand) and 0.958 (left hand). Values for both hands were significantly lower for patients than controls (p<0.001, right hand; p=0.004, left hand). Conclusion Patients who are alcohol dependent have a significantly lower 2D:4D than controls, similar to the results of previous studies, which suggest that a higher prenatal testosterone level in the gonadal period is related to alcoholism. Furthermore, 2D:4D is a possible predictive marker of alcohol dependence. PMID:27121425

  9. 11 Years of Cloud Characteristics from SEVIRI: 2nd Edition of the CLAAS Dataset by CMSAF

    NASA Astrophysics Data System (ADS)

    Finkensieper, Stephan; Stengel, Martin; Fokke Meirink, Jan; van Zadelhoff, Gerd-Jan; Kniffka, Anke

    2016-04-01

    Spatiotemporal variability of clouds is an important aspect of the climate system. Therefore climate data records of cloud properties are valuable to many researchers in the climate community. The passive SEVIRI imager onboard the geostationary Meteosat Second Generation satellites is well suited for the needs of cloud retrievals as it provides measurements in 12 spectral channels every 15 minutes and thus allows for capturing both the spatial and the temporal variability of clouds. However, requirements on climate data records are high in terms of record length and homogeneity, so that intercalibration and homogenization among the available SEVIRI instruments becomes a crucial factor. We present the 2nd edition of the CLoud Property DAtAset using SEVIRI (CLAAS-2) generated within the EUMETSAT Satellite Application Facility on Climate Monitoring (CMSAF), that is temporally extended and qualitatively improved compared to the 1st edition. CLAAS-2 covers the time period 2004-2014 and features cloud mask, cloud top properties, cloud phase, cloud type, and microphysical cloud properties on the complete SEVIRI disc in 15-minute temporal resolution. Temporally and spatially averaged quantities, mean diurnal cycles and monthly histograms are included as well. CLAAS-2 was derived from a homogenized data basis, obtained by intercalibrating visible and infrared SEVIRI radiances (of Meteosat 8, 9 and 10) with MODIS, using state-of-the-art retrieval schemes. In addition to the dataset characteristics, we will present validation results using CALIPSO as reference observations. The CLAAS-2 dataset will allow for a large variety of applications of which some will be indicated in our presentation, with focus on determining diurnal to seasonal cycles, spatially resolved frequencies of cloud properties as well as showing the potential for using CLAAS-2 data for model process studies.

  10. Penile metastases of rectal adenocarcinoma.

    PubMed

    Persec, Z; Persec, J; Sovic, T; Rako, D; Savic, I; Marinic, D K

    2014-02-01

    Penile metastases are very rare and arise most frequently from genitourinary cancers. Penile metastases from rectal adenocarcinoma are less common and only 50 or so cases have been reported. We present a 43-year-old man with penile metastases from a rectal adenocarcinoma. Two years before admittance to our department, abdomino-perineal resection of the rectum (Miles operation) was performed for a Dukes B (T3N0M0) rectal adenocarcinoma; the surgical resection margins wee negative. Adjuvant chemotherapy and radiotherapy treatment were administered. One year after initial management, excision of a local recurrence was performed followed by further chemotherapy. The patient subsequently noticed lesions of the penis measuring up to 1.2 cm in diameter. Biopsy revealed metastatic adenocarcinoma. Computed tomography showed normal structure of penis with subcutaneous nodular thickening. Soon thereafter, the entire shaft of the penis becomes indurated and the patient developed urinary obstruction. A suprapubic cystostomy was performed. The patient died within 6 months. Penile metastases arise most frequently from genitourinary cancers, primarily from the bladder and the prostate gland. Metastasis to the penis from a rectal adenocarcinoma occurs much less commonly. Other reported primary origins of penile metastases include malignancies of the lung, nasopharynx and melanoma. The major symptoms are penile nodular mass, malignant priapism, penile pain and tenderness, difficulty in micturition, and urinary retention. Possible routes of metastasis are arterial, retrograde venous spread, retrograde lymphatic spread, but direct tumor infiltration/extension is also possible. Penile metastases from rectal adenocarcinoma usually occur within 2 years after diagnosis of the primary tumor. The prognosis is very poor regardless of treatment modality. Treatment is more often palliative than curative. Survival usually varies from 7 months to 2 years. Long-term survival (9 years) has been

  11. Evaluation of the Battelle Developmental Inventory, 2nd Edition, Screening Test for Use in States' Child Outcomes Measurement Systems under the Individuals with Disabilities Education Act

    ERIC Educational Resources Information Center

    Elbaum, Batya; Gattamorta, Karina A.; Penfield, Randall D.

    2010-01-01

    This study evaluated the Battelle Developmental Inventory, 2nd Edition, Screening Test (BDI-2 ST) for use in states' child outcomes accountability systems under the Individuals with Disabilities Education Act. Complete Battelle Developmental Inventory, 2nd Edition (BDI-2), assessment data were obtained for 142 children, ages 2 to 62 months, who…

  12. The Influence of Instructional Climates on Time Spent in Management Tasks and Physical Activity of 2nd-Grade Students during Physical Education

    ERIC Educational Resources Information Center

    Logan, Samuel W.; Robinson, Leah E.; Webster, E. Kipling; Rudisill, Mary E.

    2015-01-01

    The purpose of this study is to determine the effect of two physical education (PE) instructional climates (mastery, performance) on the percentage of time students spent in a) moderate-to-vigorous physical activity (MVPA) and b) management tasks during PE in 2nd-grade students. Forty-eight 2nd graders (mastery, n = 23; performance, n = 25)…

  13. The Influence of Instructional Climates on Time Spent in Management Tasks and Physical Activity of 2nd-Grade Students during Physical Education

    ERIC Educational Resources Information Center

    Logan, Samuel W.; Robinson, Leah E.; Webster, E. Kipling; Rudisill, Mary E.

    2015-01-01

    The purpose of this study is to determine the effect of two physical education (PE) instructional climates (mastery, performance) on the percentage of time students spent in a) moderate-to-vigorous physical activity (MVPA) and b) management tasks during PE in 2nd-grade students. Forty-eight 2nd graders (mastery, n = 23; performance, n = 25)…

  14. Robotic rectal surgery: what are the benefits?

    PubMed

    Kim, C W; Baik, S H

    2013-10-01

    Robotic rectal surgery is not a rare event for colorectal surgeons any more. Even patients with colorectal diseases obtain information through the mass media and are asking surgeons about robotic surgery. Since laparoscopic rectal surgery has proved to have some benefits compared to open rectal surgery, many surgeons became interested in robotic rectal surgery. Some of them have reported the advantages and disadvantages of robotic rectal surgery over the last decade. This review will report on the outcomes of robotic rectal surgery. Robotic rectal surgery requires a longer operation time than laparoscopic or open surgery, but many authors reduced the gap as they were accustomed to the robotic system and used various additional techniques. The high cost for purchasing and maintaining the robotic system is still a problem, though. However, except for this reason, robotic rectal surgery shows comparable and even superior results in some parameters than laparoscopic or open surgery. They include pathologic and functional outcomes as well as short-term outcomes such as complication rates, length of hospital stay, time to recover normal bowel function or first flatus, time to start diet, and postoperative pain. Moreover, studies on oncologic outcomes show acceptable results. Robotic rectal surgery is safe and feasible and has a number of benefits. Therefore, it can be an alternative option to conventional laparoscopic and open surgery with strict indications.

  15. Rectal neuroendocrine neoplasms: a case report

    PubMed Central

    Su, Hao

    2016-01-01

    The gastrointestinal neuroendocrine neoplasms (GI-NENs) are very rare, among which second most common type is the rectal NENs in China. Patients with rectal NENs may experience non-specific symptoms such as pain, perianal bulge, anemia, and bloody stools, and surgery is considered as the first treatment for rectal NENs. We report a case of rectal NENs in a 68-year-old male patient with bloody stools, who received surgery and postoperative pathology revealed an elevated well-differentiated neuroendocrine carcinoma. PMID:28138616

  16. Magnamosis: a novel technique for the management of rectal atresia

    PubMed Central

    Russell, Katie W; Rollins, Michael D; Feola, G Peter; Scaife, Eric R

    2014-01-01

    We report a case of rectal atresia treated using magnets to create a rectal anastomosis. This minimally invasive technique is straightforward and effective for the treatment of rectal atresia in children. PMID:25096648

  17. What is being researched in rectal cancer?

    PubMed

    Reina Duarte, Angel; Ferrer Márquez, Manuel; Rubio Gil, Francisco A; Belda Lozano, Ricardo; Alvarez García, Antonio; Blesa Sierra, Isabel; Fuentes Porcel, Orlando; Vidaña Márquez, Elisa; Rosado Cobian, Rafael

    2014-11-25

    Clinical evidence has a more significant role in medical specialties than in surgery. Rectal cancer (CR) is no exception. This paper explores what CR-related subjects are being investigated at the present time in a quantitative and qualitative way and analyzes this information to know what possible answers clinical research could give us in the future. The data collection was carried out in April 2014 and was based on 3 sources: 2 institutional clinical trials registries -American (clinicaltrials.gov) and European (EU Clinical Trials Register)- and a survey given to members of the Asociación Española de Coloproctología (AECP). The obtained studies were exported to a database designed especially for this review, which included a number of descriptive elements that would allow the cataloging of the different studies. The AECP survey results were analyzed separately. There are currently 216 clinical trials ongoing related to CR. Two-thirds are primarily conducted by oncologists. Nearly a third are surgical. The research focuses on improving preoperative treatment: new drugs, new schemes of chemo-radiotherapy (usually induction or consolidation schemes) or optimization of radiotherapy and its effects. Surgical clinical trials are related to robotics, laparoscopy, stoma, low colorectal anastomosis, distal CR and local treatment. Most of the current clinical trials ongoing on CR are analyzing aspects of chemo-radiotherapy and its effects. A third focus on purely surgical issues. Copyright © 2014 AEC. Published by Elsevier Espana. All rights reserved.

  18. Differential contribution of specific working memory components to mathematics achievement in 2nd and 3rd graders.

    PubMed

    Meyer, M L; Salimpoor, V N; Wu, S S; Geary, D C; Menon, V

    2010-04-01

    The contribution of the three core components of working memory (WM) to the development of mathematical skills in young children is poorly understood. The relation between specific WM components and Numerical Operations, which emphasize computation and fact retrieval, and Mathematical Reasoning, which emphasizes verbal problem solving abilities in 48 2nd and 50 3rd graders was assessed using standardized WM and mathematical achievement measures. For 2nd graders, the central executive and phonological components predicted Mathematical Reasoning skills; whereas the visuo-spatial component predicted both Mathematical Reasoning and Numerical Operations skills in 3rd graders. This pattern suggests that the central executive and phonological loop facilitate performance during early stages of mathematical learning whereas visuo-spatial representations play an increasingly important role during later stages. We propose that these changes reflect a shift from prefrontal to parietal cortical functions during mathematical skill acquisition. Implications for learning and individual differences are discussed.

  19. [Re-operations for 2nd primary lung cancer detected during follow-up after lung cancer surgery].

    PubMed

    Tsuchida, Masanori

    2013-07-01

    Re-operations for 2nd primary lung cancers are one of the most challenging modality for thoracic surgeons. Surgeons should have knowledge of indication of re-operations as well as surgical techniques and perioperative management of patients with 2nd primary lung cancers. When performing repeated pulmonary resection on the same side of the 1st surgery, following points are important for accomplishment of a safe re-operation:1.Wide thoracotomy with muscle dissections is recommended. 2.Throughout adhesion lysis between lung parenchyma and surrounding structures are required before manipulating pulmonary vessels. 3.The main pulmonary artery is encircled before dissection of the pulmonary artery. 4.Surgeons should be familiar with intrapericardial exposure of the main pulmonary artery. The techniques consist of division of the ligament of arteriosum, incision of the pericardium, and encircle of the origin of the mail pulmonary. Re-operations for metachronous lung cancers provided favorable survival in patients with adequate physiologic pulmonary reserve.

  20. German: The German Language in Education in Alsace, France. 2nd Edition. Regional Dossiers Series.

    ERIC Educational Resources Information Center

    Van der Schaaf, Alie, Comp.; Morgen, Daniel, Comp.

    This regional dossier aims to provide concise, descriptive information and basic educational statistics about minority language education in a specific region of the European Union-- Alsace, a part of France along the German border. Details about the features of the educational system, recent educational policies, divisions of responsibilities,…

  1. Teachers' Spatial Anxiety Relates to 1st-and 2nd-Graders' Spatial Learning

    ERIC Educational Resources Information Center

    Gunderson, Elizabeth A.; Ramirez, Gerardo; Beilock, Sian L.; Levine, Susan C.

    2013-01-01

    Teachers' anxiety about an academic domain, such as math, can impact students' learning in that domain. We asked whether this relation held in the domain of spatial skill, given the importance of spatial skill for success in math and science and its malleability at a young age. We measured 1st-and 2nd-grade teachers' spatial anxiety…

  2. Physical properties of double perovskite-type barium neodymium osmate Ba{sub 2}NdOsO{sub 6}

    SciTech Connect

    Wakeshima, Makoto; Hinatsu, Yukio; Ohoyama, Kenji

    2013-01-15

    The crystal, magnetic structures and physical properties of the double perovskite-type barium neodymium osmate Ba{sub 2}NdOsO{sub 6} are investigated through powder X-ray and neutron diffraction, electrical conductivity, magnetic susceptibility, and specific heat measurements. The Rietveld analysis reveals that the Nd and Os ions are arranged with regularity over the six-coordinate B sites in a distorted perovskite ABO{sub 3} framework. The monoclinic crystal structure described by space group P2{sub 1}/n (tilt system a{sup -}a{sup -}c{sup +}) becomes more distorted with decreasing temperature from 300 K down to 2.5 K. This compound shows a long-range antiferromagnetic ordering of Os{sup 5+} below 65 K. An antiferromagnetic ordering of Nd{sup 3+} also occurs at lower temperatures ({approx}20 K). The magnetic structure is of Type I and the magnetic moments of Nd{sup 3+} and Os{sup 5+} ions are in the same direction in the ab-plane. - Graphical Abstract: The Magnetic structure of Ba{sub 2}NdOsO{sub 6} is of Type I, and the magnetic moments of the Nd{sup 3+} and Os{sup 5+} ions are in the same direction in the ab-plane. Highlights: Black-Right-Pointing-Pointer Crystal structures of Ba{sub 2}NdOsO{sub 6} are determined to be monoclinic below 300 K. Black-Right-Pointing-Pointer Its electrical resistivity shows a Mott variable-range hopping behavior with localized carriers. Black-Right-Pointing-Pointer An antiferromagnetic ordering of the Os{sup 5+}moment occurs at 65 K. Black-Right-Pointing-Pointer The magnetic structure of Ba{sub 2}NdOsO{sub 6} is determined to be of Type I.

  3. Teachers' Spatial Anxiety Relates to 1st-and 2nd-Graders' Spatial Learning

    ERIC Educational Resources Information Center

    Gunderson, Elizabeth A.; Ramirez, Gerardo; Beilock, Sian L.; Levine, Susan C.

    2013-01-01

    Teachers' anxiety about an academic domain, such as math, can impact students' learning in that domain. We asked whether this relation held in the domain of spatial skill, given the importance of spatial skill for success in math and science and its malleability at a young age. We measured 1st-and 2nd-grade teachers' spatial anxiety…

  4. Earthworms as Invasive Species in Latin America — the 2nd Latin American Meeting on Oligochaeta (Earthworm) Ecology and Taxonomy

    Treesearch

    Grizelle Gonzalez

    2006-01-01

    This special issue is based on scientific contributions presented at the 2nd Latin American Symposium of Earthworm Ecology and Taxonomy (ELAETAO, for its Spanish acronym) held in San Juan, Puerto Rico November 14-18, 2005. The first of these symposia was organized by George G. Brown and Klaus D. Sautter and held at Londrina, Brazil from December 1-3, 2003.The objective...

  5. PREFACE: 1st-2nd Young Researchers Meetings in Rome - Proceedings

    NASA Astrophysics Data System (ADS)

    YRMR Organizing Committee; Cannuccia, E.; Mazzaferro, L.; Migliaccio, M.; Pietrobon, D.; Stellato, F.; Veneziani, M.

    2011-03-01

    Students in science, particularly in physics, face a fascinating and challenging future. Scientists have proposed very interesting theories, which describe the microscopic and macroscopic world fairly well, trying to match the quantum regime with cosmological scales. Between the extremes of this scenario, biological phenomena in all their complexity take place, challenging the laws we observe in the atomic and sub-atomic world. More and more accurate and complex experiments have been devised and these are now going to test the paradigms of physics. Notable experiments include: the Large Hadronic Collider (LHC), which is going to shed light on the physics of the Standard Model of Particles and its extensions; the Planck-Herschel satellites, which target a very precise measurement of the properties of our Universe; and the Free Electron Lasers facilities, which produce high-brilliance, ultrafast X-ray pulses, allowing the investigation of the fundamental processes of solid state physics, chemistry, and biology. These projects are the result of huge collaborations spread across the world, involving scientists belonging to different and complementary research fields: physicists, chemists, biologists and others, keen to make the best of these extraordinary laboratories. Even though each branch of science is experiencing a process of growing specialization, it is very important to keep an eye on the global picture, remaining aware of the deep interconnections between inherent fields. This is even more crucial for students who are beginning their research careers. These considerations motivated PhD students and young post-docs connected to the Roman scientific research area to organize a conference, to establish the background and the network for interactions and collaborations. This resulted in the 1st and 2nd Young Researchers Meetings in Rome (http://ryrm.roma2.infn.it), one day conferences aimed primarily at graduate students and post-docs, working in physics in Italy

  6. White Paper Summary of 2nd ASTM International Workshop on Hydrides in Zirconium Alloy Cladding

    SciTech Connect

    Sindelar, R.; Louthan, M.; PNNL, B.

    2015-05-29

    This white paper recommends that ASTM International develop standards to address the potential impact of hydrides on the long term performance of irradiated zirconium alloys. The need for such standards was apparent during the 2nd ASTM International Workshop on Hydrides in Zirconium Alloy Cladding and Assembly Components, sponsored by ASTM International Committee C26.13 and held on June 10-12, 2014, in Jackson, Wyoming. The potentially adverse impacts of hydrogen and hydrides on the long term performance of irradiated zirconium-alloy cladding on used fuel were shown to depend on multiple factors such as alloy chemistry and processing, irradiation and post irradiation history, residual and applied stresses and stress states, and the service environment. These factors determine the hydrogen content and hydride morphology in the alloy, which, in turn, influence the response of the alloy to the thermo-mechanical conditions imposed (and anticipated) during storage, transport and disposal of used nuclear fuel. Workshop presentations and discussions showed that although hydrogen/hydride induced degradation of zirconium alloys may be of concern, the potential for occurrence and the extent of anticipated degradation vary throughout the nuclear industry because of the variations in hydrogen content, hydride morphology, alloy chemistry and irradiation conditions. The tools and techniques used to characterize hydrides and hydride morphologies and their impacts on material performance also vary. Such variations make site-to-site comparisons of test results and observations difficult. There is no consensus that a single material or system characteristic (e.g., reactor type, burnup, hydrogen content, end-of life stress, alloy type, drying temperature, etc.) is an effective predictor of material response during long term storage or of performance after long term storage. Multi-variable correlations made for one alloy may not represent the behavior of another alloy exposed to

  7. Emotional and Behavioral Disorders in 1.5th Generation, 2nd Generation Immigrant Children, and Foreign Adoptees.

    PubMed

    Tan, Tony Xing

    2016-10-01

    Existing theories (e.g., acculturative stress theory) cannot adequately explain why mental disorders in immigrants are less prevalent than in non-immigrants. In this paper, the culture-gene co-evolutionary theory of mental disorders was utilized to generate a novel hypothesis that connection to heritage culture reduces the risk for mental disorders in immigrant children. Four groups of children aged 2-17 years were identified from the 2007 United States National Survey of Children's Health: 1.5th generation immigrant children (n = 1378), 2nd generation immigrant children (n = 4194), foreign adoptees (n = 270), and non-immigrant children (n = 54,877). The 1.5th generation immigrant children's connection to their heritage culture is stronger than or similar to the 2nd generation immigrants, while the foreign adoptees have little connection to their birth culture. Controlling for age, sex, family type and SES, the odds for having ADD/ADHD, Conduct Disorder, Anxiety Disorder, and Depression diagnosis were the lowest for the 1.5th generation immigrant children, followed by the 2nd generation immigrant children and the foreign adoptees. The foreign adoptees and non-adopted children were similar in the odds of having these disorders. Connection to heritage culture might be the underlying mechanism that explained recent immigrants' lower rates of mental disorders.

  8. Multidisciplinary management in rectal cancer.

    PubMed

    Hervás Morón, Asunción; García de Paredes, María Luisa; Lobo Martínez, Eduardo

    2010-12-01

    The treatment of rectal cancer has evolved over the last few decades from surgery alone to treatments with trimodal therapy for high-risk patients. The involvement of a multidisciplinary team of radiologists, pathologists, surgeons, radiotherapists and medical oncologists is now fundamental for decision-making and outcomes. The evolution of different diagnostic and therapeutic techniques has optimised the therapeutic rate. Future studies will determine the optimal regimen for inducing complete responses in locally advanced disease and whether the intensification of local treatments could enable the use of more conservative treatments, as for other tumour locations. The study of biomarkers will be essential in this respect.

  9. Multiple rectal carcinoid tumors in monozygotic twins.

    PubMed

    Doi, Momoko; Ikawa, Osamu; Taniguchi, Hiroki; Kawamura, Takuji; Katsura, Kanade

    2016-08-01

    We report multiple rectal carcinoid tumors in monozygotic twins who, respectively, had 42 and 36 carcinoid tumors in the lower rectum. This is the first report about carcinoid tumors in monozygotic twins. Both twins developed a similar number of rectal carcinoids with a similar distribution. Investigation of their genetic background may provide information about the origin of these tumors.

  10. Fournier gangrene: rare complication of rectal cancer.

    PubMed

    Ossibi, Pierlesky Elion; Souiki, Tarik; Ibn Majdoub, Karim; Toughrai, Imane; Laalim, Said Ait; Mazaz, Khalid; Tenkorang, Somuah; Farih, My Hassan

    2015-01-01

    Fournier's Gangrene is a rare complication of rectal cancer. Its discovery is often delayed. It's incidence is about 0.3/100,000 populations in Western countries. We report a patient with peritoneal perforation of rectal cancer revealed by scrotal and perineal necrotizing fasciitis.

  11. Implications of an Economic Recession on European Defense

    DTIC Science & Technology

    2011-03-10

    25. 90 Javier Solana, “Preface,” in What ambitions for European defence in 2020?, 2nd ed., ed. Alvaro de Vasconcelos (Paris: EU Institute for...international security to NATO.88 17 Javier Solana, in his preface to “What Ambitions for European Defence in 2020?,” highlights the fact there is...available today. Alvaro de Vasconcelos recognizes there is a joint capabilities deficit that is contrary to the CSDP, and that it has a negative impact on EU

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

    ClinicalTrials.gov

    2017-04-11

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

  13. [Rectal administration of anesthetic agents].

    PubMed

    Ceriana, P; Maurelli, M

    1995-05-01

    To collect data in the current literature dealing with the diffusion, the reliability and the effectiveness of the rectal administration of anaesthetic drugs. To evaluate differences with parenteral administration. Pharmacokinetics and clinical studies published in recent years in indexed journals. Based on the study methodology, drugs employed and pharmacokinetic parameters evaluated. Factors involved in absorption of drugs from the rectal mucosa, clinical effect and pharmacokinetic data of the following drugs: diazepam, flunitrazepam, midazolam, ketamin and methohexital, then a brief evaluation of other drugs: thiopental, etomidate, morphine and chloral hydrate. The most widely used drugs are benzodiazepines: they are safe, easy to manage and highly effective; among them midazolam has the best kinetic and dynamic pattern. Ketamin is useful during painful diagnostic procedures; with the use of barbiturates there is a greater risk of respiratory depression and more caution must be employed. Wide intervariability of rate of absorption, achievement of plasma levels and clinical effect is a relevant drawback of this technique, such to make it not preferable to the parenteral route, when both are feasible. It deserves, anyway, more consideration, and maintains its validity for the preparation of the paediatric patient to general anaesthesia.

  14. Progress in Rectal Cancer Treatment

    PubMed Central

    Ceelen, Wim P.

    2012-01-01

    The dramatic improvement in local control of rectal cancer observed during the last decades is to be attributed to attention to surgical technique and to the introduction of neoadjuvant therapy regimens. Nevertheless, systemic relapse remains frequent and is currently insufficiently addressed. Intensification of neoadjuvant therapy by incorporating chemotherapy with or without targeted agents before the start of (chemo)radiation or during the waiting period to surgery may present an opportunity to improve overall survival. An increasing number of patients can nowadays undergo sphincter preserving surgery. In selected patients, local excision or even a “wait and see” approach may be feasible following active neoadjuvant therapy. Molecular and genetic biomarkers as well as innovative imaging techniques may in the future allow better selection of patients for this treatment option. Controversy persists concerning the selection of patients for adjuvant chemotherapy and/or targeted therapy after neoadjuvant regimens. The currently available evidence suggests that in complete pathological responders long-term outcome is excellent and adjuvant therapy may be omitted. The results of ongoing trials will help to establish the ideal tailored approach in resectable rectal cancer. PMID:22970381

  15. Development of Hydrologic Characterization Technology of Fault Zones -- Phase I, 2nd Report

    SciTech Connect

    Karasaki, Kenzi; Onishi, Tiemi; Black, Bill; Biraud, Sebastien

    2009-03-31

    This is the year-end report of the 2nd year of the NUMO-LBNL collaborative project: Development of Hydrologic Characterization Technology of Fault Zones under NUMO-DOE/LBNL collaboration agreement, the task description of which can be found in the Appendix 3. Literature survey of published information on the relationship between geologic and hydrologic characteristics of faults was conducted. The survey concluded that it may be possible to classify faults by indicators based on various geometric and geologic attributes that may indirectly relate to the hydrologic property of faults. Analysis of existing information on the Wildcat Fault and its surrounding geology was performed. The Wildcat Fault is thought to be a strike-slip fault with a thrust component that runs along the eastern boundary of the Lawrence Berkeley National Laboratory. It is believed to be part of the Hayward Fault system but is considered inactive. Three trenches were excavated at carefully selected locations mainly based on the information from the past investigative work inside the LBNL property. At least one fault was encountered in all three trenches. Detailed trench mapping was conducted by CRIEPI (Central Research Institute for Electric Power Industries) and LBNL scientists. Some intriguing and puzzling discoveries were made that may contradict with the published work in the past. Predictions are made regarding the hydrologic property of the Wildcat Fault based on the analysis of fault structure. Preliminary conceptual models of the Wildcat Fault were proposed. The Wildcat Fault appears to have multiple splays and some low angled faults may be part of the flower structure. In parallel, surface geophysical investigations were conducted using electrical resistivity survey and seismic reflection profiling along three lines on the north and south of the LBNL site. Because of the steep terrain, it was difficult to find optimum locations for survey lines as it is desirable for them to be as

  16. 2nd International Conference on Rheology and Modeling of Materials (IC-RMM2)

    NASA Astrophysics Data System (ADS)

    2017-01-01

    Understanding the rheological properties of materials and their rheological behaviors during their manufacturing processes and in their applications in many cases can help to increase the efficiency and competitiveness not only of the finished goods and products but the organizations and societies also. The more scientific supported and prepared organizations develop more competitive products with better thermal, mechanical, physical, chemical and biological properties and the leading companies apply more competitive equipment and technology processes. The aims of the 2nd International Conference on Rheology and Modeling of Materials (ic-rmm2) and the parallel organized symposiums of the 1st International Symposium on Powder Injection Molding (is-pim1) and the 1st International Symposium on Rheology and Fracture of Solids (is-rfs1) are the followings: Promote new methods and results of scientific research in the fields of modeling and measurements of rheological properties and behavior of materials under processing and applications; Change information between the theoretical and applied sciences as well as technical and technological implantations. Promote the communication and collaboration between the scientists, researchers and engineers of different disciplines, different nations, countries and continents. The international conference ic-rmm2 and symposiums of is-pim1 and is-rfs1 provide a platform among the leading international scientists, researchers, PhD students and engineers for discussing recent achievements in measurement, modeling and application of rheology in materials technology and materials science of liquids, melts, solids, crystals and amorphous structures. Among thr major fields of interest are the influence of materials structures, mechanical stresses, temperatures, deformation speeds and shear rates on rheological and physical properties, phase transformation of foams, foods, polymers, plastics and other competitive materials like ceramics

  17. 2nd Radio and Antenna Days of the Indian Ocean (RADIO 2014)

    NASA Astrophysics Data System (ADS)

    2014-10-01

    It was an honor and a great pleasure for all those involved in its organization to welcome the participants to the ''Radio and Antenna Days of the Indian Ocean'' (RADIO 2014) international conference that was held from 7th to 10th April 2014 at the Sugar Beach Resort, Wolmar, Flic-en-Flac, Mauritius. RADIO 2014 is the second of a series of conferences organized in the Indian Ocean region. The aim of the conference is to discuss recent developments, theories and practical applications covering the whole scope of radio-frequency engineering, including radio waves, antennas, propagation, and electromagnetic compatibility. The RADIO international conference emerged following discussions with engineers and scientists from the countries of the Indian Ocean as well as from other parts of the world and a need was felt for the organization of such an event in this region. Following numerous requests, the Island of Mauritius, worldwide known for its white sandy beaches and pleasant tropical atmosphere, was again chosen for the organization of the 2nd RADIO international conference. The conference was organized by the Radio Society, Mauritius and the Local Organizing Committee consisted of scientists from SUPELEC, France, the University of Mauritius, and the University of Technology, Mauritius. We would like to take the opportunity to thank all people, institutions and companies that made the event such a success. We are grateful to our gold sponsors CST and FEKO as well as URSI for their generous support which enabled us to partially support one PhD student and two scientists to attend the conference. We would also like to thank IEEE-APS and URSI for providing technical co-sponsorship. More than hundred and thirty abstracts were submitted to the conference. They were peer-reviewed by an international scientific committee and, based on the reviews, either accepted, eventually after revision, or rejected. RADIO 2014 brought together participants from twenty countries spanning

  18. Transanal endoscopic surgery in rectal cancer.

    PubMed

    Serra-Aracil, Xavier; Mora-Lopez, Laura; Alcantara-Moral, Manel; Caro-Tarrago, Aleidis; Gomez-Diaz, Carlos Javier; Navarro-Soto, Salvador

    2014-09-07

    Total mesorectal excision (TME) is the standard treatment for rectal cancer, but complications are frequent and rates of morbidity, mortality and genitourinary alterations are high. Transanal endoscopic microsurgery (TEM) allows preservation of the anal sphincters and, via its vision system through a rectoscope, allows access to rectal tumors located as far as 20 cm from the anal verge. The capacity of local surgery to cure rectal cancer depends on the risk of lymph node invasion. This means that correct preoperative staging of the rectal tumor is necessary. Currently, local surgery is indicated for rectal adenomas and adenocarcinomas invading the submucosa, but not beyond (T1). Here we describe the standard technique for TEM, the different types of equipment used, and the technical limitations of this approach. TEM to remove rectal adenoma should be performed in the same way as if the lesion were an adenocarcinoma, due to the high percentage of infiltrating adenocarcinomas in these lesions. In spite of the generally good results with T1, some authors have published surprisingly high recurrence rates; this is due to the existence of two types of lesions, tumors with good and poor prognosis, divided according to histological and surgical factors. The standard treatment for rectal adenocarcinoma T2N0M0 is TME without adjuvant therapy. In this type of adenocarcinoma, local surgery obtains the best results when complete pathological response has been achieved with previous chemoradiotherapy. The results with chemoradiotherapy and TEM are encouraging, but the scientific evidence remains limited at present.

  19. Influence of weather conditions on milk production and rectal temperature of Holsteins fed two levels of concentrate

    NASA Astrophysics Data System (ADS)

    Kabuga, J. D.; Sarpong, K.

    1991-12-01

    Twelve lactating Holstein cows in 2nd lactation were allocated randomly, six each, to two feeding treatments: high concentrate (1 kg dairy concentrate to 2 kg milk produced) and low concentrate (1 kg dairy concentrate to 4 kg milk produced) from 7 to 106 days postcalving. Forage and water were provided adalibitum. Milk and butter fat yields and rectal temperatures were examined in relation to 9 weather variables (minimum, maximum and mean temperatures, relative humidity, temperature-humidity index (THI), radiation, wind velocity and mean temperature of the previous day). Averages for milk yield, fat yield and rectal temperature were respectively 20.4 kg, 0.7 kg and 38.9°C for the high concentrate treatment and 18.4 kg, 0.6 kg and 38.6°C for the low concentrate treatment. Weather conditions accounted for 5.6%, 0.8% and 10.8% of the day to day variation in milk yield, fat yield and rectal remperature, respectively, for the high concentrate group and 29.4%, 9.7% and 0.6%, respectively, for the low concentrate group. Only measures of ambient temperature, especially mean temperature, were closely associated with these traits.

  20. Development of the American Society of Colon & Rectal Surgeons (ASCRS) Rectal Cancer Surgery Checklist

    PubMed Central

    Glasgow, Sean C.; Morris, Arden M.; Baxter, Nancy N.; Fleshman, James W.; Alavi, Karim S.; Luchtefeld, Martin A.; Monson, John R. T.; Chang, George J.; Temple, Larissa K.

    2016-01-01

    Background There is excellent evidence that surgical safety checklists contribute to decreased morbidity and mortality. Objective To develop a surgical checklist comprising the key phases of care for rectal cancer patients. Design Consensus-oriented decision-making model involving iterative input from subject matter experts under the auspices of the American Society of Colon and Rectal Surgeons. Results The process generated a 25-item checklist covering the spectrum of care for rectal cancer patients undergoing surgery. Limitations Lack of prospective validation. Conclusions The American Society of Colon and Rectal Surgeons Rectal Cancer Surgery checklist comprises the essential elements of pre-, intra- and postoperative care that must be addressed during the surgical treatment of patients with rectal cancer. PMID:27270511

  1. Future of therapy for rectal cancer.

    PubMed

    Minsky, Bruce D

    2013-06-01

    Since 2004, the standard of care for patients with cT3 and/or N+ rectal cancer has been preoperative chemoradiation followed by surgery and postoperative adjuvant chemotherapy. A number of advances have occurred and are defining the future of rectal cancer therapy. Among these are short course radiation, the impact of postoperative adjuvant chemotherapy, selective radiation and selective surgery, and new chemoradiation regimens with novel agents. This review will examine these developments and assess their impact on the future therapy of rectal cancer.

  2. A DICOM-based 2nd generation Molecular Imaging Data Grid implementing the IHE XDS-i integration profile.

    PubMed

    Lee, Jasper; Zhang, Jianguo; Park, Ryan; Dagliyan, Grant; Liu, Brent; Huang, H K

    2012-07-01

    A Molecular Imaging Data Grid (MIDG) was developed to address current informatics challenges in archival, sharing, search, and distribution of preclinical imaging studies between animal imaging facilities and investigator sites. This manuscript presents a 2nd generation MIDG replacing the Globus Toolkit with a new system architecture that implements the IHE XDS-i integration profile. Implementation and evaluation were conducted using a 3-site interdisciplinary test-bed at the University of Southern California. The 2nd generation MIDG design architecture replaces the initial design's Globus Toolkit with dedicated web services and XML-based messaging for dedicated management and delivery of multi-modality DICOM imaging datasets. The Cross-enterprise Document Sharing for Imaging (XDS-i) integration profile from the field of enterprise radiology informatics was adopted into the MIDG design because streamlined image registration, management, and distribution dataflow are likewise needed in preclinical imaging informatics systems as in enterprise PACS application. Implementation of the MIDG is demonstrated at the University of Southern California Molecular Imaging Center (MIC) and two other sites with specified hardware, software, and network bandwidth. Evaluation of the MIDG involves data upload, download, and fault-tolerance testing scenarios using multi-modality animal imaging datasets collected at the USC Molecular Imaging Center. The upload, download, and fault-tolerance tests of the MIDG were performed multiple times using 12 collected animal study datasets. Upload and download times demonstrated reproducibility and improved real-world performance. Fault-tolerance tests showed that automated failover between Grid Node Servers has minimal impact on normal download times. Building upon the 1st generation concepts and experiences, the 2nd generation MIDG system improves accessibility of disparate animal-model molecular imaging datasets to users outside a molecular

  3. Genetic Mutations in Blood and Tissue Samples in Predicting Response to Treatment in Patients With Locally Advanced Rectal Cancer Undergoing Chemoradiation

    ClinicalTrials.gov

    2017-09-08

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

  4. Paediatric rectal prolapse in Rwanda.

    PubMed Central

    Chaloner, E J; Duckett, J; Lewin, J

    1996-01-01

    During the 1994 crisis in Rwanda, a high incidence of full-thickness rectal prolapse was noted among the refugee children in the south-west of the country. The prolapses arose as a result of acute diarrhoeal illness superimposed on malnutrition and worm infestation. We used a modification of the Thiersch wire technique in 40 of these cases during two months working in a refugee camp. A catgut pursestring was tied around the anal margin under local, regional or general anaesthesia. This was effective in achieving short-term control of full-thickness prolapse until the underlying illness was corrected. Under the circumstances, no formal follow-up could be arranged; however, no complications were reported and only one patient presented with recurrence. Images Figure 1 PMID:9014879

  5. Electrical Properties and Superconductivity of MSr2Nd2-xCexCu2O10-δ (M=Ta, Nb)

    NASA Astrophysics Data System (ADS)

    Zhu, Yingjie; Qian, Yitai; Li, Rukang; Wang, Shiwei; Chen, Zuyao; Chen, Zhaojia; Wang, Nanling; Zhou, Guien

    1992-09-01

    A new series of layered cuprate compounds MSr2Nd2-xCexCu2O10-δ (M=Ta, Nb) have been synthesized. The structure of the compounds is similar to that of T1-1222. A peak in the R-T curve for the sample of TaSr2Nd1.3Ce0.7Cu2O10-δ has been observed at about 50 K. For the sample of NbSr2Nd1.45Ce0.55Cu2O10-δ, metal-like conductivity behaviour has been observed. We have found superconductivity at about 13.2 K in the samples of NbSr2Nd2-xCexCu2O10-δ (x=0.49, 0.50, 0.51, 0.52).

  6. 2nd International Salzburg Conference on Neurorecovery (ISCN 2013) Salzburg/Austria|November 28th-29th, 2013.

    PubMed

    Brainin, M; Muresanu, D; Slavoaca, D

    2014-01-01

    The 2nd International Salzburg Conference on Neurorecovery was held on the 28th and 29th of November, 2013, in Salzburg, one of the most beautiful cities in Austria, which is well known for its rich cultural heritage, world-famous music and beautiful surrounding landscapes. The aim of the conference was to discuss the progress in the field of neurorecovery. The conference brought together internationally renowned scientists and clinicians, who described the clinical and therapeutic relevance of translational research and its applications in neurorehabilitation.

  7. Comparison of the large scale structure of the ISM in the 2nd and 3rd Galactic Quadrants

    NASA Astrophysics Data System (ADS)

    Könyves, V.; Kiss, Cs.

    2002-05-01

    In this paper we are questing the large scale structure of the interstellar medium (ISM) using IRAS/ISSA 60 and 100 mum maps in the 3rd Galactic Quadrant (GQ). Here we identified 41 loop-like intensity enhancements and analysed their far-infrared (FIR) properties. We found major differences in the distribution and characteristics of these features when comparing the results of the 2nd and the 3rd GQs. This discrepancy can be satisfactorily explained by basic differences of the structure of the ISM in these two Galactic Quadrants.

  8. THE 2nd SCHIZOPHRENIA INTERNATIONAL RESEARCH SOCIETY CONFERENCE, 10–14 APRIL 2010, FLORENCE, ITALY: SUMMARIES OF ORAL SESSIONS

    PubMed Central

    Baharnoori, Moogeh; Bartholomeusz, Cali; Boucher, Aurelie A.; Buchy, Lisa; Chaddock, Christopher; Chiliza, Bonga; Föcking, Melanie; Fornito, Alex; Gallego, Juan A.; Hori, Hiroaki; Huf, Gisele; Jabbar, Gul A.; Kang, Shi Hyun; El Kissi, Yousri; Merchán-Naranjo, Jessica; Modinos, Gemma; Abdel-Fadeel, Nashaat A.M.; Neubeck, Anna-Karin; Ng, Hsiao Piau; Novak, Gabriela; Owolabi, Olasunmbo.O.; Prata, Diana P.; Rao, Naren P.; Riecansky, Igor; Smith, Darryl C.; Souza, Renan P.; Thienel, Renate; Trotman, Hanan D.; Uchida, Hiroyuki; Woodberry, Kristen A.; O'Shea, Anne; DeLisi, Lynn E.

    2014-01-01

    The 2nd Schizophrenia International Research Society Conference, was held in Florence, Italy, April 10–15, 2010. Student travel awardees served as rapporteurs of each oral session and focused their summaries on the most significant findings that emerged from each session and the discussions that followed. The following report is a composite of these reviews. It is hoped that it will provide an overview for those who were present, but could not participate in all sessions, and those who did not have the opportunity to attend, but who would be interested in an update on current investigations ongoing in the field of schizophrenia research. PMID:20934307

  9. 2nd International Salzburg Conference on Neurorecovery (ISCN 2013) Salzburg/ Austria | November 28th - 29th, 2013

    PubMed Central

    Brainin, M; Muresanu, D; Slavoaca, D

    2014-01-01

    The 2nd International Salzburg Conference on Neurorecovery was held on the 28th and 29th of November, 2013, in Salzburg, one of the most beautiful cities in Austria, which is well known for its rich cultural heritage, world-famous music and beautiful surrounding landscapes. The aim of the conference was to discuss the progress in the field of neurorecovery. The conference brought together internationally renowned scientists and clinicians, who described the clinical and therapeutic relevance of translational research and its applications in neurorehabilitation. PMID:25713602

  10. The 2nd International Conference on East-West Perspectives on Functional Foods: Science, Innovations and Claims.

    PubMed

    Florentino, Rodolfo F

    2008-01-01

    The 2nd International Conference on East-West Perspective on Functional Foods held in Kuala Lumpur, Malaysia, on November, 2007, discussed the current work on some traditional Asian foods and new technologies that offer both challenges and opportunities for functional foods. The highlight of the conference was on the current regulatory status of nutrition and health claims related to functional foods and the experiences in some countries on the substantiation of claims. Attention was also given to strategies for effective communication of functional foods to consumers. The conference concluded with recommendations to strengthen R and D efforts and harmonization of protocols and methodologies on functional foods within the region.

  11. Wettability characteristics of carbon steel modified with CO 2, Nd:YAG, excimer and high power diode lasers

    NASA Astrophysics Data System (ADS)

    Lawrence, J.; Li, L.

    2000-02-01

    Interaction of CO 2, Nd:YAG, excimer and high power diode laser (HPDL) radiation with the surface of a common mild steel (EN8) was found to effect changes in the wettability characteristics of the steel, namely changes in the measured contact angle. These modifications are related to changes in the surface roughness, changes in the surface oxygen content and changes in the surface energy of the mild steel. The wettability characteristics of the selected mild steel could be controlled and/or modified by laser surface treatment. A correlation between the change of the wetting properties of the mild steel and the laser wavelength was found.

  12. Mechanical suture in rectal cancer.

    PubMed

    Cheregi, Cornel Dragos; Simon, Ioan; Fabian, Ovidiu; Maghiar, Adrian

    2017-01-01

    Colorectal cancer is one of the most frequent digestive malignancies, being the third cause of death by cancer, despite early diagnosis and therapeutic progress made over the past years. Standard treatment in these patients is to preserve the anal sphincter with restoration of intestinal function by mechanical colorectal anastomosis or coloanal anastomosis, and to maintain genitourinary function by preservation of hypogastric nerves. In order to emphasize the importance of this surgical technique in the Fourth Surgical Clinic of the CF Clinical Hospital Cluj-Napoca, we conducted a prospective observational interventional study over a 3-year period (2013-2016) in 165 patients hospitalized for rectal and rectosigmoid adenocarcinoma in various disease stages, who underwent Dixon surgery using the two techniques of manual and mechanical end-to-end anastomosis. For mechanical anastomosis, we used Covidien and Panther circular staplers. The patients were assigned to two groups, group A in which Dixon surgery with manual end-to-end anastomosis was performed (116 patients), and group B in which Dixon surgery with mechanical end-to-end anastomosis was carried out (49 patients). Mechanical anastomosis allowed to restore intestinal continuity following low anterior resection in 21 patients with lower rectal adenocarcinoma compared to 2 patients in whom intestinal continuity was restored by manual anastomosis, with a statistically significant difference (p<0.000001). The double-row mechanical suture technique is associated with a reduced duration of surgery (121.67 minutes for Dixon surgery with mechanical anastomosis, compared to 165.931 minutes for Dixon surgery with manual anastomosis, p<0.0001). The use of circular transanal staplers facilitates end-to-end anastomosis by double-row mechanical suture, allowing to perform low anterior resection in situations when the restoration of intestinal continuity by manual anastomosis is technically not possible, with the aim to

  13. A rare cause of chronic rectal bleeding in children; solitary rectal ulcer: case report.

    PubMed

    Temiz, Abdulkerim; Tander, Burak; Temiz, Muhyittin; Barış, Sancar; Arıtürk, Ender

    2011-03-01

    Solitary rectal ulcer causing lower gastrointestinal bleeding is extremely rare in children. Rare presentation, non-specific symptoms, insufficient experience, and characteristics mimicking other rectal diseases may cause misdiagnosis or delay of diagnosis in some pediatric patients. Here, we report a 10-year-old boy with solitary rectal ulcer diagnosed two years after onset of the symptoms who responded well to the conservative therapy, including high-fiber diet, laxatives, defecation training, and sucralfate enema.

  14. PET-MRI in Diagnosing Patients With Colon or Rectal Cancer

    ClinicalTrials.gov

    2015-11-25

    Recurrent Colon Cancer; Recurrent Rectal Cancer; Stage IIA Colon Cancer; Stage IIA Rectal Cancer; Stage IIB Colon Cancer; Stage IIB Rectal Cancer; Stage IIC Colon Cancer; Stage IIC Rectal Cancer; Stage IIIA Colon Cancer; Stage IIIA Rectal Cancer; Stage IIIB Colon Cancer; Stage IIIB Rectal Cancer; Stage IIIC Colon Cancer; Stage IIIC Rectal Cancer; Stage IVA Colon Cancer; Stage IVA Rectal Cancer; Stage IVB Colon Cancer; Stage IVB Rectal Cancer

  15. Brain order disorder 2nd group report of f-EEG

    NASA Astrophysics Data System (ADS)

    Lalonde, Francois; Gogtay, Nitin; Giedd, Jay; Vydelingum, Nadarajen; Brown, David; Tran, Binh Q.; Hsu, Charles; Hsu, Ming-Kai; Cha, Jae; Jenkins, Jeffrey; Ma, Lien; Willey, Jefferson; Wu, Jerry; Oh, Kenneth; Landa, Joseph; Lin, C. T.; Jung, T. P.; Makeig, Scott; Morabito, Carlo Francesco; Moon, Qyu; Yamakawa, Takeshi; Lee, Soo-Young; Lee, Jong-Hwan; Szu, Harold H.; Kaur, Balvinder; Byrd, Kenneth; Dang, Karen; Krzywicki, Alan; Familoni, Babajide O.; Larson, Louis; Harkrider, Susan; Krapels, Keith A.; Dai, Liyi

    2014-05-01

    Since the Brain Order Disorder (BOD) group reported on a high density Electroencephalogram (EEG) to capture the neuronal information using EEG to wirelessly interface with a Smartphone [1,2], a larger BOD group has been assembled, including the Obama BRAIN program, CUA Brain Computer Interface Lab and the UCSD Swartz Computational Neuroscience Center. We can implement the pair-electrodes correlation functions in order to operate in a real time daily environment, which is of the computation complexity of O(N3) for N=102~3 known as functional f-EEG. The daily monitoring requires two areas of focus. Area #(1) to quantify the neuronal information flow under arbitrary daily stimuli-response sources. Approach to #1: (i) We have asserted that the sources contained in the EEG signals may be discovered by an unsupervised learning neural network called blind sources separation (BSS) of independent entropy components, based on the irreversible Boltzmann cellular thermodynamics(ΔS < 0), where the entropy is a degree of uniformity. What is the entropy? Loosely speaking, sand on the beach is more uniform at a higher entropy value than the rocks composing a mountain - the internal binding energy tells the paleontologists the existence of information. To a politician, landside voting results has only the winning information but more entropy, while a non-uniform voting distribution record has more information. For the human's effortless brain at constant temperature, we can solve the minimum of Helmholtz free energy (H = E - TS) by computing BSS, and then their pairwise-entropy source correlation function. (i) Although the entropy itself is not the information per se, but the concurrence of the entropy sources is the information flow as a functional-EEG, sketched in this 2nd BOD report. Area #(2) applying EEG bio-feedback will improve collective decision making (TBD). Approach to #2: We introduce a novel performance quality metrics, in terms of the throughput rate of faster (

  16. FOREWORD: 2nd International Workshop on New Computational Methods for Inverse Problems (NCMIP 2012)

    NASA Astrophysics Data System (ADS)

    Blanc-Féraud, Laure; Joubert, Pierre-Yves

    2012-09-01

    Conference logo This volume of Journal of Physics: Conference Series is dedicated to the scientific contributions presented during the 2nd International Workshop on New Computational Methods for Inverse Problems, (NCMIP 2012). This workshop took place at Ecole Normale Supérieure de Cachan, in Cachan, France, on 15 May 2012, at the initiative of Institut Farman. The first edition of NCMIP also took place in Cachan, France, within the scope of the ValueTools Conference, in May 2011 (http://www.ncmip.org/2011/). The NCMIP Workshop focused on recent advances in the resolution of inverse problems. Indeed inverse problems appear in numerous scientific areas such as geophysics, biological and medical imaging, material and structure characterization, electrical, mechanical and civil engineering, and finance. The resolution of inverse problems consists of estimating the parameters of the observed system or structure from data collected by an instrumental sensing or imaging device. Its success firstly requires the collection of relevant observation data. It also requires accurate models describing the physical interactions between the instrumental device and the observed system, as well as the intrinsic properties of the solution itself. Finally, it requires the design of robust, accurate and efficient inversion algorithms. Advanced sensor arrays and imaging devices provide high rate and high volume data; in this context, the efficient resolution of the inverse problem requires the joint development of new models and inversion methods, taking computational and implementation aspects into account. During this one-day workshop, researchers had the opportunity to bring to light and share new techniques and results in the field of inverse problems. The topics of the workshop were: algorithms and computational aspects of inversion, Bayesian estimation, kernel methods, learning methods, convex optimization, free discontinuity problems, metamodels, proper orthogonal decomposition

  17. VizieR Online Data Catalog: The DENIS database, 2nd Release (DENIS Consortium, 2003)

    NASA Astrophysics Data System (ADS)

    DENIS Consortium

    2003-04-01

    This catalogue is an intermediate release of the DENIS project. It consists of a set of 195204157 point sources detected by the DENIS survey in 2239 strips (covering each 30 degrees in declination and 12 arcmin in right ascension). The data in this release cover approximately 11000 square degrees of the Southern sky. Multiple detections of single point sources have been merged in image overlaps within individual strips, but sources can have multiple detections in overlapping strips. The complete set of data collected by DENIS in the period 1996-2001 will be released towards the end of 2003. DENIS is the only astronomical survey of the Southern sky made in two near-infrared bands (J at 1.25{mu}m, and Ks at 2.15{mu}m) and one optical band (Gunn-i at 0.82{mu}m), with limiting magnitudes 14.0, 16.5 and 18.5, respectively. It was conducted by a European consortium, using the 1m telescope at ESO, La Silla (Chile). The DENIS instrument is made up of a 3-channel camera built of commercially available detector arrays by the Observatoire de Paris and with major contributions from other European Institutes, notably: the IAS in Frascati, the Observatoire de Grenoble, the University of Innsbruck, the Observatoire de Lyon, and the IAC in Tenerife. The survey is carried out by observing strips of 30{deg} in declination and 12arcminutes in Right Ascension with an overlap of 2arcminutes between consecutive strips. The survey started at the end of 1995 and has been completed up to 97% in 2001. The data have been reduced at the Institut d'Astrophysique de Paris and Observatoire de Paris. The position of a general extracted point source is provided with an accuracy better than 1arcsec and its magnitude to better than 0.1mag. The Centre de Donnees Astronomiques de Strasbourg (CDS) is releasing the final databases and provides access of the processed and calibrated data to the worldwide community. The principal investigator of the DENIS project is N. Epchtein (Observatoire de la Cote d

  18. Rectal gastrointestinal stromal tumor as an incidental finding in a patient with rectal polyps.

    PubMed

    Zhou, Yong; Wu, Xu-Dong; Fan, Ren-Gen; zha, Wen-Zhang; Xu, Yong-Hua; Qing, Cheng-Lin; Jia, Jing

    2015-01-01

    A patient who was diagnosed as rectal polyps in the local hospital went to our hospital for surgical treatment. Abdominal CT demonstrated a large irregular extra-luminal tumor of at least 5 cm cross-section on the ventral side of the lower rectal wall. Intraoperatively, a large irregular extra-luminal tumor (about 5×4.5×4 cm) was found. Anterior resection with end colostomy and rectal stump (Hartmann's procedure) was performed. Postoperative histological examination showed simultaneous development of rectal GIST and polyps.

  19. Robotic-Laparoscopic Rectal Cancer Excision Versus Traditional Laparoscopy

    PubMed Central

    Tam, Michael S.; Abbass, Mohammad

    2014-01-01

    Background and Objectives: Robotic surgery has been advocated for the radical excision of rectal cancer. Most data supporting its use have been reported from European and Asian centers, with a paucity of data from the United States documenting clear advantages of the robotic technique. This study compares the short-term outcome of robotic versus laparoscopic surgery. Methods: Consecutive patients who underwent laparoscopic (group 1) or robotic (group 2) rectal cancer excision at a single institution over a 2-year period were retrospectively reviewed. The main outcome measures were operative time, blood loss, conversion rates, number of lymph nodes, margin positivity, length of hospital stay, complications, and readmission rates. Results: Forty-two patients were analyzed. The median operative time was shorter in group 1 than that in group 2 (240 minutes vs 260 minutes, P = .04). No difference was noted in blood loss, transfusion rates, intraoperative complications, or conversion rates. There was no difference in circumferential or distal margin positivity. The median length of stay was shorter in group 1 (5 days vs 6 days, P = .05). The 90-day complication rate was similar in both groups (33% vs 43%, P = .75), but there was a trend toward more anastomotic leaks in group 1 (14% vs 0%, P = .23). Similarly, a non–statistically significant trend toward a higher readmission rate was noted in group 1 (24% vs 5%, P = .18). Conclusion: Robotic rectal cancer excision yielded a longer operative time and hospital length of stay, although immediate oncologic results were comparable. The need for randomized data is critical to determine whether the added resource utilization in robotic surgery is justifiable. PMID:25392653

  20. Defining the distal margin of rectal cancer for surgical planning

    PubMed Central

    Kato, Takashi; Tanaka, Jun-Ichi

    2017-01-01

    Accurate measurement of the distal rectal tumor margin is essential in selecting the appropriate surgical procedure. However, there is no standard measurement method. The National Cancer Institute consensus group recommends use of the anal verge (AV) as a landmark, and the European Society of Gastrointestinal and Abdominal Radiology recommends use of the anorectal ring (ARR). In addition, whether measurements should be made on double contrast barium enema (BE) radiographs or magnetic resonance (MR) images remains controversial. We measured the distal tumor margin on both BE and MR images obtained preoperatively from 52 patients who underwent sphincter-saving resection for rectal cancer. The distances from the distal end of the tumor to the AV and the ARR were measured on both types of images, and the variability was investigated by Bland-Altman analysis. The mean distance from the tumor to the AV was 8.9 cm on the BE radiographs and 7.7 cm on the MR images (P=0.013). The mean distances to the ARR were 6.8 and 5.6 cm, respectively (P=0.070). Significant proportional bias was shown as the measured distances increased, the difference between the BE- and magnetic resonance imaging (MRI)-based measurements increased. Use of one or the other landmark did not affect selection of the appropriate surgical procedure. We conclude that an approximate 1-cm underestimation should be taken into account when MRI-based measurement of the distal rectal tumor margin is used to choose between sphincter-saving resection and abdominoperineal resection. PMID:28280625

  1. Drugs Approved for Colon and Rectal Cancer

    Cancer.gov

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for use in colon cancer and rectal cancer. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters.

  2. Low Rectal Cancer Study (MERCURY II)

    ClinicalTrials.gov

    2016-03-11

    Adenocarcinoma; Adenocarcinoma, Mucinous; Carcinoma; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Cystic, Mucinous, and Serous; Colorectal Neoplasms; Intestinal Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Digestive System Diseases; Gastrointestinal Diseases; Intestinal Diseases; Rectal Diseases

  3. How to Use Rectal Suppositories Properly

    MedlinePlus

    ... Lubricate the suppository tip with a water-soluble lubricant such as K-Y Jelly, not petroleum jelly (Vaseline). If you do not have this lubricant, moisten your rectal area with cool tap water. ...

  4. Robotic rectal surgery: State of the art.

    PubMed

    Staderini, Fabio; Foppa, Caterina; Minuzzo, Alessio; Badii, Benedetta; Qirici, Etleva; Trallori, Giacomo; Mallardi, Beatrice; Lami, Gabriele; Macrì, Giuseppe; Bonanomi, Andrea; Bagnoli, Siro; Perigli, Giuliano; Cianchi, Fabio

    2016-11-15

    Laparoscopic rectal surgery has demonstrated its superiority over the open approach, however it still has some technical limitations that lead to the development of robotic platforms. Nevertheless the literature on this topic is rapidly expanding there is still no consensus about benefits of robotic rectal cancer surgery over the laparoscopic one. For this reason a review of all the literature examining robotic surgery for rectal cancer was performed. Two reviewers independently conducted a search of electronic databases (PubMed and EMBASE) using the key words "rectum", "rectal", "cancer", "laparoscopy", "robot". After the initial screen of 266 articles, 43 papers were selected for review. A total of 3013 patients were included in the review. The most commonly performed intervention was low anterior resection (1450 patients, 48.1%), followed by anterior resections (997 patients, 33%), ultra-low anterior resections (393 patients, 13%) and abdominoperineal resections (173 patients, 5.7%). Robotic rectal surgery seems to offer potential advantages especially in low anterior resections with lower conversions rates and better preservation of the autonomic function. Quality of mesorectum and status of and circumferential resection margins are similar to those obtained with conventional laparoscopy even if robotic rectal surgery is undoubtedly associated with longer operative times. This review demonstrated that robotic rectal surgery is both safe and feasible but there is no evidence of its superiority over laparoscopy in terms of postoperative, clinical outcomes and incidence of complications. In conclusion robotic rectal surgery seems to overcome some of technical limitations of conventional laparoscopic surgery especially for tumors requiring low and ultra-low anterior resections but this technical improvement seems not to provide, until now, any significant clinical advantages to the patients.

  5. Influence of Nd dopant amount on microstructure and photoluminescence of TiO2:Nd thin films

    NASA Astrophysics Data System (ADS)

    Wojcieszak, Damian; Mazur, Michal; Kaczmarek, Danuta; Morgiel, Jerzy; Zatryb, Grzegorz; Domaradzki, Jaroslaw; Misiewicz, Jan

    2015-10-01

    TiO2 and TiO2:Nd thin films were deposited using reactive magnetron sputtering process from mosaic Ti-Nd targets with various Nd concentration. The thin films were characterized using X-ray diffraction (XRD), transmission electron microscopy (TEM) and spectroscopic techniques. Photoluminescence (PL) in the near infrared obtained upon 514.5 nm excitation was also examined. The relationship between the Nd concentration, structural, optical and photoluminescence properties of prepared thin films was investigated and discussed. XRD and TEM measurements showed that an increase in the Nd concentration in the thin films hinders the crystal growth in the deposited coatings. Depending on the Nd amount in the thin films, TiO2 with the rutile, mixed rutile-amorphous or amorphous phase was obtained. Transmittance measurements revealed that addition of Nd dopant to titania matrix did not deteriorate optical transparency of the coatings, however it influenced on the position of the fundamental absorption edge and therefore on the width of optical band gap energy. All TiO2:Nd thin films exhibited PL emission that occurred at ca. 0.91, 1.09 and 1.38 μm. Finally, results obtained for deposited coatings showed that titania with the rutile structure and 1.0 at.% of Nd was the most efficient in VIS to NIR photon conversion.

  6. [Medical support of the 65th Army during the East Prussian offensive operation performed by the 2nd Belorussian Front].

    PubMed

    Shelepov, A M; Leonik, S I; Lemeshkin, R N

    2015-02-01

    Prussian offensive operation performed by the 2nd Belorussian Front. An activity of the medical An activity of the medical service of the 65th Army during the East Prussian offensive operation performed by the 2nd Belorussian Front is a typical example of the medical support of troops during the final stages of World War II. Forms and methods of medical support management, which were developed during the war, haven't lost their importance in modern conditions. These methods include the establishment of specialized surgical and therapeutic field hospital, establishment of medical institutions in the Army, which worked on the evacuation directions and reserve of mobile hospitals and transport, timely extension of the first echelons of the hospital base front to change institutions hospital deployed the army base. A research of experience in organizing medical support of the offensive operations performed during the last year of World War II provides the material for the development of the theory of modern medical support operations and ability to provide on this basis, the continuity of the hospitals, the continuity of qualified and specialized medical care, improve the performance of diagnostic and treatment work.

  7. Efficacy and Safety of rAAV2-ND4 Treatment for Leber’s Hereditary Optic Neuropathy

    PubMed Central

    Wan, Xing; Pei, Han; Zhao, Min-jian; Yang, Shuo; Hu, Wei-kun; He, Heng; Ma, Si-qi; Zhang, Ge; Dong, Xiao-yan; Chen, Chen; Wang, Dao-wen; Li, Bin

    2016-01-01

    Leber’s hereditary optic neuropathy (LHON) is a mitochondrially inherited disease leading to blindness. A mitochondrial DNA point mutation at the 11778 nucleotide site of the NADH dehydrogenase subunit 4 (ND4) gene is the most common cause. The aim of this study was to evaluate the efficacy and safety of a recombinant adeno-associated virus 2 (AAV2) carrying ND4 (rAAV2-ND4) in LHON patients carrying the G11778A mutation. Nine patients were administered rAAV2-ND4 by intravitreal injection to one eye and then followed for 9 months. Ophthalmologic examinations of visual acuity, visual field, and optical coherence tomography were performed. Physical examinations included routine blood and urine. The visual acuity of the injected eyes of six patients improved by at least 0.3 log MAR after 9 months of follow-up. In these six patients, the visual field was enlarged but the retinal nerve fibre layer remained relatively stable. No other outcome measure was significantly changed. None of the nine patients had local or systemic adverse events related to the vector during the 9-month follow-up period. These findings support the feasible use of gene therapy for LHON. PMID:26892229

  8. Locally advanced rectal cancer: management challenges

    PubMed Central

    Kokelaar, RF; Evans, MD; Davies, M; Harris, DA; Beynon, J

    2016-01-01

    Between 5% and 10% of patients with rectal cancer present with locally advanced rectal cancer (LARC), and 10% of rectal cancers recur after surgery, of which half are limited to locoregional disease only (locally recurrent rectal cancer). Exenterative surgery offers the best long-term outcomes for patients with LARC and locally recurrent rectal cancer so long as a complete (R0) resection is achieved. Accurate preoperative multimodal staging is crucial in assessing the potential operability of advanced rectal tumors, and resectability may be enhanced with neoadjuvant therapies. Unfortunately, surgical options are limited when the tumor involves the lateral pelvic sidewall or high sacrum due to the technical challenges of achieving histological clearance, and must be balanced against the high morbidity associated with resection of the bony pelvis and significant lymphovascular structures. This group of patients is usually treated palliatively and subsequently survival is poor, which has led surgeons to seek innovative new solutions, as well as revisit previously discarded radical approaches. A small number of centers are pioneering new techniques for resection of beyond-total mesorectal excision tumors, including en bloc resections of the sciatic notch and composite resections of the first two sacral vertebrae. Despite limited experience, these new techniques offer the potential for radical treatment of previously inoperable tumors. This narrative review sets out the challenges facing the management of LARCs and discusses evolving management options. PMID:27785074

  9. Management of rectal varices in portal hypertension

    PubMed Central

    Al Khalloufi, Kawtar; Laiyemo, Adeyinka O

    2015-01-01

    Rectal varices are portosystemic collaterals that form as a complication of portal hypertension, their prevalence has been reported as high as 94% in patients with extrahepatic portal vein obstruction. The diagnosis is typically based on lower endoscopy (colonoscopy or sigmoidoscopy). However, endoscopic ultrasonography has been shown to be superior to endoscopy in diagnosing rectal varices. Color Doppler ultrasonography is a better method because it allows the calculation of the velocity of blood flow in the varices and can be used to predict the bleeding risk in the varices. Although rare, bleeding from rectal varices can be life threatening. The management of patients with rectal variceal bleeding is not well established. It is important to ensure hemodynamic stability with blood transfusion and to correct any coagulopathy prior to treating the bleeding varices. Endoscopic injection sclerotherapy has been reported to be more effective in the management of active bleeding from rectal varices with less rebleeding rate as compared to endoscopic band ligation. Transjugular intrahepatic portsystemic shunt alone or in combination with embolization is another method used successfully in control of bleeding. Balloon-occluded retrograde transvenous obliteration is an emerging procedure for management of gastric varices that has also been successfully used to treat bleeding rectal varices. Surgical procedures including suture ligation and porto-caval shunts are considered when other methods have failed. PMID:26730278

  10. Surgical management of rectal prolapse.

    PubMed

    Madiba, Thandinkosi E; Baig, Mirza K; Wexner, Steven D

    2005-01-01

    The problem of complete rectal prolapse is formidable, with no clear predominant treatment of choice. Surgical management is aimed at restoring physiology by correcting the prolapse and improving continence and constipation with acceptable mortality and recurrence rates. Abdominal procedures are ideal for young fit patients, whereas perineal procedures are reserved for older frail patients with significant comorbidity. Laparoscopic procedures with their advantages of early recovery, less pain, and possibly lower morbidity are recently added options. Regardless of the therapy chosen, matching the surgical selection to the patient is essential. To review the present status of the surgical treatment of rectal prolapse. Literature review using MEDLINE. All articles reporting on rectopexy were included. Articles reporting on prospective and retrospective comparisons were included. Case reports were excluded, as were studies comparing data with historical controls. The results were tabulated to show outcomes of different studies and were compared. Studies that did not report some of the outcomes were noted as "not stated." Abdominal operations offer not only lower recurrence but also greater chance for functional improvements. Suture and mesh rectopexy produce equivalent results. However, the polyvinyl alcohol (Ivalon) sponge rectopexy is associated with an increased risk of infectious complications and has largely been abandoned. The advantage of adding a resection to the rectopexy seems to be related to less constipation. Laparoscopic rectopexy has similar results to open rectopexy but has all of the advantages related to laparoscopy. Perineal procedures are better suited to frail elderly patients with extensive comorbidity. Abdominal procedures are generally better for young fit patients; the results of all abdominal procedures are comparable. Suture and mesh rectopexy are still popular with many surgeons-the choice depends on the surgeon's experience and preference

  11. Differences in microbial signatures between rectal mucosal biopsies and rectal swabs.

    PubMed

    Araújo-Pérez, Félix; McCoy, Amber N; Okechukwu, Charles; Carroll, Ian M; Smith, Kevin M; Jeremiah, Kim; Sandler, Robert S; Asher, Gary N; Keku, Temitope O

    2012-01-01

    There is growing evidence the microbiota of the large bowel may influence the risk of developing colorectal cancer as well as other diseases including type-1 diabetes, inflammatory bowel diseases and irritable bowel syndrome. Current sampling methods to obtain microbial specimens, such as feces and mucosal biopsies, are inconvenient and unappealing to patients. Obtaining samples through rectal swabs could prove to be a quicker and relatively easier method, but it is unclear if swabs are an adequate substitute. We compared bacterial diversity and composition from rectal swabs and rectal mucosal biopsies in order to examine the viability of rectal swabs as an alternative to biopsies. Paired rectal swabs and mucosal biopsy samples were collected in un-prepped participants (n = 11) and microbial diversity was characterized by Terminal Restriction Fragment Length polymorphism (T-RFLP) analysis and quantitative polymerase chain reaction (qPCR) of the 16S rRNA gene. Microbial community composition from swab samples was different from rectal mucosal biopsies (p = 0.001). Overall the bacterial diversity was higher in swab samples than in biopsies as assessed by diversity indexes such as: richness (p = 0.01), evenness (p = 0.06) and Shannon's diversity (p = 0.04). Analysis of specific bacterial groups by qPCR showed higher copy number of Lactobacillus (p < 0.0001) and Eubacteria (p = 0.0003) in swab samples compared with biopsies. Our findings suggest that rectal swabs and rectal mucosal samples provide different views of the microbiota in the large intestine.

  12. Current perspectives on preoperative integrated treatments for locally advanced rectal cancer: a review of agreement and controversies.

    PubMed

    Cellini, Francesco; Valentini, Vincenzo

    2012-08-01

    The optimal approach to the diagnosis and treatment of locally advanced rectal cancer involves multidisciplinary, integrated management. In the past 30 years, survival and freedom from disease have increased, but the ideal multidisciplinary management remains to be determined. The preferred integrated treatment modality is preoperative radio(chemo)therapy followed by total mesorectal excision. Certain aspects of this standard are still debated, and the European and American approaches vary. The chief recommendations per international guidelines are summarized, and the next generation of integrated treatments for locally advanced rectal cancer is discussed.

  13. Laparoscopic versus robotic rectal resection for rectal cancer in a veteran population.

    PubMed

    Fernandez, Ramiro; Anaya, Daniel A; Li, Linda T; Orcutt, Sonia T; Balentine, Courtney J; Awad, Samir A; Berger, David H; Albo, Daniel A; Artinyan, Avo

    2013-10-01

    Robotic rectal cancer resection remains controversial. We compared the safety and efficacy of laparoscopic vs robotic rectal cancer resection in a high-risk Veterans Health Administration population. Patients who underwent minimally invasive rectal cancer resection were identified from an institutional colorectal cancer database. Baseline characteristics and outcomes were compared between robotic and laparoscopic groups. The robotic group (n = 13) did not differ significantly from the laparoscopic group (n = 59) with respect to baseline characteristics except for a higher rate of previous abdominal surgery. Robotic patients had significantly lower tumors, more advanced disease, a higher rate of preoperative chemoradiation, and were more likely to undergo abdominoperineal resection. Robotic rectal resection was associated with longer operative time. There were no differences in blood loss, conversion rates, postoperative morbidity, lymph nodes harvested, margin positivity, or specimen quality between groups. The robotic approach for rectal cancer resection is safe with similar postoperative and oncologic outcomes compared with laparoscopy. Published by Elsevier Inc.

  14. Robotic rectal surgery: State of the art

    PubMed Central

    Staderini, Fabio; Foppa, Caterina; Minuzzo, Alessio; Badii, Benedetta; Qirici, Etleva; Trallori, Giacomo; Mallardi, Beatrice; Lami, Gabriele; Macrì, Giuseppe; Bonanomi, Andrea; Bagnoli, Siro; Perigli, Giuliano; Cianchi, Fabio

    2016-01-01

    Laparoscopic rectal surgery has demonstrated its superiority over the open approach, however it still has some technical limitations that lead to the development of robotic platforms. Nevertheless the literature on this topic is rapidly expanding there is still no consensus about benefits of robotic rectal cancer surgery over the laparoscopic one. For this reason a review of all the literature examining robotic surgery for rectal cancer was performed. Two reviewers independently conducted a search of electronic databases (PubMed and EMBASE) using the key words “rectum”, “rectal”, “cancer”, “laparoscopy”, “robot”. After the initial screen of 266 articles, 43 papers were selected for review. A total of 3013 patients were included in the review. The most commonly performed intervention was low anterior resection (1450 patients, 48.1%), followed by anterior resections (997 patients, 33%), ultra-low anterior resections (393 patients, 13%) and abdominoperineal resections (173 patients, 5.7%). Robotic rectal surgery seems to offer potential advantages especially in low anterior resections with lower conversions rates and better preservation of the autonomic function. Quality of mesorectum and status of and circumferential resection margins are similar to those obtained with conventional laparoscopy even if robotic rectal surgery is undoubtedly associated with longer operative times. This review demonstrated that robotic rectal surgery is both safe and feasible but there is no evidence of its superiority over laparoscopy in terms of postoperative, clinical outcomes and incidence of complications. In conclusion robotic rectal surgery seems to overcome some of technical limitations of conventional laparoscopic surgery especially for tumors requiring low and ultra-low anterior resections but this technical improvement seems not to provide, until now, any significant clinical advantages to the patients. PMID:27895814

  15. Influence of image slice thickness on rectal dose-response relationships following radiotherapy of prostate cancer

    NASA Astrophysics Data System (ADS)

    Olsson, C.; Thor, M.; Liu, M.; Moissenko, V.; Petersen, S. E.; Høyer, M.; Apte, A.; Deasy, J. O.

    2014-07-01

    When pooling retrospective data from different cohorts, slice thicknesses of acquired computed tomography (CT) images used for treatment planning may vary between cohorts. It is, however, not known if varying slice thickness influences derived dose-response relationships. We investigated this for rectal bleeding using dose-volume histograms (DVHs) of the rectum and rectal wall for dose distributions superimposed on images with varying CT slice thicknesses. We used dose and endpoint data from two prostate cancer cohorts treated with three-dimensional conformal radiotherapy to either 74 Gy (N = 159) or 78 Gy (N = 159) at 2 Gy per fraction. The rectum was defined as the whole organ with content, and the morbidity cut-off was Grade ≥2 late rectal bleeding. Rectal walls were defined as 3 mm inner margins added to the rectum. DVHs for simulated slice thicknesses from 3 to 13 mm were compared to DVHs for the originally acquired slice thicknesses at 3 and 5 mm. Volumes, mean, and maximum doses were assessed from the DVHs, and generalized equivalent uniform dose (gEUD) values were calculated. For each organ and each of the simulated slice thicknesses, we performed predictive modeling of late rectal bleeding using the Lyman-Kutcher-Burman (LKB) model. For the most coarse slice thickness, rectal volumes increased (≤18%), whereas maximum and mean doses decreased (≤0.8 and ≤4.2 Gy, respectively). For all a values, the gEUD for the simulated DVHs were ≤1.9 Gy different than the gEUD for the original DVHs. The best-fitting LKB model parameter values with 95% CIs were consistent between all DVHs. In conclusion, we found that the investigated slice thickness variations had minimal impact on rectal dose-response estimations. From the perspective of predictive modeling, our results suggest that variations within 10 mm in slice thickness between cohorts are unlikely to be a limiting factor when pooling multi-institutional rectal dose data that include slice thickness

  16. The 2nd Order Focusing by Energy for TOF Sector Field Mass Analyzer with an Orthogonal Acceleration: Theory, Modeling, Experiment

    NASA Astrophysics Data System (ADS)

    Poteshin, S. S.; Chernyshev, D. M.; Sysoev, Alexey A.; Sysoev, Alexander A.

    Currently axially symmetric type of analyzer with an electrostatic sector fields (AESF) is rarely used to construct time-of-flight mass spectrometers. The main drawback, hindering the wider use of the analyzers of this type, is the lack of chromatic second-order focusing by energy. However, the configuration of AESF in combination with orthogonal accelerator (OA) allows to achieved it through compensation of energy aberrations of the analyzer in the system of orthogonal input of the ion beam. In the presented work the results of theoretical calculation, simulation and experimentally obtained data are compared. Characteristics of the analyzer with OA in a large extent depend on the parameters of the incoming ion beam. Data of modeling the 2nd stage of gas-dynamic interface, which have the greatest influence on the parameters of the ion beam, is provided.

  17. Use of 2nd and 3rd Level Correlation Analysis for Studying Degradation in Polycrystalline Thin-Film Solar Cells

    SciTech Connect

    Albin, D. S.; del Cueto, J. A.; Demtsu, S. H.; Bansal, S.

    2011-03-01

    The correlation of stress-induced changes in the performance of laboratory-made CdTe solar cells with various 2nd and 3rd level metrics is discussed. The overall behavior of aggregated data showing how cell efficiency changes as a function of open-circuit voltage (Voc), short-circuit current density (Jsc), and fill factor (FF) is explained using a two-diode, PSpice model in which degradation is simulated by systematically changing model parameters. FF shows the highest correlation with performance during stress, and is subsequently shown to be most affected by shunt resistance, recombination and in some cases voltage-dependent collection. Large decreases in Jsc as well as increasing rates of Voc degradation are related to voltage-dependent collection effects and catastrophic shunting respectively. Large decreases in Voc in the absence of catastrophic shunting are attributed to increased recombination. The relevance of capacitance-derived data correlated with both Voc and FF is discussed.

  18. Measurements of the Properties of Garnet Material for Tuning a 2nd Harmonic Cavity for the Fermilab Booster

    SciTech Connect

    Madrak, R. L.; Pellico, W. A.; Romanov, G.; Tan, C. Y.; Terechkine, I.

    2016-01-01

    A perpendicularly biased 2nd harmonic cavity is being designed and built for the Fermilab Booster, to help with injection and extraction. Tunable accelerating cavities were previously designed and prototyped at LANL, TRIUMF, and SSCL for use at 45-60 MHz (LANL at 50-84 MHz). The required frequency range for FNAL is 76 - 106 MHz. The garnet material chosen for the tuner is AL-800. To reliably model the cavity, its static permeability and loss tangent must be well known. As this information is not supplied by the vendor or in publications of previous studies, a first order evaluation of these properties was made using material samples. This paper summarizes the results of the corresponding measurements

  19. 2nd ESMO Consensus Conference in Lung Cancer: locally advanced stage III non-small-cell lung cancer.

    PubMed

    Eberhardt, W E E; De Ruysscher, D; Weder, W; Le Péchoux, C; De Leyn, P; Hoffmann, H; Westeel, V; Stahel, R; Felip, E; Peters, S

    2015-08-01

    To complement the existing treatment guidelines for all tumour types, ESMO organises consensus conferences to focus on specific issues in each type of tumour. The 2nd ESMO Consensus Conference on Lung Cancer was held on 11-12 May 2013 in Lugano. A total of 35 experts met to address several questions on non-small-cell lung cancer (NSCLC) in each of four areas: pathology and molecular biomarkers, first-line/second and further lines of treatment in advanced disease, early-stage disease and locally advanced disease. For each question, recommendations were made including reference to the grade of recommendation and level of evidence. This consensus paper focuses on locally advanced disease.

  20. International collaborative study for establishment of the 2nd WHO International Standard for Haemophilus influenzae type b polysaccharide.

    PubMed

    Mawas, Fatme; Burkin, Karena; Dougall, Thomas; Saydam, Manolya; Rigsby, Peter; Bolgiano, Barbara

    2015-11-01

    In this report we present the results of a collaborative study for the preparation and calibration of a replacement International Standard (IS) for Haemophilus influenzae type b polysaccharide (polyribosyl ribitol phosphate; 5-d-ribitol-(1 → 1)-β-d-ribose-3-phosphate; PRP). Two candidate preparations were evaluated. Thirteen laboratories from 9 different countries participated in the collaborative study to assess the suitability and determine the PRP content of two candidate standards. On the basis of the results from this study, Candidate 2 (NIBSC code 12/306) has been established as the 2nd WHO IS for PRP by the Expert Committee of Biological Standards of the World Health Organisation with a content of 4.904 ± 0.185mg/ampoule, as determined by the ribose assays carried out by 11 of the participating laboratories.

  1. Effect of the nanocrystalline structure type on the optical properties of TiO2:Nd (1 at.%) thin films

    NASA Astrophysics Data System (ADS)

    Mazur, Michal; Wojcieszak, Damian; Kaczmarek, Danuta; Domaradzki, Jaroslaw; Zatryb, Grzegorz; Misiewicz, Jan; Morgiel, Jerzy

    2015-04-01

    Titanium dioxide thin films, each doped with the same amount of neodymium (1 at.%) were deposited by Low Pressure Hot Target Reactive Sputtering and High Energy Reactive Magnetron Sputtering processes in order to obtain anatase and rutile thin film structures respectively. The microstructure and phase composition were analyzed using the transmission electron microscopy method including high resolution electron microscopy imaging. The measurements of the optical properties showed, that both prepared thin films were transparent in the visible light range and had a low extinction coefficient of ca. 3 ṡ 10-3. The thin film with the anatase structure had a lower cut-off wavelength and refractive index and a higher value of optical energy band gap as-compared to the TiO2:Nd coating with the rutile structure. Simultaneously, more efficient photoluminescence emission was observed for the rutile thin films.

  2. Advances in Therapeutic Approaches to Extend Healthspan: a perspective from the 2(nd) Scripps Symposium on the Biology of Aging.

    PubMed

    Robbins, Paul D; Niedernhofer, Laura J

    2017-08-01

    The 2(nd) Scripps Florida Symposium on The Biology of Aging entitled 'Advances in Therapeutic Approaches to Extend Healthspan' was held on January 22(nd) -25(th) , 2017 at The Scripps Research Institute in Jupiter, Florida. The meeting highlighted a variety of therapeutic approaches in animal models of aging that either are or soon will be in clinic trials. For example, drugs targeting senescent cells, metformin, rapalogs, NAD precursors, young plasma, mitochondrial-targeted free radical scavengers, stem cells, and stem cell factors all have shown significant preclinical efficacy. This perspective, based on presentations and discussions at the symposium, outlines the current and future state of development of therapeutic approaches to extend human healthspan. © 2017 The Authors. Aging Cell published by the Anatomical Society and John Wiley & Sons Ltd.

  3. Characterization of γ and γ' phases in 2nd and 4th generation single crystal nickel-base superalloys

    NASA Astrophysics Data System (ADS)

    Zietara, Maciej; Neumeier, Steffen; Göken, Mathias; Czyrska-Filemonowicz, Aleksandra

    2017-01-01

    A Ni based single crystal superalloy from the 2nd generation, PWA 1484, and one from the 4th generation, PWA 1497, were comparatively studied by scanning electron microscopy, energy dispersive X-ray spectroscopy and nanoindentation technique in an atomic force microscope (NI-AFM) after high temperature creep deformation. During primary creep of both generations of superalloys, γ' precipitates start to coalesce and grow directionally. Further creep deformation leads to the topological inversion and coarsening of the rafted microstructure. The NI-AFM technique was used for measurements of the hardness of the γ and γ' phases in as-received and creep deformed samples in various conditions. The g matrix of the PWA 1497 superalloy is on average 0.8 GPa harder than that of PWA 1484 that can be explained by higher content of Re and Ru, since they partition predominantly to the matrix phase.

  4. Fetal thymus: visualization rate and volume by integrating 2D- and 3D-ultrasound during 2nd trimester echocardiography.

    PubMed

    Tonni, Gabriele; Rosignoli, Lucia; Cariati, Ettore; Martins, Wellington P; Miyague, André H; Bruns, Rafael F; Araujo Júnior, Edward

    2016-01-01

    To assess the visualization rate and transverse diameter of fetal thymus by two-dimensional ultrasound (2DUS) as well as the fetal thymus volume by three-dimensional ultrasound (3DUS) during the 2nd trimester echocardiography. A prospective cross-sectional study involving 100 normal fetuses between 18w0d and 23w6d was performed. The identification of fetal thymus and peri-thymic vessels was realized at level of three vessels and trachea (3VT). The transverse diameter was obtained placing a line cursor perpendicular to the line connecting the sternum and the spine. The fetal thymus volume was obtained by virtual organ computer-aided analysis (VOCAL) with 30° of rotation. We used the percentage of visualization rate of 2D structures and means and 95% confidence intervals (CI) for fetal thymus transverse diameter and volume. The visualization rate of fetal thymus by 2DUS was of 100% in all gestational ages using the 3VT view. Addition of color Doppler ultrasound facilitates identification of the thy-box and enhanced the calculation of both fetal thymus transverse diameter and volume. The mean fetal thymus transverse diameter by 2DUS ranged from 11 mm at 18 weeks to 19 mm at 23 weeks of gestation. The mean fetal thymus volume by 3DUS ranged from 1.25 cm(3) at 18 weeks to 2.61 cm(3) at 23 weeks of gestation. We demonstrated a high visualization rate of fetal thymus and peri-thymic vessels by 2DUS during the 2nd trimester echocardiography. The measurements of transverse diameter by 2DUS and the volume by 3DUS also showed a high success rate.

  5. Laparoscopic hepatectomy is theoretically better than open hepatectomy: preparing for the 2nd International Consensus Conference on Laparoscopic Liver Resection.

    PubMed

    Wakabayashi, Go; Cherqui, Daniel; Geller, David A; Han, Ho-Seong; Kaneko, Hironori; Buell, Joseph F

    2014-10-01

    Six years have passed since the first International Consensus Conference on Laparoscopic Liver Resection was held. This comparatively new surgical technique has evolved since then and is rapidly being adopted worldwide. We compared the theoretical differences between open and laparoscopic liver resection, using right hepatectomy as an example. We also searched the Cochrane Library using the keyword "laparoscopic liver resection." The papers retrieved through the search were reviewed, categorized, and applied to the clinical questions that will be discussed at the 2nd Consensus Conference. The laparoscopic hepatectomy procedure is more difficult to master than the open hepatectomy procedure because of the movement restrictions imposed upon us when we operate from outside the body cavity. However, good visibility of the operative field around the liver, which is located beneath the costal arch, and the magnifying provide for neat transection of the hepatic parenchyma. Another theoretical advantage is that pneumoperitoneum pressure reduces hemorrhage from the hepatic vein. The literature search turned up 67 papers, 23 of which we excluded, leaving only 44. Two randomized controlled trials (RCTs) are underway, but their results are yet to be published. Most of the studies (n = 15) concerned short-term results, with some addressing long-term results (n = 7), cost (n = 6), energy devices (n = 4), and so on. Laparoscopic hepatectomy is theoretically superior to open hepatectomy in terms of good visibility of the operative field due to the magnifying effect and reduced hemorrhage from the hepatic vein due to pneumoperitoneum pressure. However, there is as yet no evidence from previous studies to back this up in terms of short-term and long-term results. The 2nd International Consensus Conference on Laparoscopic Liver Resection will arrive at a consensus on the basis of the best available evidence, with video presentations focusing on surgical techniques and the publication

  6. Neurophysiological tests and neuroimaging procedures in non-acute headache (2nd edition).

    PubMed

    Sandrini, G; Friberg, L; Coppola, G; Jänig, W; Jensen, R; Kruit, M; Rossi, P; Russell, D; Sanchez del Rìo, M; Sand, T; Schoenen, J

    2011-03-01

    /orbital/(para)nasal region. In patients with atypical headache patterns, a history of seizures and/or focal neurological symptoms or signs, MRI may be indicated. (vi) If attacks can be fully accounted for by the standard headache classification (IHS), a PET or SPECT scan will normally be of no further diagnostic value. Nuclear medical examinations of the cerebral circulation and metabolism can be carried out in subgroups of patients with headache for the diagnosis and evaluation of complications, when patients experience unusually severe attacks or when the quality or severity of attacks has changed. (vii) Transcranial Doppler examination is not helpful in headache diagnosis. Although many of the examinations described in the present guidelines are of little or no value in the clinical setting, most of the tools, including thermal pain thresholds and transcranial magnetic stimulation, have considerable potential for differential diagnostic evaluation as well as for the further exploration of headache pathophysiology and the effects of pharmacological treatment. © 2010 The Author(s). European Journal of Neurology © 2010 EFNS.

  7. Preoperative staging of rectal cancer.

    PubMed

    Smith, Neil; Brown, Gina

    2008-01-01

    Detailed preoperative staging using high resolution magnetic resonance imaging (MRI) enables the selection of patients that require preoperative therapy for tumour regression. This information can be used to instigate neoadjuvant therapy in those patients with poor prognostic features prior to disturbing the tumour bed and potentially disseminating disease. The design of trials incorporating MR assessment of prognostic factors prior to therapy has been found to be of value in assessing treatment modalities and outcomes that are targeted to these preoperative prognostic subgroups and in providing a quantifiable assessment of the efficacy of particular chemoradiation treatment protocols by comparing pre-treatment MR staging with post therapy histology assessment. At present, we are focused on achieving clear surgical margins of excision (CRM) to avoid local recurrence. We recommend that all patients with rectal cancer should undergo pre-operative MRI staging. Of these, about half will have good prognosis features (T1-T3b, N0, EMVI negative, CRM clear) and may safely undergo primary total mesorectal excision. Of the remainder, those with threatened or involved margins will certainly benefit from pre-operative chemoradiotherapy with the aim of downstaging to permit safe surgical excision. In the future, our ability to recognise features predicting distant failure, such as extramural vascular invasion (EMVI) may be used to stratify patients for neo-adjuvant systemic chemotherapy in an effort to prevent distant relapse. The optimal pre-operative treatment regimes for these patients (radiotherapy alone, systemic chemotherapy alone or combination chemo-radiotherapy) is the subject of current and future trials.

  8. [Juvenile primary lung cancer in a 17-year-old girl as a 2nd malignant neoplasm after osteosarcoma treatment in childhood].

    PubMed

    Konoeda, Chihiro; Murakawa, Tomohiro; Sano, Atsushi; Kawashima, Mitsuaki; Nakajima, Jun

    2012-12-01

    The patient was a 17-year-old girl. She underwent treatment for osteosarcoma when she was around 10 ~ 11 years old. A follow-up chest computed tomography(CT) revealed one small pulmonary nodule 6 years later. The orthopedist thought it was metastasis. The patient was referred to our division and treated with thoracoscopic partial resection. The final pathological diagnosis was a primary lung adenocarcinoma. This case is unique because the patient is juvenile and had a history of another cancer, i.e., osteosarcoma. Her primary lung cancer is a 2nd malignancy. The incidence of 2nd malignant neoplasm is one of the significant late effects of pediatric cancer treatment. When pulmonary lesions are detected in young patient with histories of neoplasms, primary lung cancer as a 2nd malignant neoplasm as well as pulmonary metastasis from 1st neoplasm, should be considered as differential diagnosis.

  9. Directional fidelity of nanoscale motors and particles is limited by the 2nd law of thermodynamics--via a universal equality.

    PubMed

    Wang, Zhisong; Hou, Ruizheng; Efremov, Artem

    2013-07-21

    Directional motion of nanoscale motors and driven particles in an isothermal environment costs a finite amount of energy despite zero work as decreed by the 2nd law, but quantifying this general limit remains difficult. Here we derive a universal equality linking directional fidelity of an arbitrary nanoscale object to the least possible energy driving it. The fidelity-energy equality depends on the environmental temperature alone; any lower energy would violate the 2nd law in a thought experiment. Real experimental proof for the equality comes from force-induced motion of biological nanomotors by three independent groups - for translational as well as rotational motion. Interestingly, the natural self-propelled motion of a biological nanomotor (F1-ATPase) known to have nearly 100% energy efficiency evidently pays the 2nd law decreed least energy cost for direction production.

  10. Novel radiation techniques for rectal cancer

    PubMed Central

    2014-01-01

    The concepts for management of rectal cancer have changed drastically over the past few years. Through national bowel cancer screening programmes in the Western countries and the increasing use of endoscopic procedures as diagnostic tool, there is increase in detection of rectal cancer in early stages. There is increase in ageing population worldwide but more so in Western countries. In addition, there is realisation of harm from extirpative surgical procedures which are directed towards managing advanced rectal cancer in the past. Increase in cost of health care burden has also led the investigators to seek alternative treatment options which are effective, safe and cost effective. There are several modern radiation techniques which fits this bill and we need to be aware of newer novel radiation techniques to fulfil this gap. PMID:24982769

  11. Rectal mucosa in cows' milk allergy.

    PubMed Central

    Iyngkaran, N; Yadav, M; Boey, C G

    1989-01-01

    Eleven infants who were suspected clinically of having cows' milk protein sensitive enteropathy were fed with a protein hydrolysate formula for six to eight weeks, after which they had jejunal and rectal biopsies taken before and 24 hours after challenge with cows' milk protein. When challenged six infants (group 1) developed clinical symptoms and five did not (group 2). In group 1 the lesions developed in both the jejunal mucosa (four infants at 24 hours and one at three days), and the rectal mucosa, and the injury was associated with depletion of alkaline phosphatase activity. Infants in group 2 were normal. It seems that rectal injury that develops as a direct consequence of oral challenge with the protein in reactive infants may be used as one of the measurements to confirm the diagnosis of cows' milk protein sensitive enteropathy. Moreover, ingestion of such food proteins may injure the distal colonic mucosa without affecting the proximal small gut in some infants. PMID:2817945

  12. Detection of 1st- and 2nd-order temporal-envelope cues in a patient with left superior cortical damage.

    PubMed

    Füllgrabe, Christian; Maillet, Didier; Moroni, Christine; Belin, Catherine; Lorenzi, Christian

    2004-06-01

    This psychophysical study explores the extent to which the auditory cortex is necessary for various aspects of temporal-envelope perception, that is, perception of the slow temporal modulations in amplitude known to be crucial for sound identification. The ability to detect 1st- and 2nd-order sinusoidal amplitude modulation (AM) is evaluated in a single patient showing left-hemisphere damage encroaching the primary and secondary auditory cortices. Here, 1st- and 2nd-order AM refer to (1) sinusoidal variation in the amplitude of a 2 kHz pure tone, and (2) sinusoidal variation in the depth of a 64 Hz AM applied to the 2 kHz pure tone, respectively. The results replicate previous findings by showing that damage to the left auditory cortex results in a selective deficit in auditory sensitivity to the lowest 1St-order AM (i.e., 1st-order AM frequencies < 16 Hz). Moreover, a dissociation is apparent between the ability to detect 1st- and 2nd-order temporal-envelope cues. The patient shows poorer than normal ability to detect 2nd-order AM at low frequencies ranging from 4-23 Hz, but normal ability to detect the high (64 Hz) 1st-order AM carrying these 2nd-order modulations. This result indicates that damage to the left primary and secondary auditory cortices affects the ability to detect temporal variations in the local properties of sounds(such as AM depth). It is also consistent with the idea that, as in vision, central nonlinear mechanisms are involved in the computation of such local (or 2nd-order) temporal properties.

  13. Primary Transanal Management of Rectal Atresia in a Neonate

    PubMed Central

    M, Braiek; A, Ksia; I, Krichen; S, Belhassen; K, Maazoun; S, Ben youssef; N, Kechiche; M, Mekki; A, Nouri

    2016-01-01

    Rectal atresia (RA) with a normal anus is a rare anomaly. We describe a case of rectal atresia in a newborn male presenting with an abdominal distension and failure of passing meconium. The rectal atresia was primarily operated by transanal route. PMID:27123404

  14. Primary Transanal Management of Rectal Atresia in a Neonate.

    PubMed

    M, Braiek; A, Ksia; I, Krichen; S, Belhassen; K, Maazoun; S, Ben Youssef; N, Kechiche; M, Mekki; A, Nouri

    2016-01-01

    Rectal atresia (RA) with a normal anus is a rare anomaly. We describe a case of rectal atresia in a newborn male presenting with an abdominal distension and failure of passing meconium. The rectal atresia was primarily operated by transanal route.

  15. Massive zosteriform cutaneous metastasis from rectal carcinoma.

    PubMed

    Damin, D C; Lazzaron, A R; Tarta, C; Cartel, A; Rosito, M A

    2003-07-01

    A 44-year-old man presented with a large and rapidly growing skin lesion approximately six months after resection of a rectal carcinoma. The lesion measured 40 cm in size, extended from the suprapubic area to the proximal half of the left groin, and showed a particular zosteriform aspect. Biopsy confirmed a metastatic skin adenocarcinoma. Cutaneous metastases from rectal cancer are very uncommon. Their gross appearance is not distinctive, although the skin tumors are usually solid, small (less than 5 cm) and painless nodules or papules. Early biopsies for suspicious skin lesions are needed in patients with a history of colorectal cancer.

  16. Transanal Approach to Rectal Polyps and Cancer

    PubMed Central

    Rai, Vinay; Mishra, Nitin

    2016-01-01

    A transanal approach to rectal polyp and cancer excision is often an appropriate alternative to conventional rectal resection, and has a lower associated morbidity. There has been a steady evolution in the techniques of transanal surgery over the past 30 years. It started with traditional transanal excision and was revolutionized by introduction of transanal endoscopic microsurgery in early 1980s. Introduction of transanal minimally invasive surgery made it more accessible to surgeons around the world. Now robotic platforms are being tried in certain institutions. Concerns have been raised about recurrence rates of cancers with transanal approach and success of subsequent salvage operations. PMID:26929754

  17. [Adjuvant chemotherapy for patients with rectal cancer].

    PubMed

    Qvortrup, Camilla; Mortensen, John Pløen; Pfeiffer, Per

    2013-09-09

    A new Cochrane meta-analysis evaluated adjuvant chemotherapy (5-fluorouracil (5FU)-based, not modern combination chemotherapy) in almost 10,000 patients with rectal cancer and showed a 17% reduction in mortality corresponding well to the efficacy observed in recent studies, which reported a reduction in mortality just about 20%. The authors recommend adjuvant chemotherapy which is in accordance with the Danish national guidelines where 5-FU-based chemotherapy is recommended for stage III and high-risk stage II rectal cancer.

  18. Neoadjuvant Treatment in Rectal Cancer: Actual Status

    PubMed Central

    Garajová, Ingrid; Di Girolamo, Stefania; de Rosa, Francesco; Corbelli, Jody; Agostini, Valentina; Biasco, Guido; Brandi, Giovanni

    2011-01-01

    Neoadjuvant (preoperative) concomitant chemoradiotherapy (CRT) has become a standard treatment of locally advanced rectal adenocarcinomas. The clinical stages II (cT3-4, N0, M0) and III (cT1-4, N+, M0) according to International Union Against Cancer (IUCC) are concerned. It can reduce tumor volume and subsequently lead to an increase in complete resections (R0 resections), shows less toxicity, and improves local control rate. The aim of this review is to summarize actual approaches, main problems, and discrepancies in the treatment of locally advanced rectal adenocarcinomas. PMID:22295206

  19. Incidence, Risk Factors, Management, and Complications of Rectal Injuries During Radical Prostatectomy.

    PubMed

    Mandel, Philipp; Linnemannstöns, Anna; Chun, Felix; Schlomm, Thorsten; Pompe, Raisa; Budäus, Lars; Rosenbaum, Clemens; Ludwig, Tim; Dahlem, Roland; Fisch, Margit; Graefen, Markus; Huland, Hartwig; Tilki, Derya; Steuber, Thomas

    2017-02-07

    Rectal injury (RI) during radical prostatectomy (RP) is a severe complication. So far, only limited data describing the incidence, risk factors, management, and complications of RI are available. In an analysis of data for 24178 patients, we identified 113/24076 patients (0.47%) undergoing open or robotic RP and 7/102 patients (6.86%) after salvage RP who experienced an RI. Besides salvage RP, local tumor stage, Gleason grade, lymph node status, and surgical experience, but not surgical approach (robotic vs open), could be identified as risk factors for RI in univariate and multivariate analysis. Intraoperative management of RI comprised closure with two to three layers. In 13/109 patients (11.9%), a diverting colostomy/ileostomy was carried out. Some 12% of men with closure of an RI developed a recto-anastomosis fistula, and 57% of those who had an additional diverting enterostomy. Thus, the overall incidence of recto-anastomosis fistula after RP was <0.1%. The extent of rectal laceration, prior radiation, and intraoperative signs of rectal infiltration were associated with the development of a subsequent recto-anastomosis fistula. Some 83% of patients with a recto-anastomosis fistula needed further intervention. We analyzed the incidence, risk factors, management, and complications of rectal injury during radical prostatectomy. Overall, the incidence of rectal injury and subsequent development of recto-anastomosis fistulas is low unless the patient has significant risk factors. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  20. Preference and practices relating to lubricant use during anal intercourse: implications for rectal microbicides.

    PubMed

    Javanbakht, Marjan; Murphy, Ryan; Gorbach, Pamina; LeBlanc, Marc-André; Pickett, Jim

    2010-06-01

    The importance of the acceptability of rectal microbicides for HIV and sexually transmissible infections (STIs) prevention is widely recognised. Given relatively consistent use of lubricants for anal intercourse (AI) and the potential for lubricant-like rectal microbicides, understanding barriers to lubricant use may help inform hurdles likely to be encountered once a rectal microbicide becomes available. We conducted an internet-based survey using a 25-item questionnaire to assess AI and lubricant use, including lubricant preferences and barriers to use. The majority of the 6124 respondents who reported AI were male (93%), 25 years or older (80%) and from North America (70%). Consistent condom use during AI was reported by a minority (35%) and consistent lubricant use was reported by over half of respondents. Reasons for non-use differed by age and region. Among men, those <25 years were more likely to report barriers around cost compared with those 45 and older (odds ratio (OR) = 6.64; 95% confidence interval (CI) 3.14-14.03). European men (OR = 1.92; 95% CI 1.50-2.45), Latin American women (OR = 3.69; 95% CI 1.27-10.75) and Asian women (OR = 4.04; 95% CI 1.39-11.78) were more likely to report sexual preference as a reason for non-use. Rectal lubricants are widely used, but barriers to use vary by age and region for dry sex. A lubricant-like rectal microbicide would potentially be acceptable and such a product may be useful as a method of HIV prevention. However, targeted marketing and educational approaches may be needed to enhance use and acceptability of such a product.

  1. Roles of doping ions in afterglow properties of blue CaAl2O4:Eu2+,Nd3+ phosphors

    NASA Astrophysics Data System (ADS)

    Wako, A. H.; Dejene, B. F.; Swart, H. C.

    2014-04-01

    Eu2+ doped and Nd3+ co-doped calcium aluminate (CaAl2O4:Eu2+,Nd3+) phosphor was prepared by a urea-nitrate solution combustion method at furnace temperatures as low as 500 °C. The produced CaAl2O4:Eu2+,Nd3+ powder was investigated in terms of phase composition, morphology and luminescence by X-Ray diffraction (XRD), Scanning Electron Microscope (SEM), Fourier Transform Infra Red spectroscopy (FTIR) and Photoluminescence (PL) techniques respectively. XRD analysis depicts a dominant monoclinic phase that indicates no change in the crystalline structure of the phosphor with varying concentration of Eu2+ and Nd3+. SEM results show agglomerates with non-uniform shapes and sizes with a number of irregular network structures having lots of voids and pores. The Energy Dispersive X-ray Spectroscopy (EDS) and (FTIR) spectra confirm the expected chemical components of the phosphor. PL measurements indicated one broadband excitation spectra from 200 to 300 nm centered around 240 nm corresponding to the crystal field splitting of the Eu2+ d-orbital and an emission spectrum in the blue region with a maximum on 440 nm. This is a strong indication that there was dominantly one luminescence center, Eu2+ which represents emission from transitions between the 4f7 ground state and the 4f6-5d1 excited state configuration. High concentrations of Eu2+ and Nd3+ generally reduce both intensity and lifetime of the phosphor powders. The optimized content of Eu2+ is 1 mol% and for Nd3+ is 1 mol% for the obtained phosphors with excellent optical properties. The phosphor also emits visible light at around 587 and 616 nm. Such emissions can be ascribed to the 5D0-7F1 and 5D0-7F2 intrinsic transition of Eu3+ respectively. The decay characteristics exhibit a significant rise in initial intensity with increasing Eu2+ doping concentration while the decay time increased with Nd3+ co-doping. The observed afterglow can be ascribed to the generation of suitable traps due to the presence of the Nd3

  2. Study between axillary and rectal temperature measurements in children.

    PubMed

    Haddadin, R B; Shamo'on, H I

    2007-01-01

    We compared axillary and rectal temperatures in 216 patients to assess the reliability of axillary temperature for determining fever in children under 14 years of age. Beyond the neonatal period, the mean rectal temperature was significantly higher than the axillary temperature. The sensitivity of axillary temperature in detecting fever was 87.5% among neonates but only 46% among older children. Axillary temperature correlated well with rectal temperature in neonates but not older children. There was no direct mathematical relationship between axillary and rectal temperature. Axillary temperature should be taken in neonates as it is less hazardous; rectal temperature should be used beyond this age.

  3. Distribution of fibronectin in the rectal mucosa.

    PubMed

    Scott, D L; Morris, C J; Blake, A E; Low-Beer, T S; Walton, K W

    1981-07-01

    Fibronectin is a glycoprotein of high molecular weight present in tissues, plasma, and tissue fluids. Its distribution in the rectal mucosa was studied by immunofluorescent and immunoperoxidase techniques using a monospecific antiserum. Immunofluorescent reactivity for fibronectin was present in the normal rectal mucosa of control subjects in epithelial cells, on basement membranes, and as a loose cribriform network of extracellular reactivity in the lamina propria that codistributed with histochemically demonstrable reticulin. Fibronectin was demonstrated immunoelectromicroscopically on collagen fibres, on smooth muscle cells and within and between columnar epithelial cells. In the rectal mucosa of patients with colitis with marked inflammatory changes, fibronectin appeared thickened and more prominent when present on basement membranes and as sparse strands between inflammatory cells infiltrating the lamina propria. In patients with longstanding colitis and less inflammatory cell infiltration there was a diffuse increase in fibronectin which was densely and uniformly present throughout the lamina propria. Fibronectin is a structural component of the rectal mucosa and changes in its distribution may form an important part of the local reaction to inflammatory bowel disease.

  4. Rectal bezoars due to pumpkin seeds.

    PubMed

    Mirza, Mohammad Salman; Al-Wahibi, Khalifa; Baloch, Shafiq; Al-Qadhi, Hani

    2009-01-01

    Rectal bezoars commonly occur due to seeds, especially in children living in countries south of the Mediterranean and in the Middle-East. Dried seeds are considered a delicacy and consumed widely. Inadequate chewing or hastily eating without removing the hull may lead to their impaction as bezoars, which may require manual removal under general anaesthesia.

  5. Combined radical retropubic prostatectomy and rectal resection.

    PubMed

    Klee, L W; Grmoljez, P

    1999-10-01

    To present our experience with a small series of men who underwent simultaneous radical retropubic prostatectomy and rectal resection. Three men with newly diagnosed prostate cancer were found to have concurrent rectal tumors requiring resection. All three men underwent non-nerve-sparing radical retropubic prostatectomy and abdominoperineal resection (APR) or low anterior resection (LAR) of the rectum at the same operation. In the 2 patients undergoing APR, the levators were approximated posterior to the urethra, and the bladder was secured to the pubis. The patient undergoing LAR had urinary diversion stents placed and a diverting transverse loop colostomy. All 3 patients had excellent return of urinary continence. One patient required reoperation in the early postoperative period for small bowel adhesiolysis and stoma revision. Another patient had a mild rectal anastomotic stricture and a bladder neck stricture; both were successfully treated with a single dilation. No other significant complications occurred in these patients. Radical retropubic prostatectomy can safely be performed with partial or complete rectal resection in a single operation. A few minor modifications of the standard radical retropubic prostatectomy in this setting are suggested.

  6. [Rectal cancer: diagnosis, screening and treatment].

    PubMed

    Decanini-Terán, César Oscar; González-Acosta, Jorge; Obregón-Méndez, Jorge; Vega-de Jesús, Martín

    2011-01-01

    Rectal cancer is one of the primary malignant neoplasms occurring in Mexican patients of reproductive age. Unfortunately, randomized studies in rectal cancer do not exist as they do with well-recognized colon cancer. We must individualize the epidemiology, risk factors, diagnostic approach, staging and treatment because management is different in rectal cancers affecting the mid- and lower third of the rectum than in the upper third and in colon cancers. Histological staging is the primary prognostic factor. TNM staging (tumor, node, and metastasis) is used internationally by the American Joint Committee on Cancer (AJCC). Staging is done with the assistance of endorectal ultrasound, which is best used in early-stage cancer; however, there are certain disadvantages in detecting node involvement. Magnetic resonance, on the other hand, allows for the evaluation of stenotic tumors and node involvement. Once the correct diagnosis and staging have been made, the next step is correct treatment. Neoadjuvant treatment has demonstrated to be better than adjuvant treatment. Abdominoperineal resection is rarely practiced currently, with sphincter preservation being the preferred procedure. Laparoscopic approach has conferred the advantages of the approach itself when performed by experts in the procedure but there is insufficient evidence to make it the "gold standard." Rectal cancer is a complex pathology that must be considered totally different from colon cancer for diagnosis and treatment. The patient must be staged completely and appropriately for individualizing correct treatment. More long-term studies are needed for optimizing treatment modalities.

  7. [Electronic rectal temperature measurement. A clinical trial].

    PubMed

    Ottesen, S; Nielsen, F T; Lund, H

    1993-05-24

    Rectal measurement of body temperature with an electronic device (Ivac) was compared to measurement with mercury thermometers in 157 adult patients on a medical ward. The electronic thermometers were less accurate, giving 3.6 times as many febrile patients. This was reduced to 1.6 after thermometer calibration. It is necessary to make regular calibrations of Ivac thermometers.

  8. Comparison of Adjuvant Chemotherapy Regimens in Treating Patients With Stage II or Stage III Rectal Cancer Who Are Receiving Radiation Therapy and Fluorouracil Before or After Surgery

    ClinicalTrials.gov

    2013-02-26

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

  9. Experimental observations on the response of 1(st) and 2(nd) order fibre optic long period grating coupling bands to the deposition of nanostructured coatings.

    PubMed

    James, Stephen W; Cheung, C S; Tatam, Ralph P

    2007-10-01

    The sensitivity of attenuation bands corresponding to the 2(nd) order coupling to cladding modes by a fibre optic long period grating (LPG) to the deposition of nanostructured coatings is investigated and compared with that of the 1(st) order coupling. The experimental observations support previously reported theoretical descriptions of LPGs with nanoscale coatings.

  10. Dynamics of the properties of steppe paleosols of the Sarmatian time (2nd century BC-4th century AD) in relation to secular variations in climatic humidity

    NASA Astrophysics Data System (ADS)

    Demkin, V. A.; Zolotareva, B. N.; Demkina, T. S.; Khomutova, T. E.; Kashirskaya, N. N.; El'Tsov, M. V.; Udal'Tsov, S. N.

    2012-02-01

    Paleosols buried under kurgans of the Early (2nd-1st centuries BC), Middle (1st-2nd centuries AD) and Late (2nd-IV centuries AD) Sarmatian epochs were studied in dry steppes and desert steppes of the Lower Volga region (the Privolzhskaya and Ergeni Uplands and the Caspian Lowland). It was found that temporal variations in the morphological, chemical, microbiological, and magnetic properties of the paleosols in the interval of 2200-1600 BP were characterized by the cyclic pattern related to secular dynamics of climatic humidity with changes in the mean annual precipitation of ±30-50 mm. These climate changes did not transform chestnut paleosols and paleosolonetzes at the type or subtype taxonomic levels. However, they led to certain changes in the humus, carbonate, and salt profiles of the soils; in the character of solonetzic horizon B1; and in the state of microbial communities. According to these data, the Sarmatian time was characterized by alternation of micropluvial and microarid stages lasting fro about 100-200 years. In particular, the stages of humidization were observed in the 1st century BC-1st century AD and in the 4th century AD; the most arid conditions were observed in the second half of the 2nd and the first half of the 3rd century AD.

  11. Research and Prediction of the Application of Multimedia Teaching Aid in Teaching Technical Education on the 2nd Level of Primary Schools

    ERIC Educational Resources Information Center

    Stebila, Ján

    2011-01-01

    The purpose and the main aim of the pedagogic experiment were to practically verify the success of Multimedia Teaching Aid (MTA) in conditions of primary schools. We assumed that the use of our multimedia teaching aid in teaching technical education on the 2nd level of primary schools would significantly affect the level of knowledge of pupils…

  12. Fabrication of 30 mm long baseline single-layer 2nd-order high- Tc SQUID gradiometer

    NASA Astrophysics Data System (ADS)

    Lee, Soon-Gul; Oh, Soo-Ho; Kang, Chan Seok; Kim, In-Seon

    2007-09-01

    We have designed and fabricated a 30 mm long baseline 2nd-order SQUID gradiometer from a single-layer YBa 2Cu 3O 7 film. The design rule was the same as that of our previous study on short baseline gradiometers. Three linearly aligned 10.2 mm × 10.2 mm pickup loops were coupled directly to a dc SQUID to measure ∂ 2Bz/∂ x2. The device had an overall size of 70.2 mm × 10.6 mm and was patterned from a single layer of YBa 2Cu 3O 7 film on a sapphire substrate by argon ion milling with a photoresist mask. The Josephson element of the SQUID was YBa 2Cu 3O 7 nanobridges formed by focused ion beam writing technique. Balancing of the device was achieved by optimizing the inductance of the center loop. Estimated sensitivity of the gradiometer was ∼1.8 × 10 -10 T/m 2/Hz 1/2, which is equivalent to a field noise of 160 fT/Hz 1/2, for an intrinsic SQUID flux noise of 10 -5 ϕ0/Hz 1/2.

  13. 2nd dimensional GC-MS analysis of sweat volatile organic compounds prepared by solid phase micro-extraction.

    PubMed

    Choi, Mi-Jung; Oh, Chang-Hwan

    2014-01-01

    The characteristics of an individual's odor from sweat, breath and skin provide important information for criminal tracking in field of forensic science. Solid phase micro-extraction gas chromatography/mass spectrometry (SPME-GC/MS) was used to determine human sweat volatile organic compounds (VOCs) profiles. The mass spectrometric analysis (with electron impact mode) followed by 2nd dimensional separation with two different GC columns (one polar and one relatively nonpolar) connected in parallel were used to identify the 574 compounds from sweat samples. The components included alcohols, aldehydes, aliphatics/aromatics, carboxylic acids, esters, ketones, and other organic compounds (amides/amines, thio/thioesters, oxide, sulfides, nitro compounds). Of these compounds, 1-tridecanol, 1,3-bis(1,1-dimethyl ethyl)-benzene, 4,4'-(1-methylethylidene) bis-phenol and 7-acetyl-6-ethyl-1,1,4,4,-tetramethyl-tetraline were common components in all donor's sweat volatile samples. Age-related specific compounds were also detected. The results suggest that characteristic volatile profiles of human sweat emanations could provide the valuable information to forensic scientists.

  14. Horizontal transmission of hepatitis B virus amongst British 2nd World War soldiers in South-East Asia.

    PubMed

    Gill, G V; Bell, D R; Vandervelde, E M

    1991-01-01

    Infection with hepatitis B virus (HBV) is much more common in tropical than in temperate countries. Visitors to the tropics are thus at risk from HBV, though the degree of risk, and the routes of infection involved are uncertain. We report serological markers of HBV in two groups of 2nd World War soldiers, who served in the Thai/Burma jungles. The groups comprised 100 ex-prisoners of the Japanese (POW), and 100 Burma Campaign Veterans (BCV). Surface antigen to HBV (HbsAg) was positive in 0% of POW and 2% of BCV (P = not significant). Surface antibody (anti-HBs) and core antibody (anti-HBc) were both positive in 40% POW and 13% BCV (P less than 0.001). Quoted UK prevalence rates for these markers are 0.1% for HBsAg, 1.5% for anti-HBs and 0.7% for anti-HBc. Both groups thus show very high rates of past HBV infection. For the POW there were many possible reasons, including contaminated surgical instruments and needles, blood transfusions, and multiple beatings with common weapons. None of these factors operated significantly for BCV. Malarial transmission was, however, intense in both groups, though more so in POW. The data thus again raise the possibility of horizontal transmission of HBV by biting insects in tropical countries.

  15. [Evaluation of the Marburg Spelling Training (MRT) in 2nd- and 3rd-grade students with spelling difficulties].

    PubMed

    Barkmann, Claus; Kuhlmann, Ester; Rosenboom, Lea; Wessolowski, Nino; Schulte-Markwort, Michael

    2012-05-01

    Children with severe dyslexia are substantially impaired because reading and writing are key competencies necessary for a successful academic and occupational career. In this evaluation study, a cohort of 2nd- and 3rd-grade students from a variety of Hamburg primary schools was trained with the Marburger Rechtschreibtraining (MRT) by supervised university graduates. The research questions focused on the feasibility of the MRT as a within-school training, the improvement of spelling and reading skills of the participants, subjective assessments of success, as well as potential predictors. Besides established performance tests, we also considered the subjective appraisals of parents, teachers, and coaches. The results demonstrate that standardized spelling training methods like the MRT can be consistently used during morning hours at schools. Within a year of starting MRT exercises, mean effect sizes in writing and reading were observed in performance tests using test norms. However, parent, teacher, and coach reports failed to replicate these improvements. Changes in writing performance were mainly associated with school class level; improvements in reading ability were dependent on initial writing performance. The results provide starting points for optimizing current training practices in elementary schools and for posing questions regarding the effectiveness of the MRT, as well as for training programs in general.

  16. Near infrared emission and energy transfer in Eu2+ - Nd3+ co-doped Ca2BO3Cl

    NASA Astrophysics Data System (ADS)

    Talewar, R. A.; Joshi, C. P.; Moharil, S. V.

    2016-05-01

    Novel near infrared (NIR) emitting phosphor, Ca2BO3Cl:Eu2+, Nd3+ was synthesized by conventional solid-state reaction and characterized with X-ray diffraction, photoluminescence emission, photoluminescence excitation spectra and fluorescence decay measurements. When excited with 400 nm, the phosphor gives broadband emission at 560 nm, which corresponds to the allowed 5d → 4f transition of Eu2+ and an intense NIR emissions in the range 800-1400 nm, which are assigned to the characteristic 4I9/2,11/2,13/2 transitions of Nd3+ ions. The dependence of visible and NIR emissions, decay lifetime and the energy transfer efficiency (ηETE) were investigated in detail. The luminescence spectra, both in visible (VIS) and NIR regions, and decay lifetime curves of Eu2+ have been measured to prove energy transfer (ET) from Eu2+ to Nd3+. These results demonstrate the possibility for enhancing the photovoltaic conversion efficiency of silicon solar cell by modifying the absorption and utilizing the UV to blue part of the solar spectrum where the efficiency of c-Silicon solar cell is low.

  17. Increasing the water temperature of a 2nd order stream reach: Hydraulic aspects of a whole-stream manipulative experiment

    NASA Astrophysics Data System (ADS)

    de Lima, João L. M. P.; Canhoto, Cristina

    2015-04-01

    What will happen when water temperatures of streams increases, due to climate changes or in connection with rapidly changing human systems? Trying to answer to this question a whole-stream manipulative experiment was undertaken, where an increase in water temperature was artificially induced on a 2nd order stream reach. The main objective of this poster is to describe this experiment focusing on the design of the hydraulic system. The system maintained a steady flow while allowing natural variation in abiotic factors and was successfully used to evaluate the effects of warming on a stream ecosystem at several levels of biological organization. A constant flow of stream water was controlled by a hydraulic setup (~22m long; ~1.5m width) subdivided into two independent channels. One channel of the study reach received heated water (~3°C above the other), while the other received water at stream ambient temperature. The warming system maintained a steady gravity controlled flow making use of weirs and valves.

  18. RF SOI CMOS technology on 1st and 2nd generation trap-rich high resistivity SOI wafers

    NASA Astrophysics Data System (ADS)

    Kazemi Esfeh, B.; Makovejev, S.; Basso, Didier; Desbonnets, Eric; Kilchytska, V.; Flandre, D.; Raskin, J.-P.

    2017-02-01

    In this work three different types of UNIBOND™ Silicon-on-Insulator (SOI) wafers including one standard HR-SOI and two types of trap-rich high resistivity HR-SOI substrates named enhanced signal integrity high resistivity silicon-on-insulator (eSI HR-SOI) provided by SOITEC are studied and compared. The DC and RF performances of these wafers are compared by means of passive and active devices such as coplanar waveguide (CPW) lines, crosstalk- and noise injection-structures as well as partially-depleted (PD) SOI MOSFETs. It is demonstrated that by employing enhanced signal integrity high resistivity silicon-on-insulator (eSI HR-SOI) compared to HR-SOI wafer, a reduction of 24 dB is measured on both generations of trap-rich HR-SOI for 2nd harmonics. Furthermore, it is shown that in eSI HR-SOI, digital substrate noise is effectively reduced compared with HR-SOI. Purely capacitive behavior of eSI HR-SOI is demonstrated by crosstalk structure. Reduction of self-heating effect in the trap-rich HR-SOI with thinner BOX is finally studied.

  19. Summary of the 2nd International Symposium on Arthrogryposis, St. Petersburg, Russia, September 17-19, 2014.

    PubMed

    Hall, Judith G; Agranovich, Olga; Ogranovich, Alga; Pontén, Eva; Pontén, Ava; van Bosse, Harold J P

    2015-06-01

    Enormous progress has been made in understanding the etiology and therapies for arthrogryposis (multiple congenital contractures). A 2nd International Symposium on Arthrogryposis was sponsored by the Turner Institute in St. Petersburg, Russia. Olga Agranovich, Head of the Arthrogryposis Department of the Turner Institute, organized this special meeting. Care providers from multiple disciplines from all over the world representing 18 nations attended. Participants included: Pediatric orthopedic specialists, rehabilitation physicians, occupational therapists, physical therapists, medical geneticists, neurologists, craniofacial physicians, psychologists, developmental biologists, as well as representatives from parent support groups. The 1st symposium established the need for a collaborative and interdisciplinary approach to the treatment of arthrogryposis, engagement of parent support organizations, and the aim for more research. The Second Symposium highlighted the continuing need for more research on various therapies, identification of different types of arthrogryposis, standardized descriptions of severity, development of new orthotics, improved prenatal diagnosis, and studying adult outcome. Major progress has been made on both upper and lower limb treatments. © 2015 Wiley Periodicals, Inc.

  20. Explicit formulas for 2nd-order driving terms due to sextupoles and chromatic effects of quadrupoles.

    SciTech Connect

    Wang, C-X. )

    2012-04-25

    Optimization of nonlinear driving terms have become a useful tool for designing storage rings, especially modern light sources where the strong nonlinearity is dominated by the large chromatic effects of quadrupoles and strong sextupoles for chromaticity control. The Lie algebraic method is well known for computing such driving terms. However, it appears that there was a lack of explicit formulas in the public domain for such computation, resulting in uncertainty and/or inconsistency in widely used codes. This note presents explicit formulas for driving terms due to sextupoles and chromatic effects of quadrupoles, which can be considered as thin elements. The computation is accurate to the 4th-order Hamiltonian and 2nd-order in terms of magnet parameters. The results given here are the same as the APS internal note AOP-TN-2009-020. This internal nte has been revised and published here as a Light Source Note in order to get this information into the public domain, since both ELEGANT and OPA are using these formulas.

  1. The 2nd to 4th digit ratio (2D:4D) and eating disorder diagnosis in women

    PubMed Central

    Smith, April Rose; Joiner, Thomas

    2010-01-01

    Eating disorders are more common in females than in males and are believed to be caused, in part, by biological and hormonal factors. Digit ratio or 2D:4D (the ratio of the 2nd to the 4th digit) is considered to be a proxy for prenatal testosterone (PT) and prenatal oestrogen (PE) exposure. However, how 2D:4D may be related to type of eating pathology is unknown. The relationship between 2D:4D and eating disorder diagnosis was investigated in recovered and currently eating disordered (n=31) and control (n=99) women. Mean 2D:4D ratio was significantly lower (indicating higher levels of PT and lower levels of PE) in anorexic (AN) compared to bulimic (BN) women, with controls intermediary. In eating disordered women, 2D:4D was positively and significantly related to current weight, lowest weight and current BMI, with strongest associations for right 2D:4D. Among women, low 2D:4D is related to AN and high 2D:4D to BN, suggesting a differential causal influence of prenatal sex hormones on later eating pathology. PMID:21765573

  2. Extreme sea storm in the Mediterranean Sea. Trends during the 2nd half of the 20th century.

    NASA Astrophysics Data System (ADS)

    Pino, C.; Lionello, P.; Galati, M. B.

    2009-04-01

    Extreme sea storm in the Mediterranean Sea. Trends during the 2nd half of the 20th century Piero Lionello, University of Salento, piero.lionello@unisalento.it Maria Barbara Galati, University of Salento, mariabarbara.galati@unisalento.it Cosimo Pino, University of Salento, pino@le.infn.it The analysis of extreme Significant Wave Height (SWH) values and their trend is crucial for planning and managing coastal defences and off-shore activities. The analysis provided by this study covers a 44-year long period (1958-2001). First the WW3 (Wave Watch 3) model forced with the REMO-Hipocas regional model wind fields has been used for the hindcast of extreme SWH values over the Mediterranean basin with a 0.25 deg lat-lon resolution. Subsequently, the model results have been processed with an ad hoc software to detect storms. GEV analysis has been perfomed and a set of indicators for extreme SWH have been computed, using the Mann Kendall test for assessing statistical significance of trends for different parameter such as the number of extreme events, their duration and their intensity. Results suggest a transition towards weaker extremes and a milder climate over most of the Mediterranean Sea.

  3. InAs/GaSb type II superlattices for advanced 2nd and 3rd generation detectors

    NASA Astrophysics Data System (ADS)

    Walther, Martin; Rehm, Robert; Schmitz, Johannes; Fleissner, Joachim; Rutz, Frank; Kirste, Lutz; Scheibner, Ralf; Wendler, Joachim; Ziegler, Johann

    2010-01-01

    InAs/GaSb short-period superlattices (SL) based on GaSb, InAs and AlSb have proven their great potential for high performance infrared detectors. Lots of interest is currently focused on the development of short-period InAs/GaSb SLs for advanced 2nd and 3rd generation infrared detectors between 3 - 30 μm. For the fabrication of mono- and bispectral thermal imaging systems in the mid-wavelength infrared region (MWIR) a manufacturable technology for high responsivity thermal imaging systems has been developed. InAs/GaSb short-period superlattices can be fabricated with up to 1000 periods in the intrinsic region without revealing diffusion limited behavior. This enables the fabrication of InAs/GaSb SL camera systems with high responsivity comparable to state of the art CdHgTe and InSb detectors. The material system is also ideally suited for the fabrication of dual-color MWIR/MWIR InAs/GaSb SL camera systems with high quantum efficiency for missile approach warning systems with simultaneous and spatially coincident detection in both spectral channels.

  4. Enhanced deficits in long-term potentiation in the adult dentate gyrus with 2nd trimester ethanol consumption.

    PubMed

    Helfer, Jennifer L; White, Emily R; Christie, Brian R

    2012-01-01

    Ethanol exposure during pregnancy can cause structural and functional changes in the brain that can impair cognitive capacity. The hippocampal formation, an area of the brain strongly linked with learning and memory, is particularly vulnerable to the teratogenic effects of ethanol. In the present experiments we sought to determine if the functional effects of developmental ethanol exposure could be linked to ethanol exposure during any single trimester-equivalent. Ethanol exposure during the 1(st) or 3(rd) trimester-equivalent produced only minor changes in synaptic plasticity in adult offspring. In contrast, ethanol exposure during the 2(nd) trimester equivalent resulted in a pronounced decrease in long-term potentiation, indicating that the timing of exposure influences the severity of the deficit. Together, the results from these experiments demonstrate long-lasting alterations in synaptic plasticity as the result of developmental ethanol exposure and dependent on the timing of exposure. Furthermore, these results allude to neural circuit malfunction within the hippocampal formation, perhaps relating to the learning and memory deficits observed in individuals with fetal alcohol spectrum disorders.

  5. Power-law residence time distribution in the hyporheic zone of a 2nd-order mountain stream

    NASA Astrophysics Data System (ADS)

    Haggerty, Roy; Wondzell, Steven M.; Johnson, Matthew A.

    2002-07-01

    We measured the hyporheic residence time distribution in a 2nd-order mountain stream at the H. J. Andrews Experimental Forest, Oregon, and found it to be a power-law over at least 1.5 orders of magnitude in time (1.5 hr to 3.5 d). The residence time distribution has a very long tail which scales as t-1.28, and is poorly characterized by an exponential model. Because of the small power-law exponent, efforts to characterize the mean hyporheic residence time (ts) in this system result in estimates that are scale invariant, increasing with the characteristic advection time within the stream channel (tad). The distribution implies the hyporheic zone has a very large range of exchange timescales, with significant quantities of water and solutes stored over time-scales very much longer than tad. The hyporheic zone in such streams may contribute to short-time fractal scaling in time series of solute concentrations observed in small-watershed studies.

  6. Report on the 2nd International Consortium on Hallucination Research: evolving directions and top-10 "hot spots" in hallucination research.

    PubMed

    Waters, Flavie; Woods, Angela; Fernyhough, Charles

    2014-01-01

    This article presents a report on the 2nd meeting of the International Consortium on Hallucination Research, held on September 12th and 13th 2013 at Durham University, UK. Twelve working groups involving specialists in each area presented their findings and sought to summarize the available knowledge, inconsistencies in the field, and ways to progress. The 12 working groups reported on the following domains of investigation: cortical organisation of hallucinations, nonclinical hallucinations, interdisciplinary approaches to phenomenology, culture and hallucinations, subtypes of auditory verbal hallucinations, a Psychotic Symptoms Rating Scale multisite study, visual hallucinations in the psychosis spectrum, hallucinations in children and adolescents, Research Domain Criteria behavioral constructs and hallucinations, new methods of assessment, psychological therapies, and the Hearing Voices Movement approach to understanding and working with voices. This report presents a summary of this meeting and outlines 10 hot spots for hallucination research, which include the in-depth examination of (1) the social determinants of hallucinations, (2) translation of basic neuroscience into targeted therapies, (3) different modalities of hallucination, (4) domain convergence in cross-diagnostic studies, (5) improved methods for assessing hallucinations in nonclinical samples, (6) using humanities and social science methodologies to recontextualize hallucinatory experiences, (7) developmental approaches to better understand hallucinations, (8) changing the memory or meaning of past trauma to help recovery, (9) hallucinations in the context of sleep and sleep disorders, and (10) subtypes of hallucinations in a therapeutic context.

  7. 1st and 2nd order Raman scattering from n-Graphene Layer (nGL) Films on Silicon Substrates.

    NASA Astrophysics Data System (ADS)

    Gupta, Awnish; Chen, Gugang; Eklund, Peter

    2007-03-01

    Results of room temperature Raman scattering experiments on graphene and n-graphene layer films (nGLs) will be presented [1]. We find that the G band at ˜ 1582 cm-1 exhibits an interesting upshift in frequency with 1/n which we tentatively assign to a surface strain phenomenon connected with surface roughness of the substrate and compensated by the increase in stiffness of the nGL with increasing n. Interesting n-specific bands are observed in the ˜1350 cm-1 (or D-band) region which may correlate with deviations from planarity of the nGL. The second order scattering is very interesting and for small n (n<4) the (2D' or G') band intensity at ˜ 2700 cm-1 is actually higher than the first-order G-band scattering. The shape of this band is sensitive to n and thus can be used to identify n without an AFM measurement. Whereas, the 2D' band is sensitive to n, the 2nd order 2G band ˜ 3248 cm-1 is independent of n. These observations will be discussed in terms of the phonon and electronic dispersion of nGLs. 1 A. Gupta, G. Chen, P. Joshi, S. Tadigadapa and P.C. Eklund, `` Raman Scattering from High-Frequency Phonons in Supported n-Graphene Layer Films'' NanoLett (in Press).

  8. Gasification. 2nd. ed.

    SciTech Connect

    Christopher Higman; Maarten van der Burgt

    2008-02-15

    This book covers gasification as a comprehensive topic, covering its many uses, from refining, to natural gas, to coal. It provides an overview of commercial processes and covers applications relevant to today's demands. The new edition is expanded and provides more detail on the integration issues for current generation, state-of-the-art Integrated Gasification Combined Cycles (IGCC); CO{sub 2} capture in the IGCC context addressing the issues of pre-investment and retrofitting as well as defining what the term 'CO{sub 2} capture ready' might mean in practice; issues of plant reliability, availability and maintainability (RAM) including as evaluation of feedback from existing plants; implementation of fuel cell technology in IGCC concepts. Contents are: Introduction; The Thermodynamics of Gasification; The Kinetics of Gasification and Reactor Theory; Feedstocks and Feedstock Characteristics; Gasification Processes; Practical Issues; Applications; Auxiliary Technologies; Economics, environmental, and Safety Issues; Gasification and the Future. 5 apps.

  9. Universe (2nd edition)

    SciTech Connect

    Kaufmann, W.J. III

    1988-01-01

    A general text on astronomy is presented. The foundations of the science are reviewed, including descriptions of naked-eye observatons of eclipses and planetary motions and such basic tools as Kepler's laws, the fundamental properties of light, and the optics of telescopes. The formation of the solar system is addressed, and the planets and their satellites are discussed individually. Solar science is treated in detail. Stellar evolution is described chronologically from birth to death. Molecular clouds, star clusters, nebulae, neutron stars, black holes, and various other phenomena that occur in the life of a star are examined in the sequence in which they naturally occur. A survey of the Milky Way introduces galactic astronomy. Quasars and cosmology are addressed, including the most recent developments in research. 156 references.

  10. Bladder urothelial carcinoma extending to rectal mucosa and presenting with rectal bleeding

    PubMed Central

    Aneese, Andrew M; Manuballa, Vinayata; Amin, Mitual; Cappell, Mitchell S

    2017-01-01

    An 87-year-old-man with prostate-cancer-stage-T1c-Gleason-6 treated with radiotherapy in 1996, recurrent prostate cancer treated with leuprolide hormonal therapy in 2009, and bladder-urothelial-carcinoma in situ treated with Bacillus-Calmette-Guerin and adriamycin in 2010, presented in 2015 with painless, bright red blood per rectum coating stools daily for 5 mo. Rectal examination revealed bright red blood per rectum; and a hard, fixed, 2.5 cm × 2.5 cm mass at the normal prostate location. The hemoglobin was 7.6 g/dL (iron saturation = 8.4%, indicating iron-deficiency-anemia). Abdominopelvic-CT-angiography revealed focal wall thickening at the bladder neck; a mass containing an air cavity replacing the normal prostate; and adjacent rectal invasion. Colonoscopy demonstrated an ulcerated, oozing, multinodular, friable, 2.5 cm × 2.5 cm mass in anterior rectal wall, at the usual prostate location. Histologic and immunohistochemical analysis of colonoscopic biopsies of the mass revealed poorly-differentiated-carcinoma of urothelial origin. At visceral angiography, the right-superior-rectal-artery was embolized to achieve hemostasis. The patient subsequently developed multiple new metastases and expired 13 mo post-embolization. Comprehensive literature review revealed 16 previously reported cases of rectal involvement from bladder urothelial carcinoma, including 11 cases from direct extension and 5 cases from metastases. Patient age averaged 63.7 ± 9.6 years (all patients male). Rectal involvement was diagnosed on average 13.5 ± 11.8 mo after initial diagnosis of bladder urothelial carcinoma. Symptoms included constipation/gastrointestinal obstruction-6, weight loss-5, diarrhea-3, anorexia-3, pencil thin stools-3, tenesmus-2, anorectal pain-2, and other-5. Rectal examination in 9 patients revealed annular rectal constriction-6, and rectal mass-3. The current patient had the novel presentation of daily bright red blood per rectum coating the stools simulating

  11. Complications and outcomes following rectal pull-through surgery in dogs with rectal masses: 74 cases (2000-2013).

    PubMed

    Nucci, Daniel J; Liptak, Julius M; Selmic, Laura E; Culp, William T N; Durant, April M; Worley, Deanna; Maritato, Karl C; Thomson, Maurine; Annoni, Maurizio; Singh, Ameet; Matz, Brad; Benson, John; Buracco, Paolo

    2014-09-15

    To evaluate the incidence of and factors associated with complications following rectal pull-through (RPT) surgery and the outcome for dogs with rectal tumors. Retrospective case series. 74 dogs with rectal masses. Information regarding signalment, history, diagnostic testing, type of rectal disease, surgical details, and postoperative complications, treatments, and outcomes was obtained from medical records and follow-up communications. Survival times were calculated. Descriptive statistics were generated. Regression analyses were used to evaluate the effect of various variables on the development of postsurgical complications and survival time. 58 (78.4%) dogs developed postsurgical complications, the most common of which was fecal incontinence with 42 (56.8%) dogs affected, of which 23 (54.8%) developed permanent incontinence. Other complications included diarrhea (n = 32), tenesmus (23), stricture formation (16), rectal bleeding (8), constipation (7), dehiscence (6), and infection (4). The rectal tumor recurred in 10 dogs. The median survival time was 1,150 days for all dogs and 726 days for dogs with malignant tumors. The 2 most common rectal masses were rectal carcinoma and rectal carcinoma in situ, and the dogs with these tumors had median survival times of 696 and 1,006 days, respectively. Dogs with rectal diseases that underwent RPT surgery had a high incidence of complications; however, those dogs had good local tumor control and survival times. The risk and impact of postsurgical complications on the quality of life and oncological outcomes should be discussed with owners before RPT surgery is performed in dogs with rectal masses.

  12. European Symposium on X-Ray Topography and High Resolution Diffraction (2nd) Held in Berlin, Germany on 5-7 September 1994. Programme and Abstracts

    DTIC Science & Technology

    1994-09-07

    iaAs surfaces,, while the quantumi wires were faibricatedl by using InAs/OaAs quantum wells grown hy molecular beamn epilaxy onto (I fl0l)aAs...techniques can be used in two different ways: i) in multi quantum well based heterostructures tile interface parameters can be determined by fitting the...superlattice peak intensity and broadening in x-ray rocking curves. ii) in single quantum well heterostructures the intensity fringes arising from the

  13. Basic Space Science; United Nations/European Space Agency Workshops for Developing Countries, 2nd, Bogota, Colombia, November 9-13, 1992

    NASA Technical Reports Server (NTRS)

    Haubold, Hans J. (Editor); Torres, Sergio (Editor)

    1994-01-01

    The conference primarily covered astrophysical and astronomical topics on stellar and solar modeling and processes, high magnetic field influence on stellar spectra, cosmological topics utilizing Cosmic Background Explorer (COBE) data and radioastronomic mapping as well as cosmic gravitational instability calculations, astrometry of open clusters amd solar gravitational focusing, extremely energetic gamma rays, interacting binaries, and balloon-borne instrumentation. Other papers proposed an active Search for Extraterrestrial Intelligence (SETI) communication scheme to neighboring solar-like systems and more direct involvement of and with the public in astronomy and space exploration projects.

  14. Basic Space Science; United Nations/European Space Agency Workshops for Developing Countries, 2nd, Bogota, Colombia, November 9-13, 1992

    NASA Technical Reports Server (NTRS)

    Haubold, Hans J. (Editor); Torres, Sergio (Editor)

    1994-01-01

    The conference primarily covered astrophysical and astronomical topics on stellar and solar modeling and processes, high magnetic field influence on stellar spectra, cosmological topics utilizing Cosmic Background Explorer (COBE) data and radioastronomic mapping as well as cosmic gravitational instability calculations, astrometry of open clusters amd solar gravitational focusing, extremely energetic gamma rays, interacting binaries, and balloon-borne instrumentation. Other papers proposed an active Search for Extraterrestrial Intelligence (SETI) communication scheme to neighboring solar-like systems and more direct involvement of and with the public in astronomy and space exploration projects.

  15. Differences between 2nd and 3rd generation seric parathormone determination methods on mortality in haemodialysis patients.

    PubMed

    Rodríguez-Osorio, Laura; de la Piedra, Concepción; Rubert, Mercedes; Martín-Fernández, Marta; González Casaus, María Luisa; Gracia-Iguacel, Carolina; Egido, Jesús; Villa-Bellosta, Ricardo; González Parra, Emilio

    Parathormone plays a key role in controlling mineral metabolism. PTH is considered a uremic toxin causing cardiovascular damage and cardiovascular mortality in dialysis patients. There are two different assays to measure PTH called 2nd generation or intact PTH (iPTH) and 3rd generation or bioPTH (PTHbio). To evaluate the differences in mortality of dialysis patients between both assays to measure PTH, as well as the possible prognostic role of the PTHbio/iPTH ratio. 145 haemodialysis patients were included with 2-year monitoring including baseline laboratory test and annually thereafter. 21 patients died in the first year and 28 in the second. No correlation was found between PTH, PTHbio and PTHbio/iPTH ratio with mortality. Both PTH have a perfect correlation between them and correlate similarly with other molecules of the mineral metabolism. The extreme baseline values of PTH are those of higher mortality. In survival by iPTH intervals (according to guidelines and COSMOS study), a J curve is observed. When iPTH increases, the ratio decreases, possibly when increasing fragments no. 1-84. There is no greater prognostic approximation on mortality with PTHbio than PTHi. There was also no difference in mortality when progression ratio PTHbio/PTHi was analysed. We didn't find any advantages to using bioPTH vs. PTHi as a marker of mortality. BioPTH limits of normality must be reevaluated because its relationship with iPTH is not consistent. Not knowing these limits affects its prognostic value. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  16. Differences in risk factors for 2nd and 3rd degree hypospadias in the National Birth Defects Prevention Study

    PubMed Central

    in 't Woud, Sander Groen; van Rooij, Iris A.L.M.; van Gelder, Marleen M.H.J.; Olney, Richard S.; Carmichael, Suzan L.; Roeleveld, Nel; Reefhuis, Jennita

    2015-01-01

    Background Hypospadias is a frequent birth defect with three phenotypic subtypes. With data from the National Birth Defects Prevention Study, a large, multi-state, population-based, case-control study, we compared risk factors for second and third degree hypospadias. Methods A wide variety of data on maternal and pregnancy-related risk factors for isolated second and third degree hypospadias was collected via computer-assisted telephone interviews to identify potential etiological differences between the two phenotypes. Logistic regression was used to calculate odds ratios including a random effect by study center. Results In total, 1547 second degree cases, 389 third degree cases, and 5183 male controls were included in our study. Third degree cases were more likely to have a non-Hispanic black or Asian/Pacific Islander mother, be delivered preterm, have a low birth weight, be small for gestational age, and be conceived with fertility treatments than second degree cases and controls. Associations with both second and third degree hypospadias were observed for maternal age, family history, parity, plurality, and hypertension during pregnancy. Risk estimates were generally higher for third degree hypospadias except for family history. Conclusions Most risk factors were associated with both or neither phenotype. Therefore, it is likely that the underlying mechanism is at least partly similar for both phenotypes. However, some associations were different between 2nd and 3rd degree hypospadias, and went in opposite directions for second and third degree hypospadias for Asian/Pacific Islander mothers. Effect estimates for subtypes of hypospadias may be over- or underestimated in studies without stratification by phenotype. PMID:25181604

  17. Use of prelecture assignment to enhance learning in pharmacology lectures for the 2(nd) year medical students.

    PubMed

    Ahsan, Marya; Mallick, Ayaz Khurram

    2016-10-01

    Majority of teaching hours allotted by the Medical Council of India in pharmacology are utilized in the form of didactic lecture. Although these lectures are an excellent tool to deliver the information to a large group of students, it usually ends up as a one-sided teaching session with most students being the passive listeners. To make these lectures interesting and effective, we introduced the students to prelecture assignment (PLA) in the form of clinical case before the delivery of the lecture. This prospective educational trial was conducted in the Department of Pharmacology with undergraduate medical students in their 2(nd) year of their professional course. They were divided into two groups of 75 each. Group A was provided the PLA before the lecture. Group B students directly attended the lecture, sans the PLA. Multiple-choice questions-based test was conducted 2 days after the lecture. Students who failed to complete the assignment and were absent from the lecture and test were excluded from the study. Feedback from the students was obtained after the lecture. The scores in the test and responses were compiled and analyzed using Statistical Package for Social Sciences (SPSS) software version 21.0 (SPSS Inc., Chicago, IL, USA). Results were expressed in percentages and as mean ± standard deviation as applicable. P < 0.05 was considered statistically significant. Fifty-six students from Group A and 42 from Group B appeared for the test. The students who were given PLA scored better. They felt more confident in answering and understood the topic better than the students of other group. PLA is a useful teaching-learning tool. The pharmacology lectures are interactive, interesting, and easy to understand with this tool.

  18. A novel antidoping and medical care delivery model at the 2nd Summer Youth Olympic Games (2014), Nanjing China.

    PubMed

    Mountjoy, Margo; Akef, Najla; Budgett, Richard; Greinig, Susan; Li, Guoping; Manikavasagam, Jegathesan; Soligard, Torbjorn; Haiming, Xai; Yang, Xiaoye

    2015-07-01

    Antidoping and medical care delivery programmes are required at all large international multisport events. To document and critique the novel antidoping and medical care delivery models implemented at the 2nd Summer Youth Olympic Games, Nanjing 2014. The International Olympic Committee implemented two new models of delivery of antidoping and medical care at the YOG. A review of these models as well as the public health programme and two health educational initiatives in the Cultural and Educational Program was undertaken by the International Olympic Committee. The implementation of the new antidoping model was feasible in the setting of the YOG. The antidoping rules and regulations of the International Olympic Committee were respected. This model enhanced the educational initiative and provided financial as well as human resource savings. The execution of the hospital-based venue model of medical care delivery at the YOG was also feasible in this setting. This model provided a practical infrastructure for the delivery of medical care at multisport events with the goal of providing optimum athlete healthcare. A public health prevention programme was implemented and no public health risks were encountered by the participants or the Nanjing citizens during the YOG. Finally, the implementation of the athlete health educational programmes within the Cultural and Educational Program provided athletes with an opportunity to improve their health and performance. To achieve the goal of protecting athlete health, and of employing effective doping control and education, new alternate models of antidoping and medical care delivery can be implemented. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. ENABLE -- A systolic 2nd level trigger processor for track finding and e/[pi] discrimination for ATLAS/LHC

    SciTech Connect

    Klefenz, F.; Noffz, K.H.; Zoz, R. . Lehrstuhl fuer Informatik V); Maenner, R. . Interdisziplinaeres Zentrum fuer Wissenschaftliches Rechnen)

    1994-08-01

    The Enable Machine is a systolic 2nd level trigger processor for the transition radiation detector (TRD) of ATLAS/LHC. It is developed within the EAST/RD-11 collaboration at CERN. The task of the processor is to find electron tracks and to reject pion tracks according to the EAST benchmark algorithm in less than 10[mu]s. Track are identified by template matching in a ([psi],z) region of interest (RoI) selected by a 1st level trigger. In the ([psi],z) plane tracks of constant curvature are straight lines. The relevant lines form mask templates. Track identification is done by histogramming the coincidences of the templates and the RoI data for each possible track. The Enable Machine is an array processor that handles tracks of the same slope in parallel, and tracks of different slope in a pipeline. It is composed of two units, the Enable histogrammer unit and the Enable z/[psi]-board. The interface daughter board is equipped with a HIPPI-interface developed at JINR/-Dubna, and Xilinx 'corner turning' data converter chips. Enable uses programmable gate arrays (XILINX) for histogramming and synchronous SRAMs for pattern storage. With a clock rate of 40 MHz the trigger decision time is 6.5 [mu]s and the latency 7.0 [mu]s. The Enable machine is scalable in the RoI size as well as in the number of tracks processed. It can be adapted to different recognition tasks and detector setups. The prototype of the Enable Machine has been tested in a beam time of the RD6 collaboration at CERN in October 1993.

  20. Use of prelecture assignment to enhance learning in pharmacology lectures for the 2nd year medical students

    PubMed Central

    Ahsan, Marya; Mallick, Ayaz Khurram

    2016-01-01

    Objectives: Majority of teaching hours allotted by the Medical Council of India in pharmacology are utilized in the form of didactic lecture. Although these lectures are an excellent tool to deliver the information to a large group of students, it usually ends up as a one-sided teaching session with most students being the passive listeners. To make these lectures interesting and effective, we introduced the students to prelecture assignment (PLA) in the form of clinical case before the delivery of the lecture. Methods: This prospective educational trial was conducted in the Department of Pharmacology with undergraduate medical students in their 2nd year of their professional course. They were divided into two groups of 75 each. Group A was provided the PLA before the lecture. Group B students directly attended the lecture, sans the PLA. Multiple-choice questions-based test was conducted 2 days after the lecture. Students who failed to complete the assignment and were absent from the lecture and test were excluded from the study. Feedback from the students was obtained after the lecture. The scores in the test and responses were compiled and analyzed using Statistical Package for Social Sciences (SPSS) software version 21.0 (SPSS Inc., Chicago, IL, USA). Results were expressed in percentages and as mean ± standard deviation as applicable. P < 0.05 was considered statistically significant. Results: Fifty-six students from Group A and 42 from Group B appeared for the test. The students who were given PLA scored better. They felt more confident in answering and understood the topic better than the students of other group. Conclusion: PLA is a useful teaching-learning tool. The pharmacology lectures are interactive, interesting, and easy to understand with this tool. PMID:28031612

  1. Electrocradiographic Qrs Axis, Q Wave and T-wave Changes in 2nd and 3rd Trimester of Normal Pregnancy.

    PubMed

    M, Sunitha; S, Chandrasekharappa; Brid, S V

    2014-09-01

    Pregnancy although a physiological phenomena affects all the functions of the maternal body and brings about remarkable changes in the cardiovascular system. The cardiovascular changes and many of the physiological adaptations of normal pregnancy alter the physical findings thus, sometimes misleading the diagnosis of heart disease. Pregnancy also brings about various changes in the electrocardiogram, further confusing with that of heart disease. This study is undertaken to highlight the effect of normal pregnancy on the QRS axis, Q wave and T-wave of the Electrocardiogram and thereby helps us to distinguish it from that of pathological changes. To study the effect of normal pregnancy on the QRS axis, Q wave and T-wave in the electrocardiogram and to compare with that of normal non pregnant women. Fifty normal pregnant women in 2nd and 3rd trimester each between 20- 35 y of age and 50 normal non pregnant women of the same age group were selected for the study. A 12 lead ECG was recorded by using ECG machine with special emphasis on QRS axis, Q wave and T-wave changes and all the parameters were analysed. The ECG changes observed in our study include, deviation of QRS axis towards left as pregnancy advanced, significant increased incidence of occurrence of prominent Q waves in lead II, III and avF in pregnant group (p < 0.05 ) and, T-wave abnormalities like flat and inverted T-waves in lead III, V1 - V3 were more frequent in pregnant group ( p<0.05 ) than in non pregnant group. Normal pregnancy brings about various changes in ECG. These changes during pregnancy should be interpretated with caution by the physicians. It is necessary to understand the normal physiological changes which in turn help us in better management of those with cardiac disease.

  2. Interaction between Short-Term Heat Pretreatment and Fipronil on 2nd Instar Larvae of Diamondback Moth, Plutella Xylostella (Linn)

    PubMed Central

    Gu, Xiaojun; Tian, Sufen; Wang, Dehui; Gao, Fei; Wei, Hui

    2010-01-01

    Based on the cooperative virulence index (c.f.) and LC50 of fipronil, the interaction effect between short-term heat pretreatment and fipronil on 2nd instar larvae of diamondback moth (DBM), Plutella xylostella (Linnaeus), was assessed. The results suggested that pretreatment of the tested insects at 30 °C for 2, 4 and 8h could somewhat decrease the toxicity of fipronil at all set concentrations. The LC50 values of fipronil increased after heat pretreatment and c.f. values in all these treatments were below zero. These results indicated that real mortalities were less than theoretical ones and antagonism was found in the treatments of fipronil at 0.39 and 0.78 mg/L after heat pretreatment at 30 °C at 2, 4 and 8 h. However, pretreatment at 30 °C for 12h could increase the toxicity of fipronil at all set concentrations, the LC50 of fipronil decreased after heat pretreatment and c.f. values in all these treatments were above zero, which indicated real mortalities were higher than theoretical ones. Pretreatment of the tested insects at 35 °C for 2, 4, 8 and 12h was found to increase the toxicity of fipronil at all set concentrations which resulted in the decrease of LC50 values of fipronil and c.f. above zero in all treatments with only one exception. Most interactions were assessed as synergism. The results indicated that cooperative virulence index (c.f.) may be adopted in hormetic effect assessment. PMID:20877489

  3. Geochemical and geophysical approach to the Tenerife (Canary Islands) anomalous seismic swarm on the 2nd October 2016

    NASA Astrophysics Data System (ADS)

    Luengo-Oroz, Natividad; Torres-González, Pedro; Domíguez Cerdeña, Itahiza; Moure, David; Villasante-Marcos, Víctor; Jiménez-Mejías, María; del Fresno, Carmen; García-Cañada, Laura

    2017-04-01

    On the 2nd October 2016, anomalous seismic activity took place in the volcanic island of Tenerife. During 5 hours, 96 low magnitude earthquakes (<1mbLg) were located in the SW zone of the island with an average depth of 10 km, close to the area where a seismic crisis took place in 2004. Seismic analysis of the swarm reveals more than 800 events manually detected showing a high correlation between their waveforms. Relocation by double differences shows all hypocenters situated in a small cluster with a radius of a few hundred meters. Magnitudes ranged between 0 and 0.9 but the time evolution shows a variation in narrow bands of ±0.2 magnitudes. In order to better understand the origin and main causes of such anomalous behavior in the volcanic island, data obtained from different volcano monitoring techniques were analyzed. GPS deformation data did not show anomalous changes related to the studied phenomena. In the aim of this interdisciplinary interpretation, available geochemical data from the IGN volcano monitoring network were also revised. Values of several geochemical parameters previous to the seismic swarm have been studied. Chemical and isotopic analysis from fumaroles and soil gases, groundwater physicochemical parameters, CO2 diffuse emissions from the soil, Rn and CO2 concentrations inside a gallery and soil temperature in the summit of Teide volcano did not revealed significant geochemical changes clearly related to the seismic activity on the 2thOctober 2016. However, this conclusion could be reconsidered in the future since upcoming events may show new insights into past circumstances.

  4. Transanal local excision of rectal cancer.

    PubMed

    Read, D R; Sokil, S; Ruiz-Salas, G

    1995-01-01

    Twenty-five patients with invasive rectal cancer treated by transanal excision between 1978-1989 are presented. Two patients had poorly differentiated tumours and were converted to abdominoperineal resection and one patient had extensive liver metastases documented preoperatively. The remaining twenty-two, mean age 64 years, fulfilled the criteria for local treatment. Eighty-two percent of tumours were T1 or T2 stage. There was no operative mortality. Six complications in five patients occurred, none requiring surgical intervention. Five patients died of unrelated causes without evidence of recurrence at 4, 4, 14, 26 and 58 months. The length of follow-up for the surviving group (17 patients) was 16 to 115 months (mean 63 months). Two patients developed local recurrence at 32 and 60 months. Transanal excision can be curative for selected rectal cancers.

  5. [Fatal intoxication following rectal instillation of alcohol].

    PubMed

    Nadjem, H; Ropohl, D; Werp, J

    1990-01-01

    A 62-year old man who had been living on a remote farm was found dead in his bed. Inserted in his rectum was a synthetic flexible tube filled with brandy (43 vol. %) and connected to a bicycle pump. Samples taken during autopsy from 3 different parts of the body showed ethanol concentrations from 4.87% to 5.35% in the blood and 6.73% in the urine. The ethanol concentrations in the small and large intestine were considerably higher (more than 29%) than in the stomach (9%). The decreased had a tumor as large as a tennis ball on the base of his tongue, almost completely filling the oropharynx, making swallowing very difficult, which probably was the reason of the rectal instillation of alcohol. The report deals with this unusual case of rectal alcohol instillation, and with the different ethanol and congener alcohol concentrations in the body fluids.

  6. Management of radiation-induced rectal bleeding.

    PubMed

    Laterza, Liboria; Cecinato, Paolo; Guido, Alessandra; Mussetto, Alessandro; Fuccio, Lorenzo

    2013-11-01

    Pelvic radiation disease is one of the major complication after radiotherapy for pelvic cancers. The most commonly reported symptom is rectal bleeding which affects patients' quality of life. Therapeutic strategies for rectal bleeding are generally ignored and include medical, endoscopic, and hyperbaric oxygen treatments. Most cases of radiation-induced bleeding are mild and self-limiting, and treatment is normally not indicated. In cases of clinically significant bleeding (i.e. anaemia), medical therapies, including stool softeners, sucralfate enemas, and metronidazole, should be considered as first-line treatment options. In cases of failure, endoscopic therapy, mainly represented by argon plasma coagulation and hyperbaric oxygen treatments, are valid and complementary second-line treatment strategies. Although current treatment options are not always supported by high-quality studies, patients should be reassured that treatment options exist and success is achieved in most cases if the patient is referred to a dedicated centre.

  7. Altemeier operation for gangrenous rectal prolapse.

    PubMed

    Abdelhedi, Cherif; Frikha, F; Bardaa, S; Kchaw, A; Mzali, R

    2014-08-08

    A stranguled rectal prolapse is a rare cause of intestinal occlusion. It requires emergency surgery. A patient who underwent emergency perineal proctectomy, the Altemeier operation, combined with diverting loop sigmoid colostomy is described. The postoperative course was uneventful, with an excellent final result after colostomy closure. The successful treatment of this patient illustrates the value of the Altemeier procedure in the difficult and unusual scenario of bowel incarceration.

  8. The Emergence of Cultural Self-Constructs: Autobiographical Memory and Self-Description in European American and Chinese Children

    ERIC Educational Resources Information Center

    Wang, Qi

    2004-01-01

    This study examined the emergence of cultural self-constructs as reflected in children's remembered and conceptual aspects of the self. European American and Chinese children in preschool through 2nd grade participated (N=180). Children each recounted 4 autobiographical events and described themselves in response to open-ended questions. American…

  9. The Emergence of Cultural Self-Constructs: Autobiographical Memory and Self-Description in European American and Chinese Children

    ERIC Educational Resources Information Center

    Wang, Qi

    2004-01-01

    This study examined the emergence of cultural self-constructs as reflected in children's remembered and conceptual aspects of the self. European American and Chinese children in preschool through 2nd grade participated (N=180). Children each recounted 4 autobiographical events and described themselves in response to open-ended questions. American…

  10. Rectal balloon use limits vaginal displacement, rectal dose, and rectal toxicity in patients receiving IMRT for postoperative gynecological malignancies.

    PubMed

    Wu, Cheng-Chia; Wuu, Yen-Ruh; Yanagihara, Theodore; Jani, Ashish; Xanthopoulos, Eric P; Tiwari, Akhil; Wright, Jason D; Burke, William M; Hou, June Y; Tergas, Ana I; Deutsch, Israel

    2017-09-01

    Pelvic radiotherapy for gynecologic malignancies traditionally used a 4-field box technique. Later trials have shown the feasibility of using intensity-modulated radiotherapy (IMRT) instead. But vaginal movement between fractions is concerning when using IMRT due to greater conformality of the isodose curves to the target and the resulting possibility of missing the target while the vagina is displaced. In this study, we showed that the use of a rectal balloon during treatment can decrease vaginal displacement, limit rectal dose, and limit acute and late toxicities. Little is known regarding the use of a rectal balloon (RB) in treating patients with IMRT in the posthysterectomy setting. We hypothesize that the use of an RB during treatment can limit rectal dose and acute and long-term toxicities, as well as decrease vaginal cuff displacement between fractions. We performed a retrospective review of patients with gynecological malignancies who received postoperative IMRT with the use of an RB from January 1, 2012 to January 1, 2015. Rectal dose constraint was examined as per Radiation Therapy Oncology Group (RTOG) 1203 and 0418. Daily cone beam computed tomography (CT) was performed, and the average (avg) displacement, avg magnitude, and avg magnitude of vector were calculated. Toxicity was reported according to RTOG acute radiation morbidity scoring criteria. Acute toxicity was defined as less than 90 days from the end of radiation treatment. Late toxicity was defined as at least 90 days after completing radiation. Twenty-eight patients with postoperative IMRT with the use of an RB were examined and 23 treatment plans were reviewed. The avg rectal V40 was 39.3% ± 9.0%. V30 was65.1% ± 10.0%. V50 was 0%. Separate cone beam computed tomography (CBCT) images (n = 663) were reviewed. The avg displacement was as follows: superior 0.4 + 2.99 mm, left 0.23 ± 4.97 mm, and anterior 0.16 ± 5.18 mm. The avg magnitude of displacement was superior

  11. Increasing trend in retained rectal foreign bodies

    PubMed Central

    Ayantunde, Abraham A; Unluer, Zynep

    2016-01-01

    AIM To highlight the rising trend in hospital presentation of foreign bodies retained in the rectum over a 5-year period. METHODS Retrospective review of the cases of retained rectal foreign bodies between 2008 and 2012 was performed. Patients’ clinical data and yearly case presentation with data relating to hospital episodes were collected. Data analysis was by SPSS Inc. Chicago, IL, United States. RESULTS Twenty-five patients presented over a 5-year period with a mean age of 39 (17-62) years and M: F ratio of 2:1. A progressive rise in cases was noted from 2008 to 2012 with 3, 4, 4, 6, 8 recorded patients per year respectively. The majority of the impacted rectal objects were used for self-/partner-eroticism. The commonest retained foreign bodies were sex vibrators and dildos. Ninty-six percent of the patients required extraction while one passed spontaneously. Two and three patients had retrieval in the Emergency Department and on the ward respectively while 19 patients needed examination under anaesthesia for extraction. The mean hospital stay was 19 (2-38) h. Associated psychosocial issues included depression, deliberate self-harm, illicit drug abuse, anxiety and alcoholism. There were no psychosocial problems identified in 15 patients. CONCLUSION There is a progressive rise in hospital presentation of impacted rectal foreign bodies with increasing use of different objects for sexual arousal. PMID:27830039

  12. Giant rectal gastrointestinal stromal tumours: a diagnostic and therapeutic challenge

    PubMed Central

    Alder, L.S.; Elver, G.; Foo, F.J.; Dobson, M.

    2013-01-01

    Gastrointestinal stromal tumour (GIST are the most common mesenchymal tumours; however, rectal GISTs account for <5%. In the pelvis they represent a diagnostic challenge with giant GISTs likely to be malignant. They may present with urological, gynaecological or rectal symptoms. Sphincter-preserving surgery can be aided by neoadjuvant therapy. We present an uncommon case of giant rectal GIST masquerading as acute urinary retention. PMID:24968434

  13. Endoscopic Ultrasound-Guided Management of Bleeding Rectal Varices.

    PubMed

    Philips, Cyriac Abby; Augustine, Philip

    2017-01-01

    Rectal variceal bleeding, though rare, can pose significant morbidity and mortality in the wake of treatment failure. Conventional treatment utilizing endoscopic glue injection might not be feasible in all cases due to poor visualization and inadvertent missing of variceal source of bleed. Endoscopic ultrasound (EUS)-guided rectal variceal management is a promising and effective modality. We provide real-time images and a video of EUS-guided precision management of rectal variceal bleed using coiling and glue in a cirrhotic.

  14. Rectal Diclofenac Versus Rectal Paracetamol: Comparison of Antipyretic Effectiveness in Children

    PubMed Central

    Sharif, Mohammad Reza; Haji Rezaei, Mostafa; Aalinezhad, Marzieh; Sarami, Golbahareh; Rangraz, Masoud

    2016-01-01

    Background Fever is the most common complaint in pediatric medicine and its treatment is recommended in some situations. Paracetamol is the most common antipyretic drug, which has serious side effects such as toxicity along with its positive effects. Diclofenac is one of the strongest non-steroidal anti-inflammatory (NSAID) drugs, which has received little attention as an antipyretic drug. Objectives This study was designed to compare the antipyretic effectiveness of the rectal form of Paracetamol and Diclofenac. Patients and Methods This double-blind controlled clinical trial was conducted on 80 children aged six months to six years old. One group was treated with rectal Paracetamol suppositories at 15 mg/kg dose and the other group received Diclofenac at 1 mg/kg by rectal administration (n = 40). Rectal temperature was measured before and one hour after the intervention. Temperature changes in the two groups were compared. Results The average rectal temperature in the Paracetamol group was 39.6 ± 1.13°C, and 39.82 ± 1.07°C in the Diclofenac group (P = 0.37). The average rectal temperature, one hour after the intervention, in the Paracetamol and the Diclofenac group was 38.39 ± 0.89°C and 38.95 ± 1.09°C, respectively (P = 0.02). Average temperature changes were 0.65 ± 0.17°C in the Paracetamol group and 1.73 ± 0.69°C in the Diclofenac group (P < 0.001). Conclusions In the first one hour, Diclofenac suppository is able to control the fever more efficient than Paracetamol suppositories. PMID:26889398

  15. [Ventral rectal sacropexy (colpo-perineal) in the treatment of rectal and rectogenital prolapse].

    PubMed

    Enríquez-Navascués, José M; Elósegui, José L; Apeztegui, Francisco J; Placer, Carlos; Borda, Nerea; Irazusta, Martín; Múgica, José A; Murgoitio, Javier

    2009-11-01

    Ventral sacral-rectopexy with mesh corrects rectal prolapse and minimises rectal dissection. Subsequent colpopexy corrects apical and posterior prolapses of the vagina. The combination of both procedures can lead to the simultaneous correction of pelvic organ prolapses (POP). To present the results of a patient series with several types of POP treated using the same approach and operation. A total of 57 patients diagnosed with any type of POP were operated on between January 2005 and August 2008 using ventral rectal-colpo-sacropexy, who were grouped into three types: A, total rectal prolapse isolated or combined with a hysterocele or colpocele (11 patients); B, rectoenterocele with internal rectal invagination and/or descending perineum (4 patients); and C, middle and posterior genital compartment prolapse (42 patients). The laparoscopic approach was used in the 15 patients of groups A and B and 11 from group C. A biological mesh was used in 41 patients and a macroporous synthetic one in the rest. The mean age of the patients in the series was 66 (19-81) years, with 55 females and 2 males. The median follow up was 25 (4-48) months. There were no major post-surgical complications. A recurrence of prolapse was recorded in one patient in group A (1/11); the 7 patients who suffered from incontinence improved after the surgery, no case of de novo constipation being recorded and an improvement in 8 of the 9 patients from groups A and B with obstructive defaecation. There were 9 (21%) recurrences detected in group C, but only 4 (9%) required reintervention. In all the recurrences a biological mesh had been used. Laparoscopic ventral rectal-colpo-pexy is an effective technique to correct POP. Although safe and innocuous, the results with biological meshes did not last as long.

  16. Comparison of the preventive analgesic effect of rectal ketamine and rectal acetaminophen after pediatric tonsillectomy.

    PubMed

    Heidari, S Morteza; Mirlohi, S Zahra; Hashemi, S Jalal

    2012-03-01

    There is a little data about rectal administration of Ketamine as a postoperative analgesic, so we compared the efficacy of rectal ketamine with rectal acetaminophen, which is applied routinely for analgesia after painful surgeries like tonsillectomy. In this single-blinded comparative trial, we enrolled 70 children undergoing elective tonsillectomy, and divided them randomly in two groups. Patients received rectal ketamine (2 mg / kg) or rectal acetaminophen (20 mg / kg) at the end of surgery. The children's Hospital of Eastern Ontario Pain scale was used to estimate pain in children. Also the vital signs, Wilson sedation scale, and side effects in each group were noted and compared for 24 hours. The ketamine group had a lower pain score at 15 minutes and 60 minutes after surgery in Recovery (6.4 ± 0.8, 7.4 ± 1 vs. 7.1 ± 1.2, 7.8 ± 1.2 in the acetaminophen group, P < 0.05) and one hour and two hours in the ward (7.2 ± 0.7, 7 ± 0.5 vs. 7.9 ± 1.2, 7.5 ± 1.2 in the acetaminophen group, P < 0.05), with no significant differences till 24 hours. Dreams and hallucinations were not reported in the ketamine group. Systolic blood pressure was seen to be higher in the ketamine group (104.4 ± 7.9 vs. 99.8 ± 7.7 in the acetaminophen group) and nystagmus was reported only in the ketamine group (14.2%). Other side effects were equivalent in both the groups. With low complications, rectal ketamine has analgesic effects, especially in the first hours after surgery in comparison with acetaminophen, and it can be an alternative analgesic with easy administration in children after tonsillectomy.

  17. Laparoscopic intersphincteric resection for low rectal cancer.

    PubMed

    Lim, Sang Woo; Huh, Jung Wook; Kim, Young Jin; Kim, Hyeong Rok

    2011-12-01

    Laparoscopic intersphincteric resection (ISR) after neoadjuvant chemoradiation is helpful in the management of patients with low rectal cancer. With the advent of this technique, the need for performance of abdominoperineal resection seems to have decreased in patients with very low rectal tumors. The aim of the present study was to evaluate the feasibility, the functional outcome, and the short-term oncologic outcomes of laparoscopic ISR for low rectal adenocarcinoma at our institution. We retrospectively reviewed the data of 111 consecutive patients who underwent laparoscopic ISR for low rectal adenocarcinoma between July 2005 and December 2009. Demographic status, surgical outcomes, functional outcome data, and oncologic outcome data were collected. The mean distance of the tumor from the anal verge was 3.4 cm (range: 1-5 cm). The mean operative time was 214.7 min (range, 150-450 min). The mean distal resection margin was 1.3 ± 1.1 cm. Morbidity occurred in 24 patients (21.6%), including anastomotic leakage in 2 patients (1.8%). The mean Wexner continence score after stoma repair was 7.5 ± 2.7 (range: 2 ~ 19), and 9.8 in total ISR, 7.3 in partial ISR (P = 0.071). The 3-year overall survival rate was 92.8%, and the 3-year disease-free survival rate was 73.0%. Local recurrence was noted in 6 of the 111 patients with TNM stage I to III (5.4%). The patients with lesions at 2 cm to the dentate line had a 7.07-fold greater risk of local recurrence, including a 13.42-fold greater risk of lateral pelvic wall recurrence and perineal recurrence (95% Confidence interval [CI], 1.141-158.006; P = 0.009) than in those who had lesions more than 2 cm from the anal verge (95% CI, 1.290-38.832; P = 0.011). Laparoscopic ISR after neoadjuvant chemoradiation can be recommended as a technically feasible, minimally invasive, and a sphincter-saving procedure with acceptable functional and short-term oncologic outcomes in patients with very low rectal cancer.

  18. Evaluating national practice of preoperative radiotherapy for rectal cancer based on clinical auditing.

    PubMed

    van Leersum, N J; Snijders, H S; Wouters, M W J M; Henneman, D; Marijnen, C A M; Rutten, H R; Tollenaar, R A E M; Tanis, P J

    2013-09-01

    Internationally, the use of preoperative radiotherapy (RT) for rectal cancer varies largely, related to different decision-making based on the harm-benefit ratio. In the Dutch guideline, RT is indicated in all cT2-4 tumours. We aimed to evaluate the use of RT in the Netherlands and to discuss Dutch practice in the context of current literature. Data of the Dutch Surgical Colorectal Audit (DSCA) were used and 6784 patients surgically treated for primary rectal cancer in 2009-2011 were included. The application and type of RT were described according to age, comorbidity, tumour localization and tumour stage at population level with analysis of hospital variation for specific subsets. In total, 85% of patients who underwent resection for rectal cancer received RT. Comorbidity (Charlson Comorbidity Index 2+) and older age (≥70 years) were associated with a slight decrease in application of RT (75 and 80% respectively). In stage I tumours, 77% of patients received RT, but large hospital variation existed (0-100%). The proportion chemoradiotherapy of the whole group of RT increased with increasing N-stage, increasing T-stage, decreasing distance from the anus, younger age and less comorbidity with hospital variation from 0 to 73%. From a European perspective, a high percentage of rectal cancer patients are treated with RT in the Netherlands. Considerable hospital variation was observed for RT in stage I and the proportion of chemoradiotherapy among all RT schemes. Data from clinical auditing enable evaluation of national practice and current standards from both a scientific and international perspective. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Bupivacaine administered intrathecally versus rectally in the management of intractable rectal cancer pain in palliative care

    PubMed Central

    Zaporowska-Stachowiak, Iwona; Kowalski, Grzegorz; Łuczak, Jacek; Kosicka, Katarzyna; Kotlinska-Lemieszek, Aleksandra; Sopata, Maciej; Główka, Franciszek

    2014-01-01

    Background Unacceptable adverse effects, contraindications to and/or ineffectiveness of World Health Organization step III “pain ladder” drugs causes needless suffering among a population of cancer patients. Successful management of severe cancer pain may require invasive treatment. However, a patient’s refusal of an invasive procedure necessitates that clinicians consider alternative options. Objective Intrathecal bupivacaine delivery as a viable treatment of intractable pain is well documented. There are no data on rectal bupivacaine use in cancer patients or in the treatment of cancer tenesmoid pain. This study aims to demonstrate that bupivacaine administered rectally could be a step in between the current treatment options for intractable cancer pain (conventional/conservative analgesia or invasive procedures), and to evaluate the effect of the mode of administration (intrathecal versus rectal) on the bupivacaine plasma concentration. Cases We present two Caucasian, elderly inpatients admitted to hospice due to intractable rectal/tenesmoid pain. The first case is a female with vulvar cancer, and malignant infiltration of the rectum/vagina. Bupivacaine was used intrathecally (0.25–0.5%, 1–2 mL every 6 hours). The second case is a female with ovarian cancer and malignant rectal infiltration. Bupivacaine was adminstered rectally (0.05–0.1%, 100 mL every 4.5–11 hours). Methods Total bupivacaine plasma concentrations were determined using the high-performance liquid chromatography-ultraviolet method. Results Effective pain control was achieved with intrathecal bupivacaine (0.077–0.154 mg·kg−1) and bupivacaine in enema (1.820 mg·kg−1). Intrathecal bupivacaine (0.5%, 2 mL) caused a drop in blood pressure; other side effects were absent in both cases. Total plasma bupivacaine concentrations following intrathecal and rectal bupivacaine application did not exceed 317.2 ng·mL−1 and 235.7 ng·mL−1, respectively. Bupivacaine elimination was

  20. Transanal endoscopic microsurgery for the treatment of uncommon rectal lesions.

    PubMed

    Ferrer-Márquez, Manuel; Rubio-Gil, Francisco; Ortega-Ruiz, Sofía; Blesa-Sierra, Isabel; Álvarez-García, Antonio; Jorge-Cerrudo, Jaime; Vidaña-Márquez, Elisabet; Belda-Lozano, Ricardo; Reina-Duarte, Ángel

    Transanal endoscopic microsurgery (TEM) was developed as a less aggressive alternative treatment for rectal lesions (mainly adenomas and adenocarcinomas). However, its use for other rectal lesions has become more frequent, trying to reduce the morbidity associated with more invasive techniques. The aim of this study is to describe our experience in the use of TEM in other rectal lesions. Retrospective and descriptive study including patients operated with TEM (from June 2008 to December 2016) for the treatment of rectal lesions different from adenomas or adenocarcinomas. Among the 138 patients treated by TEM in our department, 10 patients were operated on for rectal lesions other than adenomas or adenocarcinomas. Rectal lesions were 3neuroendocrine tumours, a neuroendocrine tumour metastasis, a rectal stenosis, a cloacogenic polyp, an endometrioma, a retrorrectal tumour, a presacral abscess and a lesion in the rectovaginal septum. Mean operative time was 72min and postoperative stay was 4.2 days. Only one patient needed a reoperation, due to rectal bleeding. TEM could be a useful tool for the treatment of rectal lesions different from adenomas or adenocarcinomas, potentially decreasing the morbidity associated with more aggressive surgical techniques. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Rectal transmission of bovine leukemia virus in cattle and sheep.

    PubMed

    Henry, E T; Levine, J F; Coggins, L

    1987-04-01

    Bovine leukemia virus (BLV) was transmitted by rectal inoculation of BLV-infective whole blood into cattle and sheep. Two cows and 2 sheep each were given 500 ml and 50 ml of blood, respectively, by rectal infusion. Two sheep which served as positive controls each were given 1 ml of the same blood, IV. All animals became seropositive to BLV by postinoculation week 5. Although relatively large volumes of blood were used for rectal inoculation, a base line for infectivity was established for the rectal route.

  2. Case report: Sigmoid strangulation from evisceration through a perforated rectal prolapse ulcer – An unusual complication of rectal prolapse

    PubMed Central

    Li, Jennifer Z.; Kittmer, Tiffaney; Forbes, Shawn; Ruo, Leyo

    2015-01-01

    Introduction Rectal prolapse occurs particularly in elder females and presentation can sometimes lead to complications such as strangulation and evisceration of other organs through the necrotic mucosa. Presentation of case This is a case of a 61 year-old female with rectal prolapse complicated by rectal perforation through which a segment of sigmoid colon eviscerated and became strangulated. This patient initially presented with sepsis requiring ICU admission, but fully recovered following a Hartmann’s procedure with a sacral rectopexy. Discussion Complications of rectal prolapse include incarceration, strangulation, and rarely, perforation with evisceration of other viscera requiring urgent operation. This report provides a brief overview of complications associated with rectal prolapse, reviews similar cases of transrectal evisceration, and discusses the management of chronic rectal prolapse. Conclusion Prompt surgical consult is warranted if any signs or symptoms suggestive of complications from prolapse are present. PMID:25680532

  3. Proceedings of the Biennial EO/EEO Research Symposium (2nd) Held in Cocoa Beach, Florida on December 2-4, 1997

    DTIC Science & Technology

    1998-04-01

    conducted using Gender (male/female) and Grade. Finally, cross- tabulation was used to examine distributions of responses by minority/majority and women...1. AGENCY USE ONLY (Leave blank) 4. TITLE AND SUBTITLE Proceedings: 2nd Biennial EO/EEO Research Symposium 6. AUTHOR(S) Various...Editor: Dr. Mickey Dansby) 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 11. SUPPLEMENTARY NOTES 12a. DISTRIBUTION / AVAILABILITY

  4. Akt Inhibitor MK2206 in Treating Patients With Previously Treated Colon or Rectal Cancer That is Metastatic or Locally Advanced and Cannot Be Removed by Surgery

    ClinicalTrials.gov

    2016-12-13

    Colon Mucinous Adenocarcinoma; Colon Signet Ring Cell Adenocarcinoma; Rectal Mucinous Adenocarcinoma; Rectal Signet Ring Cell Adenocarcinoma; Recurrent Colon Carcinoma; Recurrent Rectal Carcinoma; Stage IIIA Colon Cancer; Stage IIIA Rectal Cancer; Stage IIIB Colon Cancer; Stage IIIB Rectal Cancer; Stage IIIC Colon Cancer; Stage IIIC Rectal Cancer; Stage IVA Colon Cancer; Stage IVA Rectal Cancer; Stage IVB Colon Cancer; Stage IVB Rectal Cancer

  5. Cloud Occurrence Measurements Over Sea during the 2nd 7 Southeast Asian Studies (7SEAS) Field Campaign in Palawan Archipelago

    NASA Astrophysics Data System (ADS)

    Antioquia, C. T.; Uy, S. N.; Caballa, K.; Lagrosas, N.

    2014-12-01

    Ground based sky imaging cameras have been used to measure cloud cover over an area to aid in radiation budget models. During daytime, certain clouds tend to help decrease atmospheric temperature by obstructing sunrays in the atmosphere. Thus, the detection of clouds plays an important role in the formulation of radiation budget in the atmosphere. In this study, a wide angled sky imager (GoPro Hero 2) was brought on board M/Y Vasco to detect and quantity cloud occurrence over sea during the 2nd 7SEAS field campaign. The camera is just a part of a number of scientific instruments used to measure weather, aerosol chemistry and solar radiation among others. The data collection started during the departure from Manila Bay on 05 September 2012 and went on until the end of the cruise (29 September 2012). The camera was placed in a weather-proof box that is then affixed on a steel mast where other instruments are also attached during the cruise. The data has a temporal resolution of 1 minute, and each image is 500x666 pixels in size. Fig. 1a shows the track of the ship during the cruise. The red, blue, hue, saturation, and value of the pixels are analysed for cloud occurrence. A pixel is considered to "contain" thick cloud if it passes all four threshold parameters (R-B, R/B, R-B/R+B, HSV; R is the red pixel color value, blue is the blue pixel color value, and HSV is the hue saturation value of the pixel) and considered thin cloud if it passes two or three parameters. Fig. 1b shows the daily analysis of cloud occurrence. Cloud occurrence here is quantified as the ratio of the pixels with cloud to the total number of pixels in the data image. The average cloud cover for the days included in this dataset is 87%. These measurements show a big contrast when compared to cloud cover over land (Manila Observatory) which is usually around 67%. During the duration of the cruise, only one day (September 6) has an average cloud occurrence below 50%; the rest of the days have

  6. PREFACE: The 2nd International Conference on Geological, Geographical, Aerospace and Earth Sciences 2014 (AeroEarth 2014)

    NASA Astrophysics Data System (ADS)

    Lumban Gaol, Ford; Soewito, Benfano

    2015-01-01

    The 2nd International Conference on Geological, Geographical, Aerospace and Earth Sciences 2014 (AeroEarth 2014), was held at Discovery Kartika Plaza Hotel, Kuta, Bali, Indonesia during 11 - 12 October 2014. The AeroEarth 2014 conference aims to bring together researchers and engineers from around the world. Through research and development, earth scientists have the power to preserve the planet's different resource domains by providing expert opinion and information about the forces which make life possible on Earth. Earth provides resources and the exact conditions to make life possible. However, with the advent of technology and industrialization, the Earth's resources are being pushed to the brink of depletion. Non-sustainable industrial practices are not only endangering the supply of the Earth's natural resources, but are also putting burden on life itself by bringing about pollution and climate change. A major role of earth science scholars is to examine the delicate balance between the Earth's resources and the growing demands of industrialization. Through research and development, earth scientists have the power to preserve the planet's different resource domains by providing expert opinion and information about the forces which make life possible on Earth. We would like to express our sincere gratitude to all in the Technical Program Committee who have reviewed the papers and developed a very interesting Conference Program as well as the invited and plenary speakers. This year, we received 98 papers and after rigorous review, 17 papers were accepted. The participants come from eight countries. There are four Parallel Sessions and two invited Speakers. It is an honour to present this volume of IOP Conference Series: Earth and Environmental Science (EES) and we deeply thank the authors for their enthusiastic and high-grade contributions. Finally, we would like to thank the conference chairmen, the members of the steering committee, the organizing committee

  7. Hybrid distributed Raman amplification combining random fiber laser based 2nd-order and low-noise LD based 1st-order pumping.

    PubMed

    Jia, Xin-Hong; Rao, Yun-Jiang; Yuan, Cheng-Xu; Li, Jin; Yan, Xiao-Dong; Wang, Zi-Nan; Zhang, Wei-Li; Wu, Han; Zhu, Ye-Yu; Peng, Fei

    2013-10-21

    A configuration of hybrid distributed Raman amplification (H-DRA), that is formed by incorporating a random fiber laser (RFL) based 2nd-order pump and a low-noise laser-diode (LD) based 1st-order pump, is proposed in this paper. In comparison to conventional bi-directional 1st-order DRA, the effective noise figure (ENF) is found to be lower by amount of 0 to 4 dB due to the RFL-based 2nd-order pump, depending on the on-off gain, while the low-noise 1st-order Raman pump is used for compensating the worsened signal-to-noise ratio (SNR) in the vicinity towards the far end of the fiber and avoiding the potential nonlinear impact induced by excess injection of pump power and suppressing the pump-signal relative intensity noise (RIN) transfer. As a result, the gain distribution can be optimized along ultra-long fiber link, due to combination of the 2nd-order RFL and low-noise 1st-order pumping, making the transmission distance be extended significantly. We utilized such a configuration to achieve ultra-long-distance distributed sensing based on Brillouin optical time-domain analysis (BOTDA). A repeater-less sensing distance record of up to 154.4 km with 5 m spatial resolution and ~ ± 1.4 °C temperature uncertainty is successfully demonstrated.

  8. Studies of Nondefective Adenovirus 2-Simian Virus 40 Hybrid Viruses III. Base Composition, Molecular Weight, and Conformation of the Ad2+ND1 Genome

    PubMed Central

    Crumpacker, Clyde S.; Henry, Patrick H.; Kakefuda, Tuyoski; Rowe, Wallace P.; Levin, Myron J.; Lewis, Andrew M.

    1971-01-01

    The nondefective adenovirus 2 (Ad2)-simian virus 40 (SV40) hybrid virus, Ad2+ND1, differs from the defective Ad-SV40 hybrid populations previously described, in that this hybrid virus can replicate without the aid of nonhybrid adenovirus helper. Consequently, the deoxyribonucleic acid (DNA) from this virus, which can be obtained free of nonhybrid adenovirus DNA, is well suited for biophysical studies on Ad-SV40 hybrid DNA. Such studies have been performed and demonstrate Ad2+ND1 DNA to have a buoyant density (1.715 g/cm3) and thermal denaturation profile (Tm = 75.1 C) almost identical with nonhybrid Ad2 DNA. Furthermore, its molecular weight, as determined by analytical zone sedimentation and electron microscopy, was 22 × 106 to 25 × 106 daltons, which is also very similar to that determined for Ad2. Electron micrographs showed all of the hybrid molecules to be double-stranded and linear. By using this determination of the molecular weight of Ad2+ND1 DNA and assuming that 1% of this molecule consists of covalently linked SV40 DNA (see companion paper), we calculate that the hybrid DNA molecule contains 220 × 103 to 250 × 103 daltons of SV40 DNA, or the equivalent of one-tenth of the SV40 genome. PMID:4323710

  9. All-optical 1st- and 2nd-order differential equation solvers with large tuning ranges using Fabry-Pérot semiconductor optical amplifiers.

    PubMed

    Chen, Kaisheng; Hou, Jie; Huang, Zhuyang; Cao, Tong; Zhang, Jihua; Yu, Yuan; Zhang, Xinliang

    2015-02-09

    We experimentally demonstrate an all-optical temporal computation scheme for solving 1st- and 2nd-order linear ordinary differential equations (ODEs) with tunable constant coefficients by using Fabry-Pérot semiconductor optical amplifiers (FP-SOAs). By changing the injection currents of FP-SOAs, the constant coefficients of the differential equations are practically tuned. A quite large constant coefficient tunable range from 0.0026/ps to 0.085/ps is achieved for the 1st-order differential equation. Moreover, the constant coefficient p of the 2nd-order ODE solver can be continuously tuned from 0.0216/ps to 0.158/ps, correspondingly with the constant coefficient q varying from 0.0000494/ps(2) to 0.006205/ps(2). Additionally, a theoretical model that combining the carrier density rate equation of the semiconductor optical amplifier (SOA) with the transfer function of the Fabry-Pérot (FP) cavity is exploited to analyze the solving processes. For both 1st- and 2nd-order solvers, excellent agreements between the numerical simulations and the experimental results are obtained. The FP-SOAs based all-optical differential-equation solvers can be easily integrated with other optical components based on InP/InGaAsP materials, such as laser, modulator, photodetector and waveguide, which can motivate the realization of the complicated optical computing on a single integrated chip.

  10. Rectal sensation test helps avoid pain of apical prostate biopsy.

    PubMed

    Jones, J Stephen; Zippe, Craig D

    2003-12-01

    Apical cores obtained during transrectal prostate biopsy are associated with greater pain than cores obtained from the remainder of the gland. We present a method to minimize this pain. During 30 consecutive apical biopsies the needle was purposefully placed above all rectal pain fibers, which are anatomically present only below the dentate line. All patients received a periprostatic nerve block prior to biopsy. The patient was asked if he felt the sharp sensation of the needle as it was placed lightly against the rectal mucosa when the needle was aimed at apex (the rectal sensation test). If so, the needle was advanced cranially 2 to 3 mm or until he could no longer detect its light touch. The probe handle was then rotated dorsally, pulling the rectal mucosa downward until the needle was again aimed at the apex. Patients were asked to report a visual analog pain score for each biopsy. These results were compared to those obtained when doing 30 consecutive apical biopsies without the rectal sensation test. The average visual analog pain score for apical biopsy was 1.25 (range 0 to 2.2) for patients in whom the rectal sensation test was used to bypass rectal pain sensory fibers. The average score in control patients in whom the rectal sensation test was not used was higher at 2.28 (range 0.3-6.2). These results were statistically significant (p > 0.0005). Increased sensitivity to apical prostate biopsy is due to rectal pain fibers located below the dentate line. These fibers and the associated pain may be safely avoided by passing through the rectal wall above the dentate line. The rectal sensation test easily identifies the sensate area below the dentate line. Painless apical biopsy can then be achieved by rotating the ultrasound probe to aim the biopsy needle in the desired path.

  11. Lubricant Provides Poor Rectal Mucosal HIV Coverage.

    PubMed

    Shieh, Eugenie C; Weld, Ethel D; Fuchs, Edward J; Hiruy, Hiwot; Buckheit, Karen W; Buckheit, Robert W; Breakey, Jennifer; Hendrix, Craig W

    2017-08-01

    Given the rising HIV incidence in men who have sex with men (MSM) despite repeatedly proven effectiveness of oral HIV pre-exposure prophylaxis, behaviorally congruent periodic dosing strategies, such as dosing microbicides as lubricants, are now in demand. Rectal microbicide gel studies largely administer gels using vaginal applicators, which have not been well received and do not mimic lubricant use. We compared rectal gel manually dosed as lubricant with applicator dosing in five healthy, HIV-negative MSM who received 10 or 3.5 ml of (99m)Tc-DTPA-radiolabeled hydroxyethyl cellulose universal placebo gel intrarectally. After washout, participants received 10 ml of radiolabeled Wet(®) Original(®) lubricant to apply to the anus with fingers and/or a phallus in a manner typical of sexual lubricant use with a partner, followed by simulated receptive anal intercourse. Single-photon emission computed tomography with transmission computed tomography was performed 4 h after each gel administration. Manual dosing was associated with more variable rectosigmoid distribution, 4.4-15.3 cm from the anorectal junction, compared with more uniform distribution, 5.9-7.4 and 5.3-7.6 cm after 10 and 3.5 ml applicator dosing, respectively. A significantly smaller fraction of the initial 10 ml dose was retained within the colon after manual dosing, 3.4%, compared with 94.9% and 88.4% after 10 and 3.5 ml applicator dosing, respectively (both p < .001). Manual dosing of a sexual lubricant delivered a small, variable fraction of the dose with variable rectosigmoid distribution compared with applicator dosing. These results raise concern that dosing a rectal microbicide gel as a sexual lubricant may not provide adequate or predictable mucosal coverage for HIV protection.

  12. Abdominosacral resection for locally recurring rectal cancer

    PubMed Central

    Belli, Filiberto; Gronchi, Alessandro; Corbellini, Carlo; Milione, Massimo; Leo, Ermanno

    2016-01-01

    AIM To investigate feasibility and outcome of abdominal-sacral resection for treatment of locally recurrent rectal adenocarcinoma. METHODS A population of patients who underwent an abdominal-sacral resection for posterior recurrent adenocarcinoma of the rectum at the National Cancer Institute of Milano, between 2005 and 2013, is considered. Retrospectively collected data includes patient characteristics, treatment and pathology details regarding the primary and the recurrent rectal tumor surgical resection. A clinical and instrumental follow-up was performed. Surgical and oncological outcome were investigated. Furthermore an analytical review of literature was conducted in order to compare our case series with other reported experiences. RESULTS At the time of abdomino-sacral resection, the mean age of patients was 55 (range, 38-64). The median operating time was 380 min (range, 270-480). Sacral resection was performed at S2/S3 level in 3 patients, S3/S4 in 3 patients and S4/S5 in 4 patients. The median operating time was 380 ± 58 min. Mean intraoperative blood loss was 1750 mL (range, 200-680). The median hospital stay was 22 d. Overall morbidity was 80%, mainly type II complication according to the Clavien-Dindo classification. Microscopically negative margins (R0) is obtained in all patients. Overall 5-year survival after first surgical procedure is 60%, with a median survival from the first surgery of 88 ± 56 mo. The most common site of re-recurrence was intrapelvic. CONCLUSION Sacral resection represents a feasible approach to posterior rectal cancer recurrence without evidence of distant spreading. An accurate staging is essential for planning the best therapy. PMID:28070232

  13. [Robotic total mesorectal excision for rectal cancer].

    PubMed

    Rossi, Gustavo; Alvarez, Fernando A; Mentz, Ricardo; Vaccaro, Carlos A; Im, Víctor; Quintana, Guillermo Ojea

    2013-06-01

    Laparoscopic total mesorectal excision (TME) has proven to be feasible and safe. However, it represents a major technical challenge, since it involves the dissection of the rectum in a confined space such as the bony pelvis using un-ergonomic surgical devices. This difficulty is accentuated in patients with distal tumors and high body mass index (BMI), in which the surgical margins and the hypogastric nerves may be affected. Therefore, robotic surgery aims to overcome these limitations that conspire against the mininvasive surgical approach of rectal cancer. We present an obese (BMI = 32 kg/m2) 82-year-old man with a history of smoking and prostate cancer that was recently diagnosed with a middle rectal adenocarcinoma at 9 cm from the anal verge. Rectal examination evidenced a mobile lesion. Computed tomography scan ruled out metastases and at the local staging by MRI, the tumor was considered as T3-N0 with free circumferential margins. Surgical treatment was decided and a hybrid technique was used combining an initial laparoscopic approach followed by the robotic TME. The patient had a full recovery and was discharged three days after surgery without complications. Pathological examination revealed a low-grade adenocarcinoma with mesorectal invasion, free circumferential and distal margins, and 24 negative lymph nodes (pT3-pN0-pM0/Stage II). Robotic TME was performed safely in an obese patient. It facilitated dissection maneuvers in a confined space with proper identification and preservation of the hypogastric nerves, allowing retrieving an intact mesorectum. Prospective randomized trials will define the role of this new technology.

  14. A new 'enterocompressor' to facilitate rectal anastomosis.

    PubMed

    Barraza, R P

    1990-02-01

    A newly devised enterocompressor facilitates low rectal anastomosis in children with Hirschsprung's disease. This simple surgical instrument, composed of two semicylindrical valves, a hinge, and a regulating screw, maintains intestinal anastomoses properly placed and produces spur crushing. In addition, it is inexpensive and reusable. The enterocompressor, used in 33 primary and 15 secondary Duhamel operations, and applied to normalize intestinal transit in 10 colectomies, provided adequate anastomosis and prevented leakage of intestinal contents. This enterocompressor can be used safely in children as young as six months of age.

  15. Combined modality therapy for rectal cancer.

    PubMed

    Minsky, Bruce D; Röedel, Claus; Valentini, Vincenzo

    2010-01-01

    The standard adjuvant treatment for cT3 and/or N+ rectal cancer is preoperative chemoradiation. However, there are many controversies regarding this approach. These include the role of short course radiation, whether postoperative adjuvant chemotherapy necessary for all patients and whether the type of surgery after chemoradiation should be based on the response rate. More accurate imaging techniques and/or molecular markers may help identify patients with positive pelvic nodes to reduce the chance of overtreatment with preoperative therapy. Will more effective systemic agents both improve the results of radiation as well as modify the need for pelvic radiation? These questions and others remain active areas of clinical investigation.

  16. Adjuvant therapy of resectable rectal cancer.

    PubMed

    Minsky, Bruce D

    2002-08-01

    The two conventional treatments for clinically resectable rectal cancer are surgery followed by postoperative combined modality therapy and preoperative combined modality therapy followed by surgery and postoperative chemotherapy. Preoperative therapy (most commonly combined modality therapy) has gained acceptance as a standard adjuvant therapy. The potential advantages of the preoperative approach include decreased tumor seeding, less acute toxicity, increased radiosensitivity due to more oxygenated cells, and enhanced sphincter preservation. There are a number of new chemotherapeutic agents that have been developed for the treatment of patients with colorectal cancer. Phase I/II trials examining the use of new chemotherapeutic agents in combination with pelvic radiation therapy are in progress.

  17. Rectal and appendiceal inflammatory myofibroblastic tumors.

    PubMed

    Khoddami, Maliheh; Sanae, Shahram; Nikkhoo, Bahram

    2006-07-01

    Inflammatory myofibroblastic tumors are neoplasms characterized by spindle cell proliferation and a fiboinflammatory vascular stroma. Herein, we presented the successful treatment of a rectal inflammatory myofibroblastic tumor in an 11-year-old boy who presented with diarrhea and abdominal pain of 1(1/2) months duration and an appendiceal inflammatory myofibroblastic tumor in a 29-year-old man presented with recurrent abdominal pain of two months duration with associated tenderness and rebound tenderness in the right lower abdomen. Histologically, our cases had inflammatory myofibroblastic tumors very similar to that of other sites; the spindle cells were positive for vimentin and muscle-specific actin.

  18. A tertiary care hospital's 10 years' experience with rectal ultrasound in early rectal cancer.

    PubMed

    Akhter, Ahmed; Walker, Andrew; Heise, Charles P; Kennedy, Gregory D; Benson, Mark E; Pfau, Patrick R; Johnson, Eric A; Frick, Terrence J; Gopal, Deepak V

    2017-08-24

    Rectal endoscopic ultrasound (RUS) has become an essential tool in the management of rectal adenocarcinoma because of the ability to accurately stage lesions. The aim of this study was to identify the staging agreement of early RUS-staged rectal adenocarcinoma with surgical resected pathology and ultimately determine how this impacts the management of early rectal cancer (T1-T2). Retrospective chart review was performed from November 2002 to November 2013 to identify procedure indication, RUS staging data, surgical management, and postoperative surgical pathology data. There were a total of 693 RUS examinations available for review and 282 of these were performed for a new diagnosis of rectal adenocarcinoma. There was staging agreement between RUS and surgical pathology in 19 out of 20 (95%) RUS-staged T1 cases. There was staging agreement between RUS and surgical pathology in 3 out of 9 (33%) RUS-staged T2 cases. There was significantly better staging agreement for RUS-staged T1 lesions compared to RUS staged T2 lesions (P = 0.002). Nearly 60% of T1N0 cancers were referred for transanal excisions (TAEs), and 78% of T2N0 cancers underwent low anterior resection. This study identified only a small number of T1-T2 adenocarcinomas. There was good staging agreement between RUS and surgical pathology among RUS-staged T1 lesions whereas poor staging agreement among RUS-staged T2 lesions. Although TAE is largely indicated by the staging of a T1 lesion, this approach may be less appropriate for T2 lesions due to high reported local recurrence.

  19. Locally advanced rectal cancer: Preliminary results of rectal preservation after neoadjuvant chemoradiotherapy.

    PubMed

    Vaccaro, Carlos Alberto; Yazyi, Federico Julio; Ojra Quintana, Guillermo; Santino, Juan Pablo; Sardi, Mabel Edith; Beder, Damián; Tognelli, Joaquin; Bonadeo, Fernando; Lastiri, José María; Rossi, Gustavo Leandro

    2016-05-01

    The standard treatment for locally advanced rectal cancer is total mesorectal excision. However, organ preservation has been proposed for tumors with good response to neoadjuvant treatment. The aim of this study was to evaluate the oncologic results of this strategy. This is a retrospective cohort study (2005-2014) including a consecutive series of patients with rectal adenocarcinoma with complete or almost complete clinical response after preoperative chemo-radiotherapy, that were treated according to a strategy of preservation of the rectum. A total of 204 patients with rectal cancer received neoadjuvant therapy. Thirty (14.7%) had a good response and were treated with rectal preservation (23 «Watch and Wait» and 7 local resections). Median follow-up was 46 months (interquartile range: 30-68). In the group of «Watch & Wait», 4 patients had local recurrence before 12 months (actuarial local recurrence rate=18.5%). All of them underwent salvage surgery (2 with radical surgery and 2 local resections) without any further recurrence. Disease-free survival actuarial rate at 3 years follow-up was 94.1% (95% CI 82.9-100). None of the 7 patients that were treated by local excision had local recurrence. The organ preservation rate for the whole group was 93%. The strategy of organ preservation in locally advanced rectal cancer is feasible in cases with good response to neoadjuvant therapy. When implemented in a highly selected group of patients this strategy is associated with satisfactory oncologic results. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Is rectal MRI beneficial for determining the location of rectal cancer with respect to the peritoneal reflection?

    PubMed

    Jung, Eun Joo; Ryu, Chun Geun; Kim, Gangmi; Kim, Su Ran; Nam, Sang Eun; Park, Hee Sun; Kim, Young Jun; Hwang, Dae-Yong

    2012-12-01

    An objective method for determining the location of the cancer with respect to peritoneal reflection would be helpful to decide the treatment modality for rectal cancer. This study was designed to evaluate the accuracy and usefulness of rectal MRI to determine spatial relations between the peritoneal reflection and rectal cancer and to compare these with operative findings. Patients that underwent a rectal cancer operation after a rectal MRI check between November 2008 and June 2010 were considered for the study. The patients that received preoperative concurrent chemoradiation or trans-anal local excision were excluded. Fifty-four patients constituted the study cohort. By comparing surgical and radiologic findings, the accuracy for predicting tumour location in relation to the peritoneal reflection by rectal MRI in all patients was 90.7%. In terms of tumour location in relation to peritoneal reflection, the accuracy of rectal MRI was 93.5% in patients with a tumour located above the peritoneal reflection, 90.0% in patients with a tumour located on the peritoneal reflection, and 84.6% in patients with a tumour located below the peritoneal reflection (p=0.061). When the cohort was subdivided by gender, body mass index (BMI), operative findings, or tumour size, no significant difference was observed among subgroups. Rectal MRI could be a useful tool for evaluating the relation between rectal cancer and peritoneal reflection especially when tumour size is less than 8cm. Rectal MRI can provide information regarding the location of rectal cancer in relation to the peritoneal reflection for treatment planning purposes.

  1. Rectal gonorrhoea in male homosexuals. Presentation and therapy.

    PubMed

    Fluker, J L; Deherogoda, P; Platt, D J; Gerken, A

    1980-12-01

    In a review of rectal gonorrhoea 73 episodes were studied in 65 homosexual men. The presenting signs and symptoms were carefully noted. Treatment with a single injection of spectinomycin hydrochloride 2 g resulted in a cure rate of 94.5%. The relatively high treatment failure rate associated with rectal gonorrhoea may possibly be due to microbial mechanisms.

  2. Rectal chlamydia - should screening be recommended in women?

    PubMed

    Andersson, Nirina; Boman, Jens; Nylander, Elisabet

    2017-04-01

    Chlamydia trachomatis is the most common bacterial sexually transmitted infection in Europe and has large impacts on patients' physical and emotional health. Unidentified asymptomatic rectal Chlamydia trachomatis could be a partial explanation for the high Chlamydia trachomatis prevalence. In this study, we evaluated rectal Chlamydia trachomatis testing in relation to symptoms and sexual habits in women and men who have sex with men. Rectal Chlamydia trachomatis prevalence was 9.1% in women and 0.9% in men who have sex with men. None of the patients reported any rectal symptoms; 59.0% of the women with a rectal Chlamydia trachomatis infection denied anal intercourse and 18.8% did not have a urogenital infection; 9.4% did neither have a urogenital infection nor reported anal sex. We suggest that rectal sampling should be considered in women visiting sexually transmitted infection clinics regardless of rectal symptoms and irrespective of anal intercourse, since our data suggest that several cases of rectal Chlamydia trachomatis otherwise would be missed, thus enabling further disease transmission.

  3. Predictors for Rectal and Intestinal Acute Toxicities During Prostate Cancer High-Dose 3D-CRT: Results of a Prospective Multicenter Study

    SciTech Connect

    Vavassori, Vittorio; Fiorino, Claudio . E-mail: fiorino.claudio@hsr.it; Rancati, Tiziana; Magli, Alessandro; Fellin, Gianni; Baccolini, Michela; Bianchi, Carla; Cagna, Emanuela; Mauro, Flora A.; Monti, Angelo F.; Munoz, Fernando; Stasi, Michele; Franzone, Paola; Valdagni, Riccardo

    2007-04-01

    Purpose: To find predictors for rectal and intestinal acute toxicity in patients with prostate cancer treated with {>=}70 Gy conformal radiotherapy. Methods and Materials: Between July 2002 and March 2004, 1,132 patients were entered into a cooperative study (AIROPROS01-02). Toxicity was scored using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer scale and by considering the changes (before and after treatment) of the scores of a self-administered questionnaire on rectal/intestinal toxicity. The correlation with a number of parameters was assessed by univariate and multivariate analyses. Concerning the questionnaire, only moderate/severe complications were considered. Results: Of 1,132 patients, 1,123 were evaluable. Of these patients, 375, 265, and 28 had Grade 1, 2, and 3 Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer toxicity, respectively. The mean rectal dose was the most predictive parameter (p = 0.0004; odds ratio, 1.035) for Grade 2 or worse toxicity, and the use of anticoagulants/antiaggregants (p 0.02; odds ratio, 0.63) and hormonal therapy (p = 0.04, odds ratio, 0.65) were protective. The questionnaire-based scoring revealed that a greater mean rectal dose was associated with a greater risk of bleeding; larger irradiated volumes were associated with frequency, tenesmus, incontinence, and bleeding; hormonal therapy was protective against frequency and tenesmus; hemorrhoids were associated with a greater risk of tenesmus and bleeding; and diabetes associated highly with diarrhea. Conclusion: The mean rectal dose correlated with acute rectal/intestinal toxicity in three-dimensional conformal radiotherapy for prostate cancer, and hormonal therapy and the use of anticoagulants/antiaggregants were protective. According to the moderate/severe injury scores on the self-assessed questionnaire, several clinical and dose-volume parameters were independently predictive for

  4. Predictive Biomarkers to Chemoradiation in Locally Advanced Rectal Cancer

    PubMed Central

    Conde-Muíño, Raquel; Cuadros, Marta; Zambudio, Natalia; Segura-Jiménez, Inmaculada; Cano, Carlos; Palma, Pablo

    2015-01-01

    There has been a high local recurrence rate in rectal cancer. Besides improvements in surgical techniques, both neoadjuvant short-course radiotherapy and long-course chemoradiation improve oncological results. Approximately 40–60% of rectal cancer patients treated with neoadjuvant chemoradiation achieve some degree of pathologic response. However, there is no effective method of predicting which patients will respond to neoadjuvant treatment. Recent studies have evaluated the potential of genetic biomarkers to predict outcome in locally advanced rectal adenocarcinoma treated with neoadjuvant chemoradiation. The articles produced by the PubMed search were reviewed for those specifically addressing a genetic profile's ability to predict response to neoadjuvant treatment in rectal cancer. Although tissue gene microarray profiling has led to promising data in cancer, to date, none of the identified signatures or molecular markers in locally advanced rectal cancer has been successfully validated as a diagnostic or prognostic tool applicable to routine clinical practice. PMID:26504848

  5. Predictive Biomarkers to Chemoradiation in Locally Advanced Rectal Cancer.

    PubMed

    Conde-Muíño, Raquel; Cuadros, Marta; Zambudio, Natalia; Segura-Jiménez, Inmaculada; Cano, Carlos; Palma, Pablo

    2015-01-01

    There has been a high local recurrence rate in rectal cancer. Besides improvements in surgical techniques, both neoadjuvant short-course radiotherapy and long-course chemoradiation improve oncological results. Approximately 40-60% of rectal cancer patients treated with neoadjuvant chemoradiation achieve some degree of pathologic response. However, there is no effective method of predicting which patients will respond to neoadjuvant treatment. Recent studies have evaluated the potential of genetic biomarkers to predict outcome in locally advanced rectal adenocarcinoma treated with neoadjuvant chemoradiation. The articles produced by the PubMed search were reviewed for those specifically addressing a genetic profile's ability to predict response to neoadjuvant treatment in rectal cancer. Although tissue gene microarray profiling has led to promising data in cancer, to date, none of the identified signatures or molecular markers in locally advanced rectal cancer has been successfully validated as a diagnostic or prognostic tool applicable to routine clinical practice.

  6. Immunological Landscape and Clinical Management of Rectal Cancer

    PubMed Central

    Pérez-Ruiz, Elísabeth; Berraondo, Pedro

    2016-01-01

    The clinical management of rectal cancer and colon cancer differs due to increased local relapses in rectal cancer. However, the current molecular classification does not differentiate rectal cancer and colon cancer as two different entities. In recent years, the impact of the specific immune microenvironment in cancer has attracted renewed interest and is currently recognized as one of the major determinants of clinical progression in a wide range of tumors. In colorectal cancer, the density of lymphocytic infiltration is associated with better overall survival. Due to the need for biomarkers of response to conventional treatment with chemoradiotherapy in rectal tumors, the immune status of rectal cancer emerges as a useful tool to improve the management of patients. PMID:26941741

  7. MRI in local staging of rectal cancer: an update

    PubMed Central

    Tapan, Ümit; Özbayrak, Mustafa; Tatlı, Servet

    2014-01-01

    Preoperative imaging for staging of rectal cancer has become an important aspect of current approach to rectal cancer management, because it helps to select suitable patients for neoadjuvant chemoradiotherapy and determine the appropriate surgical technique. Imaging modalities such as endoscopic ultrasonography, computed tomography, and magnetic resonance imaging (MRI) play an important role in assessing the depth of tumor penetration, lymph node involvement, mesorectal fascia and anal sphincter invasion, and presence of distant metastatic diseases. Currently, there is no consensus on a preferred imaging technique for preoperative staging of rectal cancer. However, high-resolution phased-array MRI is recommended as a standard imaging modality for preoperative local staging of rectal cancer, with excellent soft tissue contrast, multiplanar capability, and absence of ionizing radiation. This review will mainly focus on the role of MRI in preoperative local staging of rectal cancer and discuss recent advancements in MRI technique such as diffusion-weighted imaging and dynamic contrast-enhanced MRI. PMID:25010367

  8. Rectal prolapse as initial clinical manifestation of colon cancer.

    PubMed

    Chen, C-W; Hsiao, C-W; Wu, C-C; Jao, S-W

    2008-04-01

    Rectal prolapse as the initial clinical manifestation of colorectal cancer is uncommon. We describe the case of a 75-year-old woman who was diagnosed as having adenocarcinoma of the sigmoid colon after presenting with complete rectal prolapse. The tumor caused rectosigmoid intussusception and then it prolapsed out through the anus. She underwent rectosigmoidectomy and rectopexy. The postoperative course was uneventful. The relationship between colorectal cancer and rectal prolapse has not been clearly established. This case report describes an unusual presentation of colorectal cancer. It suggests that rectal prolapse can present as the initial symptom of colorectal cancer and may also be a presenting feature of the occult intra-abdominal pathology. The importance of adequate investigation such as colonoscopy should be emphasized in patients who develop a new onset of rectal prolapse.

  9. [Local diagnostics for rectal cancer. What is realistic?].

    PubMed

    Ptok, H; Gastinger, I; Lippert, H

    2012-05-01

    Accurate pretherapeutic staging of rectal cancer is crucial for further therapeutic management and important for prognosis. The most accurate diagnostic tools in the assessment of T and N categories of rectal cancer are endorectal ultrasound (EUS) and magnetic resonance imaging (MRI). Furthermore, MRI can accurately predict the distance of the tumor to the colorectal membrane (CRM) and computed tomography (CT) is more suitable for detecting distant metastases. In the routine care of rectal cancer EUS is the most frequently used diagnostic tool for local staging. The achieved accuracy for determining T category by EUS in routine clinical staging is lower than results reported in the literature. Furthermore, the accuracy of EUS depends on the experience of the examiner. Currently the frequency of using MRI for routine clinical staging of rectal cancer is low and in one out of five cases the local staging of rectal cancer is exclusively carried out by CT.

  10. Comparison of rectal and axillary temperatures in dogs and cats.

    PubMed

    Goic, Joana B; Reineke, Erica L; Drobatz, Kenneth J

    2014-05-15

    To compare rectal versus axillary temperatures in dogs and cats. Prospective observational study. 94 dogs and 31 cats. Paired axillary and rectal temperatures were measured in random order with a standardized method. Animal signalment, initial complaint, blood pressure, blood lactate concentration, and variables associated with vascular perfusion and coat were evaluated for associations with axillary and rectal temperatures. Axillary temperature was positively correlated with rectal temperature (ρ = 0.75 in both species). Median axillary temperature (38.4°C [101.1°F] in dogs, and 38.4°C [101.2°F] in cats) was significantly different from median rectal temperature in dogs (38.9°C [102.0°F]) but not in cats (38.6°C [101.5°F]). Median rectal-axillary gradient (difference) was 0.4°C (0.7°F; range, -1.3° to 2.3°C [-2.4° to 4.1°F]) in dogs and 0.17°C (0.3°F; range -1.1° to 1.6°C [-1.9° to 3°F]) in cats. Sensitivity and specificity for detection of hyperthermia with axillary temperature were 57% and 100%, respectively, in dogs and 33% and 100%, respectively, in cats; sensitivity and specificity for detection of hypothermia were 86% and 87%, respectively, in dogs and 80% and 96%, respectively, in cats. Body weight (ρ = 0.514) and body condition score (ρ = 0.431) were correlated with rectal-axillary gradient in cats. Although axillary and rectal temperatures were correlated in dogs and cats, a large gradient was present between rectal temperature and axillary temperature, suggesting that axillary temperature should not be used as a substitute for rectal temperature.

  11. Transanal total mesorectal excision (TaTME) for rectal cancer: effects on patient-reported quality of life and functional outcome.

    PubMed

    Koedam, T W A; van Ramshorst, G H; Deijen, C L; Elfrink, A K E; Meijerink, W J H J; Bonjer, H J; Sietses, C; Tuynman, J B

    2017-01-01

    Transanal total mesorectal excision (TaTME) has rapidly become an important component of the treatment of rectal cancer surgery. Cohort studies have shown feasibility concerning procedure, specimen quality and morbidity. However, concerns exist about quality of life and ano(neo)rectal function. The aim of this study was to prospectively evaluate quality of life in patients following TaTME for rectal cancer with anastomosis. Consecutive patients who underwent restorative TaTME surgery for rectal adenocarcinoma in an academic teaching center with tertiary referral function were evaluated. Validated questionnaires were prospectively collected. Quality of life was assessed by the EuroQol 5D (EQ-5D), European Organization for Research and Treatment of Cancer's QLQ-C30 and QLQ-CR29 and low anterior resection syndrome (LARS) scale. Outcomes of the questionnaires at 1 and 6 months were compared with preoperative (baseline) values. Thirty patients after restorative TaTME for rectal cancer were included. Deterioration for all domains was mainly observed at 1 month after surgery compared to baseline, but most outcomes had returned to baseline at 6 months. Social function and anal pain remained significantly worse at 6 months. Major LARS (score >30) was 33% at 6 months after ileostomy closure. No end colostomies were required. TaTME is associated with acceptable quality of life and functional outcome at 6 months after surgery comparable to published results after conventional laparoscopic low anterior resection.

  12. An isolated vaginal metastasis from rectal cancer.

    PubMed

    Sadatomo, Ai; Koinuma, Koji; Horie, Hisanaga; Lefor, Alan K; Sata, Naohiro

    2016-02-01

    Isolated vaginal metastases from colorectal cancer are extremely rare. There are only a few reported cases in the English literature, and the characteristics of such cases of metastasis remain relatively unknown. We present a case of isolated vaginal metastasis from rectal cancer in a 78-year-old female patient. The patient had no symptoms related to vaginal tumor. Magnetic resonance imaging (MRI) showed thickening of the middle rectum and a vaginal tumor. Biopsy from the vaginal tumor showed adenocarcinoma, similar to the rectal lesion. Low anterior resection with ileostomy, hystero-oophorectomy, and transvaginal tumor resection was performed. After nineteen months, computed tomography scan revealed multiple lung metastases and recurrent tumor in the pelvis. The patient refused chemotherapy and is alive three months after developing recurrent disease. Most cases of primary vaginal carcinoma are squamous cell carcinoma. Other histologic types such as adenocarcinoma are usually metastatic lesions. Primary lesions associated with metastatic vaginal adenocarcinoma are most often the uterus, and are very rarely from the colon or rectum. We review previous case reports of isolated vaginal metastases from colorectal cancer and discuss their symptoms, treatments, and outcomes. We should keep the vagina within the field of view of pelvic MRI, which is one of the preoperative diagnostic tools for colorectal cancer. If female patients show gynecological symptoms, gynecological examination should be recommended. Isolated vaginal metastases are an indication for surgical resection, and adjuvant chemotherapy is also recommended.

  13. [Radiotherapy in pelvic recurrences of rectal cancer].

    PubMed

    Morganti, A G; Santoni, R; Osti, M F

    2001-01-01

    Patients with locally recurrent rectal carcinoma have an unfavourable prognosis for the high incidence of distant metastases, the infrequent feasibility of radical surgical resection, and, in these last cases, the high incidence of re-recurrences. Based on the low resectability rate of pelvic recurrences, the clear impact of tumor diameter on resectability and outcome, and the documented possibility to achieve a significant tumor downstaging and downsizing with the use of concurrent chemoradiation, it is evident that the most promising treatment several authors have considered concurrent chemoradiation followed, if feasible, by radical resection. Furthermore, based on the high local and distant failure rate after surgery, the utilization of intraoperative radiation therapy (IORT) and adjuvant chemotherapy seems justified. Some published comparisons between patients treated with and without IORT seems to suggest the possible improvement in both local control and survival in these patients. Particularly interesting issues in this field are: 1) the definition of the most effective treatment modality (both in terms of radiation dose, fractionation and techniques, and drugs to be used concurrently to radiotherapy); 2) the analysis of the prognostic impact of several factors, with the aim of designing and validating staging systems of local rectal recurrences; 3) the possibility to treat with relatively high doses also patients previously irradiated on the pelvis.

  14. Focusing the management of rectal cancer

    PubMed Central

    Dbeis, Rachel; Smart, Neil J.

    2016-01-01

    Rectal cancer treatment has undergone major changes over the last 15 years with a focus on individualized care based around MRI assessment of the relationship of the tumour to the mesorectal fascia, improved surgical techniques and targeted use of pre-operative oncological therapies in patients with locally advanced disease. The recognition that some tumours responded completely to pre-operative chemoradiotherapy, and the selective use of a non-operative policy has led to a quest to further identify those patients and their tumour in whom this approach could be used, irrespective of MRI stage. With no clear patient factors identified, the tumour and its gene expression has become a target for research to identify individual single-nucleotide polymorphisms, which may indicate a response to specific treatment, or not. To date some agents have been identified and trialed, such as cetuximab, with individual tumours being assessed for response allowing directed treatment. The reviewed paper by Sebio and colleagues report a study that links polymorphisms in the DNA repair gene XRCC1 with response to neoadjuvant 5-Fluorouracil treatment in rectal cancer patients. However, genetic heterogeneity alone may not explain the variations of drug response and environmental factors may lead to epigenetic effects and therefore alter responses. Therefore whilst this study demonstrates the impact of different single nucleotide polymorphisms (SNPs), it is only one step forward, but perhaps a step in the right direction. PMID:28149883

  15. Laparoscopic rectopexy for solitary rectal ulcer syndrome without overt rectal prolapse: a case report and review of the literature.

    PubMed

    Menekse, Ebru; Ozdogan, Mehmet; Karateke, Faruk; Ozyazici, Sefa; Demirturk, Pelin; Kuvvetli, Adnan

    2014-02-20

    Solitary rectal ulcer syndrome is a rare clinical entity. Several treatment options has been described. However, there is no consensus yet on treatment algorithm and standard surgical procedure. Rectopexy is one of the surgical options and it is generally performed in patients with solitary rectal ulcer accompanied with overt prolapse. Various outcomes have been reported for rectopexy in the patients with occult prolapse or rectal intussusception. In the literature; outcomes of laparoscopic non-resection rectopexy procedure have been reported in the limited number of case or case series. No study has emphasized the outcomes of laparoscopic non-resection rectopexy procedure in the patients with solitary rectal ulcer without overt prolapse. In this report we aimed to present clinical outcomes of laparoscopic non-resection posterior suture rectopexy procedure in a 21-year-old female patient with solitary rectal ulcer without overt prolapse.

  16. Laparoscopic rectopexy for solitary rectal ulcer syndrome without overt rectal prolapse. A case report and review of the literature.

    PubMed

    Menekse, Ebru; Ozdogan, Mehmet; Karateke, Faruk; Ozyazici, Sefa; Demirturk, Pelin; Kuvvetli, Adnan

    2014-01-01

    Solitary rectal ulcer syndrome is a rare clinical entity. Several treatment options has been described. However, there is no consensus yet on treatment algorithm and standard surgical procedure. Rectopexy is one of the surgical options and it is generally performed in patients with solitary rectal ulcer accompanied with overt prolapse. Various outcomes have been reported for rectopexy in the patients with occult prolapse or rectal intussusception. In the literature; outcomes of laparoscopic non-resection rectopexy procedure have been reported in the limited number of case or case series. No study has emphasized the outcomes of laparoscopic non-resection rectopexy procedure in the patients with solitary rectal ulcer without overt prolapse. In this report we aimed to present clinical outcomes of laparoscopic non-resection posterior suture rectopexy procedure in a 21-year-old female patient with solitary rectal ulcer without overt prolapse.

  17. 2010 SSO John Wayne clinical research lecture: rectal cancer outcome improvements in Europe: population-based outcome registrations will conquer the world.

    PubMed

    van Gijn, W; van de Velde, C J H

    2011-03-01

    During the past two decades, rectal cancer treatment has improved considerably in Europe. Clinical trials played a crucial role in improving surgical techniques, (neo)adjuvant treatment schedules, imaging, and pathology. However, there is still a wide variation in outcome after rectal cancer. In most western health care systems, efforts are made to reduce hospital variation by focusing on selective referral and encouraging patients to seek care in high-volume hospitals. On the other hand, the expertise for diagnosis and treatment of common types of cancer should be preferably widespread and easily accessible for all patients. As an alternative to volume-based referral, hospitals and surgeons can improve their results by learning from their own outcome statistics and those from colleagues treating a similar patient group. Several European surgical (colo)rectal audits have led to improvements with a greater impact than any of the adjuvant therapies currently under study. However, differences remain between European countries, which cannot be easily explained. To generate the best care for colorectal cancer in the whole of Europe and to meet political and public demands for transparency, the European CanCer Organisation (ECCO) initiated an international, multidisciplinary, outcome-based quality improvement program: European Registration of Cancer Care (EURECCA). The goal is to create a multidisciplinary European registration structure for patient, tumor, and treatment characteristics linked to outcome registration. Clinical trials will always play a major role in improving rectal cancer treatment. To further improve outcomes and diminish variation, EURECCA will establish the basis for a strong, multidisciplinary, international audit structure that can be used as a template for similar projects worldwide.

  18. Rectal HSV-2 Infection May Increase Rectal SIV Acquisition Even in the Context of SIVΔnef Vaccination.

    PubMed

    Guerra-Pérez, Natalia; Aravantinou, Meropi; Veglia, Filippo; Goode, Diana; Truong, Rosaline; Derby, Nina; Blanchard, James; Grasperge, Brooke; Gettie, Agegnehu; Robbiani, Melissa; Martinelli, Elena

    2016-01-01

    Prevalent HSV-2 infection increases the risk of HIV acquisition both in men and women even in asymptomatic subjects. Understanding the impact of HSV-2 on the mucosal microenvironment may help to identify determinants of susceptibility to HIV. Vaginal HSV-2 infection increases the frequency of cells highly susceptible to HIV in the vaginal tissue of women and macaques and this correlates with increased susceptibility to vaginal SHIV infection in macaques. However, the effect of rectal HSV-2 infection on HIV acquisition remains understudied. We developed a model of rectal HSV-2 infection in macaques in combination with rectal SIVmac239Δnef (SIVΔnef) vaccination and our results suggest that rectal HSV-2 infection may increase the susceptibility of macaques to rectal SIVmac239 wild-type (wt) infection even in SIVΔnef-infected animals. Rectal SIVΔnef infection/vaccination protected 7 out of 7 SIVΔnef-infected macaques from SIVmac239wt rectal infection (vs 12 out of 16 SIVΔnef-negative macaques), while 1 out of 3 animals co-infected with SIVΔnef and HSV-2 acquired SIVmac239wt infection. HSV-2/SIVmac239wt co-infected animals had increased concentrations of inflammatory factors in their plasma and rectal fluids and a tendency toward higher acute SIVmac239wt plasma viral load. However, they had higher blood CD4 counts and reduced depletion of CCR5+ CD4+ T cells compared to SIVmac239wt-only infected animals. Thus, rectal HSV-2 infection generates a pro-inflammatory environment that may increase susceptibility to rectal SIV infection and may impact immunological and virological parameters during acute SIV infection. Studies with larger number of animals are needed to confirm these findings.

  19. Characterization of the 1st and 2nd EF-hands of NADPH oxidase 5 by fluorescence, isothermal titration calorimetry, and circular dichroism

    PubMed Central

    2012-01-01

    Background Superoxide generated by non-phagocytic NADPH oxidases (NOXs) is of growing importance for physiology and pathobiology. The calcium binding domain (CaBD) of NOX5 contains four EF-hands, each binding one calcium ion. To better understand the metal binding properties of the 1st and 2nd EF-hands, we characterized the N-terminal half of CaBD (NCaBD) and its calcium-binding knockout mutants. Results The isothermal titration calorimetry measurement for NCaBD reveals that the calcium binding of two EF-hands are loosely associated with each other and can be treated as independent binding events. However, the Ca2+ binding studies on NCaBD(E31Q) and NCaBD(E63Q) showed their binding constants to be 6.5 × 105 and 5.0 × 102 M-1 with ΔHs of -14 and -4 kJ/mol, respectively, suggesting that intrinsic calcium binding for the 1st non-canonical EF-hand is largely enhanced by the binding of Ca2+ to the 2nd canonical EF-hand. The fluorescence quenching and CD spectra support a conformational change upon Ca2+ binding, which changes Trp residues toward a more non-polar and exposed environment and also increases its α-helix secondary structure content. All measurements exclude Mg2+-binding in NCaBD. Conclusions We demonstrated that the 1st non-canonical EF-hand of NOX5 has very weak Ca2+ binding affinity compared with the 2nd canonical EF-hand. Both EF-hands interact with each other in a cooperative manner to enhance their Ca2+ binding affinity. Our characterization reveals that the two EF-hands in the N-terminal NOX5 are Ca2+ specific. Graphical abstract PMID:22490336

  20. Intraoperative changes in blood pressure, heart rate, plasma vasopressin, and urinary noradrenalin during elective ovariohysterectomy in dogs: repeatability at removal of the 1st and 2nd ovary.

    PubMed

    Höglund, Odd V; Hagman, Ragnvi; Olsson, Kerstin; Olsson, Ulf; Lagerstedt, Anne-Sofie

    2014-10-01

    To investigate the physiologic reactions after removal of 1st ovary and whether this is repeated during removal of the 2nd ovary in elective ovariohysterectomy. Prospective study. Dogs (n = 10). Dogs were premedicated with acepromazine, carprofen, and methadone and anesthetized with propofol and isoflurane. Blood pressure, heart rate, and end-tidal isoflurane concentration were measured every minute. The effects of various events during surgery on physiologic variables were analyzed using mixed linear models. Blood and urine samples were collected before anesthesia, before incision, before and after removal of ovaries with a 15 minute pause between ovary removal, and after abdominal closure. Plasma vasopressin and urinary noradrenalin and creatinine concentrations were analyzed. The magnitude of blood pressure increase at removal of the 1st ovary was greater than for the 2nd ovary because of an elevation in baseline. Similarly, the heart rate increased at the removal of the 1st ovary but not at removal of the 2nd ovary. Plasma vasopressin concentration increased at removal of both ovaries. Urinary noradrenalin/creatinine ratio increased at anesthesia, removal of both ovaries, and was elevated at closure of the abdomen. End-tidal isoflurane concentration did not change. Blood pressure and vasopressin concentrations changed in parallel using z-scores for comparison. Peak values for blood pressure, heart rate, plasma vasopressin concentration, and urinary noradrenalin/creatinine ratio did not differ between removals of the ovaries. Relative changes differed between repeated noxious stimuli, which should be considered in evaluation of methods at ovary removal. © Copyright 2014 by The American College of Veterinary Surgeons.

  1. System-based factors influencing intraoperative decision-making in rectal cancer by surgeons: an international assessment.

    PubMed

    Augestad, K M; Lindsetmo, R-O; Stulberg, J J; Reynolds, H; Champagne, B; Senagore, A J; Delaney, C P

    2012-10-01

    Sound surgical judgement is the goal of training and experience; however, system-based factors may also colour selection of options by a surgeon. We analysed potential organizational characteristics that might influence rectal cancer decision-making by an experienced surgeon. One hundred and seventy-three international centres treating rectal cancer were invited to participate in a survey assessment of key treatment options for patients undergoing curative rectal-cancer surgery. The key organizational characteristics were analysed using multivariate methods for association with intra-operative surgical decision-making. The response rate was 71% (123 centres). Sphincter-saving surgery was more likely to be performed at university hospitals (OR=3.63, P=0.01) and by high-caseload surgeons (OR=2.77 P=0.05). A diverting stoma was performed more frequently in departments with clinical audits (OR=3.06, P=0.02), and a diverting stoma with coloanal anastomosis was more likely in European centres (OR=4.14, P=0.004). One-stage surgery was less likely where there was assessment by a multidisciplinary team (OR=0.24, P=0.02). Multivariate analysis showed that university hospital, clinical audit, European centre, multidisciplinary team and high caseload significantly impacted on surgical decision-making. Treatment variance of rectal cancer surgeons appears to be significantly influenced by organizational characteristics and complex team-based decision-making. System-based factors may need to be considered as a source of outcome variation that may impact on quality metrics. © 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.

  2. The current status of research into Attention Deficit Hyperactivity Disorder: Proceedings of the 2nd International Congress on ADHD: From Childhood to Adult Disease.

    PubMed

    Thome, Johannes; Reddy, Duvvoor Prathap

    2009-12-01

    Despite being a devastating psychiatric condition with high prevalence, ADHD has traditionally been widely under-researched, specifically in adult patients. Therefore, the recent surge in scientific projects focusing on ADHD is impressive. By reviewing selected research findings presented at the 2nd International Congress on ADHD, this paper gives an overview about current state-of-the art research in such different areas as diagnosis, classification, epidemiology, differential diagnosis and comorbidity, neurobiology (including molecular genetics, proteomics, neuroimaging and electrophysiology), environmental factors, modelling of ADHD, treatment (pharmacological and non-pharmacological), as well as forensic and social aspects.

  3. Second-order adjoint sensitivity analysis methodology (2nd-ASAM) for computing exactly and efficiently first- and second-order sensitivities in large-scale linear systems: I. Computational methodology

    NASA Astrophysics Data System (ADS)

    Cacuci, Dan G.

    2015-03-01

    This work presents the second-order forward and adjoint sensitivity analysis methodologies (2nd-FSAM and 2nd-ASAM) for computing exactly and efficiently the second-order functional derivatives of physical (engineering, biological, etc.) system responses (i.e., "system performance parameters") to the system's model parameters. The definition of "system parameters" used in this work includes all computational input data, correlations, initial and/or boundary conditions, etc. For a physical system comprising Nα parameters and Nr responses, we note that the 2nd-FSAM requires a total of (Nα2/2 + 3Nα / 2) large-scale computations for obtaining all of the first- and second-order sensitivities, for all Nr system responses. On the other hand, for one functional-type system response, the 2nd-ASAM requires one large-scale computation using the first-level adjoint sensitivity system for obtaining all of the first-order sensitivities, followed by at most Nα large-scale computations using the second-level adjoint sensitivity systems for obtaining exactly all of the second-order sensitivities. Therefore, the 2nd-FSAM should be used when Nr ≫Nα, while the 2nd-ASAM should be used when Nα ≫Nr. The original 2nd-ASAM presented in this work should enable the hitherto very difficult, if not intractable, exact computation of all of the second-order response sensitivities (i.e., functional Gateaux-derivatives) for large-systems involving many parameters, as usually encountered in practice. Very importantly, the implementation of the 2nd-ASAM requires very little additional effort beyond the construction of the adjoint sensitivity system needed for computing the first-order sensitivities.

  4. Rectal and colon cancer: Not just a different anatomic site.

    PubMed

    Tamas, K; Walenkamp, A M E; de Vries, E G E; van Vugt, M A T M; Beets-Tan, R G; van Etten, B; de Groot, D J A; Hospers, G A P

    2015-09-01

    Due to differences in anatomy, primary rectal and colon cancer require different staging procedures, different neo-adjuvant treatment and different surgical approaches. For example, neoadjuvant radiotherapy or chemoradiotherapy is administered solely for rectal cancer. Neoadjuvant therapy and total mesorectal excision for rectal cancer might be responsible in part for the differing effect of adjuvant systemic treatment on overall survival, which is more evident in colon cancer than in rectal cancer. Apart from anatomic divergences, rectal and colon cancer also differ in their embryological origin and metastatic patterns. Moreover, they harbor a different composition of drug targets, such as v-raf murine sarcoma viral oncogene homolog B (BRAF), which is preferentially mutated in proximal colon cancers, and the epidermal growth factor receptor (EGFR), which is prevalently amplified or overexpressed in distal colorectal cancers. Despite their differences in metastatic pattern, composition of drug targets and earlier local treatment, metastatic rectal and colon cancer are, however, commonly regarded as one entity and are treated alike. In this review, we focused on rectal cancer and its biological and clinical differences and similarities relative to colon cancer. These aspects are crucial because they influence the current staging and treatment of these cancers, and might influence the design of future trials with targeted drugs.

  5. Microscopy detection of rectal gonorrhoea in asymptomatic men.

    PubMed

    Forni, J; Miles, K; Hamill, M

    2009-11-01

    This audit aimed to determine the usefulness of microscopy to detect presumptive rectal gonorrhoea (GC) infection in asymptomatic men. We retrospectively audited more than 400 male patients attending a London genitourinary medicine clinic from January 2005 to March 2007 who tested rectal culture positive for Neisseria gonorrhoeae and compared this with the microscopy detection rate. In total, 123/423 (29%) of culture positive samples were microscopy positive. Of those that tested microscopy negative (300/423), 64 (21%) were symptomatic and 236 (79%) asymptomatic. In addition, a time and motion study examined 81 rectal slides over a two-week period to identify microscopy reading time required to make a presumptive diagnosis of GC. Three slides were positive, resulting in six hours and 45 minutes to detect one positive sample. Given the low sensitivity for rectal microscopy coupled with the length of time required to obtain a presumptive positive rectal GC result, we believe rectal microscopy is no longer a cost-effective tool screening for asymptomatic men, and this report supports the BASHH guideline that it is not recommended in the management of asymptomatic rectal infection.

  6. Postembryonic development of rectal pads in bees (Hymenoptera, Apidae).

    PubMed

    Santos, Carolina Gonçalves; Neves, Clóvis Andrade; Zanuncio, José Cola; Serrão, José Eduardo

    2009-10-01

    The morphology and development of the digestive tract of insects has been extensively studied, but little attention has been given to the development of the rectal pads. These organs are responsible for absorption of water and salts. In insects where they occur, there are usually six ovoid rectal pads located in the medial-anterior portion of the rectum. The rectal pad has three types of cells: principal, basal, and junctional. The arrangement of these three cell types delimits an intrapapillary lumen. The aim of the current study is to describe the development of the rectal pads during postembryonic development of Melipona quadrifasciata anthidioides and Melipona scutellaris. Specimens were analyzed at the following developmental stages: white-, pink-, brown-, and black-eyed pupae, and adult workers. The development of the rectal pad begins as a thickening of the epithelium in white-eyed pupae at 54 hr. At this stage, there is neither a basal cell layer nor intrapapillary lumen. The basal layers begin to form in the pink-eyed pupa and are completely formed at the end of the development of the brown-eyed pupa. In the brown-eyed pupal stage, the intrapapillary lumen is formed and the junctional cells are positioned and completely differentiated. Necrotic and apoptotic cell death were detected along with cell proliferation in the whole rectum during pupal development, suggesting that the development of the rectal pads involves cell proliferation, death, and differentiation. The rectal pads originate only from the ectoderm.

  7. Transcutaneous Electrical Nerve Stimulation Increases Rectal Activity in Children.

    PubMed

    Moeller Joensson, Iben; Hagstroem, Soren; Siggaard, Charlotte; Bower, Wendy; Djurhuus, Jens Christian; Krogh, Klaus

    2015-07-01

    Neurostimulation is increasingly used in treating bladder and bowel dysfunction, but its effect on rectal motility is obscure. The aim of the study was to evaluate the acute effect of transcutaneous electrical nerve stimulation (TENS) on rectal motility in children with overactive bladder (OAB). In this double-blind placebo-controlled study in 20 children with OAB (mean age 8.6 ± 1.8 years; 7 girls), 48-hour urodynamic monitoring including rectal manometry was performed. After 24-hours of baseline investigation without stimulation the children were randomised to either active TENS (n = 10) or placebo (n = 10). Surface electrodes were placed over the sacral bone. The exterior of active and placebo stimulators was identical. Starting in the morning, the children received either continuous TENS stimulation or placebo until bedtime. Rectal contractions were defined as pressure runs exceeding 5 cm H2O and lasting ≥3 minutes. At baseline there was no significant difference in proportion of time with rectal contractions in the 2 groups (TENS group median 31% [range 12%-66%] vs placebo group median 31% [range 10%-66%]; P = 0.75); however, on the day of stimulation there was more time with rectal contractions in the group receiving TENS (median 51% [range 25%-78%]) compared with placebo (median 32% [range 4%-68%]; P = 0.02). Also, there was an increase in time with rectal contractions in the TENS group (P = 0.007) but not in the placebo group (P = 0.39). The night after the TENS was disabled, rectal activity in both groups returned to baseline level. TENS acutely increases time with rectal contractions in children undergoing urodynamic investigation. The effect disappears when the stimulator is turned off.

  8. Prospects for European labour demand.

    PubMed

    Lindley, R M

    1988-07-01

    The impact of economic and technological trends upon the level and structure of labor demand is examined, exploring the methods used to model the labor market and making special reference to demography and technology. Evidence on recent and prospective changes in labor demand is reviewed for France, Germany, Italy, the Netherlands, and the UK. The models used to explore future employment scenarios usually fail to incorporate the linkages required to fully analyze the various demographic-economic interactions. Further, this is not generally viewed as a limitation, given the time frame of most employment projections and their preoccupation with changes in the structure of labor demand. Medium-term multisectoral models tend to pay more attention to both demographic and technical change, but the treatment of both aspects is limited. The projections provide a framework for considering how both socioeconomic behavior and policy might change to achieve different outcomes. The greater a model's behavioral content, as expressed in its relationships between different variables, the greater the insight obtainable from simulation exercises. The 1st half of the 1970s was characterized by a reduction in German employment, representing the severest of European reactions to the oil crisis. The 2nd half of the decade recorded rapid growth in Italy and the Netherlands. The 1980s started with marked declines in Germany and the UK. Overall, the net gains of the 1970s were lost in the recession following the 2nd oil crisis. In none of the 5 countries studied does any realistic prospect emerge of achieving full employment before 2000. The most optimistic outcome is that unemployment will decline only slowly, it at all. The growth of both new forms and areas of employment will not compensate sufficiently for the loss of jobs elsewhere and the growth of labor supply. The industrial sector will continue to experience change in favor of the service sector but at a slower rate than during

  9. The radiation-induced changes in rectal mucosa: Hyperfractionated vs. hypofractionated preoperative radiation for rectal cancer

    SciTech Connect

    Starzewski, Jacek J.; Pajak, Jacek T.; Pawelczyk, Iwona; Lange, Dariusz; Golka, Dariusz . E-mail: dargolka@wp.pl; Brzeziska, Monika; Lorenc, Zbigniew

    2006-03-01

    Purpose: The purpose of the study was the qualitative and quantitative evaluation of acute radiation-induced rectal changes in patients who underwent preoperative radiotherapy according to two different irradiation protocols. Patients and Methods: Sixty-eight patients with rectal adenocarcinoma underwent preoperative radiotherapy; 44 and 24 patients underwent hyperfractionated and hypofractionated protocol, respectively. Fifteen patients treated with surgery alone served as a control group. Five basic histopathologic features (meganucleosis, inflammatory infiltrations, eosinophils, mucus secretion, and erosions) and two additional features (mitotic figures and architectural glandular abnormalities) of radiation-induced changes were qualified and quantified. Results: Acute radiation-induced reactions were found in 66 patients. The most common were eosinophilic and plasma-cell inflammatory infiltrations (65 patients), erosions, and decreased mucus secretion (54 patients). Meganucleosis and mitotic figures were more common in patients who underwent hyperfractionated radiotherapy. The least common were the glandular architectural distortions, especially in patients treated with hypofractionated radiotherapy. Statistically significant differences in morphologic parameters studied between groups treated with different irradiation protocols were found. Conclusion: The system of assessment is a valuable tool in the evaluation of radiation-induced changes in the rectal mucosa. A greater intensity of regenerative changes was found in patients treated with hyperfractionated radiotherapy.

  10. How to identify rectal sub-regions likely involved in rectal bleeding in prostate cancer radiotherapy

    NASA Astrophysics Data System (ADS)

    Dréan, G.; Acosta, O.; Ospina, J. D.; Voisin, C.; Rigaud, B.; Simon, A.; Haigron, P.; de Crevoisier, R.

    2013-11-01

    Nowadays, the de nition of patient-speci c constraints in prostate cancer radiotherapy planning are solely based on dose-volume histogram (DVH) parameters. Nevertheless those DVH models lack of spatial accuracy since they do not use the complete 3D information of the dose distribution. The goal of the study was to propose an automatic work ow to de ne patient-speci c rectal sub-regions (RSR) involved in rectal bleeding (RB) in case of prostate cancer radiotherapy. A multi-atlas database spanning the large rectal shape variability was built from a population of 116 individuals. Non-rigid registration followed by voxel-wise statistical analysis on those templates allowed nding RSR likely correlated with RB (from a learning cohort of 63 patients). To de ne patient-speci c RSR, weighted atlas-based segmentation with a vote was then applied to 30 test patients. Results show the potentiality of the method to be used for patient-speci c planning of intensity modulated radiotherapy (IMRT).

  11. Death by Disimpaction: A Bradycardic Arrest Secondary to Rectal Manipulation

    PubMed Central

    Shea, Cory M.

    2016-01-01

    Rectal examination and fecal disimpaction are common procedures performed in the Emergency Department on a daily basis. Here, we report a rare case of a patient suffering a cardiac arrest and ultimately death likely due to rectal manipulation. A 66-year-old male presented to the Emergency Department (ED) with a complaint of abdominal distention and constipation. A rectal exam was performed. During the examination the patient became apneic. On the cardiac monitor the patient was found to be in pulseless electrical activity with a bradycardic rate. Our recommendation would be to provide adequate analgesia and close patient monitoring of those undergoing this procedure especially patients with significant stool burdens. PMID:28116179

  12. Endoscopic Ultrasound-Guided Management of Bleeding Rectal Varices

    PubMed Central

    Augustine, Philip

    2017-01-01

    Rectal variceal bleeding, though rare, can pose significant morbidity and mortality in the wake of treatment failure. Conventional treatment utilizing endoscopic glue injection might not be feasible in all cases due to poor visualization and inadvertent missing of variceal source of bleed. Endoscopic ultrasound (EUS)-guided rectal variceal management is a promising and effective modality. We provide real-time images and a video of EUS-guided precision management of rectal variceal bleed using coiling and glue in a cirrhotic. PMID:28879206

  13. Perineal Rectosigmoidectomy (Altemeier Procedure) as Treatment of Strangulated Rectal Prolapse.

    PubMed

    Cernuda, Ricardo Baldonedo; Ángel, Janet Pagnozzi; Fernández, Nuria Truan; Sánchez-Farpón, José Herminio; Pérez, Jose Antonio Álvarez

    2016-12-01

    Incarceration of a rectal prolapse is an unusual entity that represents a surgical emergency. Even more rarely, it becomes strangulated, requiring emergency surgery. When surgery becomes inevitable, the choice of procedure varies. A 57-year-old man who presented with strangulated rectal prolapse is described. The patient underwent emergency perineal proctosigmoidectomy, the Altemeier operation, combined with diverting loop sigmoid colostomy. The postoperative course was uneventful. After a 6-month follow-up, there was no recurrence, but the patient continued with fecal incontinence. This case underlines the importance of the Altemeier procedure as treatment in the patient with a strangulated prolapsed rectal segment.

  14. Fournier gangrene: first manifestation of occult rectal cancer.

    PubMed

    Ruiz-Tovar, J; Córdoba, L; Devesa, J M

    2011-01-01

    Fournier gangrene is a necrotizing fasciitis of the genital and perineal region. Diverse factors predispose to Fournier gangrene, such as diabetes mellitus, ethylism, liver dysfunction, haematological disorders, obesity or recent regional instrumentation. Rectal tumours can also predispose to Fournier gangrene; most of the reported cases are perforated or unresectable colorectal tumours, but some cases of anorectal cancer diagnosed after recovery from Fournier gangrene have also been reported. In these cases, the presence of a rectal tumour at the time of, or prior to, diagnosis of Fournier gangrene could not be ruled out. We present three cases of rectal cancer whose first manifestation was as Fournier gangrene.

  15. Proforma-based reporting in rectal cancer.

    PubMed

    Taylor, F; Mangat, N; Swift, I R; Brown, G

    2010-10-04

    The improvements in outcomes associate with the use of preoperative therapy rather than postoperative treatment means that clinical teams are increasingly reliant on imaging to identify high-risk features of disease to determine treatment plans. For many solid tumours, including rectal cancer, validated techniques have emerged in identifying prognostic factors pre-operatively. In the MERCURY study, a standardised scanning technique and the use of reporting proformas enabled consistently accurate assessment and documentation of the prognostic factors. This is now an essential tool to enable our clinical colleagues to make treatment decisions. In this review, we describe the proforma-based reporting tool that enables a systematic approach to the interpretation of the magnetic resonance images, thereby enabling all the clinically relevant features to be adequately assessed.

  16. Rectal versus non-rectal primary signet ring cell carcinoma of the colorectum: a retrospective survival analysis controlled for confounders.

    PubMed

    Ciarrocchi, Andrea

    2014-09-01

    Our objective was to compare the outcomes of rectal and non-rectal primary signet ring cell adenocarcinoma of the colorectum. A retrospective survival analysis was performed using the Surveillance, Epidemiology, and End Results Program database between 2004 and 2009 on subjects who were diagnosed as having a primary signet ring cell carcinoma of the colorectum. Cox proportional hazard regression analysis controlled for confounders was used to assess overall survival comparing rectal and non-rectal cancers. Our population was composed of 1,484 patients: 200 affected by rectal cancer and 1,284 by non-rectal cancer. Unadjusted survival curves resulted to be almost superimposable (P = 0.916). After controlling for age, gender, race, tumor stage, grade, and size, tumor location demonstrated a statistically significant impact on overall survival (P = 0.032; 95% confidence interval 0.640-0.980; hazard ratio 0.792). On the basis of analysis of information from the SEER database, the signet ring cell carcinoma of the rectum was associated to a worse prognosis as compared to non-rectal cancer.

  17. Radiotherapy and local control in rectal cancer.

    PubMed

    Valentini, V; Rosetto, M E; Fares, C; Mantini, G; Salvi, G; Turriziani, A

    1998-01-01

    Recurrence is a stage in the natural history of rectal cancer. Preoperative radiotherapy or postoperative radiochemotherapy lower the rate of recurrence, improving local control. From 1980 to 1997, at the "Divisione di Radioterapia" of the "Università Cattolica del S. Cuore" of Rome 380 patients with rectal cancer of early clinical stage T2-3, candidates for surgery for cure, underwent radiation therapy. 119 patients underwent postoperative radiotherapy (45-50 Gy); 45 patients underwent "sandwich" radiotherapy (45 Gy:27 Gy before and 28 Gy after surgery), of whom 7 were treated with preoperative radiotherapy alone; 145 patients underwent preoperative concomitant radiochemotherapy according to 3 different protocols, radiotherapy (38 Gy) combined with mitomycin C and 5-FU; radiotherapy (50.4 Gy) combined with cisplatin and 5-FU; radiotherapy (45 Gy) combined with 5-FU and folinic acid. 71 patients were treated with preoperative radiotherapy (38 Gy) combined with IORT (10 Gy). Median follow-up was 6 years. Overall local control was 85% at 3 years, 83% at 5 years, 81% at 10 years. The rate of local control at 5 years was: 76% for postoperative radiotherapy, 83% for "sandwich" radiotherapy, 84% for preoperative radiochemotherapy and 93% for preoperative radiotherapy combined with IORT. Local control was shown to be significantly better with preoperative treatment as compared to postoperative treatment (p = 0.02). The incidence of metastases was 35% in the patients with local recurrence and 16% in those with local control. The difference in survival was highly significant in patients with local control as compared to those with local recurrence: at 5 years 87% and 32% respectively. Patients with local control showed a lower incidence of metastasis and a better survival.

  18. [Strangled rectal prolapse in young adults: about a case and review of the literature].

    PubMed

    Bayar, Rached; Djebbi, Achref; Mzoughi, Zeineb; Talbi, Ghofrane; Gharbi, Lassaad; Arfa, Nafaa; Mestiri, Hafedh; Khalfallah, Mohamed Taher

    2016-01-01

    Rectal prolapse is a rectal static disorder which involves rectal wall intussusception inducing its externalization through the anus. It usually affects children and the elderly. Its occurrence in young adults is rare. Strangulated rectal prolapse is also a rare complication. We report the case of a 30-year old patient who underwent emergency surgery for strangulated rectal prolapse. Emergency perineal rectosigmoidectomy (Altemeier repair) was performed with simple outcome.

  19. Spectrophotometric methods for the determination of urea in real samples using silver nanoparticles by standard addition and 2nd order derivative methods.

    PubMed

    Ali, Nauman; Ismail, Muhammad; Khan, Adnan; Khan, Hamayun; Haider, Sajjad; Kamal, Tahseen

    2018-01-15

    In this work, we have developed simple, sensitive and inexpensive methods for the spectrophotometric determination of urea in urine samples using silver nanoparticles (AgNPs). The standard addition and 2nd order derivative methods were adopted for this purpose. AgNPs were prepared by chemical reduction of AgNO3 with hydrazine using 1,3-di-(1H-imidazol-1-yl)-2-propanol (DIPO) as a stabilizing agent in aqueous medium. The proposed methods were based on the complexation of AgNPs with urea. Using this concept, urea in the urine samples was successfully determined spectrophotometric methods. The results showed high percent recovery with ±RSD. The recoveries of urea in the three urine samples by spectrophotometric standard addition were 99.2%±5.37, 96.3%±4.49, 104.88%±4.99 and that of spectrophotometric 2nd order derivative method were 115.3%±5.2, 103.4%±2.6, 105.93%±0.76. The results show that these methods can open doors for a potential role of AgNPs in the clinical determination of urea in urine, blood, biological, non-biological fluids. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. From palmistry to anthropometry: can 2nd to 4th digit length (2D:4D) predict the risk of prostate cancer?

    PubMed

    Salomão, Layla; Figueiredo, Rui Teófilo; Oliveira Santos, Rafael; Damião, Ronaldo; da Silva, Eloisio Alexsandro

    2014-01-01

    The 2nd to 4th digit length (2D:4D) is inversely related to androgen exposure during the fetal period, which may represent a risk factor for several steroid-related diseases. We aimed to evaluate the relationship between 2D:4D ratio and the risk of developing prostate cancer (PCa). We assessed the 2D:4D ratio of 474 men >40 years old, stratified into three groups: group 1 (n = 222) patients with PCa, group 2 (n = 82) subjects with high risk of PCa, and group 3 (n = 170) men with low risk of PCa. Subjects were submitted to a digital picture of the ventral surface of the right hand and 2nd and 4th fingers measurements were determined by the distance from the proximal crease to the tip using computer-assisted analysis. The mean serum prostate-specific antigen level was 7.5 ng/ml in the high-risk group and 0.92 ng/ml in the low-risk group (p < 0.05). The mean 2D:4D ratios were 0.96 ± 0.04, 0.97 ± 0.04 and 0.96 ± 0.04 for the PCa, high-risk and low-risk groups, respectively, and no difference was found among the three groups (p = 0.12). Anthropometry of the hand using the 2D:4D ratio is not a predictor of PCa. 2013 S. Karger AG, Basel.

  1. Carbon dioxide emissions and the overshoot ratio change resulting from the implementation of 2nd Energy Master Plan in South Korea

    NASA Astrophysics Data System (ADS)

    Yeo, M. J.; Kim, Y. P.

    2015-12-01

    The direction of the energy policies of the country is important in the projection of environmental impacts of the country. The greenhouse gases (GHGs) emission of the energy sector in South Korea is very huge, about 600 MtCO2e in 2011. Also the carbon footprint due to the energy consumption contributes to the ecological footprint is also large, more than 60%. Based on the official plans (the national greenhouse gases emission reduction target for 2030 (GHG target for 2030) and the 2nd Energy Master Plan (2nd EMP)), several scenarios were proposed and the sensitivity of the GHG emission amount and 'overshoot ratio' which is the ratio of ecological footprint to biocapacity were estimated. It was found that to meet the GHG target for 2030 the ratio of non-emission energy for power generation should be over 71% which would be very difficult. We also found that the overshoot ratio would increase from 5.9 in 2009 to 7.6 in 2035. Thus, additional efforts are required to reduce the environmental burdens in addition to optimize the power mix configuration. One example is the conversion efficiency in power generation. If the conversion efficiency in power generation rises up 50% from the current level, 40%, the energy demand and resultant carbon dioxide emissions would decrease about 10%. Also the influence on the environment through changes in consumption behavior, for example, the diet choice is expected to be meaningful.

  2. Management of osteoporosis in central and eastern Europe (CEE): conclusions of the "2nd Summit on Osteoporosis-CEE", 21-22 November 2008, Warsaw, Poland.

    PubMed

    Lorenc, Roman S; Resch, Heinrich

    2009-12-01

    In November 2008, the "2nd Summit on Osteoporosis-Central and Eastern Europe (CEE)" was held in Warsaw, Poland. Discussions at this meeting focused on the identification and discussion of diagnostic, preventive, and therapeutic measures used in CEE. Evaluated information was used to identify issues regarding diagnosis and therapy of osteoporosis in these countries to facilitate the subsequent setup of appropriate support and development strategies. The main debate was structured according to the following five subjects: (1) present status and future perspectives for implementation of FRAX(R) into local (CEE) diagnostic algorithms, (2) principles of drug selection in osteoporosis treatment in CEE countries, (3) nonpharmacological interventions in osteoporosis treatment and prophylaxis in CEE countries, (4) treatment benefit evaluation, and (5) cost-effectiveness and evaluation of reimbursement policies in CEE countries. The most important and substantial comments of the delegates are summarized in the present article. The multinational panel of experts with representatives from many CEE countries as well as Austria and Switzerland made the "2nd Summit on Osteoporosis-CEE" a perfect platform to identify issues and needs regarding diagnosis and therapy of osteoporosis as well as the cost-effectiveness of osteoporosis management in CEE countries. The information gained will serve as a basis for the development of strategies to resolve the identified issues at the "3rd Summit on Osteoporosis-CEE" in November 2009.

  3. Rectal Douching and Implications for Rectal Microbicides among Populations Vulnerable to HIV in South America: A Qualitative Study

    PubMed Central

    Galea, Jerome T.; Kinsler, Janni J.; Imrie, John; Nureña, César R.; Sánchez, Jorge; Cunningham, William E.

    2014-01-01

    Objective While gel-formulated Rectal Microbicides (RM) are the first to enter clinical trials, rectal douching in preparation for anal intercourse is a common practise, thus RMs formulated as douches may be a convenient alternative to gels. Nonetheless, little is known about potential users’ thoughts regarding douche-formulated RMs or rectal douching practises, data needed to inform the advancement of douche-based RMs. This qualitative study examined thoughts regarding douches, their use as a RM and current douching practises among men who have sex with men and transgender women. Methods Ten focus groups and 36 in-depth interviews were conducted (N=140) to examine the overall acceptability of RM, of which one component focused on rectal douching. Focus groups and interviews were recorded, transcribed verbatim and coded; text relating to rectal douching was extracted and analysed. Sociodemographic information was collected using a self-administered questionnaire. Results Support for a douche-formulated RM centred on the possibility of combined pre-coital hygiene and HIV protection, and it was believed that a deeply-penetrating liquid douche would confer greater HIV protection than a gel. Drawbacks included rectal dryness; impracticality and portability issues; and, potential side effects. Non-commercial douching apparatus use was common and liquids used included detergents, vinegar, bleach, lemon juice and alcohol. Conclusions A douche-formulated RM while desirable and perceived as more effective than a gel-formulated RM also generated questions regarding practicality and side-effects. Of immediate concern were the non-commercial liquids already being used which likely damage rectal epithelia, potentially increasing HIV infection risk. Pre-coital rectal douching is common and a RM formulated as such is desirable, but education on rectal douching practices is needed now. PMID:23966338

  4. [CHALLENGES OF THE NURSING PROFESSION AT EUROPEAN LEVEL].

    PubMed

    Bereciartu Martínez, Griselda

    2015-11-01

    Professional nurses are internationally sought after, a fact reinforced under the frames of exchange and cooperation promoted by the European Union. Given the high percentage of mobility shown by health professionals, nurses need a thorough preparation to facilitate their integration in the countries where they are likely to develop their professional careers. In order to promote exchange and facilitate discussion between nurses from different European countries, the Health School of the Polytechnic Institute of Portalegre (Portugal), organized on the 2nd and 3rd of September the International Health Sciences Meeting ESS 2015 ("Promoting bonds - A newchallenge for the future ofhealth professions in Europe"). The diverse working conditions that nurses are faced with in different countries highlight the need to foster awareness of the profession at European level, facilitating ties, exchange and scientific platforms to address the current reality of the labor market.

  5. Efficacy and safety of intramuscular midazolam versus rectal diazepam in controlling status epilepticus in children.

    PubMed

    Momen, Ali Akbar; Azizi Malamiri, Reza; Nikkhah, Ali; Jafari, Maryam; Fayezi, Abbas; Riahi, Kourosh; Maraghi, Elham

    2015-03-01

    The aim of this study was to evaluate the efficacy and safety of intramuscular midazolam in controlling convulsive status epilepticus in children, by comparing it with rectal diazepam. In this randomized trial, 100 children (50 in each group) with convulsive status epilepticus aged 1 month to 16 years were enrolled and randomly assigned into two groups to receive either 0.3 mg/kg intramuscular midazolam or 0.5 mg/kg rectal diazepam. Main outcome measure was stopping of all motor activity after drug administration. Another measures were times between patient's arrival to emergency department till drug administration, between drug administration to seizure cessation, and between patient's arrival to seizure cessation. Both medication were effective for seizure control and no significant difference was found between successful treatments after administering the medication (P = 0.061). In the midazolam group, in 96% (48/50) of cases treatment was successful and in the diazepam group, in 94% (47/50) of cases treatment was successful. Time from arrival to administering the medication was significantly shorter in midazolam group (P = 0.017). The majority of seizures in midazolam group were stopped in less than 66 s (median) compared to 130 s (median) for diazepam group, (P < 0.001). No serious adverse effects were seen in both groups. IM midazolam is not superior but may be at least as effective as rectal diazepam for controlling of status epilepticus in children. Midazolam via IM route could be one of the choices in children with convulsive status seizures who have difficult IV access. Copyright © 2014 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  6. Ano-rectal lymphogranuloma venereum: 22 cases reported in a sexually transmited infections center in Paris.

    PubMed

    Halioua, B; Bohbot, J M; Monfort, L; Nassar, N; de Barbeyrac, B; Monsonego, J; Sednaoui, P

    2006-01-01

    In January 2004 the European Surveillance of Sexually Transmitted Infections Network (ESSTI) issued an international alert regarding an outbreak of Lymphogranuloma venereum (LGV) in Rotterdam in a sexual network of men who have sex with men (MSM). Further to this alert, a retrospective survey was set up by the Institut de Veille Sanitaire and the reference laboratories for N.gonorrhoeae and Chlamydia in France. Our STI clinic in Paris carried out a clinico-biological retrospective study involving 154 MSM screened for anorectal sexually transmitted infections (STIs) between January 2002 and May 2004 and a prospective study between May 2004 and August 2004. Out of 216 swabs of rectal discharge from homosexual or bisexual males, a total of 32 were positive for C. trachomatis (14.8%) (3 patients in 2002, 11 in 2003 and 18 in 2004). C. trachomatis-positive rectal strains were genotyped to detect the specific C. trachomatis serovars and revealed serovars L(2) for 22 patients (respectively 1 in 2002, 9 in 2003 and 12 in 2004). Serum antibody titers for Chlamydia trachomatis were determined among 14 subjects and revealed strongly positive in 13 cases (1/512 to 1/16384) titers of IgG. These 22 patients with clinico-biologically confirmed anorectal lymphogranuloma venereum (ARLGV) were all homosexual men. They ranged from 28 to 52 years (mean age 39.2 years). 12 of 21 (57.1%) subjects with an ARLGV diagnosis were seropositive for human immunodeficiency virus (HIV) (one not done). Although rare, anorectal lymphogranuloma venereum (ARLGV) still exists in France and should not be forgotten in the differential diagnosis of rectal problems in male homosexuals.

  7. The Quality-of-Life Effects of Neoadjuvant Chemoradiation in Locally Advanced Rectal Cancer

    SciTech Connect

    Herman, Joseph M.; Narang, Amol K.; Griffith, Kent A.; Zalupski, Mark M.; Reese, Jennifer B.; Gearhart, Susan L.; Azad, Nolifer S.; Chan, June; Olsen, Leah; Efron, Jonathan E.; Lawrence, Theodore S.; Ben-Josef, Edgar

    2013-01-01

    Purpose: Existing studies that examine the effect of neoadjuvant chemoradiation (CRT) for locally advanced rectal cancer on patient quality of life (QOL) are limited. Our goals were to prospectively explore acute changes in patient-reported QOL endpoints during and after treatment and to establish a distribution of scores that could be used for comparison as new treatment modalities emerge. Methods and Materials: Fifty patients with locally advanced rectal cancer were prospectively enrolled at 2 institutions. Validated cancer-specific European Organization for Research and Treatment of Cancer (EORTC QLQ-CR30) and colorectal cancer-specific (EORTC QLQ-CR38 and EORTC QLQ-CR 29) QOL questionnaires were administered to patients 1 month before they began CRT, at week 4 of CRT, and 1 month after they had finished CRT. The questionnaires included multiple symptom scales, functional domains, and a composite global QOL score. Additionally, a toxicity scale was completed by providers 1 month before the beginning of CRT, weekly during treatment, and 1 month after the end of CRT. Results: Global QOL showed a statistically significant and borderline clinically significant decrease during CRT (-9.50, P=.0024) but returned to baseline 1 month after the end of treatment (-0.33, P=.9205). Symptoms during treatment were mostly gastrointestinal (nausea/vomiting +9.94, P<.0001; and diarrhea +16.67, P=.0022), urinary (dysuria +13.33, P<.0001; and frequency +11.82, P=.0006) or fatigue (+16.22, P<.0001). These symptoms returned to baseline after therapy. However, sexual enjoyment (P=.0236) and sexual function (P=.0047) remained persistently diminished after therapy. Conclusions: Rectal cancer patients undergoing neoadjuvant CRT may experience a reduction in global QOL along with significant gastrointestinal and genitourinary symptoms during treatment. Moreover, provider-rated toxicity scales may not fully capture this decrease in patient-reported QOL. Although most symptoms are transient

  8. Late Side Effects and Quality of Life After Radiotherapy for Rectal Cancer

    SciTech Connect

    Bruheim, Kjersti; Guren, Marianne G.; Skovlund, Eva; Hjermstad, Marianne J.; Dahl, Olav; Frykholm, Gunilla; Carlsen, Erik; Tveit, Kjell Magne

    2010-03-15

    Purpose: There is little knowledge on long-term morbidity after radiotherapy (50 Gy) and total mesorectal excision for rectal cancer. Therefore, late effects on bowel, anorectal, and urinary function, and health-related quality of life (QoL), were studied in a national cohort (n = 535). Methods and Materials: All Norwegian patients who received pre- or postoperative (chemo-)radiotherapy for rectal cancer from 1993 to 2003 were identified. Patients treated with surgery alone served as controls. Patients were without recurrence or metastases. Bowel and urinary function was scored with the LENT SOMA scale and the St. Marks Score for fecal incontinence and QoL with the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30). Results: Median time since surgery was 4.8 years. Radiation-treated (RT+) patients (n = 199) had increased bowel frequency compared with non-radiation-treated (RT-) patients (n = 336); 19% vs. 6% had more than eight daily bowel movements (p < 0.001). In patients without stoma, a higher proportion of RT+ (n = 69) compared with RT- patients (n = 240), were incontinent for liquid stools (49% vs. 15%, p < 0.001), needed a sanitary pad (52% vs. 13%, p < 0.001), and lacked the ability to defer defecation (44% vs. 16%, p < 0.001). Daily urinary incontinence occurred more frequently after radiotherapy (9% vs. 2%, p = 0.001). Radiation-treated patients had worse social function than RT- patients, and patients with fecal or urinary incontinence had impaired scores for global quality of life and social function (p < 0.001). Conclusions: Radiotherapy for rectal cancer is associated with considerable long-term effects on anorectal function, especially in terms of bowel frequency and fecal incontinence. RT+ patients have worse social function, and fecal incontinence has a negative impact on QoL.

  9. Rectal tuberculosis in an HIV-infected patient: case report

    PubMed Central

    de Barros, Marcos dos Santos Vieira; Christiano, Celso Guilherme; Lovisolo, Silvana Maria; Rosa, Vladimir Mulele Pinto Santa

    2014-01-01

    The gastrointestinal (GI) tract has been increasingly affected by tuberculosis, especially in immunocompromised patients. Although strict rectal involvement is rare, the GI site mostly affected is the ileocecal region. Thus, tuberculosis should always be considered in the differential diagnosis of perianal and rectal lesions, and more so in patients infected by the HIV virus. The authors report the case of a 32-year-old man presenting a long-term history of fever, night sweats, weight loss, bloody diarrhea, fecal incontinence, tenesmus, and rectal pain. HIV serology was positive. The patient underwent anoscopy and biopsy, which disclosed the diagnosis of rectal tuberculosis. Thus the patient was referred to an outpatient clinic to follow the standard treatment. PMID:28573121

  10. Tailoring treatment of rectal adenocarcinoma: immunohistochemistry for predictive biomarkers.

    PubMed

    Kapur, Payal

    2011-04-01

    Over the past couple of decades, multimodality treatment for the management of resectable rectal cancer has substantially improved the outcome of affected patients. However, the broad and unpredictable response to tumor of patients with rectal cancer treated with preoperative chemoradiotherapeutic interventions shows that our understanding of the molecular events leading to radioresistance in patients affected with this malignancy remains sparse. Multiple attempts by individual molecular markers in gene array and tissue microarray studies have emerged with the goal of identifying predictors of a response to chemoradiation in patients with rectal cancer. In this report, we discuss the status of the markers currently available in an attempt to tailor specific targeted therapies for rectal cancer in the neoadjuvant setting.

  11. Refining Preoperative Therapy for Locally Advanced Rectal Cancer

    Cancer.gov

    In the PROSPECT trial, patients with locally advanced, resectable rectal cancer will be randomly assigned to receive either standard neoadjuvant chemoradiation therapy or neoadjuvant FOLFOX chemotherapy, with chemoradiation reserved for nonresponders.

  12. Adult rectosigmoid junction intussusception presenting with rectal prolapse.

    PubMed

    Du, Jing Zeng; Teo, Li Tserng; Chiu, Ming Terk

    2015-05-01

    Most cases of intussusception in adults present with chronic and nonspecific symptoms, and can sometimes be challenging to diagnose. We herein report on a patient with the rare symptom of colonic intussusceptions presenting with rectal prolapse and review the existing literature of similar case reports to discuss how to reach an accurate diagnosis. A 75-year-old woman with dementia presented with per rectal bleeding, rectal prolapse and lower abdominal pain. An operation was scheduled and a large sigmoid intussusception with a polyp as a leading point was found intraoperatively. She subsequently recovered well and was discharged. As large sigmoid intussusceptions may present as rectal prolapse, intussusception should be considered as a differential diagnosis for immobile patients, especially when the leading point is a lesion.

  13. Adult rectosigmoid junction intussusception presenting with rectal prolapse

    PubMed Central

    Du, Jing Zeng; Teo, Li Tserng; Chiu, Ming Terk

    2015-01-01

    Most cases of intussusception in adults present with chronic and nonspecifi c symptoms, and can sometimes be challenging to diagnose. We herein report on a patient w ith the rare symptom of colonic intussusceptions presenting with rectal prolapse and review the existing literature of similar case reports to discuss how to reach an accurate diagnosis. A 75-year-old woman with dementia presented with per rectal bleeding, rectal prolapse and lower abdominal pain. An operation was scheduled and a large sigmoid intussusception with a polyp as a leading point was found intraoperatively. She subsequently recovered well and was discharged. As large sigmoid intussusceptions may present as rectal prolapse, intussusception should be considered as a differential diagnosis for immobile patients, especially when the leading point is a lesion. PMID:26034324

  14. Intractable rectal stricture caused by hot water enema.

    PubMed

    Kye, Bong-Hyeon; Kim, Hyung-Jin; Lee, Kang Moon; Cho, Hyeon-Min

    2011-11-01

    Rectal burns caused by hot water enema have been reported only occasionally and the majority of them were treated in a conservative manner. Although intractable rectal stricture caused by rectal burn is rare, it may be treated by endoscopic intervention or surgery. A 52-year-old woman who had used various methods of enema to treat her chronic constipation eventually undertook a hot water enema herself. After that, anal pain and constipation became aggravated prompting her to visit our clinic. Although various nonoperative treatments including endoscopic stenting were performed, her obstructive symptom did not improve and endoscopic findings had not changed. Hence, we performed a laparoscopic proctosigmoidectomy and transanal coloanal anastomosis with ileal diversion to treat the disease, and as a result, her obstructive symptom improved well. Corrective surgery such as resection of involved segment with anastomosis may be beneficial in relieving obstructive symptoms of an intractable rectal stricture caused by hot water enema.

  15. Intractable rectal stricture caused by hot water enema

    PubMed Central

    Kye, Bong-Hyeon; Kim, Hyung-Jin; Lee, Kang Moon

    2011-01-01

    Rectal burns caused by hot water enema have been reported only occasionally and the majority of them were treated in a conservative manner. Although intractable rectal stricture caused by rectal burn is rare, it may be treated by endoscopic intervention or surgery. A 52-year-old woman who had used various methods of enema to treat her chronic constipation eventually undertook a hot water enema herself. After that, anal pain and constipation became aggravated prompting her to visit our clinic. Although various nonoperative treatments including endoscopic stenting were performed, her obstructive symptom did not improve and endoscopic findings had not changed. Hence, we performed a laparoscopic proctosigmoidectomy and transanal coloanal anastomosis with ileal diversion to treat the disease, and as a result, her obstructive symptom improved well. Corrective surgery such as resection of involved segment with anastomosis may be beneficial in relieving obstructive symptoms of an intractable rectal stricture caused by hot water enema. PMID:22148129

  16. A crunching colon: rectal bezoar caused by pumpkin seed consumption.

    PubMed

    Manne, Janaki R; Rangu, Venu M; Motapothula, Uma Maheswara R; Hall, Matthew C

    2012-05-01

    Rectal seed bezoars are an uncommon cause of fecal impaction, particularly in the United States. Although the literature has reported several cases of phytobezoars composed of various types of seeds, bezoars formed of pumpkin seeds have rarely been reported. We report a case of a man, aged 62 years, with a rectal bezoar composed of pumpkin seeds with complications necessitating extensive treatment, including manual disimpaction and colonoscopy.

  17. Bioavailabilities of rectal and oral methadone in healthy subjects

    PubMed Central

    Dale, Ola; Sheffels, Pamela; Kharasch, Evan D

    2004-01-01

    Aims Rectal administration of methadone may be an alternative to intravenous and oral dosing in cancer pain, but the bioavailability of the rectal route is not known. The aim of this study was to compare the absolute rectal bioavailability of methadone with its oral bioavailability in healthy humans. Methods Seven healthy subjects (six males, one female, aged 20–39 years) received 10 mg d5-methadone-HCl rectally (5 ml in 20% glycofurol) together with either d0-methadone intravenously (5 mg) or orally (10 mg) on two separate occasions. Blood samples for the LC-MS analyses of methadone and it's metabolite EDDP were drawn for up to 96 h. Noninvasive infrared pupillometry was peformed at the same time as blood sampling. Results The mean absolute rectal bioavalability of methadone was 0.76 (0.7, 0.81), compared to 0.86 (0.75, 0.97) for oral administration (mean (95% CI)). Rectal absorption of methadone was more rapid than after oral dosing with Tmax values of 1.4 (0.9, 1.8) vs. 2.8 (1.6, 4.0) h. The extent of formation of the metabolite EDDP did not differ between routes of administration. Single doses of methadone had a duration of action of at least 10 h and were well tolerated. Conclusions Rectal administration of methadone results in rapid absorption, a high bioavailability and long duration of action. No evidence of presystemic elimination was seen. Rectal methadone has characteristics that make it a potential alternative to intravenous and oral administration, particularly in cancer pain and palliative care. PMID:15255797

  18. Combined-modality therapy for rectal cancer using irinotecan.

    PubMed

    Minsky, Bruce D

    2002-05-01

    Preoperative or postoperative pelvic radiation plus concurrent fluorouracil-based chemotherapy is standard adjuvant treatment for patients with T3 and/or N1/2 rectal cancer. Newer chemotherapeutic regimens have been developed for the treatment of patients with metastatic disease. Irinotecan (CPT-11, Camptosar)-based regimens have improved survival in patients with metastatic disease and are being actively investigated in combination with pelvic radiation therapy for patients with rectal cancer.

  19. The evaluation of the oxidative stress for patients receiving neoadjuvant chemoradiotherapy for locally advanced rectal cancer

    PubMed Central

    Serbanescu, GL; Gruia, MI; Bara, M; Anghel, RM

    2017-01-01

    Hypothesis: Nowadays, rectal cancer is an important healthcare challenge that affects many thousands of people each year worldwide, being diagnosed especially after the age of 50 years. Objective: This study attempted to evaluate the oxidative stress in patients with rectal cancer. Methods and results: 30 patients from the “Prof. Dr. Al. Trestioreanu” Institute of Oncology in Bucharest were treated with neoadjuvant radiochemotherapy during 2014 and 2016 and were included in the clinical study. Blood samples were obtained in dynamics during the treatment. From the blood samples, the serum was separated and used to identify the biochemical oxidative stress parameters. Results: Regarding the determination of lipid peroxides, albumin thiols, the cuprum oxidase activity of ceruloplasmin, the values registered in the dynamic of the treatment highlighted their increase to a maximum at the treatment’s endpoint due to an important oxidative stress. Regarding the serum values for total antioxidants, the results pointed out the activation of the natural protection systems, which in time were overwhelmed, due to the installed oxidative stress. Conclusion: Part of the cytotoxic effect of radiotherapy was due to the production of oxidative stress. The cell was constantly exposed to the cytotoxic action of the reactive oxygen species. The obtained results indicated the dual relation to which the tumoral cell exposed itself and the installed oxidative stress, respectively, the oxidative stress being a cause or a consequence of the malign transformation. Abbreviations: CT = computed tomography, MRI = magnetic resonance imaging, ESMO = European Society for Medical Oncology, ECOG = performance status scale PMID:28255388

  20. The evaluation of the oxidative stress for patients receiving neoadjuvant chemoradiotherapy for locally advanced rectal cancer.

    PubMed

    Serbanescu, G L; Gruia, M I; Bara, M; Anghel, R M

    2017-01-01

    Hypothesis: Nowadays, rectal cancer is an important healthcare challenge that affects many thousands of people each year worldwide, being diagnosed especially after the age of 50 years. Objective: This study attempted to evaluate the oxidative stress in patients with rectal cancer. Methods and results: 30 patients from the "Prof. Dr. Al. Trestioreanu" Institute of Oncology in Bucharest were treated with neoadjuvant radiochemotherapy during 2014 and 2016 and were included in the clinical study. Blood samples were obtained in dynamics during the treatment. From the blood samples, the serum was separated and used to identify the biochemical oxidative stress parameters. Results: Regarding the determination of lipid peroxides, albumin thiols, the cuprum oxidase activity of ceruloplasmin, the values registered in the dynamic of the treatment highlighted their increase to a maximum at the treatment's endpoint due to an important oxidative stress. Regarding the serum values for total antioxidants, the results pointed out the activation of the natural protection systems, which in time were overwhelmed, due to the installed oxidative stress. Conclusion: Part of the cytotoxic effect of radiotherapy was due to the production of oxidative stress. The cell was constantly exposed to the cytotoxic action of the reactive oxygen species. The obtained results indicated the dual relation to which the tumoral cell exposed itself and the installed oxidative stress, respectively, the oxidative stress being a cause or a consequence of the malign transformation. Abbreviations: CT = computed tomography, MRI = magnetic resonance imaging, ESMO = European Society for Medical Oncology, ECOG = performance status scale.

  1. Excretory transport of xenobiotics by dogfish shark rectal gland tubules.

    PubMed

    Miller, D S; Masereeuw, R; Henson, J; Karnaky, K J

    1998-09-01

    Marine elasmobranch rectal gland is a specialized, osmoregulatory organ composed of numerous blind-ended, branched tubules emptying into a central duct. To date, NaCl excretion has been its only described function. Here we use isolated rectal gland tubule fragments from dogfish shark (Squalus acanthias), fluorescent xenobiotics, and confocal microscopy to describe a second function, xenobiotic excretion. Isolated rectal gland tubules rapidly transported the fluorescent organic anion sulforhodamine 101 from bath to lumen. Luminal accumulation was concentrative, saturable, and inhibited by cyclosporin A (CSA), chlorodinitrobenzene, leukotriene C4, and KCN. Inhibitors of renal organic anion transport (probenecid, p-aminohippurate), organic cation transport (tetraethylammonium and verapamil), and P-glycoprotein (verapamil) were without effect. Cellular accumulation of sulforhodamine 101 was not concentrative, saturable, or inhibitable. Rectal gland tubules did not secrete fluorescein, daunomycin, or a fluorescent CSA derivative. Finally, frozen rectal gland sections stained with an antibody to a hepatic canalicular multispecific organic anion transporter (cMOAT or MRP2) showed heavy and specific staining on the luminal membrane of the epithelial cells. We conclude that rectal gland is capable of active and specific excretion of xenobiotics and that such transport is mediated by a shark analog of MRP2, an ATP-driven xenobiotic transporter, but not by P-glycoprotein.

  2. Management and outcome of rectal injury during gynecologic laparoscopic surgery.

    PubMed

    Jo, Eun Ju; Lee, Yoo-Young; Kim, Tae-Joong; Choi, Chel Hun; Lee, Jeong-Won; Bae, Duk-Soo; Kim, Byoung-Gie

    2013-01-01

    To assess the incidence and management of accidental rectal injury during gynecologic laparoscopic surgery. A retrospective study with review of outcomes (Canadian Task Force classification II-3). A tertiary care/research/university hospital. Patients with colon injury during laparoscopy for gynecologic diseases at Samsung Medical Center, Seoul, Korea, from January 2000 to April 2012. Use of absorbable suture or staples in primary repair of injured colon. From January 2000 to April 2012, 12 354 patients underwent laparoscopic surgery. Rectal injury occurred in 15 women (0.12%). Their median age was 42.5 years (30-49), and the median length of injury was 3 cm (0.7-7). Among 13 patients with rectal injuries recognized during surgery, 10 patient injuries were repaired primarily with interrupted absorbable sutures without converting laparotomy, 1 patient underwent laparoscopic low anterior resection with Endo-GIA, 1 underwent open primary repair, and 1 underwent open low anterior resection. Two rectal injuries were detected after surgery. One of these patients underwent primary repair under laparotomy at day 4 after surgery. The other patient had development of a rectovaginal fistula requiring open segmental resection 30 days after primary laparoscopy despite conservative management, including percutaneous drainage and prophylactic antibiotics. Rectal injury during laparoscopy in the gynecologic field can be repaired successfully without the need for a colostomy regardless of mechanism of injury and the size of injury if adequate rectal tissue is available and recognized during surgery. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

  3. Management of rectal cancers in relation to treatment guidelines: a population-based study comparing Italian and French patients.

    PubMed

    Minicozzi, Pamela; Bouvier, Anne-Marie; Faivre, Jean; Sant, Milena

    2014-07-01

    Few studies have investigated rectal cancer management at the population level. We compared how rectal cancers diagnosed in Italy (2003-2005) and France (2005) were managed, and evaluated the extent to which management adhered to European guidelines. Samples of 3938 Italian and 2287 French colorectal cancer patients were randomly extracted from 8 and 12 cancer registries respectively. Rectal cancer patients (860 Italian, 559 French) were analysed. Logistic regression models estimated odds ratios (ORs) of being treated with curative intent, receiving sphincter-saving surgery, and receiving preoperative radiotherapy. Similar proportions of Italian and French patients were treated with curative intent (70% vs. 67%; OR=0.92 [0.73-1.16]); the respective proportions receiving sphincter-saving surgery were 21% and 33% (OR=1.15 [0.86-1.53]). In about 50% of those treated with curative intent, ≥ 12 lymph nodes were harvested in both countries. The proportion receiving postoperative radiotherapy was higher in Italy than in France (25% vs. 11%, p<0.01), but French patients were more likely to receive preoperative radiotherapy (52% vs. 21%; OR=4.06 [2.79-5.91]). The proportions of patients receiving preoperative radiotherapy and the numbers of lymph nodes sampled were low in both countries. Centralising treatment and potentiating screening would be practical ways of improving outcomes and adhering to guidelines. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  4. PREFACE: 2nd Russia-Japan-USA Symposium on the Fundamental and Applied Problems of Terahertz Devices and Technologies (RJUS TeraTech - 2013)

    NASA Astrophysics Data System (ADS)

    Karasik, Valeriy; Ryzhii, Viktor; Yurchenko, Stanislav

    2014-03-01

    The 2nd Russia-Japan-USA Symposium 'The Fundamental & Applied Problems of Terahertz Devices & Technologies' (RJUS TeraTech - 2013) Bauman Moscow State Technical University Moscow, Russia, 3-6 June, 2013 The 2nd Russia-Japan-USA Symposium 'The Fundamental & Applied Problems of Terahertz Devices & Technologies' (RJUS TeraTech - 2013) was held in Bauman Moscow State Technical University on 3-6 June 2013 and was devoted to modern problems of terahertz optical technologies. RJUS TeraTech 2013 was organized by Bauman Moscow State Technical University in cooperation with Tohoku University (Sendai, Japan) and University of Buffalo (The State University of New York, USA). The Symposium was supported by Bauman Moscow State Technical University (Moscow, Russia) and Russian Foundation for Basic Research (grant number 13-08-06100-g). RJUS TeraTech - 2013 became a foundation for sharing and discussing modern and promising achievements in fundamental and applied problems of terahertz optical technologies, devices based on grapheme and grapheme strictures, condensed matter of different nature. Among participants of RJUS TeraTech - 2013, there were more than 100 researchers and students from different countries. This volume contains proceedings of the 2nd Russia-Japan-USA Symposium 'The Fundamental & Applied Problems of Terahertz Devices & Technologies'. Valeriy Karasik, Viktor Ryzhii and Stanislav Yurchenko Bauman Moscow State Technical University Symposium chair Anatoliy A Aleksandrov, Rector of BMSTU Symposium co-chair Valeriy E Karasik, Head of the Research and Educational Center 'PHOTONICS AND INFRARED TECHNOLOGY' (Russia) Invited Speakers Taiichi Otsuji, Research Institute of Electrical Communication, Tohoku University, Sendai, Japan Akira Satou, Research Institute of Electrical Communication, Tohoku University, Sendai, Japan Michael Shur, Electrical, Computer and System Engineering and Physics, Applied Physics, and Astronomy, Rensselaer Polytechnic Institute, NY, USA Natasha

  5. Management of 2nd-degree facial burns using the Versajet(®) hydrosurgery system and xenograft: a prospective evaluation of 20 cases.

    PubMed

    Duteille, Franck; Perrot, Pierre

    2012-08-01

    There is no single therapeutic scheme for the management of intermediary 2nd-degree facial burns, which can cause problems because of their uncertain course. It is preferable to obtain optimal healing of the face in order to avoid functional or cosmetic sequelae. Some practitioners recommend early excision (first week) of these burns, whereas others prefer to wait and perform surgery later (after 2 weeks). The practice in our burns unit is early surgery (from the first week) associated with hydrosurgical excision and application of a biosynthetic dressing (xenograft). A prospective follow-up of 20 cases was carried out to evaluate the efficacy of our protocol. The prospective evaluation was performed with follow-up at 2 weeks and 3, 6 and 12 months. The patients included had intermediary 2nd-degree burns on at least 15% of the face and no life-threatening prognosis. The mean age in our series was 40.5 years (16-72), the mean percentage of burn surface area was 27.75% and the mean percentage of facial burn was 60.75%. Early excision was performed (day 5-10) using the Versajet(®) system, which allows tangential water-dissection. Porcine xenograft (E-Z Derm(®)) was applied immediately afterwards. Patients whose healing process was not complete at 2 weeks were then scheduled to receive a thin autograft. Patients were followed up 2 weeks, 3, 6 and 12 months after discharge. Excision was performed at a mean 7.6 days, and mean initial healing time was 13.4 days. In three cases, a full-thickness skin graft was used, whereas healing occurred in the other patients without further grafts. Two patients had functional sequelae (ectropion) corrected later by repair surgery. The course of healing for the other patients proceeded normally. There is no consensus about the management of intermediate depth 2nd-degree facial burns. We chose to perform early surgery using the Versajet(®) system, which allows fine, precise excision, leaving nearly all of the healthy tissue in place

  6. Surgery for constipation: systematic review and practice recommendations: Results III: Rectal wall excisional procedures (Rectal Excision).

    PubMed

    Mercer-Jones, M; Grossi, U; Pares, D; Vollebregt, P F; Mason, J; Knowles, C H

    2017-09-01

    To assess the outcomes of rectal excisional procedures in adults with chronic constipation. Standardised methods and reporting of benefits and harms were used for all CapaCiTY reviews that closely adhered to PRISMA 2016 guidance. Main conclusions were presented as summary evidence statements with a summative Oxford Centre for Evidence-Based Medicine (2009) level. Forty-seven studies were identified, providing data on outcomes in 8340 patients. Average length of procedures was 44 min and length of stay (LOS) was 3 days. There was inadequate evidence to determine variations in procedural duration or LOS by type of procedure. Overall morbidity rate was 16.9% (0-61%), with lower rates observed after Contour Transtar procedure (8.9%). No mortality was reported after any procedures in a total of 5896 patients. Although inconsistently reported, good or satisfactory outcome occurred in 73-80% of patients; a reduction of 53-91% in Longo scoring system for obstructive defecation syndrome (ODS) occurred in about 68-76% of patients. The most common long-term adverse outcome is faecal urgency, typically occurring in up to 10% of patients. Recurrent prolapse occurred in 4.3% of patients. Patients with at least 3 ODS symptoms together with a rectocoele with or without an intussusception, who have failed conservative management, may benefit from a rectal excisional procedure. Rectal excisional procedures are safe with little major morbidity. It is not possible to advise which excisional technique is superior from the point of view of efficacy, peri-operative variables, or harms. Future study is required. © 2017 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.

  7. TEM and conventional rectal surgery for T1 rectal cancer: a meta-analysis.

    PubMed

    Wu, Yong; Wu, Yong-You; Li, Shan; Zhu, Bao-Song; Zhao, Kui; Yang, Xiao-Dong; Xing, Chun Gen

    2011-01-01

    To compare transanal endoscopic microsurgery (TEM) with conventional radical surgery (CRS) for T1 rectal cancer focusing on safety, feasibility and efficacy of both procedures. An online search of Ovid, Medline, Embase, Pubmed and Cochrane Controlled Trials Register was undertaken to identify studies comparing TEM with CRS published in English between 1984 and March 2010. Only studies comparing TEM with CRS for T1 rectal cancer treatment and with a minimum of 20 cases were included. The parameters compared were postoperative complications, hospital mortality, recurrence rate and 5-year survival. Five studies met screening criteria and 397 patients were enrolled in the meta-analysis; 216 were treated with TEM and the rest received CRS. Complications were observed in 16/196 in the TEM group and 77/163 in the CRS group. The difference was significant (p=0.01). The rate of mortality was 3.68% in CRS group, and 0 in TEM group (p=0.01). The 5-year survival was similar (p=0.84), the TEM group was 80.1% and the CRS group was 81.0%. However, there was more recurrence in the TEM group compared to CRS group (p=0.0004). TEM group was 12.0%, while CRS group was 0.5%. Compared with CRS, TEM had significant shorter hospital stay and fewer postoperative complications. TEM is a safe, feasible and effective option for T1 rectal cancer. Though TEM had a slightly higher rate of recurrence than CRS, no significant difference on 5-year survival was observed.

  8. Rectal microbicides: clinically relevant approach to the design of rectal specific placebo formulations

    PubMed Central

    2011-01-01

    Background The objective of this study is to identify the critical formulation parameters controlling distribution and function for the rectal administration of microbicides in humans. Four placebo formulations were designed with a wide range of hydrophilic characteristics (aqueous to lipid) and rheological properties (Newtonian, shear thinning, thermal sensitive and thixotropic). Aqueous formulations using typical polymers to control viscosity were iso-osmotic and buffered to pH 7. Lipid formulations were developed from lipid solvent/lipid gelling agent binary mixtures. Testing included pharmaceutical function and stability as well as in vitro and in vivo toxicity. Results The aqueous fluid placebo, based on poloxamer, was fluid at room temperature, thickened and became shear thinning at 37°C. The aqueous gel placebo used carbopol as the gelling agent, was shear thinning at room temperature and showed a typical decrease in viscosity with an increase in temperature. The lipid fluid placebo, myristyl myristate in isopropyl myristate, was relatively thin and temperature independent. The lipid gel placebo, glyceryl stearate and PEG-75 stearate in caprylic/capric triglycerides, was also shear thinning at both room temperature and 37°C but with significant time dependency or thixotropy. All formulations showed no rectal irritation in rabbits and were non-toxic using an ex vivo rectal explant model. Conclusions Four placebo formulations ranging from fluid to gel in aqueous and lipid formats with a range of rheological properties were developed, tested, scaled-up, manufactured under cGMP conditions and enrolled in a formal stability program. Clinical testing of these formulations as placebos will serve as the basis for further microbicide formulation development with drug-containing products. PMID:21385339

  9. Space Ops 2002: Bringing Space Operations into the 21st Century. Track 3: Operations, Mission Planning and Control. 2nd Generation Reusable Launch Vehicle-Concepts for Flight Operations

    NASA Technical Reports Server (NTRS)

    Hagopian, Jeff

    2002-01-01

    With the successful implementation of the International Space Station (ISS), the National Aeronautics and Space Administration (NASA) enters a new era of opportunity for scientific research. The ISS provides a working laboratory in space, with tremendous capabilities for scientific research. Utilization of these capabilities requires a launch system capable of routinely transporting crew and logistics to/from the ISS, as well as supporting ISS assembly and maintenance tasks. The Space Shuttle serves as NASA's launch system for performing these functions. The Space Shuttle also serves as NASA's launch system for supporting other science and servicing missions that require a human presence in space. The Space Shuttle provides proof that reusable launch vehicles are technically and physically implementable. However, a couple of problems faced by NASA are the prohibitive cost of operating and maintaining the Space Shuttle and its relative inability to support high launch rates. The 2nd Generation Reusable Launch Vehicle (2nd Gen RLV) is NASA's solution to this problem. The 2nd Gen RLV will provide a robust launch system with increased safety, improved reliability and performance, and less cost. The improved performance and reduced costs of the 2nd Gen RLV will free up resources currently spent on launch services. These resource savings can then be applied to scientific research, which in turn can be supported by the higher launch rate capability of the 2nd Gen RLV. The result is a win - win situation for science and NASA. While meeting NASA's needs, the 2nd Gen RLV also provides the United States aerospace industry with a commercially viable launch capability. One of the keys to achieving the goals of the 2nd Gen RLV is to develop and implement new technologies and processes in the area of flight operations. NASA's experience in operating the Space Shuttle and the ISS has brought to light several areas where automation can be used to augment or eliminate functions

  10. Crystal structure of nonsuperconducting Pb 2(Sr 0.94Nd 0.06) 2(Nd 0.76Sr 0.24)Cu 3O 8

    NASA Astrophysics Data System (ADS)

    Hayri, Eric A.; Kvick, Åke

    1990-01-01

    The crystal structure of Pb 2(Sr 0.94Nd 0.06) 2(Nd 0.76Sr 0.24)Cu 3O 8 was determined by single crystal X-ray diffraction. The compound was found to be orthorhombic ( Cmmm) with a = 5.437(3), b = 5.472(2), c = 15.797(7)Å and Z = 2. In the structure double layers of CuO square pyramids are separated by (Nd, Sr) oxygen deficient layers which are stacked between (PbO)Cu(PbO) slabs. The oxygen in the Pb planes is shifted toward a pair of Pb atoms resulting in an orthorhombic distortion of the tetragonal unit cell. The possibilities for modulations and superlattices are discussed as is the role of the PbO planes in superconductivity.

  11. Report from the 2nd Cardiovascular Outcome Trial (CVOT) Summit of the Diabetes and Cardiovascular Disease (D&CVD) EASD Study Group.

    PubMed

    Schnell, Oliver; Standl, Eberhard; Catrinoiu, Doina; Genovese, Stefano; Lalic, Nebojsa; Skra, Jan; Valensi, Paul; Rahelic, Dario; Ceriello, Antonio

    2017-03-11

    The 2nd Cardiovascular Outcome Trial (CVOT) Summit of the Diabetes and Cardiovascular Disease (D&CVD) EASD Study Group was held on the 20th-21st October 2016 in Munich. This second Summit was organized in light of recently published CVOTs on diabetes, with the aim of serving as a reference meeting for discussion on this topic. Along with presentations on the results of the most recently published CVOTs, panel discussions on trial implications for reimbursement and the perspective of cardiologists and/or nephrologists, as well as on CVOTs weaknesses and potentials constituted the heart of the program. Future activities of the D&CVD EASD Study Group in 2017 include an annual meeting in Milano and the 3rd CVOT Summit on Diabetes of the D&CVD EASD Study Group, in Munich ( http://www.dcvd.org ).

  12. Phase transition in tungsten-bronze Li2Pb2Nd2W2Ti4Nb4O30 ferroelectric

    NASA Astrophysics Data System (ADS)

    Parida, B. N.; Das, Piyush R.; Padhee, R.; Choudhary, R. N. P.

    2013-08-01

    The polycrystalline sample of Li2Pb2Nd2W2Ti4Nb4O30 was prepared by a solid-state reaction technique. Room temperature X-ray structural analysis confirms the formation of a single-phase compound. The morphology of the sintered sample recorded by scanning electron microscope exhibits a uniform grain distribution. Detailed studies of the nature of variation of dielectric constant, tangent loss, and polarization with temperature and frequency confirmed the existence of ferroelectricity in the material at room temperature. The temperature and frequency dependence of impedance parameters (impedance, modulus, etc.) of the material exhibits a strong correlation of its microstructure (i.e., bulk, grain boundary, etc.). Furthermore, the temperature dependence of DC conductivity shows a typical Arrhenius behavior of the material. The nature of variation of pyroelectric coefficient and current with temperature suggests that material has good pyroelectric properties useful for pyroelectric detector.

  13. Eye-Safe KGd(WO4)2:Nd Laser: Nano- and Subnanosecond Pulse Generation in Self-Frequency Raman Conversion Mode with Active Q-Switching

    NASA Astrophysics Data System (ADS)

    Dashkevich, V. I.; Orlovich, V. A.

    2017-03-01

    The shape of the multimode Stokes pulse generated by an eye-safe KGd(WO4)2:Nd laser with self-frequency Raman conversion and active Q-switching was shown to depend on the inhomogeneity of the active-medium pump. The laser generated a short and undistorted Stokes pulse of length 2.5 ns that increased with increasing laser cavity length for a moderately inhomogeneous pump characterized by a higher population inversion in the center of the active element. The energy of the Stokes pulse ( 11.5 mJ) varied little as the output-mirror reflectivity varied in the range 5-45%. The Raman pulse became distorted if the inhomogeneity of the pump was increased considerably. The degree of pump inhomogeneity was negligible with fundamental TEM00 mode selection. The laser generated subnanosecond Stokes pulses with peak power in the MW range.

  14. Magnetic structure and spin-wave excitations in the multiferroic magnetic metal-organic framework (CD3)2ND2[Mn(DCO2)3

    NASA Astrophysics Data System (ADS)

    Walker, H. C.; Duncan, H. D.; Le, M. D.; Keen, D. A.; Voneshen, D. J.; Phillips, A. E.

    2017-09-01

    We report the magnetic diffraction pattern and spin-wave excitations in (CD3)2ND2[Mn(DCO2)3] measured using elastic and inelastic neutron scattering. The magnetic structure is shown to be a G -type antiferromagnet with moments pointing along the b axis. By comparison with simulations based on linear spin-wave theory, we have developed a model for the magnetic interactions in this multiferroic metal-organic framework material. The interactions form a three-dimensional network with antiferromagnetic nearest-neighbor interactions along three directions of J1=-0.103 (8 ) meV, J2=-0.032 (8 ) meV, and J3=-0.035 (8 ) meV.

  15. [Quality standards in rectal cancer surgery].

    PubMed

    Pera, M; Pascual, M

    2005-01-01

    The results of surgery for rectal cancer have classically been measured through indicators such as morbidity, mortality, and length of hospital stay. In the last few years other parameters have been included that evaluate healthcare quality such as the functional results of the surgical technique employed and quality of life. Total resection of the mesorectum, performed by experienced surgeons, is the surgical technique of choice. Currently, the sphincter can be preserved in 70% of patients. Anastomotic dehiscence after anterior resection of the rectum is the most serious complication and the most important risk factor is the height of the anastomosis. The overall dehiscence rate should be less than 15% and operative mortality should be between 2% and 3%. The colonic reservoir improves functional outcome and consequently it is the procedure of choice to reconstruct transit after low anterior resection. Local recurrence should be less than 10% and 5-year survival should be between 70% and 80%. In general, quality of life is better after anterior resection of the rectum than after abdominoperineal amputation, despite the functional deterioration presented by some patients.

  16. [Peri-operative treatments for rectal cancer].

    PubMed

    Gérard, Jean-Pierre; Doyen, Jerome; Bénézery, Karen; Borens, Bruno; Hannoun-Levi, Jean-Michel; François, Éric

    2015-06-01

    Depending on its location or stage, rectal cancer may differ significantly. Before any treatment decision a careful work up is mandatory relying mainly on endoscopy and imaging (MRI). Surgery according to the TME principle is the cornerstone of treatment. Most of the time surgery is associated with external beam radiotherapy often combined with concurrent chemotherapy (capecitabine) according to the neoadjuvant regimen CAP 50 (5 weeks long). It is sometimes possible to escalate safely the dose of irradiation using contact X-ray brachytherapy 50 Kv or Iridium 192 interstitial brachytherapy. Adjuvant chemotherapy may be given in case of pejorative pathological findings but its benefit is not yet proven in contrast with colon cancer. Local recurrences are becoming unusual as is permanent APE surgery with permanent stoma. To reduce the risk of distant metastasis clinical trials are testing first line chemotherapy in T3-4 lesions. For early stage (T2-"small" T3) clinical trials try to achieve organ preservation. Intensification of CAP 50 either with more chemotherapy or radiation dose escalation using contact X-ray aim at achieving a clinical complete response followed by local excision or close surveillance.

  17. Outcome of young patients with rectal adenocarcinoma

    PubMed Central

    Salcedo-Hernández, Rosa A.; Ruiz-García, Erika B.; León-Takahashi, Alberto M.; García-Pérez, Leticia

    2017-01-01

    Background There is an increase in the incidence of rectal carcinoma (RC) in young patients. Methods We analyzed 175 patients with sporadic RC which were divided in two groups according their age: 24 patients ≤40 years and 151 patients >40 years and the two groups were compared in order to determine if the outcomes (especially overall 5-year survival) were different. Results Overall 5-year survival was similar between groups (67.1% for patients over 40 years and 70.4% for those under 40 years, P=0.803). The only differences found were in some clinicopathologic features: patients <40 years showed more dissected lymph nodes (LNs) (21 vs. 15, P=0.035) and more LN metastasis (54.2% vs. 39.1%, P=0.048). In multivariate analysis factors associated with worse survival were incomplete resection and no use of neoadjuvant therapy. Age did not demonstrate prognostic value (P=0.077). Conclusions RC in people ≤40 years demonstrated greater number of LN harvested and LN metastases but oncologic outcomes, especially 5-year overall survival, were similar between groups. PMID:28280614

  18. Rectal suppository: commonsense and mode of insertion.

    PubMed

    Abd-el-Maeboud, K H; el-Naggar, T; el-Hawi, E M; Mahmoud, S A; Abd-el-Hay, S

    1991-09-28

    Rectal suppository is a well-known form of medication and its use is increasing. The commonest shape is one with an apex (pointed end) tapering to a base (blunt end). Because of a general lack of information about mode of insertion, we asked 360 lay subjects (Egyptians and non-Egyptians) and 260 medical personnel (physicians, pharmacists, and nurses) by questionnaire which end they inserted foremost. Apart from 2 individuals, all subjects suggested insertion with the apex foremost. Commonsense was the most frequent basis for this practice (86.9% of lay subjects and 84.6% of medical personnel) followed by information from a relative, a friend, or medical personnel, or from study at medical school. Suppository insertion with the base or apex foremost was compared in 100 subjects (60 adults, 40 infants and children). Retention with the former method was more easily achieved in 98% of the cases, with no need to introduce a finger in the anal canal (1% vs 83%), and lower expulsion rate (0% vs 3%). The designer of the "torpedo-shaped" suppository suggested its insertion with apex foremost. Our data suggest that a suppository is better inserted with the base foremost. Reversed vermicular contractions or pressure gradient of the anal canal might press it inwards.

  19. The influence of Nd3+ in CaAl2O4:Eu2+,Nd3+ phosphor fabricated by combustion synthesis

    NASA Astrophysics Data System (ADS)

    Yang, Zhiping; Yang, Yong; Li, Xingmin; Li, Xu; Liu, Chong; Feng, Jianwei

    2005-01-01

    Eu2+, Nd3+ co-doped calcium aluminate (CaAl2O4) phosphor with high brightness and long afterglow were fabricated by urea-nitrate solution combustion synthesis at 600°C. The phosphor powder of combustion synthesis were generally more homogeneous and had fewer impurity than phosphor fabricated by conventional solid-state methods, the character could conduce to obtain more exact data. The excitation and emission spectrum indicated that there waxs only one luminescence center Eu2+, both of the characteristic spectrums of Eu3+ and Nd3+ weren't discovered. As a secondary activator, Nd3+ could make remarkable influence on the afterglow of phosphor. From altering the moral ratio of Eu2+ and Nd3+, the lasting time of afterglow and thermoluminescence were studied respectively, when Nd3+ wasn't appended, the intensity of initial brightness could compared with other materials which had different ratio of Eu2+ and Nd3+, however the brightness of afterglow decayed rapidly, the lasting time and brightness of afterglow were improved with reduce the radio of Eu2+ and Nd3+, while the ratio achieved some value, the lasting time of afterglow become shorten with the reduce of ratio of Eu2+ and Nd3+. Moreover the depth of trap was calculated from the parameter of thermoluminescence. However, the emission spectrum and XRD patterns didn't change obviously with the altering ratio of Eu2+ and Nd3+. It showed that the little amount of doped rear earth ions (Eu2+ and Nd3+) had almost no effect on the CaAl2O4 phase composition. Based on these conclusions, the model of the luminescence process of CaAl2O4:Eu2+, Nd3+ was built.

  20. Differentially expressed genes in the head of the 2nd instar pre-molting larvae of the nm2 mutant of the silkworm, Bombyx mori

    PubMed Central

    Wu, Fan; Xu, Pingzhen; Shen, Xingjia

    2017-01-01

    Molting is an important physiological process in the larval stage of Bombyx mori and is controlled by various hormones and peptides. The silkworm mutant that exhibits the phenotype of non-molting in the 2nd instar (nm2) is incapable of molting in the 2nd instar and dies after seven or more days. The ecdysone titer in the nm2 mutant is lower than that in the wildtype, and the mutant can be rescued by feeding with 20E and cholesterol. The results of positional cloning indicated that structural alteration of BmCPG10 is responsible for the phenotype of the nm2 mutant. To explore the possible relationship between BmCPG10 and the ecdysone titer as well as the genes affected by BmCPG10, digital gene expression (DGE) profile analysis was conducted in the nm2 mutant, with the wildtype strain C603 serving as the control. The results revealed 1727 differentially expressed genes, among which 651 genes were upregulated and 1076 were downregulated in nm2. BLASTGO analysis showed that these differentially expressed genes were involved in various biological processes, cellular components and molecular functions. KEGG analysis indicated an enrichment of these differentially expressed genes in 240 pathways, including metabolic pathways, pancreatic secretion, protein digestion and absorption, fat digestion and absorption and glycerolipid metabolism. To verify the accuracy of the DGE results, quantitative reverse transcription PCR (qRT-PCR) was performed, focusing on key genes in several related pathways, and the results were highly consistent with the DGE results. Our findings indicated significant differences in cuticular protein genes, ecdysone biosynthesis genes and ecdysone-related nuclear receptors genes, but no significant difference in juvenile hormone and chitin biosynthesis genes was detected. Our research findings lay the foundation for further research on the formation mechanism of the nm2 mutant. PMID:28727825

  1. Wound healing and soft tissue effects of CO2, contact Nd: YAG and combined CO2-Nd: YAG laser beams on rabbit trachea.

    PubMed

    Laranne, J; Lagerstedt, A; Pukander, J; Rantala, I

    1997-11-01

    Rabbit trachea was used as an experimental model to study tissue effects and healing of full-thickness tracheal lesions produced by CO2, contact Nd: YAG and combined, coaxial CO2-Nd: YAG (Combo) laser beams. Two power settings (10 W and 16 W) were used with CO2 and contact Nd: YAG lasers. Three different CO2/Nd:YAG power ratios (1:1, 1:2 and 1:4) and power settings (12 W 15 W and 16 W) were used with the Combolaser. Histological specimens for light and transmission electron microscopy were prepared immediately and 1, 3, 5, 7, 14 and 21 days postoperatively. The wound with the most precise and fastest healing was produced by contact Nd: YAG laser. CO2 laser produced a moderate amount of charring and the largest amount of coagulated tissue with a slightly prolonged healing period. In the acute phase, tissue defects produced by the Combolaser with power ratios 1:1 and 1:2 resembled the CO2 laser lesions but with slightly less charring. The power ratio 1:4 diminished the cutting properties of the beam considerably. During the healing period the Combolaser produced the most intensive inflammation and granulation tissue formation resulting in delayed regeneration of the lesion. In transmission electron micrographs the most severe damage to chondrocytes was seen after using the Combolaser. These findings indicate that the Combolaser produces deeper tissue damage than CO2 or contact Nd:YAG laser. However, the Combolaser appears to be suitable for tracheobronchial operations, owing to its good simultaneous cutting and haemostatic properties.

  2. Robot-assisted Versus Laparoscopic Surgery for Rectal Cancer: A Phase II Open Label Prospective Randomized Controlled Trial.

    PubMed

    Kim, Min Jung; Park, Sung Chan; Park, Ji Won; Chang, Hee Jin; Kim, Dae Yong; Nam, Byung-Ho; Sohn, Dae Kyung; Oh, Jae Hwan

    2017-05-25

    The phase II randomized controlled trial aimed to compare the outcomes of robot-assisted surgery with those of laparoscopic surgery in the patients with rectal cancer. The feasibility of robot-assisted surgery over laparoscopic surgery for rectal cancer has not been established yet. Between February 21, 2012 and March 11, 2015, patients with rectal cancer (cT1-3NxM0) were enrolled. Patients were randomized 1:1 to either robot-assisted or laparoscopic surgery, and stratified per sex and administration of preoperative chemoradiotherapy. The primary outcome was the quality of total mesorectal excision (TME) specimen. Secondary outcomes were the circumferential and distal resection margins, the number of harvested lymph nodes, morbidity, bowel function recovery, and quality of life. A total of 163 patients were randomly assigned to the robot-assisted (n = 81) and laparoscopic (n = 82) surgery groups, and 139 patients were eligible for the analyses (73 vs 66, respectively). One patient (1.2%) in the robot-assisted group was converted to open surgery. The TME quality did not differ between the robot-assisted and laparoscopic groups (80.3% vs 78.1% complete TME, respectively; 18.2% vs 21.9% nearly complete TME, respectively; P = 0.599). The resection margins, number of harvested lymph nodes, morbidity, and bowel function recovery also were not significantly different. On analyzing quality of life, scores of the European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLQ C30) and EORTC QLQ CR38 were similar in the 2 groups, but in the EORTC QLQ CR 38 questionnaire, sexual function 12 months postoperatively was better in the robot-assisted group than in the laparoscopic group (P = 0.03). Robot-assisted surgery in rectal cancer showed TME quality comparable with that of laparoscopic surgery, and it demonstrated similar postoperative morbidity, bowel function recovery, and quality of life.

  3. [A Case of Rectal Syphilis Incidentally Found at Regular Medical Check-up].

    PubMed

    You, Ji Hong; Cho, Ki Won; Cha, Yoon Jin; Park, Hyo Jin

    2016-10-25

    Syphilis is a rare disease in the rectum. It is difficult to diagnose because the characteristics of the rectal syphilis rectal lesion are highly varied. The endoscopic findings of rectal syphilis are proctitis, ulcers, and masses. If rectal syphilis is suspected to be the cause for rectal lesions, it is important for physicians to consider the sexual history and sexual orientation of the patient. We report a case of incidental rectal syphilis in a 41-year-old man diagnosed during a regular medical check-up.

  4. Digital rectal examination in the evaluation of rectovaginal septal defects.

    PubMed

    Rachaneni, Suneetha; Atan, Ixora Kamisan; Shek, Ka Lai; Dietz, Hans Peter

    2017-02-17

    The objective was to evaluate the diagnostic potential of digital rectal examination in the identification of a true rectocele. This is a retrospective observational study utilising 187 archived data sets of women presenting with lower urinary tract symptoms and/or pelvic organ prolapse between August 2012 and November 2013. Evaluation included a standardised interview, ICS-POPQ, rectal examination and 4D translabial ultrasound. The main outcome measure was the diagnosis of rectocele by digital rectal palpation on Valsalva manoeuvre. This diagnosis correlated with the sonographic diagnosis of rectocele to determine agreement between digital examination and ultrasound findings. Complete data sets were available for 180 participants. On imaging, the mean position of the rectal ampulla was 11.07 (-36.3 to 44.3) mm below the symphysis pubis; 42.8% (77) had a rectocele of a depth of ≥10 mm. On palpation, a rectocele was detected in 60 women (33%). Agreement between palpation and imaging was observed in 77%; the kappa was 0.52 (CI 0.39-0.65). On receiver operator characteristic analysis, the area under the curve was 0.854 for the relationship between rectocele pocket depth and the detection of rectocele on palpation. Moderate agreement was found between digital rectal examination for rectocele and translabial ultrasound findings of a "true rectocele". Digital rectal examination may be used to identify these defects in clinical practice. Extending the clinical examination of prolapse to include rectal examination to palpate defects in the rectovaginal septum may reduce the need for defecatory proctograms for the assessment of obstructive defecation and may help triage patients in the management of posterior compartment prolapse.

  5. 'Objective' assessment of rectal sensation: a novel approach.

    PubMed

    Shafik, Ahmed; El-Sibai, Olfat; Shafik, Ali A; Ahmed, Ismail

    2004-01-01

    Rectal sensation is used as an investigative tool in the diagnosis of anorectal pathology. However, the data obtained are subjective depending on the patient's perception of the sensation. We investigated the hypothesis that sympathetic skin response (SSR) can be used as a tool for objective assessment of the rectal sensation. The SSR was recorded in 24 healthy volunteers (age 37.2 years, 14 men) using a surface electrode applied to the skin of the palmar surface of the subject's hand and a reference electrode to the dorsum of the same hand. The EMG activity of the pelvic floor muscles was registered by a surface electrode fixed to the perineal skin. The subject was asked before and after individual anesthetization of the rectum and palm to report the first rectal and urge sensations during balloon filling of the rectum in increments of 10 ml of saline. Low volume rectal distension effected no sympathetic skin or pelvic floor responses, while larger volumes produced the response. The skin and pelvic floor responses occurred with every rectal sensation and corresponded with the volunteers' subjective perception. Urge suppression was associated with synchronous decrease of skin and pelvic floor responses which disappeared on balloon expulsion. Rectal balloon distension, 20 minutes after individual anesthetization of the rectum or palm produced no palm skin response, which returned however 3 hours later. A novel approach which can objectively define subjective perceptions arising from the rectum has been identified. Rectal sensations produce coordinated sympathetic skin response and pelvic floor activity which seem to be mediated through a reflex which we term the "recto-palmar reflex". Further studies are required to investigate the role of this reflex in defection and sympathetic disorders.

  6. Apex technique in the treatment of obstructed defecation syndrome associated with rectal intussusception and full rectal mucosa prolapse.

    PubMed

    Regadas, F Sergio P; Abedrapo, Mario; Cruz, Jose Vinicius; Murad Regadas, Sthela M; Regadas Filho, F Sergio P

    2014-11-01

    The aim of the current study was to demonstrate the use of a modified stapling technique, called the apex technique, to treat rectal intussusception and full rectal mucosal prolapse. It was conducted as a retrospective study at 3 centers (2 in Brazil and 1 in Chile). The apex technique is performed by using a HEM/EEA-33 stapler. A pursestring suture is placed at the apex of the prolapse, on the 4 quadrants, independent of the distance to the dentate line. A second pursestring is then placed to define the band of rectal mucosa to be symmetrically resected. Outcome measures included width of the resected full-thickness rectal wall; the intensity of postoperative pain on a visual analog scale from 1 to 10; full mucosal prolapse and rectal intussusception assessed by physical examination, cinedefecography, or echodefecography; and change in the constipation scale. Forty-five patients (30 women/15 men; mean age, 59.5 years) with rectal intussusception and full mucosal prolapse were included. The median operative time was 17 (range, 15-30) minutes. Bleeding after stapler fire requiring manual suture occurred in 3 patients (6.7%); 25 (55.6%) patients reported having no postoperative pain. Hospital stay was 24 hours. The mean width of the resected rectal wall was 5.9 (range, 5.0-7.5) cm. Stricture at the staple line was seen in 4 patients, of whom 1 required dilation under anesthesia. The median follow-up time was 120 (range, 90-120) days. A small residual prolapse was identified in 6 (13.3%) patients. Imaging demonstrated complete disappearance of rectal intussusception in all patients, and the mean postoperative constipation score decreased from 13 (range, 8-15) to 5 (range, 3-7). The apex technique appears to be a safe, quickly performed, and low-cost method for the treatment of rectal intussusception. In this series, imaging examinations showed the disappearance of rectal intussusception, and a significant decrease in constipation score suggested improvement in

  7. Results of Neoadjuvant Short-Course Radiation Therapy Followed by Transanal Endoscopic Microsurgery for T1-T2 N0 Extraperitoneal Rectal Cancer

    SciTech Connect

    Arezzo, Alberto; Arolfo, Simone; Allaix, Marco Ettore; Munoz, Fernando; Cassoni, Paola; Monagheddu, Chiara; Ricardi, Umberto; Ciccone, Giovannino; Morino, Mario

    2015-06-01

    Purpose: This study was undertaken to assess the short-term outcomes of neoadjuvant short-course radiation therapy (SCRT) followed by transanal endoscopic microsurgery (TEM) for T1-T2 N0 extraperitoneal rectal cancer. Recent studies suggest that neoadjuvant radiation therapy followed by TEM is safe and has results similar to those with abdominal rectal resection for the treatment of extraperitoneal early rectal cancer. Methods and Materials: We planned a prospective pilot study including 25 consecutive patients with extraperitoneal T1-T2 N0 M0 rectal adenocarcinoma undergoing SCRT followed by TEM 4 to 10 weeks later (SCRT-TEM). Safety, efficacy, and acceptability of this treatment modality were compared with historical groups of patients with similar rectal cancer stage and treated with long-course radiation therapy (LCRT) followed by TEM (LCRT-TEM), TEM alone, or laparoscopic rectal resection with total mesorectal excision (TME) at our institution. Results: The study was interrupted after 14 patients underwent SCRT of 25 Gy in 5 fractions followed by TEM. Median time between SCRT and TEM was 7 weeks (range: 4-10 weeks). Although no preoperative complications occurred, rectal suture dehiscence was observed in 7 patients (50%) at 4 weeks follow-up, associated with an enterocutaneous fistula in the sacral area in 2 cases. One patient required a colostomy. Quality of life at 1-month follow-up, according to European Organization for Research and Treatment of Cancer QLQ-C30 survey score, was significantly worse in SCRT-TEM patients than in LCRT-TEM patients (P=.0277) or TEM patients (P=.0004), whereas no differences were observed with TME patients (P=.604). At a median follow-up of 10 months (range: 6-26 months), we observed 1 (7%) local recurrence at 6 months that was treated with abdominoperineal resection. Conclusions: SCRT followed by TEM for T1-T2 N0 rectal cancer is burdened by a high rate of painful dehiscence of the suture line and enterocutaneous

  8. Nomogram to predict rectal toxicity following prostate cancer radiotherapy

    PubMed Central

    Delobel, Jean-Bernard; Ospina, Juan David; Beckendorf, Véronique; Chira, Ciprian; Zhu, Jian; Bossi, Alberto; Messai, Taha; Acosta, Oscar; Castelli, Joël; de Crevoisier, Renaud

    2017-01-01

    Background To identify predictors of acute and late rectal toxicity following prostate cancer radiotherapy (RT), while integrating the potential impact of RT technique, dose escalation, and moderate hypofractionation, thus enabling us to generate a nomogram for individual prediction. Methods In total, 972 patients underwent RT for localized prostate cancer, to a total dose of 70 Gy or 80 Gy, using two different fractionations (2 Gy or 2.5 Gy/day), by means of several RT techniques (3D conformal RT [3DCRT], intensity-modulated RT [IMRT], or image-guided RT [IGRT]). Multivariate analyses were performed to identify predictors of acute and late rectal toxicity. A nomogram was generated based on the logistic regression model used to predict the 3-year rectal toxicity risk, with its accuracy assessed by dividing the cohort into training and validation subgroups. Results Mean follow-up for the entire cohort was 62 months, ranging from 6 to 235. The rate of acute Grade ≥2 rectal toxicity was 22.2%, decreasing when combining IMRT and IGRT, compared to 3DCRT (RR = 0.4, 95%CI: 0.3–0.6, p<0.01). The 5-year Grade ≥2 risks for rectal bleeding, urgency/tenesmus, diarrhea, and fecal incontinence were 9.9%, 4.5%, 2.8%, and 0.4%, respectively. The 3-year Grade ≥2 risk for overall rectal toxicity increased with total dose (p<0.01, RR = 1.1, 95%CI: 1.0–1.1) and dose per fraction (2Gy vs. 2.5Gy) (p = 0.03, RR = 3.3, 95%CI: 1.1–10.0), and decreased when combining IMRT and IGRT (RR = 0.50, 95% CI: 0.3–0.8, p<0.01). Based on these three parameters, a nomogram was generated. Conclusions Dose escalation and moderate hypofractionation increase late rectal toxicity. IMRT combined with IGRT markedly decreases acute and late rectal toxicity. Performing combined IMRT and IGRT can thus be envisaged for dose escalation and moderate hypofractionation. Our nomogram predicts the 3-year rectal toxicity risk by integrating total dose, fraction dose, and RT technique. PMID:28640871

  9. [Repeatability of measurements of the rectal temperature and comparison of vaginal and rectal temperature in puerperal sows].

    PubMed

    Stiehler, T; Heuwieser, W; Pfützner, A; Voigtsberger, R; Burfeind, O

    2013-01-01

    Postpartum diseases of sows are economically important in the pig industry. They affect animal health and welfare of sows and piglets. Measuring rectal temperature in sows post partum is a commonly used diagnostic method to early detection of infectious diseases. The study consisted of five parts. The objective of the first four parts was to evaluate the influence of different factors on the measurements of rectal temperature (e.g. investigator, thermometer, penetration depth of the thermometer). The secondary objective of this study was to validate the application of a temperature logger to continuously measure vaginal temperature. Thirty sows on the first day postpartum were used in the first four parts of the study. Rectal temperature was measured repeatedly by one investigator, by different investigators, with different thermometers and at different penetration depths. For the fifth part of the study 21 sows on the first day postpartum were used. A temperature logger was inserted in the vagina for a duration of 6 hours. Additionally, rectal temperature was measured. The data showed that rectal temperature can be measured repeatably (mean ± standard deviation = 38.7 ± 0.1 °C, coefficient of variation = 0.2%). Different investigators or thermometers resulted in low differences (0.0 °C and 0.1 °C). The penetration depth of the thermometer influenced the result (difference of 0.4 °C between 5 and 10 cm). Rectal and vaginal temperatures, measured in 21 sows, were highly correlated (r = 0.80, p < 0.01) with a mean difference of 0.3 °C. Rectal temperature measurement can be regarded as a repeatable diagnostic method. The measurement should be standardized (type of thermometer, penetration depth). The measurement of vaginal temperature with a data logger in early puerperal sows is a possible means for a continuous and non-invasive monitoring of body temperature.

  10. Sexual Function in Males After Radiotherapy for Rectal Cancer

    SciTech Connect

    Bruheim, Kjersti; Guren, Marianne G.; Dahl, Alv A.; Skovlund, Eva; Balteskard, Lise; Carlsen, Erik; Fossa, Sophie D.; Tveit, Kjell Magne

    2010-03-15

    Purpose: Knowledge of sexual problems after pre- or postoperative radiotherapy (RT) with 50 Gy for rectal cancer is limited. In this study, we aimed to compare self-rated sexual functioning in irradiated (RT+) and nonirradiated (RT-) male patients at least 2 years after surgery for rectal cancer. Methods and Materials: Patients diagnosed with rectal cancer from 1993 to 2003 were identified from the Norwegian Rectal Cancer Registry. Male patients without recurrence at the time of the study. The International Index of Erectile Function, a self-rated instrument, was used to assess sexual functioning, and serum levels of serum testosterone were measured. Results: Questionnaires were returned from 241 patients a median of 4.5 years after surgery. The median age was 67 years at survey. RT+ patients (n = 108) had significantly poorer scores for erectile function, orgasmic function, intercourse satisfaction, and overall satisfaction with sex life compared with RT- patients (n = 133). In multiple age-adjusted analysis, the odds ratio for moderate-severe erectile dysfunction in RT+ patients was 7.3 compared with RT- patients (p <0.001). Furthermore, erectile dysfunction of this degree was associated with low serum testosterone (p = 0.01). Conclusion: RT for rectal cancer is associated with significant long-term effects on sexual function in males.

  11. Toward Restored Bowel Health in Rectal Cancer Survivors.

    PubMed

    Steineck, Gunnar; Schmidt, Heike; Alevronta, Eleftheria; Sjöberg, Fei; Bull, Cecilia Magdalena; Vordermark, Dirk

    2016-07-01

    As technology gets better and better, and as clinical research provides more and more knowledge, we can extend our ambition to cure patients from cancer with restored physical health among the survivors. This increased ambition requires attention to grade 1 toxicity that decreases quality of life. It forces us to document the details of grade 1 toxicity and improve our understanding of the mechanisms. Long-term toxicity scores, or adverse events as documented during clinical trials, may be regarded as symptoms or signs of underlying survivorship diseases. However, we lack a survivorship nosology for rectal cancer survivors. Primarily focusing on radiation-induced side effects, we highlight some important observations concerning late toxicity among rectal cancer survivors. With that and other data, we searched for a preliminary survivorship-disease nosology for rectal cancer survivors. We disentangled the following survivorship diseases among rectal cancer survivors: low anterior resection syndrome, radiation-induced anal sphincter dysfunction, gut wall inflammation and fibrosis, blood discharge, excessive gas discharge, excessive mucus discharge, constipation, bacterial overgrowth, and aberrant anatomical structures. The suggested survivorship nosology may form the basis for new instruments capturing long-term symptoms (patient-reported outcomes) and professional-reported signs. For some of the diseases, we can search for animal models. As an end result, the suggested survivorship nosology may accelerate our understanding on how to prevent, ameliorate, or eliminate manifestations of treatment-induced diseases among rectal cancer survivors.

  12. [Rectal ozone therapy for patients with pulmonary emphysema].

    PubMed

    Calunga, José Luis; Paz, Yuleidys; Menéndez, Silvia; Martínez, Alfredo; Hernández, Aparicio

    2011-04-01

    Ozone therapy may stimulate antioxidant systems and protect against free radicals. It has not been used formerly in patients with pulmonary emphysema. To assess the effects of rectal ozone therapy in patients with pulmonary emphysema. Sixty four patients with pulmonary emphysema, aged between 40 and 69 years, were randomly assigned to receive rectal ozone in 20 daily sessions, rectal medicinal oxygen or no treatment. Treatments were repeated three months later in the first two groups. At baseline and at the end of the study, spirometry and a clinical assessment were performed. fifty patients completed the protocol, 20 receiving ozone therapy, 20 receiving rectal oxygen and 10 not receiving any therapy. At baseline, patients on ozone therapy had significantly lower values of forced expiratory volume in the first second (fEV1) and fEV1/forced vital capacity. At the end of the treatment period, these parameters were similar in the three treatment groups, therefore they only improved significantly in the group on ozone therapy. No differences were observed in other spirometric parameters. Rectal ozone therapy may be useful in patients with pulmonary emphysema.

  13. Bladder and rectal complications following radiotherapy for cervix cancer

    SciTech Connect

    Stryker, J.A.; Bartholomew, M.; Velkley, D.E.; Cunningham, D.E.; Mortel, R.; Craycraft, G.; Shafer, J.

    1988-01-01

    One-hundred and thirty-two patients with cervix carcinoma who were treated with whole pelvis irradiation and two intracavitary applications had bladder and rectal dosimetry during brachytherapy with contrast agents placed into the bladder and rectum prior to orthogonal simulator radiographs. Doses were computer calculated at points A and B, F (bladder), R1 (rectum), and R2 (rectosigmoid). Late occurring bladder and rectal complications were graded on a severity scale of 1 to 3, and 14% had grade 2 or 3 injuries (9% developed fistulas). Statistical evaluation of the data showed that severe bladder and rectal injuries occur more commonly in stage IIIA and IIIB disease and in those receiving high external beam doses (5000 rad +). Analysis of variance tests revealed a significant correlation of brachytherapy dose to points R1 and R2 with severe rectal injuries but there was not a correlation of dose to F with bladder injuries. Nor was there correlation of injuries with dose to point A or the milligram-hour dose. We conclude that our technique for rectal dosimetry is adequate but that an improved technique of bladder dosimetry is needed. Also, when combining whole pelvis irradiation with two intracavitary applications (4000 rad to point A), the whole pelvis dose should probably not exceed 4000-4500 rad.

  14. Patterns of metastasis in colon and rectal cancer

    PubMed Central

    Riihimäki, Matias; Hemminki, Akseli; Sundquist, Jan; Hemminki, Kari

    2016-01-01

    Investigating epidemiology of metastatic colon and rectal cancer is challenging, because cancer registries seldom record metastatic sites. We used a population based approach to assess metastatic spread in colon and rectal cancers. 49,096 patients with colorectal cancer were identified from the nationwide Swedish Cancer Registry. Metastatic sites were identified from the National Patient Register and Cause of Death Register. Rectal cancer more frequently metastasized into thoracic organs (OR = 2.4) and the nervous system (1.5) and less frequently within the peritoneum (0.3). Mucinous and signet ring adenocarcinomas more frequently metastasized within the peritoneum compared with generic adenocarcinoma (3.8 [colon]/3.2 [rectum]), and less frequently into the liver (0.5/0.6). Lung metastases occurred frequently together with nervous system metastases, whereas peritoneal metastases were often listed with ovarian and pleural metastases. Thoracic metastases are almost as common as liver metastases in rectal cancer patients with a low stage at diagnosis. In colorectal cancer patients with solitary metastases the survival differed between 5 and 19 months depending on T or N stage. Metastatic patterns differ notably between colon and rectal cancers. This knowledge should help clinicians to identify patients in need for extra surveillance and gives insight to further studies on the mechanisms of metastasis. PMID:27416752

  15. Patient surveillance after curative-intent surgery for rectal cancer.

    PubMed

    Johnson, Frank E; Longo, Walter E; Ode, Kenichi; Shariff, Umar S; Papettas, Trifonas; McGarry, Alaine E; Gammon, Steven R; Lee, Paul A; Audisio, Riccardo A; Grossmann, Erik M; Virgo, Katherine S

    2005-09-01

    The follow-up of patients with rectal cancer after potentially curative resection has significant financial and clinical implications for patients and society. The ideal regimen for monitoring patients is unknown. We evaluated the self-reported practice patterns of a large, diverse group of experts. There is little information available describing the actual practice of clinicians who perform potentially curative surgery on rectal cancer patients and follow them after recovery. The 1795 members of the American Society of Colon and Rectal Surgeons were asked, via a detailed questionnaire, how often they request 14 discrete follow-up modalities in their patients treated for cure with TNM stage I, II, or III rectal cancer over the first five post-treatment years. 566/1782 (32%) responded and 347 of the respondents (61%) provided evaluable data. Members of the American Society of Colon and Rectal Surgeons typically follow their own patients postoperatively rather than sending them back to their referral source. Office visit and serum CEA level are the most frequently requested items for each of the first five postoperative years. Endoscopy and imaging tests are also used regularly. Considerable variation exists among these highly experienced, highly credentialed experts. The surveillance strategies reported here rely most heavily on relatively simple and inexpensive tests. Endoscopy is employed frequently; imaging tests are employed less often. The observed variation in the intensity of postoperative monitoring is of concern.

  16. Lamellipodin-Deficient Mice: A Model of Rectal Carcinoma

    PubMed Central

    Miller, Cassandra L.; Muthupalani, Sureshkumar; Shen, Zeli; Drees, Frauke; Ge, Zhongming; Feng, Yan; Chen, Xiaowei; Gong, Guanyu; Nagar, Karan K.; Wang, Timothy C.; Gertler, Frank B.; Fox, James G.

    2016-01-01

    During a survey of clinical rectal prolapse (RP) cases in the mouse population at MIT animal research facilities, a high incidence of RP in the lamellipodin knock-out strain, C57BL/6-Raph1tm1Fbg (Lpd-/-) was documented. Upon further investigation, the Lpd-/- colony was found to be infected with multiple endemic enterohepatic Helicobacter species (EHS). Lpd-/- mice, a transgenic mouse strain produced at MIT, have not previously shown a distinct immune phenotype and are not highly susceptible to other opportunistic infections. Predominantly male Lpd-/- mice with RP exhibited lesions consistent with invasive rectal carcinoma concomitant to clinically evident RP. Multiple inflammatory cytokines, CD11b+Gr1+ myeloid-derived suppressor cell (MDSC) populations, and epithelial cells positive for a DNA damage biomarker, H2AX, were elevated in affected tissue, supporting their role in the neoplastic process. An evaluation of Lpd-/- mice with RP compared to EHS-infected, but clinically normal (CN) Lpd-/- animals indicated that all of these mice exhibit some degree of lower bowel inflammation; however, mice with prolapses had significantly higher degree of focal lesions at the colo-rectal junction. When Helicobacter spp. infections were eliminated in Lpd-/- mice by embryo transfer rederivation, the disease phenotype was abrogated, implicating EHS as a contributing factor in the development of rectal carcinoma. Here we describe lesions in Lpd-/- male mice consistent with a focal inflammation-induced neoplastic transformation and propose this strain as a mouse model of rectal carcinoma. PMID:27045955

  17. Multiple differential expression networks identify key genes in rectal cancer.

    PubMed

    Li, Ri-Heng; Zhang, Ai-Min; Li, Shuang; Li, Tian-Yang; Wang, Lian-Jing; Zhang, Hao-Ran; Li, Ping; Jia, Xiong-Jie; Zhang, Tao; Peng, Xin-Yu; Liu, Min-Di; Wang, Xu; Lang, Yan; Xue, Wei-Lan; Liu, Jing; Wang, Yan-Yan

    2016-01-01

    Rectal cancer is an important contributor to cancer mortality. The objective of this paper is to identify key genes across three phenotypes (fungating, polypoid and polypoid & small-ulcer) of rectal cancer based on multiple differential expression networks (DENs). Differential interactions and non-differential interactions were evaluated according to Spearman correlation coefficient (SCC) algorithm, and were selected to construct DENs. Topological analysis was performed for exploring hub genes in largest components of DENs. Key genes were denoted as intersections between nodes of DENs and rectal cancer associated genes from Genecards. Finally, we utilized hub genes to classify phenotypes of rectal cancer on the basis of support vector machines (SVM) methodology. We obtained 19 hub genes and total 12 common key genes of three largest components of DENs, and EGFR was the common element. The SVM results revealed that hub genes could classify phenotypes, and validated feasibility of DEN methods. We have successfully identified significant genes (such as EGFR and UBC) across fungating, polypoid and polypoid & small-ulcer phenotype of rectal cancer. They might be potential biomarkers for classification, detection and therapy of this cancer.

  18. Recent advances in robotic surgery for rectal cancer.

    PubMed

    Ishihara, Soichiro; Otani, Kensuke; Yasuda, Koji; Nishikawa, Takeshi; Tanaka, Junichiro; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Hata, Keisuke; Kawai, Kazushige; Nozawa, Hiroaki; Kazama, Shinsuke; Yamaguchi, Hironori; Sunami, Eiji; Kitayama, Joji; Watanabe, Toshiaki

    2015-08-01

    Robotic technology, which has recently been introduced to the field of surgery, is expected to be useful, particularly in treating rectal cancer where precise manipulation is necessary in the confined pelvic cavity. Robotic surgery overcomes the technical drawbacks inherent to laparoscopic surgery for rectal cancer through the use of multi-articulated flexible tools, three-dimensional stable camera platforms, tremor filtering and motion scaling functions, and greater ergonomic and intuitive device manipulation. Assessments of the feasibility and safety of robotic surgery for rectal cancer have reported similar operation times, blood loss during surgery, rates of postoperative morbidity, and circumferential resection margin involvement when compared with laparoscopic surgery. Furthermore, rates of conversion to open surgery are reportedly lower with increased urinary and male sexual functions in the early postoperative period compared with laparoscopic surgery, demonstrating the technical advantages of robotic surgery for rectal cancer. However, long-term outcomes and the cost-effectiveness of robotic surgery for rectal cancer have not been fully evaluated yet; therefore, large-scale clinical studies are required to evaluate the efficacy of this new technology.

  19. Voiding Dysfunction after Total Mesorectal Excision in Rectal Cancer

    PubMed Central

    Kim, Jae Heon; Noh, Tae Il; Oh, Mi Mi; Park, Jae Young; Lee, Jeong Gu; Um, Jun Won; Min, Byung Wook

    2011-01-01

    Purpose The aim of this study was to assess the voiding dysfunction after rectal cancer surgery with total mesorectal excision (TME). Methods This was part of a prospective study done in the rectal cancer patients who underwent surgery with TME between November 2006 and June 2008. Consecutive uroflowmetry, post-voided residual volume, and a voiding questionnaire were performed at preoperatively and postoperatively. Results A total of 50 patients were recruited in this study, including 28 male and 22 female. In the comparison of the preoperative data with the postoperative 3-month data, a significant decrease in mean maximal flow rate, voided volume, and post-voided residual volume were found. In the comparison with the postoperative 6-month data, however only the maximal flow rate was decreased with statistical significance (P=0.02). In the comparison between surgical methods, abdominoperineal resection patients showed delayed recovery of maximal flow rate, voided volume, and post-voided residual volume. There was no significant difference in uroflowmetry parameters with advances in rectal cancer stage. Conclusions Voiding dysfunction is common after rectal cancer surgery but can be recovered in 6 months after surgery or earlier. Abdominoperineal resection was shown to be an unfavorable factor for postoperative voiding. Larger prospective study is needed to determine the long-term effect of rectal cancer surgery in relation to male and female baseline voiding condition. PMID:22087426

  20. [Current MRI staging of rectal cancer].

    PubMed

    Wietek, B M; Kratt, T

    2012-11-01

    Colorectal carcinoma is the second most prevalent cause for cancer, and has very variable outcomes. Advancements in surgery, the change from adjuvant to neo-adjuvant radio-chemo-therapies as well as in clinical diagnostics have improved the prognosis for patients in a multi-modal therapy concept. An accurate primary staging including a reliable prediction of the circumferential resection margin (CRM) has established MR Imaging (MRI) beside intraluminal endoscopic ultrasound (EUS). MRI facilitates the selection of patients likely to benefit from a preoperative therapy, especially in cases of unfavorable factors. Currently the relationship of the tumor to the mesorectal fascia has become a more important prognostic factor than the T-staging, particularly for surgical therapy. In addition further prognostic factors like the depth of infiltration into the perirectal fat and the extramural venous infiltration (EMVI) have important impact on therapy and prognosis. High resolution MRI has proved useful in clarifying the relationship between the tumor and the mesorectal fascia, which represents the CRM at the total mesorectal excision (TME) especially in the upper and middle third. Preoperative evaluation of the other prognostic factors as well as the nodal status is still difficult. It is used increasingly not only for primary staging but also progressively for the monitoring of neoadjuvant therapy. The addition of diffusion weighted imaging (DWI) is an interesting option for the improvement of response evaluation. The following overview provides an introduction of MRI diagnosis as well as its importance for the evaluation of the clinically relevant prognostic factors leading to an improvement of therapy and prognosis of patients with rectal carcinoma. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Electrophysiological characterization of human rectal afferents

    PubMed Central

    Ng, Kheng-Seong; Brookes, Simon J.; Montes-Adrian, Noemi A.; Mahns, David A.

    2016-01-01

    It is presumed that extrinsic afferent nerves link the rectum to the central nervous system. However, the anatomical/functional existence of such nerves has never previously been demonstrated in humans. Therefore, we aimed to identify and make electrophysiological recordings in vitro from extrinsic afferents, comparing human rectum to colon. Sections of normal rectum and colon were procured from anterior resection and right hemicolectomy specimens, respectively. Sections were pinned and extrinsic nerves dissected. Extracellular visceral afferent nerve activity was recorded. Neuronal responses to chemical [capsaicin and “inflammatory soup” (IS)] and mechanical (Von Frey probing) stimuli were recorded and quantified as peak firing rate (range) in 1-s intervals. Twenty-eight separate nerve trunks from eight rectums were studied. Of these, spontaneous multiunit afferent activity was recorded in 24 nerves. Peak firing rates increased significantly following capsaicin [median 6 (range 3–25) spikes/s vs. 2 (1–4), P < 0.001] and IS [median 5 (range 2–18) spikes/s vs. 2 (1–4), P < 0.001]. Mechanosensitive “hot spots” were identified in 16 nerves [median threshold 2.0 g (range 1.4–6.0 g)]. In eight of these, the threshold decreased after IS [1.0 g (0.4–1.4 g)]. By comparison, spontaneous activity was recorded in only 3/30 nerves studied from 10 colons, and only one hot spot (threshold 60 g) was identified. This study confirms the anatomical/functional existence of extrinsic rectal afferent nerves and characterizes their chemo- and mechanosensitivity for the first time in humans. They have different electrophysiological properties to colonic afferents and warrant further investigation in disease states. PMID:27789454

  2. Electrophysiological characterization of human rectal afferents.

    PubMed

    Ng, Kheng-Seong; Brookes, Simon J; Montes-Adrian, Noemi A; Mahns, David A; Gladman, Marc A

    2016-12-01

    It is presumed that extrinsic afferent nerves link the rectum to the central nervous system. However, the anatomical/functional existence of such nerves has never previously been demonstrated in humans. Therefore, we aimed to identify and make electrophysiological recordings in vitro from extrinsic afferents, comparing human rectum to colon. Sections of normal rectum and colon were procured from anterior resection and right hemicolectomy specimens, respectively. Sections were pinned and extrinsic nerves dissected. Extracellular visceral afferent nerve activity was recorded. Neuronal responses to chemical [capsaicin and "inflammatory soup" (IS)] and mechanical (Von Frey probing) stimuli were recorded and quantified as peak firing rate (range) in 1-s intervals. Twenty-eight separate nerve trunks from eight rectums were studied. Of these, spontaneous multiunit afferent activity was recorded in 24 nerves. Peak firing rates increased significantly following capsaicin [median 6 (range 3-25) spikes/s vs. 2 (1-4), P < 0.001] and IS [median 5 (range 2-18) spikes/s vs. 2 (1-4), P < 0.001]. Mechanosensitive "hot spots" were identified in 16 nerves [median threshold 2.0 g (range 1.4-6.0 g)]. In eight of these, the threshold decreased after IS [1.0 g (0.4-1.4 g)]. By comparison, spontaneous activity was recorded in only 3/30 nerves studied from 10 colons, and only one hot spot (threshold 60 g) was identified. This study confirms the anatomical/functional existence of extrinsic rectal afferent nerves and characterizes their chemo- and mechanosensitivity for the first time in humans. They have different electrophysiological properties to colonic afferents and warrant further investigation in disease states. Copyright © 2016 the American Physiological Society.

  3. Results of radical surgery for rectal cancer.

    PubMed

    Heald, R J; Karanjia, N D

    1992-01-01

    This paper examines the hypothesis that a reduction in the distal mural margin during anterior resection for sphincter conservation in rectal cancer excision is safe, provided total mesorectal excision is undertaken with wash-out of the clamped rectum. One hundred ninety-two patients underwent anterior resection and 21 (less than 10%) patients underwent abdomino-perineal excision (APE) by one surgeon (RJH). Anterior resections were classified as "curative" (79%) and "non-curative" (21%); in the "curative" sub-group less than 4% of patients developed local recurrence. The series was retrospectively analyzed for the effect of mural margins on local recurrence with 152 patients undergoing "curative" anterior resections and 40 patients undergoing "non-curative" resections. In the 152 specimens from curative resections, 110 had a resection margin greater than 1 cm and 42 had a resection margin less than 1 cm. Four patients developed local recurrence in the greater than 1 cm margin group (95% confidence interval: 0.8%-7.8%) and no patients developed local recurrence in the less than or equal to 1 cm margin group (95% confidence interval: 0%-5.9%). In each patient with local recurrence a cause for failure was apparent. There was no statistically significant difference in local recurrence rate between the less than or equal to 1 cm margin group and the greater than 1 cm margin group. A reduction in resection margin therefore did not compromise survival after anterior resection. The significance of lateral resection margins is discussed. The role of deep radiotherapy and cytotoxics are considered.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Neo-adjuvant radiotherapy in rectal cancer

    PubMed Central

    Glimelius, Bengt

    2013-01-01

    In rectal cancer treatment, attention has focused on the local primary tumour and the regional tumour cell deposits to diminish the risk of a loco-regional recurrence. Several large randomized trials have also shown that combinations of surgery, radiotherapy and chemotherapy have markedly reduced the risk of a loco-regional recurrence, but this has not yet had any major influence on overall survival. The best results have been achieved when the radiotherapy has been given preoperatively. Preoperative radiotherapy improves loco-regional control even when surgery has been optimized to improve lateral clearance, i.e., when a total mesorectal excision has been performed. The relative reduction is then 50%-70%. The value of radiotherapy has not been tested in combination with more extensive surgery including lateral lymph node clearance, as practised in some Asian countries. Many details about how the radiotherapy is performed are still open for discussion, and practice varies between countries. A highly fractionated radiation schedule (5 Gy × 5), proven efficacious in many trials, has gained much popularity in some countries, whereas a conventionally fractionated regimen (1.8-2.0 Gy × 25-28), often combined with chemotherapy, is used in other countries. The additional therapy adds morbidity to the morbidity that surgery causes, and should therefore be administered only when the risk of loco-regional recurrence is sufficiently high. The best integration of the weakest modality, to date the drugs (conventional cytotoxics and biologicals) is not known. A new generation of trials exploring the best sequence of treatments is required. Furthermore, there is a great need to develop predictors of response, so that treatment can be further individualized and not solely based upon clinical factors and anatomic imaging. PMID:24379566

  5. Chemoembolization Using Irinotecan in Treating Patients With Liver Metastases From Metastatic Colon or Rectal Cancer

    ClinicalTrials.gov

    2015-09-10

    Liver Metastases; Mucinous Adenocarcinoma of the Colon; Mucinous Adenocarcinoma of the Rectum; Recurrent Colon Cancer; Recurrent Rectal Cancer; Signet Ring Adenocarcinoma of the Colon; Signet Ring Adenocarcinoma of the Rectum; Stage IV Colon Cancer; Stage IV Rectal Cancer

  6. Assessment of T staging and mesorectal fascia status using high-resolution MRI in rectal cancer with rectal distention

    PubMed Central

    Rao, Sheng-Xiang; Zeng, Meng-Su; Xu, Jian-Ming; Qin, Xin-Yu; Chen, Cai-Zhong; Li, Ren-Chen; Hou, Ying-Yong

    2007-01-01

    AIM: To determine the accuracy of high-resolution magnetic resonance imaging (MRI) using phased-array coil for preoperative assessment of T staging and mesorectal fascia infiltration in rectal cancer with rectal distention. METHODS: In a prospective study of 67 patients with primary rectal cancer, high-resolution magnetic resonance imaging (in-plane resolution, 0.66 × 0.56) with phased-array coil were performed for T-staging and measurement of distance between the tumor and the mesorectal fascia. The assessment of MRI was compared with postoperative histopathologic findings. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were evaluated. RESULTS: The overall magnetic resonance accuracy was 85.1% for T staging and 88% for predicting mesorectal fascia involvement. Magnetic resonance sensitivity, specificity, accuracy, positive predictive value, and negative predictive value was 70%, 97.9%, 89.6%, 93.3% and 88.5% for ≤ T2 tumors, 90.5%, 76%, 85.1%, 86.4% and 82.6% for T3 tumors, 100%, 95.2%, 95.5%, 62.5% and 100% for T4 tumors, and 80%, 90.4%, 88%, 70.6% and 94% for predicting mesorectal fascia involvement, respectively. CONCLUSION: High-resolution MRI enables accurate preoperative assessment for T staging and mesorectal fascia infiltration in rectal cancer with rectal distention. PMID:17696238

  7. Metachronous penile metastasis from rectal cancer after total pelvic exenteration.

    PubMed

    Kimura, Yuta; Shida, Dai; Nasu, Keiichi; Matsunaga, Hiroki; Warabi, Masahiro; Inoue, Satoru

    2012-10-14

    Despite its abundant vascularization and extensive circulatory communication with neighboring organs, metastases to the penis are a rare event. A 57-year-old male, who had undergone total pelvic exenteration for rectal cancer sixteen months earlier, demonstrated an abnormal uptake within his penis by positron emission tomography/computed tomography. A single elastic nodule of the middle penis shaft was noted deep within Bucks fascia. No other obvious recurrent site was noted except the penile lesion. Total penectomy was performed as a curative resection based on a diagnosis of isolated penile metastasis from rectal cancer. A histopathological examination revealed an increase of well differentiated adenocarcinoma in the corpus spongiosum consistent with his primary rectal tumor. The immunohistochemistry of the tumor cells demonstrated positive staining for cytokeratin 20 and negative staining for cytokeratin 7, which strongly supported a diagnosis of penile metastasis from the rectum. The patient is alive more than two years without any recurrence.

  8. A Review of Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer

    PubMed Central

    Li, Yi; Wang, Ji; Ma, Xiaowei; Tan, Li; Yan, Yanli; Xue, Chaofan; Hui, Beina; Liu, Rui; Ma, Hailin; Ren, Juan

    2016-01-01

    Neoadjuvant chemoradiotherapy has become the standard treatment for locally advanced rectal cancer. Neoadjuvant chemoradiotherapy not only can reduce tumor size and recurrence, but also increase the tumor resection rate and anus retention rate with very slight side effect. Comparing with preoperative chemotherapy, preoperative chemoradiotherapy can further reduce the local recurrence rate and downstage. Middle and low rectal cancers can benefit more from neoadjuvant chemradiotherapy than high rectal cancer. It needs to refine the selection of appropriate patients and irradiation modes for neoadjuvant chemoradiotherapy. Different therapeutic reactions to neoadjuvant chemoradiotherapy affect the type of surgical techniques, hence calling for the need of much attention. Furthermore, many problems such as accurate staging before surgery, selection of suitable neoadjuvant chemoradiotherapy method, and sensitivity prediction to preoperative radiotherapy need to be well settled. PMID:27489505

  9. ["The three-lies disease": solitary rectal ulcer syndrome].

    PubMed

    Crespo Pérez, L; Moreira Vicente, V; Redondo Verge, C; López San Román, A; Milicua Salamero, J M

    2007-11-01

    Solitary rectal ulcer syndrome is an uncommon benign condition characterized by rectal bleeding, passage of mucus, and pain. Histological features are well established as obliteration of the lamina propria by fibrosis and smooth-muscle fibers extending from a thickened muscularis mucosa to the lumen. Diagnosis can usually be made on sigmoidoscopy, and biopsies should always be taken. Ulceration is not universally present, and polypoid, non-ulcerated lesions and erythematous areas are also seen. The lesion or lesions are most often found on the anterior or anterolateral wall of the rectum, although they can also be located in the left colon and be more extensive or even circumferential. Lesions are multiple in 30 percent of cases. These are the reasons why this entity is also known as "the disease of three lies". We report a case of solitary rectal ulcer syndrome presenting at endoscopy with an erythematous area on the left side wall of the rectum.

  10. Unique considerations in the patient with rectal cancer.

    PubMed

    Minsky, Bruce D

    2011-08-01

    In the past two decades, substantial progress has been made in the adjuvant management of colorectal cancer. Chemotherapy has improved overall survival in patients with node-positive (N+) disease. In contrast with colon cancer, which has a low incidence of local recurrence, patients with rectal cancer have a higher incidence requiring the addition of pelvic radiation therapy (chemoradiation). Patients with rectal cancer have a number of unique management considerations: for example, the role of short-course radiation, whether postoperative adjuvant chemotherapy is necessary for all patients, and if the type of surgery following chemoradiation should be based on the response rate. More accurate imaging techniques and/or molecular markers may help identify patients with positive pelvic nodes to reduce the chance of overtreatment with preoperative therapy. Will more effective systemic agents both improve the results of radiation as well as modify the need for pelvic radiation? This review will address these and other controversies specific to patients with rectal cancer.

  11. Smooth muscle pseudotumours: a potentially confusing artefact of rectal biopsy.

    PubMed Central

    Dankwa, E K; Davies, J D

    1988-01-01

    An artefactual smooth muscle lesion was found in seven of 500 consecutive rectal biopsy specimens. The lesions had the deceptive appearance of a genuine tumour although none of the patients with the lesion had presented with a rectal mucosal swelling. The morphology of the lesion and its poor reproducibility under experimental conditions suggested that it was an artefact of the biopsy procedure: it was easily reproduced in resected specimens of large bowel using punch or basket forceps but not when using flat forceps. The presence of the lesion seems to depend on the type of forceps used rather than on differences in deployment and seems to be caused by avulsion of the superficial part of the muscularis propria and its incorporation into the tissues included in rectal biopsy specimens. Images Fig 2 Fig 3 Fig 1 Fig 4 PMID:3045159

  12. Reproducibility with repeat CT in radiomics study for rectal cancer

    PubMed Central

    Hu, Panpan; Wang, Jiazhou; Zhong, Haoyu; Zhou, Zhen; Shen, Lijun; Hu, Weigang; Zhang, Zhen

    2016-01-01

    Purpose To evaluate the reproducibility of radiomics features by repeating computed tomographic (CT) scans in rectal cancer. To choose stable radiomics features for rectal cancer. Results Volume normalized features are much more reproducible than unnormalized features. The average value of all slices is the most reproducible feature type in rectal cancer. Different filters have little effect for the reproducibility of radiomics features. For the average type features, 496 out of 775 features showed high reproducibility (ICC ≥ 0.8), 225 out of 775 features showed medium reproducibility (0.8 > ICC ≥ 0.5) and 54 out of 775 features showed low reproducibility (ICC < 0.5). Methods 40 rectal cancer patients with stage II were enrolled in this study, each of whom underwent two CT scans within average 8.7 days. 775 radiomics features were defined in this study. For each features, five different values (value from the largest slice, maximum value, minimum value, average value of all slices and value from superposed intermediate matrix) were extracted. Meanwhile a LOG filter with different parameters was applied to these images to find stable filter value. Concordance correlation coefficients (CCC) and inter-class correlation coefficients (ICC) of two CT scans were calculated to assess the reproducibility, based on original features and volume normalized features. Conclusions Features are recommended to be normalized to volume in radiomics analysis. The average type radiomics features are the most stable features in rectal cancer. Further analysis of these features of rectal cancer can be warranted for treatment monitoring and prognosis prediction. PMID:27669756

  13. Human Collagen Injections to Reduce Rectal Dose During Radiotherapy

    SciTech Connect

    Noyes, William R.; Hosford, Charles C.; Schultz, Steven E.

    2012-04-01

    Objectives: The continuing search for interventions, which address the incidence and grade of rectal toxicities associated with radiation treatment of prostate cancer, is a major concern. We are reporting an investigational trial using human collagen to increase the distance between the prostate and anterior rectal wall, thereby decreasing the radiation dose to the rectum. Methods: This is a pilot study evaluating the use of human collagen as a displacing agent for the rectal wall injected before starting a course of intensity-modulated radiotherapy (IMRT) for prostate cancer. Using a transperineal approach, 20 mL of human collagen was injected into the perirectal space in an outpatient setting. Computerized IMRT plans were performed pre- and postcollagen injection, and after a patient completed their radiotherapy, to determine radiation dose reduction to the rectum associated with the collagen injection. Computed tomography scans were performed 6 months and 12 months after completing their radiotherapy to evaluate absorption rate of the collagen. All patients were treated with IMRT to a dose of 75.6 Gy to the prostate. Results: Eleven patients were enrolled into the study. The injection of human collagen in the outpatient setting was well tolerated. The mean separation between the prostate and anterior rectum was 12.7 mm. The mean reduction in dose to the anterior rectal wall was 50%. All men denied any rectal symptoms during the study. Conclusions: The transperineal injection of human collagen for the purpose of tissue displacement is well tolerated in the outpatient setting. The increased separation between the prostate and rectum resulted in a significant decrease in radiation dose to the rectum while receiving IMRT and was associated with no rectal toxicities.

  14. Human collagen injections to reduce rectal dose during radiotherapy.

    PubMed

    Noyes, William R; Hosford, Charles C; Schultz, Steven E

    2012-04-01

    The continuing search for interventions, which address the incidence and grade of rectal toxicities associated with radiation treatment of prostate cancer, is a major concern. We are reporting an investigational trial using human collagen to increase the distance between the prostate and anterior rectal wall, thereby decreasing the radiation dose to the rectum. This is a pilot study evaluating the use of human collagen as a displacing agent for the rectal wall injected before starting a course of intensity-modulated radiotherapy (IMRT) for prostate cancer. Using a transperineal approach, 20 mL of human collagen was injected into the perirectal space in an outpatient setting. Computerized IMRT plans were performed pre- and postcollagen injection, and after a patient completed their radiotherapy, to determine radiation dose reduction to the rectum associated with the collagen injection. Computed tomography scans were performed 6 months and 12 months after completing their radiotherapy to evaluate absorption rate of the collagen. All patients were treated with IMRT to a dose of 75.6 Gy to the prostate. Eleven patients were enrolled into the study. The injection of human collagen in the outpatient setting was well tolerated. The mean separation between the prostate and anterior rectum was 12.7 mm. The mean reduction in dose to the anterior rectal wall was 50%. All men denied any rectal symptoms during the study. The transperineal injection of human collagen for the purpose of tissue displacement is well tolerated in the outpatient setting. The increased separation between the prostate and rectum resulted in a significant decrease in radiation dose to the rectum while receiving IMRT and was associated with no rectal toxicities. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Variability of Marker-Based Rectal Dose Evaluation in HDR Cervical Brachytherapy

    SciTech Connect

    Wang Zhou; Jaggernauth, Wainwright; Malhotra, Harish K.; Podgorsak, Matthew B.

    2010-01-01

    In film-based intracavitary brachytherapy for cervical cancer, position of the rectal markers may not accurately represent the anterior rectal wall. This study was aimed at analyzing the variability of rectal dose estimation as a result of interfractional variation of marker placement. A cohort of five patients treated with multiple-fraction tandem and ovoid high-dose-rate (HDR) brachytherapy was studied. The cervical os point and the orientation of the applicators were matched among all fractional plans for each patient. Rectal points obtained from all fractions were then input into each clinical treated plan. New fractional rectal doses were obtained and a new cumulative rectal dose for each patient was calculated. The maximum interfractional variation of distances between rectal dose points and the closest source positions was 1.1 cm. The corresponding maximum variability of fractional rectal dose was 65.5%. The percentage difference in cumulative rectal dose estimation for each patient was 5.4%, 19.6%, 34.6%, 23.4%, and 13.9%, respectively. In conclusion, care should be taken when using rectal markers as reference points for estimating rectal dose in HDR cervical brachytherapy. The best estimate of true rectal dose for each fraction should be determined by the most anterior point among all fractions.

  16. Rectal cancer with synchronous liver metastases: Do we have a clear direction?

    PubMed

    Pathak, S; Nunes, Q M; Daniels, I R; Smart, N J; Poston, G J; Påhlman, L

    2015-12-01

    Rectal cancer is a common entity and often presents with synchronous liver metastases. There are discrepancies in management guidelines throughout the world regarding the treatment of advanced rectal cancer, which are further compounded when it presents with synchronous liver metastases. The following article examines the evidence regarding treatment options for patients with synchronous rectal liver metastases and suggests potential treatment algorithms.

  17. Microstructure imaging of human rectal mucosa using multiphoton microscopy

    NASA Astrophysics Data System (ADS)

    Liu, N. R.; Chen, G.; Chen, J. X.; Yan, J.; Zhuo, S. M.; Zheng, L. Q.; Jiang, X. S.

    2011-01-01

    Multiphoton microscopy (MPM) has high resolution and sensitivity. In this study, MPM was used to image microstructure of human rectal mucosa. The morphology and distribution of the main components in mucosa layer, absorptive cells and goblet cells in the epithelium, abundant intestinal glands in the lamina propria and smooth muscle fibers in the muscularis mucosa were clearly monitored. The variations of these components were tightly relevant to the pathology in gastrointestine system, especially early rectal cancer. The obtained images will be helpful for the diagnosis of early colorectal cancer.

  18. Rectal inflammatory stenosis secondary to Chlamydia trachomatis: a case report.

    PubMed

    Pérez Sánchez, Luis Eduardo; Hernández Barroso, Moisés; Hernández Hernández, Guillermo

    2017-09-01

    The rectal inflammatory originated strictures constitute a rare cause of intestinal obstruction. We present a 30-year-old male patient with a history of HIV and protctitis caused by Chalmydia trachomatis and HSV-2, in which develops a low intestinal obstruction refractory to medical treatment. Surgery was performed with good clinical evolution. The medical treatment constitutes the fundamental basis of the therapy in these patients. Despite that, when fibrotic stenoses are not treatable medical or endoscopically, they often require surgical treatment. We must pay attention to the proctitis infectious diseases as a cause of rectal stenosis, especially by Chlamydia trachomatis, and assess surgical option in refractory cases.

  19. Perineal rectosigmoidectomy for incarcerated rectal prolapse (Altemeier’s procedure)

    PubMed Central

    Sipahi, Mesut; Arslan, Ergin; Börekçi, Hasan; Aytekin, Faruk Önder; Külah, Bahadır; Banlı, Oktay

    2016-01-01

    Perineal procedures have higher recurrence and lower mortality rates than abdominal alternatives for the treatment of rectal prolapse. Presence of incarceration and strangulation also influences treatment choice. Perineal rectosigmoidectomy is one of the treatment options in patients with incarceration and strangulation, with low mortality and acceptable recurrence rates. This operation can be performed especially to avoid general anesthesia in old patients with co-morbidities. We aimed to present perineal rectosigmoidectomy and diverting loop colostomy in a patient with neurological disability due to spinal trauma and incarcerated rectal prolapse. PMID:27528816

  20. Fatal cerebral air embolism following endoscopic evaluation of rectal stump

    PubMed Central

    Baban, Chwanrow Karim; Murphy, Michael; Hennessy, Tony; O'Hanlon, Deirdre

    2013-01-01

    A 63-year-old man underwent endoscopic evaluation of the rectal stump for rectal bleeding and suffered a massive cerebral air embolism with severe neurological impairment and subsequent death. The patient underwent a Hartmann's procedure 9 month previously for ischaemic bowel and was noted to have portal hypertension at laparotomy. We hypothesise that air entered the venous plexus around rectum and entered the azygos vein via a porto-systemic shunt and travelled retrogradely via the superior vena cava to the venous sinuses of the brain. PMID:23704447